medics gone wild [pique]

7/29/2019 Medics Gone Wild [PIQUE]

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FREESTITC H ES

MEDI

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Fall festival reviewedP.12

Kashi RichardsonP.29

VSO plays PlazaP.60

19.29

July 19, 2012 | WHISTLERS WEEKLY NEWSMAGAZINE | www.piquenewsmagazine.com


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Medics gone wildFrom mouth-to-mouth to climate change, the Wilderness Medical Society has stitched and sutured it all.

- By tobias c. van Veen

COVER: Being one of the statistics, Ive had my fair share of mishaps and rescues. Im happy to know thatthere are people out there willing to study them in the hopes of giving us statistics a fighting chance the next

time we place ourselves in danger. - J on Parris

COVERSTORY

WEEKLYFEATURES

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W

30Feature

MEDICSGONEWILDStory and photos bytobias c. van Veen

With the Westins rock lobster waterfall

crashing down behind us, Loren Greenway,

Chief Executive Officer of the Wilderness

Medical Society (WMS), keeps to the shade

of the Firerock patio. He fixes me with

a steady stare a gaze perfected in all

probability during his time as a Hospital

Corspman for the US Navy.This is what itmeans to be under the manic eye of a medic,

I think to myself.They see right through you

to your bones.

Greenway, who can claim more

experience than you can shake a

defibril lator at and whom

I will respectfully, under

pain of the bends, call

an elder is not

only an avid fisher,

diver, and search and

rescue enthusiast, but

a licenced Respiratory

Care Practitioner and a Masters

Fellow in Dive Medicine with a PhD in

Business Administration. Greenway hasbeen involved with the WMS for 10 years,

holding down the fort as CEO since 2008.

He and scores of other like-minded people

were in Whistler this past weekend for

the sixth World Congress on Wilderness

Medicine.

Why does this matter? Well, with his

medical interests, outdoor passions and

rescue and relief background, Greenway

epitomizes something of the spirit of the

501(c)3 charity for the public good that

is the Wilderness Medical Society.

The Wilderness Medical Society,

says Greenway, is a membership society

that people with experience or interest

in wilderness medicine can become amember of and participate in, reminding

me that hey, I too could get in on the

latex action. Anyone can sign up, be they

physicians, EMTs, guides, or just layabouts

who want to poke needles into soft and

tender bits the WMS is an open society,

focused on research, publication, and

practice, offering education and training

on all levels.

We dont treat them any different

though, says Loren of the newbies,

otherwise known as the medically

unprofessionalized, many of whom put in

the hard hours of education, training, and

examination to become FAWNs Fellows

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4/9www.piquenewsmagazine.com| J ul y 19, 2012 |

FeatureSTORY

of the Academy of Wilderness Medicine.

Point being that the WMS provides next-

level involvement for physicians, patrollers,

guides, firefighters, and other response

and rescue personnel, as well as an

entry-level starting point for those

intrigued in the outdoor medical

profession and/or seeking to tune uptheir survival and medical skills.

Checkout from the ERyou like it so far?

It is strange to think that our entire

medical system is based upon high-speed

ambulances carrying the unlucky to well-

stocked hospitals. What the WMS grapples

with are the hard issues of access and

survival where 911 is not an option. The

WMS is the wild outlier to a medical

establishment entrenched in urban areas;

it is the Do-it-Yourself remedy to a systemthat relies upon ready access to advanced

technologies.

Really and truly, when youre up on a

mountain somewhere, and you dont have

the ER behind you, its a really different

set of skills, says outgoing WMS President

Tony Islas, who was peacefully drinking

ice water with lemon until I showed up

and started badgering him on the patio.

He adds: It is a different skill set that we

are teaching.

Islas, who is a Family and Sports

Medicine Physician, and teaches as an

Associate Professor at the Paul L. Foster

School of Medicine in El Paso, Texas,

emphasizes that the mission of the WMSis to take any medical practitioner of

any background as well as the all-but

uneducated members of the public and

give them the kind of training that will

allow them to adapt to the demands of

outdoor emergencies or situations where

supplies and resources are scarce.

Besides learning to treat the patient in

what the WMS calls adverse environments,

wilderness medicine encompasses basic

survival and safety skills for the practitioner.

