Wilderness Medicine- The Art and Science


Wilderness Medicine is considered one of the oldest forms of medicine.  If we put this into perspective starting with men and women and their children living in the woods and jungles before the luxury of houses. If someone was injured, they had to take care of the medical or traumatic issue themselves their where no doctors, nurses or paramedics to intervene.  Medicine was handed down from generation to generation, thus people were self-reliant.  As we progressed as a society, we had people who emerged with the knowledge of medicine began to help people with their ailments.  Whether it was through nutrition, herbal or plant remedies or having the knowledge how to stop the bleeding and prevent infections.


I often think about this as I venture into the mountains and forest seeking my pleasures and remedies of the souI. I think about the many people that I have encountered during these adventures and treks that required my interventions as a medical provider.  First, I think about the simple questions as to how and why they are in the predicament they are in.


In most cases it’s the lack of understanding the environment in which they put themselves in.  Not preparing for injuries or illness, or are they just complacent? Some of the most rewarding emergency situations that I have been involved in where on trips into the remote, the vertical and the cold.  Why you may ask do I get involved?  It’s because it’s the art of managing someone else’s crises during an emergency using the science and art that has been developing for hundreds of years and applying them to the situation.


My history as a climbing guide, a soldier, and as an adventurer has always had a medical component built into it. It didn’t take me long to get injured and sick while out on climbs in the mountains or in the field with the Army.  So, I took the time to learn the science and art of medicine.  Having the knowledge and skills to prevent and take care of injuries and illnesses have led to my success in so many ways.


Now that I am an educator in austere medicine. I enjoy sharing what I have learned with others and seeing them want to learn the tricks of the trade in order to have their own successful encounters with their adventures.  My favorite course is Wilderness First - Aid.  It’s a short but important foundation to new comers to the art of wilderness medicine.  It always impresses me to be a part of these peoples willingness to want to learn how to take care of themselves or others in the time of need.  Wilderness First Responder is another great course.  Typically these are people that really want to learn more and expand their ability to perform medical interventions in the field.  This is great because so many new people each year are coming into the remote setting for the first time. It is important to understand the basic medical interventions needed to respond to someone who is sick or injured.


When I first joined a back-country rescue team as a climbing medical responder. At first I thought my skill set would really never be needed, I quickly learned that our team responded frequently.  We responded to climbers, back packers, skiers, runners, and boaters.  It really was a great job and plays a big factor in why I do what I do today.  People who become sick or injured while in the back-country are often in a place of environmental hostility, in an austere situation, cold, in the dark or hanging off the side of cliff after a huge fall.  Learning the basics in backpacking, traveling at night with a headlamp, being able to create a shelter, how to obtain clean drinking water and so on.  These skills combined is an art.  To watch a team of seasoned mountaineers come into a camp and set the whole thing up as well as cooking and caring for themselves and their partners is amazing.  It looks simple, and most people go wrong there.  It’s through trial and error that they can perform these tasks in the worst of conditions and make it look easy. 


It’s the same with wilderness medicine. I can remember one rescue operation we were called to.  Three ice climbers where traveling up a three-thousand-foot ice fall and slab when the lead climber fell and basically wiped out the other two climbers.  This resulted in one climber with a broken leg and arm, the other was pretty beat up and having issues with his breathing.  The third was just completely scared and unable to help.  Of course, there were many contributing factors to how and why all of this happened, but the bottom line is they were out of their ability level and they didn’t have the skill sets to manage the climb. They were lured into the climb because it was rated as pretty easy, but with strong winds, snow falling, and very cold conditions complied together along with not having the experience, led to this disaster.


When we arrived at the top of the mountain in which we were flown to by helicopter, the conditions where marginal at best and we wouldn’t be getting a ride back.  So, we were prepared to make the 8-mile ski and sled extrication out if needed.  We rappelled in to where the climbers were, we constructed a new anchor system to safe ourselves and the injured party and took control.  We assessed each patient and stabilized each of them like if they were laying on the coach.  We packaged them up and managed hypothermia as well as started to feed them food and fluids.  We had to lower these climbers over a thousand feet to the base of the cliff.  It took several hours to get them down and several more to ski them to our awaiting responders.

Once we got to the base of the cliff, we set up a shelter and put two of the least injured climbers in there with one rescuer managing them.  The other climber we packaged and skied out in a sled to an established point on the trail to meet other rescuers and support people who took them from there.  With an ambulance waiting, as well as a physicians, and a trauma surgeon on standby monitoring our progress. The art of the system worked.  Did we have issues as a rescue team? Yes, but we were able to manage this situation and rescue because of our skills, experience and willingness to share our science and art.


This climbing party recovered and one of the things I remember most about this rescue was the look in their eyes when we arrived and took over and applied our skills to a very bad situation.  You could sense the relief and their willingness to let us take control and get them fixed up and out.  I also remember their eyes when we transferred them over to the other providers in the ambulance.  They understood we risked our lives to save theirs, and the thank you with heart felt hugs was all we needed to feel great about what we do.


Had these climbers been more educated in their craft, pre-planned their adventure and had some more experience, they may have managed their own ordeal.


Now I am much older and do not participate on a back-country rescue team, but I am on the trails and cliffs and I still find myself providing aid and medical care to those who fall victim to accidents or illness.  The art and the science is the same and in most cases the gratification of helping is there as well as genuine Thank You 


So, with all of this said, if you go out and adventure and enjoy the outdoors, please learn the art and science of wilderness medicine this may be instrumental to your survival.  It is every persons’ responsibility to get educated and learn the skills required to manage your group or yourself in an emergency.  Learn the craft of your sport, pre-plan, practice, train, and bring the necessary equipment to handle whatever maybe the worst-case scenario.



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