Tag: backpacking

i don’t like heights, just to be honest with you

There’s an inherent problem with fear-of-heights (acrophobia) and mountain rescue. Like a lifeguard who’s afraid of water, there exists a constant and underlying carrier signal that ranges from slight anxiety to full fledged terror. Interestingly enough I’ve met a lot of climbers who only got into vertical pursuits because they were afraid of heights.

Exposure therapy can be done in a clinical setting under the guidance of a skilled practitioner or you can just DIY the goddamn thing. Like home surgery it may not work out well all the time but you can’t knock the sense of accomplishment when you pull it off successfully. Chalk it up to the many cases of things that work out well for you but that you may not advise others to do themselves.

prussik
A view from my harness as I dangle on the edge of a cliff.

So when I got tapped in rescue training the other day for “edge”, I had the dueling voices in my head:

  • Voice A, my helpful voice, the angel on my shoulder: “This is great, you’re around expert climbers and riggers, you know all your system components yourself, and you’re going to get exposure and show yourself that you know how to do it.”
  • Voice B, my other-than-helpful-voice, the coward on my shoulder: “HOLY SHIT NO YOU’RE GOING TO DIE WTF ARE YOU THINKING!?!?!?!?!”

I nodded at my instructor, “Got it, edge.” For those not in the know, “edge” basically means you hang out near, on, and sort-of-but-not-really-over the cliff edge. Rarely are “edges” a clear delineating 90 degrees, hence the vagueness. People up higher who aren’t in the “hot” or “death” zone as it’s affectionately called can be unroped, but “edge” needs to be properly able to move around, securely, while ensuring a nice, happy, and safe environment in the aforementioned “death” or “hot” zone. Terms clearly used to remind you that a single careless act will, not could, result in your untimely expiration.

These days, I’ve found it best to not think about the scary stuff. The old expression of “don’t look down” is well intentioned but unrealistic. Better for me is “look at the task at hand and things you need to pay attention to.” That gives me a focal point and objectives so I keep my mind occupied in a constructive capacity.

Like telling someone to think of anything other than an elephant, instantly they think of an elephant. I’ve needed to scrape the whole concept of “down” out of my mind and fill it with anchors, edge protection, patient comfort and safety, and kilonewtons. Randomly tapping on my carabiner gates to ensure that yes, just like thirty seconds ago, they’re still locked.

ericsky1
Yeah, I really didn’t like doing this either. Solo skydiving is no longer an activity I voluntarily participate in.

I’m still a scaredy cat around heights and have very little desire to intentionally place myself in harm’s way. Gravity never sleeps and the minute you screw up Newtonian physics is there to turn you into a mushy pile of goo at the bottom of whatever you’re on top of. Ladders, roofs, mountains, ski lifts: we should all do these wide eyed, knowing that better people have died doing the same.

roofshovel
Shoveling the roof, thirty feet in the air, on top of snow and ice. Mid winter, 2016/2017.

But I’ve tried to replace that fear with more helpful things. The other day I tied some bowlines in an old 8mm rope and had some fun. Secure one end to a big rock and the other to my truck’s 8,000lb winch, I had a go at it. Then I did the same with a dynamic load by having it tied off to my truck’s rear bumper as I drove away. Faster and faster until eventually it broke. It might sound dumb, but now I know my properly-tied-tail-inside-double-bowline on 8mm from GM climbing will hold me. There’s more parts to the system to verify (anchors, harness, etc), but piece by piece we can build confidence.

In rescue world, we have dedicated safety officers who are inspecting all the equipment that you can’t see yourself, monitoring for loosening, chafe, and the such. Once you get to know the system, you can start drilling into the component parts a bit more. Coupling all that knowledge with the mental discipline to never even think of the “down” word, one can at least occupy their mind with other things. Things that are productive, helpful, and genuinely reduce the risk of you turning into a human pancake hundreds of feet below.

And then when on flat and wonderful ground again you can shake your head at all these stupid vertical objects on our world and go sit on the couch, where god intended us to be all along.

 

WFR vs WEMT (Wilderness First Responder vs Wilderness EMT) for search and rescue

As I study my WEMT material, I’m pondering the differences between the two courses thus far. Currently a WFR, I’m headed up to Alaska in the fall for a multi-week WEMT course. Sleeping in a bunkhouse with my other classmates, on a somewhat remote Alaskan island (population 741), I’ll have 8am-8pm class 6 days a week, in addition to the months of material I’ve had to go over in advance (doing it now) and the WFR I needed just to register.

 

I started writing a whole primer on the various levels of wilderness medicine but I deleted it all as the topic is huge. Instead, I’ll try something new and focus on the title: WFR vs WEMT, specifically for search and rescue folks.

study
WFR is the books on the right. WEMT is the books on the left *and* the books on the right.