And last but not least, as Islas emphasizes,

the idea is to pass along such holistic skills to

others be it a ski patrol or Scout group. In

this sense, it is the humanitarian mission of

the WMS to diffuse medical practice beyond

hospital walls.

It doesnt really matter if you are an

OBGYN or a family physician, says Islas,

adding acronyms that most of us can only

nod unknowingly at. If you become adept

at that certain skill set, theres a place for

you in the Wilderness Medical Society.Of course, much hinges on what is

meant by that skill set, and the WMS

defines it broadly across vast spectrums

of outdoor activity from desert to dive

medicine, jungle to mountain medical,

disaster triage and relief logistics to

search and rescue. If you can imagine it

somewhere on the planet, whether its a

destitute situation (such as a hurricane) or

the outcome of a sudden act of violence

(such as terrorism), the WMS has probably

written a response manual for it. Indeed,

looking up such topics in the conference

program, I find both are more-or-less

covered. Likewise, if its the unfortunate

consequence of some gnarly, quasi-lunaticsport, the WMS probably has some kind of

training in it, if not a Fellow who has been

there, done that.

Fellowship of the Spirited Wild

Given that Whistler has no hospital and

would be utterly cut off should something

take out our access roadways a disaster

scenario compounded if the weather socks

in it would seem that the benefits of

the WMS to the valleys outdoor keeners

is clear. The WMS conceives of medicine

for the rest of the world, which is to say

most of the world a planet that, even in

its overdeveloped state, is nonetheless still

a challenging globe of all but inaccessible

wonders. And what is called wilderness

medicine in the West is more or less slang

for standard practice in the rest of theunderdeveloped world. This is medicine

without sterilized hospitals, high-end

anesthetic, prescriptions on demand, and

technological basics including electricity

which is why the WMS handles not

only backcountry and rescue scenarios, but

disaster and relief medicine, working with

NGOs and aid organizations worldwide. In

terms of medical theory and practice, the

backcountry and the so-called Third (and

Fourth) world go hand-in-hand.

le

Really and truly, when youre up on a mountain

somewhere, andyou dont have the ER behind you,

its a really different set of skills,- Tony Islas

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FeatureSTORY

So if I say that there is a spirit to the

WMS, it is clear why this is not your

usual bunch of pallid and pale doctors

shoo-shooing you for taking part in

extreme sports or giving you the evileye for going on yet another dangerous

trip to some part of the world where,

hey, all kinds of other people live just fine

all the time. These are physicians who are

also dedicated climbers, who have been

bitten by weird bugs, who have suffered

dehydration at altitude, have had their

heads and ears blown out with the bends,

and collapsed in a heap, babbling about

becoming an Incan flower god after taking

too much ayahuasca. Well, maybe not the

last one though it ispossible. These are

fun people to be around.

Its soul-regenerating to hear people

talk not only about high-altitude problems,

dehydration issues, heat issues, but hearing

them give their presentations and tellingyou about the things that they do . . . it is

very, very invigorating, says Islas, getting

a tad misty-eyed. He goes on to explain

the camaraderie experienced by WMS

members when experiencing the challenges

of fieldwork. But he also adds, significantly,

that this experience of belonging and

community also has to do with the beauty

you encounter when you are out there.

In short, nature, and a love for it, is the

common denominator of the WMS, the

silent partner in the medics go bag.

Getting wild withthe wild beauty

Any medical practitioner seeking wild

medicine must thus be a wild lover as

in a lover of the wilderness world. The

WMS membership is stocked with climbers

and divers, paddlers and alpinists, skiers

and overall backcountry addicts. These

physicians, paramedics, nurses and first

responders mix getting off in the outdoors

with everything from hyperbaric medicine

(what to do if you get the bends) to Exercise

Associated Hyponatremia (extreme sodiumloss from endurance activities).

Then theres the seminar I missed, due

to a wacky and dated schedule (trust the

WMS with field triage, but not with the

interwebz) Field Orthopaedics by

Sam Baker and Bob Quinn, otherwise

known as how to saw through bone in the

backcountry. I had this on my mind when

wandering unexpectedly into a room full of

half-undressed participants bearing unusual

tattoos, reclining on tables while the rest of

the rooms participants poked and prodded

them with ultrasound equipment.

This was interesting. The tattoos, I mean.

