December 23, 2008 — Dr. Clarence E. Foster, III  (BSChE ’84), a transplant surgeon at UC Irvine Medical Center, spends most days saving lives in a modern Orange County hospital, but last spring he spent 90 days on the front lines in Iraq, about 100 miles southeast of Baghdad, treating soldiers and civilian casualties of the Iraqi war.  

Foster in pre-op talks to nursing assistant and the patient.  Photo/Paul R. Kennedy

The experience was life-altering for Foster, a major in the Army Reserves, who has been deployed three times since 2003, though this was the first time in Iraq.

“Serving my country was something that I had always wanted to do,” Foster said, “but I had a lot of trepidation going over there.”

Foster grew up in New Orleans, Louisiana, and was influenced by three uncles who were drafted in the Vietnam War.  He did well in school, was named valedictorian of his high school class, and entered USC’s undergraduate program in chemical engineering on a university academic scholarship. During his sophomore year, while he was working on the hemodynamics (characteristics of blood pressure, flow and resistance) of central venous catheters as well as CFCs (chlorofluorocarbons) with Mork Department Chair Theo Tsotsis, Foster decided to go into pre-med.  

Foster was at the top of his class – a member of Omega Chi Epsilon, the national honor society for chemical engineering, as well as the honorary Trojan Knights fraternity. After graduating from USC he was accepted at The Johns Hopkins University School of Medicine; a short time later, he decided to specialize in transplant surgery.  He also realized that he could use his surgical skills to serve his country by joining the National Guard.  

Foster on his way to Camp Bucca.

“When I was a surgery resident, I switched to the Army Reserves, but I didn’t finish my surgery residency training until 1997,” he said. “And then I had to wait a while.  I wasn’t mobilized until 2003, when I went to Fort Irwin, then to Madigan Hospital in Tacoma, Washington.”  

In 2004, he was sent to Walter Reed Hospital, where he did transplant surgery during the height of the first Iraq invasion during the current war.

Transplant surgery is a very specialized field and Foster had spent years perfecting his skills. He never thought that he would wind up performing trauma surgery on the front lines in Iraq a few years later.    

But in April 2008, he was deployed to Camp Delta in Al Kut, Iraq, about 20 miles from the Iranian border, where he was assigned to a “forward surgical team.”  These teams are the first line of medical care for soldiers and civilians who have been injured during combat.  

“This wasn’t like anything I was used to.  It was emergency surgery, and we didn’t have any of the equipment, like the CT scans, X-ray machines or other diagnostic technologies, ” Foster said.  “We had two surgeons, three nurse-anesthetists, that’s it.  The conditions were austere and grim.  It was traumatic to see many burned bodies, especially women and children.”

Foster, in center, with some of the Iraqi doctors he taught while serving  as part of the 'forward surgical team' at Camp Delta.

Foster spent all of his time treating people who had been shot, severely burned or had lost a limb to an IED (improvised explosive device).  
    
“Basically I had to stop the bleeding, perform exploratory surgery to identify internal injuries, and get burn victims stabilized enough to be flown by helicopter to combat hospitals,” he said. “It was an eye-opening experience to treat these types of injuries and to be working with so little in terms of medical support. I think it made me appreciate all that we take for granted in the United States.”

When he wasn’t performing surgery, he was educating the local Iraqi doctors, whom he invited to camp for lectures and hands-on training.  

After two months in Al Kut, he was sent to Camp Bucca, a U.S. Army-run Iraqi detainee camp in the vicinity of Umm Qasr, in the southernmost province of Iraq.  This time he performed elective surgeries, such as hernias, appendectomies and gall bladder operations in a much more sophisticated facility.  

The detention camp was “a rough place,” Foster said, holding about 20,000 Iraqi detainees, well over its intended capacity, but the medical facilities included an emergency room, internal medicine clinic, optometry clinic, psychiatric services, orthopedic/surgical unit, physical therapy clinic, pharmacy, dental clinic and more. 

The surgical team in Iraq, left to right: a nurse anesthetist, a fellow surgeon and Foster.

 

The only time Foster really feared for his life was when he was traveling from one place to another, by plane or helicopter.  The sand storms and 130-degree heat were annoyances and the morale of the troops inspired him, but the trips from town to town scared him.

“That was really the most anxious time because you were out in the open and vulnerable to attack,” he said, “But I wanted to be there, because if I wasn’t there, who would be?  That’s the main reason I want to stay [in the reserves].”

Nonetheless, he was glad to get back to Orange County in August, 2008, to see his family again and to be able to use his season tickets to the USC football games. Each year, he also comes to campus for the Mork Family Department of Chemical Engineering and Materials Science’s Advisory Board meeting.  Some day, he said he would also like to hold a lecture for undergraduate chemical engineering majors and share his experiences in Iraq.  

“I like staying connected to the world and to USC,” he said.  “I’ve made lifetime friends through my service overseas, and I think I can give chemical engineering students some valuable insights into what it’s like over there and what the medical profession is all about. It would be very rewarding to be able to help engineering undergraduates decide if they want to go into medicine.”