WildernessFirstResponder

Coming in with roughly ~100 hours of training is the Wilderness First Responder, or WFR, pronounced “woof-er”. This swiss army knife of wilderness medical response is the expected level of quality sar team members and outdoor guides need.

  • Laser beam focused on the task and environment. You’ll learn nothing about ambulance gear because hey: there’s no ambulances in the wilderness.
  • While still a multi-week time commitment it’s possible for most normal people to figure out a way to pay for it and take the time off.
  • Available in a lot of parts of the world.
  • Fairly uncomplicated focus on critical system stability. Identify and treat the things that are field manageable, identify and prioritize transport for the things that need higher levels of care.
  • By being able to dismiss the urban setting and ambulance (or better) equipment, things get simple pretty fast.
  • You are not operating under an agency’s medical direction so your protocols (reducing dislocations, clearing spines, administering epinephrine, stopping CPR, and declaring dead people dead) is actually much more than an EMT would be able to do provided you’re in a wilderness context (typically defined as two or more hours from definitive care).

wemtpatch

Coming in with roughly ~200 hours of training (tack on another 100 for the WFR you generally need to take the course) is the funky WEMT or EMT+W. It’s basically an EMT+B with special focus given to non-ambulance gear and prolonged care and life support in an austere environment.

  • You can have way more patient exposure if you want it. As an EMT-B you can be treated like shit and underpaid riding around in ambulances with horrible working hours. But hey, it’s work and more importantly it’s experience.
  • On a SAR team you’ll probably be the, or at least one of, the primary medical providers as WEMT is a rare designator that few people trot around with. Again, experience.
  • You can expand your reach by riding ambulances, joining (typically smaller) fire agencies, and even working in hospitals or at a local physician’s office.
  • With all that experience, you can move towards being a paramedic (EMT-P) if that suits you and you have the time/money.
  • You’ll understand more of what’s going on with your patients at a physiological level and have a broader understanding of chronic and acute disease.

The real benefits for WEMT comes down to experience and advancement. Working as an EMT-B sucks for most people. You’ll make roughly $12/hour, which is what I currently pay my babysitter and she sits around watching Netflix not dealing with death around the clock. Even paramedics make roughly $17/hour, and that’s after spending $10,000 – $20,000 to go to paramedic school and after having worked as an EMT making peanuts long enough to get the experience to even apply to paramedic school.

All that being said, your ability to gain experience and advancement as a WFR is basically zero, strictly from a medical perspective. You’ll be limited to the patient contact you have in SAR which can be pretty thin. Also, you’re hogging it and not letting others on your team drink from the firehose that is the primary medical provider role.

It was explained to me when I got my USCG Captain’s License: this means you can do the job, you don’t get good at it until you’ve done it a lot. When you first get your driver’s license you’re a terrible driver. It’s the years of driving experience on top of the license that make you decent. The same goes with all skills including medicine.

Captains with a license but not a lot of time running commercial ships are referred to as “paper captains” on the waterfront: it’s not a term of endearment. Whether it’s driving a car, flying a kite, or diagnosing hypovolemia you are better at it the more you do it.

wemt
Typical SAR work. You’re a long way from an ambulance.

Search and rescue is basically an all volunteer system, as it always has been. Going back to 1000AD, search and rescue is a side gig. And in a big way, that’s what makes it so great. Everyone is taking time away from their families, taking time off work, and prioritizing helping others. I heard a joke the other day that to get into sar you need to take the psychological test, and fail it. Getting a chance to work with these outstanding people is a privilege. And of course it is a privilege and not a right to treat a patient when they are in one of the scariest moments of their life.

Everyone in sar needs to make the decisions for themselves as to how far “good enough” is. Perhaps because I’m a bad climber, middle of the road tracker, and crummy mountaineer I think my medical skills are where I can do the most good. It’s not lost on me that my own daughter’s life was saved by a sar team’s medical chops.

If you’re a WFR and keep your skills sharp, I’ll work with you anytime. I’ve seen firsthand a WFR keep someone alive for hours in a jacked up situation before evacuation could occur. If you’re a WFR and want to get more time with patients and perhaps go onto other aspects of medicine short of nursing or doctoring, consider the WEMT route.

 

the evolution of my sar packing

Mono Search and Rescue got called a few days in the early afternoon and we finished up around 0500 the next day: roughly 14 hours of humping and pumping through ice and snow, waiting around, treating patients, and rigging rescue lines/anchors/stuff. After some sleep I checked the back of my truck:

sarmess
Rat’s nest of line, wet gloves, dirty socks, dirty gaiters, consumed medical gear.

SAR packing seems to be based around three key concepts: mandatory, optional, and spare capacity.