Tim Benge, from Goldsboro, NC, had a

mean set of tats, combining medical crosses

and snakes with a large, round circle on

his back, fairly freshly inked, that sported a

Ju-Jitsu logo. A man watching close by wasdressed in a khaki uniform that said STORM

on it Specialized Tactics for Operational

Rescue and Medicine, a unit from the

Georgia Health Sciences University and

the National Tactical Officers Association.

I wanted to see his tattoos too, but I didnt

ask. Benge, meanwhile, was having his

eyeball scanned. The clinic, I discovered, was

Ultrasound in Disaster with Teresa Wu,

which consisted of a bunch of heavy-duty

looking ultrasound machines the size of field

laptops being used to scan participants for

intraperitoneal hemorrhage, pneumothorax

detection, maternal-fetal applications and

foreign bodies.

There were a lot of foreign bodies. Atleast to me.

Tim, meanwhile, looked like he had a

Borg implant sprouting from his eye. It was

pretty cool, I must say. However, apparently I

had missed the truly awesome session the

one with the bone saw action. Mr. STORM

said I had really missed the good one that

time. We practiced cutting through bones!

said a grinning participant beside him. When

I asked about painkillers in such situations,

they all laughed. Ha ha ha. Yah right.

The other tables were engaged in the same

weird science of ultrasound, scanning insides

for defects. Wu had the most interesting

advice. Use the liver as a window, she said,

gesturing as to where to put the hand-heldultrasound scanner, keep moving it until

youre right in the meat of the liver.

This reminds me of a quote and

appropriately indescribable 3D scene from

Andy Warhols Frankenstein with Udo Keir,

but I really wont get into that. Not here,

at least.

Point being, everyone had fun, and

let me take lots of pictures. Everyone got

their old injuries scanned, and enjoyed

pointing out things that were apparently

missing, such as John Hermans gallbladder

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FeatureSTOR

(residents of San Antonio, Texas, watch out

its on the loose).

Indeed, let us all pause for a moment

and thank the starry heavens that the green-

gown-and-scrub crowd is also into clipping

biners and/or descending into the life

aquatic because the rest of us need thesekind, overeducated, calm folks when the

seriously bad suckage hits the fan. Bite your

lip, its only bone.

But lets get back to beauty.

The WMS this year [organized] an

educational event in Nepal the Everest

Basecamp, recounts Tony, who went along

on the medical expedition that partnered

with the Himalayan Rescue Association,

raising proceeds from participation fees for

the Everest ER, a base camp hospital for

climbers founded by former WMS president

Luanne Freer in 2003. Everest ER embodies

the outreach aspects of the WMS by using

proceeds from the seasonal test-based

medical clinic to subsidize free and low-cost

health care for the Sherpa people of the

Khumbu region of Nepal.

It truly was a life-changing experience,continues Islas, clearly enraptured by his

time in the high Himalaya. It was a

beautiful experience. Life changing not

in a big way but in a little way. In the way

the people treated you, in the way the

mountains looked and the way that the

yak bells sounded and the way that the

Mani stones felt as you passed them, the

way that the prayer wheels squeaked when

you turned them its all those ways that

affects you and changes your outlook on

world issues.

Islas was one of the faculty members

on the trip, teaching 17 hours worth of

mountain medicine during lunch breaks on

the trekking trail, covering everything from

high-altitude conditions HAPE and HACE to

travellers diarrhea. To me, this combination

of education, practice and the outdoors is anexquisite introduction to what it means to be

active with an organization such as the WMS.

Then theres the next level science.

Wild Science for the FAWNS

Contrary to what we hear from our current

federal government, science can be a beautiful

thing. While on the Everest Basecamp trip,

Scott McIntosh, who is the Editor-in-Chief

of the WMS peer-reviewed publication

Wilderness & Environmental Medicine,

conducted studies in the minimum dosages

of acetazolamide, known as Diamox, to

preventatively treat Acute Mountain Sickness.He is scheduled to present his results at the

next meeting in Park City, Utah.

Indeed, the latest issue of the WMS

journal (23/2, 2012) discusses how the use of

whats called pulse oximetry monitoring

the saturation of hemoglobin to see how

much oxygen youve got in your blood

isnt as accurate at predicting altitude

sickness as many had hoped. Other pap

go on to consider genetic predispositio

for such things, which is why the Sherp

have an easier time playing soccer at 4,5

metres than us lowlanders. Then theres

paper on getting injured from marath

paddling in a canoe. No kidding. And particular interest to all of us here in t

Valley, The Epidemiology of Mountain Bi

Park Injuries at the Whistler Bike Park, Brit

Columbia (BC), Canada. Who knew th

the savage lust for dirt and air would featu

in scientific research?

This paper, carried out by a host

researchers (please buy them beers: Zacha

Ashwell, Mary Pat McKay, Jeffrey

Brubacher, Annie Gareau), digs into resear

from 2009, looking into how the downh

scene likes to destroy its limbs. Indeed, r

is somewhat high with downhill biki

the researchers conclude that injur

with significant morbidity can occ

which highlights the need for continuresearch into appropriate safety equipme

and risk avoidance measures. Of cour

risk avoidance in any sport dedicated

embracing it is a moot point, but develop

better equipment does all riders good. Deta

from the report: going over the handlebars

common; as is putting an arm out to t

side; and if youre a 20-something m

Become a mountain (wo)man

Besides the DiMM, the WMS offers an unaccredited Fellowship program. Graduatesare known as FAWNS Fellows of the Academy of Wilderness Medicine. Your next

power-up is the Masters Fellowship program, which offers specialization in a

particular discipline. Complete the Fellowship first (become a Fellow) then apply

to the Masters program.

The Fellowship requires 100 hours education in three different domains, split

between core training, an elective, and an experience component.

The Masters is a self-directed, mentored program in a specific content area,

requiring two years of work with a mentor, including the development of an

academic portfolio and a final scholarly project that is presented to a committee.

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riding in August, do take care, cause youre a

probable statistic.

The journal is an intriguing academic

publication, insofar as its reach is much

broader than one would think. Other factors

relating to human health out in the wild

are reported upon too, from the effects of

environmental changes to the increasing

commercialization of iconic peaks.

David Weber, a Mountaineering Ranger in

Denali National Park, Alaska, and a Technical

Rescue Adviser to the WMS Diploma in

Mountain Medicine program (DiMM),

comments upon the convergence of factors

that led to the nine fatalities during the 2011Denali climbing season. The editorial reflects

upon what are, I would argue, the effects

of climate change uncompromising

seasonal shifts resulting in less snow but

lower temperatures, turning snowfields

to ice and adding technical challenges to

usually easier routes along with those

of commercialization, though he avoids

pointing out what many climbers deride in

publications such as Alpinist: the increasing

Disneyfication and industrial tourism of

the backcountry. Weber does not draw

judgments, but only makes observations: the

inability to self-arrest in low-snow conditions

(i.e., to stop oneself with an ice axe), and the

fact that less-experienced parties remained

roped in terrain where self-arrest would not

be possible (thereby increasing the danger

for the rope team) led to five deaths from

climbing falls alone in 2011.

Because Everest is well known as an

over-abused peak today, it rarely sees

challenging ascents by alpinists; almost all

of its summits are made by commercial

expeditions hauling clients up established

lines along the standard route I asked Islas

what he thought of the Everest Basecamp

experience, well known to be akin to finding

oneself in one of the most beautiful places

on Earth only to discover it has been turnedinto a garbage dump. Despite valiant efforts

to clean it up, Everest itself is still strewn with

garbage. And corpses.

Those lines this year on Everest were

phenomenally long, says Islas, referring

to the practice of having all teams siege the

standard Khumbu Icefall / Hi llary Step route

at the same time. It does put people in

harms way when you do that, he explains.

I think there is an ethical issue there

weve got to say, look, at some point, weve

got to draw the line, because having that

many people on the mountain at one time

trying to summit on the same day really

causes issues.

Islas saw similar conditions as to Denali

in 2011: This was a strange year on Everest.

It was very dry. The first part of the year up

there wasnt a whole lot of snow, so there was

a lot of rockfall and it was very dangerous.

Perhaps not so strange the Himalaya

are seeing massive melt from climate change.