Mandatory Gear

Bivy sack, head lamp, dry socks, and things of that nature: stuff that you’re going to carry no matter what. Most of those items are specified by my team but I toss a couple of my own in there too. I’m sort of a dork so I wear my helmet to almost anything except blazing sun mid-day and my own medical go-bag.

All of this stuff is in my pack, ready to go.

Optional Gear

Next to my pack is a milk crate full of optional items. My tent (as opposed to my tiny bivy), my backpacking cooking gear, crampons, snow shovel, helicopter goggles, etc.

The reality is that I can’t bring everything you’d ever want so on a operation-by-operation basis an educated guess is made. Headed to the desert? Extra water. Headed up a snowy mountain? Snow anchors.

Spare Capacity

Another reason you can’t load up on everything you want from your own gear is that team gear has to be lugged out as well. The litter, oxygen tanks, vacuum splints, long ropes, and all nature of climbing and medical equipment beyond your personal gear needs to head out as well.

And remember that you need to balance all of that with the fact that the more you’re lugging the slower you go and the less nimble you are. With more gear you get to your patient(s) slower and your agility at transporting them out is reduced.

sarclean
Cleaned up, ready to go. Mandatory in the bag, optional and clothes in the crate. Down bag de-compressed and puffy.

I’m still relatively new in my SAR career so I imagine I’ll be learning and refining as I go. And then there’s winter, which in a place like Mammoth really goes haywire. My own personal gear is much bigger, overnight gear is bigger, and between skis/boots/crampons/splitboard/snowshoes it’s tricky as hell to walk around.

maps for the mammoth / june / eastern sierra (mono/inyo/yosemite)

I looked at my rather beefy selection of local maps and thought it might help some others figure out what they could use. For reference, here’s a link to the Mammoth Lakes Welcome Center.

For anyone looking to explore the area a bit via their computer, check out CalTopo if you haven’t before. CalTopo also gives you some awesome route planning options and you can print out your maps from home (for free).

Have fun and be safe!

lots of sar training this spring

Every since joining the Mono County SAR team, I’ve been working closely with existing members and my 2017 cohort. In no particular order, here are the various skills we’ve been dialing in:

  • Ice and snow anchor use and placement. Flukes, pickets, and snow bollards.
  • Rock pro anchor use and placement (climber speak for “protection”). This is for 20 kilonewton (2.4 ton) rescue loads, typically consisting of at least two sets of three independent banks of protection. You should be able to hang a Honda Civic off our rescue rigs.
sarchopper
Rescue teams being able to radio a chopper in loaded with a paramedic and hoist should make you feel better about paying your state taxes.
  • Running top speed and jumping down Bluejay, landing on our back traveling head first, sliding to our doom. No worries, just use that ice axe and self arrest without piercing your femoral artery.
  • Helicopter insertion and patient hauling, courtesy of the awesome H40 crew at CHP’s Central Division. Popping smoke grenades, grabbing the hooks without getting zapped, rotor wash everywhere, and giving your patient a fastpass ride: it’s hard to not get stoked when you see that work out smoothly.
littercarry
San Diego Mountain Rescue, performing a litter carry. I’m in the back there somewhere.
  • Tracking training (which is nearly an art form), complete with sage-on-the-hill trackers who will track people in the woods just for fun and to see if they can. One guy on our team has a sandbox of sorts at his front door and asks everyone to leave an impression so he can keep seeing different tracks.
  • Blood borne pathogens and what they mean to a first responder. Want to catch some hep c? What about working on patient A, then going over to patient B without changing out your gloves, spreading whatever goo patient A has on patient B?
  • Radio training, to include all repeaters and frequencies used by air crews, law enforcement, and municipalities throughout the county.
  • Mountain navigation, chasing down small markers scribbled on small pieces of wood across a forest and scree field. As a Navy trained sailor with a USCG captain’s license, I had to work hard for this practical and written test.

Nevermind the examinations, gear signoffs, medical provider qualifications, immunizations, pack signoff, and take home tests.

And we’re not even close to halfway done with training at this point. Really it’s just enough to turn our 2017 cohort into a field effective team for the summer.

loadedup
The back of my truck is in go-mode for the summer. Pack, uniform, “maybe” gear. Even spare undies.

Then there are the self-study sessions groups of students will do for practicing various skills, typically high angle rope work and patient care.

July marks the typical beginning of rescue season. Right now the Lakes Basin is pretty inaccessible because of snow, PCT thru-hikers are skipping the High Sierra (my backyard), and major campgrounds are scheduled to only be open for two months this year.

So even though the backcountry is pretty treacherous right now, road closures and applaudable risk analysis have kept most folks from getting into trouble. That said, the sheriff could be getting ready to hit the call-out button right now.

*As a rule, I will not and cannot discuss any particulars of search and rescue operations that approach the realms of patient privacy and law enforcement.