The title of a 2009 paper by Chinese scholars

Jianchu Xu (et. al.) is clear enough. It reads:

The Melting Himalayas: Cascading Effects of

Climate Change on Water, Biodiversity, and

Livelihoods. The paper, published in the

journal Conservation Biology(23/3), lays it outplain and simple in the abstract. Im going to

quote this here, as it matters the WMS is

very interested in the effects of the changing

environment on human health. A future

conference, WMS CEO Greenway tells me,

will be dedicated to it; Greenway also makes

the point that there is well-documented

scientific research that the glaciers on Everest

are receding, though he believes the reasons

are multi-factorial. Xu and his cohorts are

a little more on point:

Rapid reduction in the volume of

Himalayan glaciers due to climate change

is occurring. The cascading effects of rising

temperatures and loss of ice and snow

in the region are affecting, for example,water availability (amounts, seasonality),

biodiversity (endemic species, predatorprey

relations), ecosystem boundary shifts (tree-

line movements, high-elevation ecosystem

changes), and global feedbacks (monsoonal

shifts, loss of soil carbon). Climate change

will also have environmental and social

impacts that will likely increase uncertainty

in water supplies and agricultural production

for human populations across Asia.

Indeed. Which means that such climate

change is going to start and already has

started having a serious impact upon

those of us seeking to travel, especially in

areas where massive natural processes are

being rapidly altered. Here in the Coast

Range, the evidence is easy to see glaciers

have retreated significantly since the first

ascents, most notably in the Tantalus Range,

where once walkable glaciers are now nearly

impassable from the melt, the original routes

now a maze of crevasses and technicallychallenging bergschrunds.

Carnage at the Conferences

The WMS throws several conferences yearly,

with the latest having just rattled windows

in Whistler (which probably explains the

strange use of medical tubing as a unique

fashion accessory at Garfs for the past

week). The conferences have almost as

many streams as the proposed Enbridge

pipe crossing, with various subsections

holding their own pre-conferences

Dive Medicine, the Diploma in Mountain

Medicine, Disaster and HumanitarianRelief alongside a swath of panels and

speakers at the main conference, with

such endearing titles as Patient Packaging

and Transport (I always thought that

Dracula had it right ship out with a

coffin) and Surgical Airway in the Austere

Environment: Myths & Realities (myth

or reality: you can eat pine needle soup

through a hole in your neck yes or no?).

Indeed, with the latest shindig, the

WMS overran the Westin and the Hilton

for a solid five days, with seminars ranging

from the self-explanatory Bioterrorism

to a rather more opaquely titled Security

& Bug Out Kit.

As a recently infected victim of communistcarpenter ants, I was disappointed to discover

that the Bug seminar is not the ultimate

ant/mosquito defense I was hoping for,

but rather risk mitigation in the field with

development of [a] security plan for Whistler

environs, [with] preparation for unexpected

departure. This, I discovered, was cool too.

In short, if the zombie apocalypse hits and/

or the Big One shatters the tectonic plates,

sending rivers of molten lava through a fiery

village that no Tourism Whistler campaign

will ever be able to revive, this seminar

is all about buggin outta here without

wiggin out. Think survival evacuation and

long-term self-sustainability in a world

without cold beer and wine, pizza delivery,or GoogleMaps. Or oil. Or electricity.

Speaking about oil the WMS is

turning to the environment for its 2013

conference in Alabama, a State that has seen

its share of devastation from the Deepwater

Horizon fiasco of 2010. The conference

will talk about the environmental impacts

on human health.

Thats going to be a watershed

conference for us, Loren Greenway. We

are now at the end of a marathon interview

session on the patio, and he and I have both

gulped down our beers his buzzless,

mine grapefruity. Following the impacts

of the British Petroleum explosion, were

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WMS history in five stitches or less

The WMS brings medicine back to where it began: in the vast outdoors of our planet, from

caves to jungles, glaciers to forests, mountains to deserts, from search and rescue to

expedition medicine, dive to disaster medicine, wilderness trauma to wild animal attacks

(not to be confused with the trauma of a late-night cougar attack at a local dive, which can,

truth be told, be a disaster that is just the medicine you might need).

The Wilderness Medicine Society was founded in 1983 by physicians Paul Auerbach,

Ed Geerh and Ken Kizer, embodying the spirit of some outdoor-inclined California

doctors who, feeling the times, went all punk on their suburban counterparts and beganto feed the need for all-weather medicine and full-scale response in what the WMS

calls extreme situations and what we call our backyard out there in the boonies

beyond the last cell tower, with many clicks to walk or skin out, days of travel from the

remnants of our SIM-ilization. In short, just out in the middle of the Spearhead.

The WMS combines practice with publishing, with a heavy roster of annual conferences,

the peer-reviewed academic journal Wildnerness & Environmental Medicine, the Wilderness

Medicine magazine, a massive manual of how-to fix-that-broken-bit called Wilderness

Medicine (6th Edition), the Wilderness Medical Society: Practice Guidelines for Emergency

Care (nice light reading after Harry Potter), and the WMS Educational Lecture Series (fits

in well after catching up on True Blood or aging episodes of Clooney-era ER). An ongoing

series of Student Interest Groups shuttle the up-and-coming into the ranks of becoming full-

fledged enviro-addicts with a thing for splints and sutures.Indeed, environmentalism is behind the medical science too, or rather, it goes hand-

in-hand as a passion of many of the attendees. It would be hard to imagine a WMS doctor

without a burning desire for near-disaster epics, or at least, for some quality time spent

huddling in the backcountry or whipping along singletrack or white-water rafting, trekking

across the continent, whatever Point being, the WMS has a dedicated Environmental

Council, with their mission statement making it clear that WMS members love the outdoors,

[and] have deep respect for the environment and our precious natural resources. . . Given

that natural resources today are often only granted value if they can be ripped out from

the Earth and monetized for the profit of the few at the expense of the many, it is nice to

see an approach that seems some value in them great wild spaces other than untapped oil

and gas reserves (or old growth ripe for logging).

going to talk a lot about the impacts of

drilling and pollution on human health

and environmental health, he says. Its

going to be really interesting. Were going to

have the Surgeon General [of the U.S.] come

in, were going to do some actual sea lab

experimentation and observation . . . it mightprove to be one of the standing hallmarks of

the Wilderness Medical Society.

Greenway expects it to be standing room

only.

However, defining impact on human

health is not easy. We cant just focus on

ecological issues, because its just not our

focus, he adds. So somehow we have to

tie that to human health. But in that, were

going to talk about all kinds of things.

To me, this sounds like a politically coded

way of getting medical and environmental

science, as well as medical practitioners

involved in the disaster and relief scenarios

that result from climate change, involved

in the broader issues that are redefining

our ability, as the human species, to survive

on this planet. In a country as polarized

as the U.S., even taking this step would be

contentious (as it is now in Canada: all those

who oppose the Northern Gateway pipeline

are radicals funded by foreign money,according to our honourable PM).

Greenway goes on to play both sides of

the coin.

To quantify that impact [on human

health] is really difficult, Ive come to

appreciate. We all talk about the dangers

of the oil spill in the Gulf of Mexico but

we dont know at all that its impacted

anybodys human health. Its impacted some

birds and a couple of fish maybe, but I dont

know what its done to the humans.

Try saying this to those whose economic

health has been devastated due to the

loss of the Gulf of Mexico fishery. Entire

communities have been left impoverished.

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And to say the largest spill on record

knocked out a couple of birds seems to

underplay the extent of the damage. But

I see Greenways point which is always

the failing point of careful science. By

the time that slow and steady science has

established a definitive link between the

persistence of minute oil particles in the

water supply and, say, persistent cancer, it

can be generations too late.

This is really a new area for us, says

Greenway. Im afraid there will be a lot of

conservation interest, and not much medicalinterest, is what Im afraid of. And we dont

want to be PETA. Thats not what we do.

the problem is separating, at least for me,

separating the whack jobs from people who

are thoughtful about the impacts on human

health. Thats always been my cautious foray

into environmentalism. Theres a lot of heat

and a lot of angst and not a lot of science.

Id rather imagine a point down

the road where the Hippocratic Oath is

changed ever so slightly, to where the

physicians duty to protect the life of the

patient includes not just the one body, but

the body of the environment that nurtured

the patient into being.

Step Right Up to the MagicalMedical Mystery Tour

Out on the patio with Greenway, basking in

the sweltering waves of a climate-changed

summer, I have been lost in thought again,

paused in the middle of a question, and

thinking of the volcanic revenge we are

all due should the Great One unearth the

induction faults and all I can thinkabout is: if I had to, would I cut my arm off

with a penknife?

Greenway is from Utah, as is famed

outdoorsman Aron Ralston, who after

being trapped by a dislodged boulder in a

slot canyon for five days and seven hours,

cut off his withered and useless limb with

a dull multi-tool. The epic self-rescue was

dramatized in the flick 127 Hours, which

should all but put anyone off travelling

solo in the backcountry. Its probably one

of the few flicks I can think of that nearly

everyone at this conference has seen (and

Im certainly not going to mention the likes

ofCliffhanger).

Thinking about Ralstons ordeal has me

wondering what level of first aid I should be

carrying into the backcountry. My training,

like so many fellow skiers and mountain

bikers I know, has long since lapsed. Sure

I can tie tight that bleeding stump, but Ive

gone hazy on the details of chest wounds

and spinal fractures. New medical research

has also updated standards in basic first

aid over the past few years. In 2010, good

ol CardioPulmonary Resuscitation (CPR)

even changed its breathing regime, requiring

a new, arm-intensive 30:2 ratio of chest

compressions to breath ventilations. The oldmemory moniker of ABC (Airway, Breathing,

Chest Compressions) switched up to CAB.

And theres a different ratio for children

(15:2). In short, my skills are dwindling.

Besides getting recertified and taking a

Wilderness First Aid course, is the WMS for

me? Indeed, shouldnt I, and others like

me, get a bit more educated so that should

the karma cards come up short, the steps to

survival will be clear?

We do, after all, live in Whistler and

play on its boundaries. Take a jaunt East or

West and it be lonely back there. It is also

vast inside the Valley. As I discovered three

years ago, even a minor escapade along Cut

Yer Bars can result in broken wrists and acareful walk out.

To this end, tuning up with challenging,

hands-on wilderness medical education is

one of the prime goals of the WMS.

Nurse, turn on thelights its DiMM!

In 2005, the WMS launched the Academy of

Wilderness Medicine a series of standards

for certified education in wilderness

medicine, organized as a modular system of

adult education combining both classroom

and practice, held to critical standards of

academic excellence. In short: you better be

good both in the field and in the books.

Currently, at least in the United States,

and I think everywhere, you dont have to

have any specific training to hold yourself out

as a wilderness medical practitioner, saysGreenway, reflecting upon one of the main

missions of the Society: wilderness medical

education. If youre a physician, it doesnt

matter what your background is, you can say

that youre a wilderness medical practitioner

without having any experience or formal

training in wilderness medicine. The same

can be said for mountain medicine.

To this end, the WMS set out to create a

diploma program to standardize mountain

medicine.

What [DiMM] will provide is a group

of individuals who actually have a codified

background and experience in mountain

medicine, explains Greenway, specifically

in search and rescue mountain medicine,who have been tested, and who have

demonstrated the skills necessary to really

know what theyre doing in the outdoors.

DiMM is geared specifically to medical

practitioners; while doctors receive a

diploma; mid-level medical personnel

receive a certification, even though the

course content and exams are the same.

For those with Wilderness First Aid, or

who are Wilderness EMTs, this would be

a logical next step. Besides the didactic

education required in the classroom, the

DiMM features hands-on training in the

backcountry, blending technical rescue,

wilderness medicine and self-sufficiency,

while moving through the disciplines ofexpedition medicine, search and rescue

operations, mountain guiding, ski patrol,

and mountain recreation. Candidates must

also be competent in the backcountry

as hikers and basic-level climbers, with

snow travel and cold weather camping

experience. The DiMM is an internationally

recognized certification, satisfying the hard

requirements thrown down by the worlds

guiding associations including UIAA, ICAR

and ISMM.

To this end, the DiMM would be a

worthy course for a Whistler University

while offering diplomas in tourism and

hotel management might satisfy the Bates

Motel crowd, expanding any planned higher-education to include in-depth training in

wilderness medicine and emergency

response would create a whole other level of

academic training in the Valley one that

the Corridor (and beyond) needs, and one

that Whistler could undertake exceptionally

well given its current setting as a DIMMs

course location for its outdoor environs.

Though the WMS offers the DiMM

through the University of Utah and the

University of Colorado, similar training is

already available here in Canada through

The Canadian Society of Mountain Medicine,

which has a DiMM module upcoming from

September 9th15th.

FeatureSTORY

Don t mess wi t h a man

wi t h bot h J i u- J i t s u and

medi cal serpent t ats .

Thi s be one of t hos e

l ev el ni ne sel f - heal i n

ni n j a types who can st i ck

your eyes out wi t h one

hand and sut ure hi s own

wounds wi t h the ot her.

J us t sayi n .

medics gone wild [pique]

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