From Offshore: Wilderness Medicine (with gratitude to Dennis Kerrigan, 1960–2016)
Thursday, June 23, 2016 11:26 AM
In 22 years of responding out here as an emergency medical technician, I cannot think of a single call that really required more than what an experienced Wilderness First Responder could provide.
Eva Murray lives, works and writes on Matinicus Island.
Back in 1994, five year-round Matinicus residents spent the winter around Lori’s kitchen table with our instructor, Luke Church, EMT-P (paramedic), studying and practicing and looking at gory pictures of bloody injuries, in mind to become EMTs. This island had lost its last resident RN some years before, and it was time we had some little bit of health care. As soon as we passed our exams that summer, we each made our plan to begin training for the important part of our credential, that of “Wilderness” EMT.
First through Stonehearth Open Learning Opportunities (SOLO) in New Hampshire, and later through Maine’s own Wilderness Medical Associates International, we trained in the skills needed for response where there is no hospital. Wilderness medicine isn’t about “covering your butt” or protection from litigation, or about specialization, and it definitely isn’t about ordering all the testing “just in case.” It’s about realizing, “OK, I’m out here in the weather, with a little bit of gear and a couple of civilian helpers, and somebody’s in trouble. What can I do, what are the priorities, and how do I know whether this is life-or-death, or they’re just whining a lot?”
People say it’s “MacGyver-style” emergency response. I’ve never actually seen that show, truth be told, but I guess we all know what that means. When you’re on top of a mountain, or way up in the woods, or out to sea, you probably don’t have everything by way of the latest in elaborate medical equipment. You probably have clothing and rope and band-aids and soap and random sporting equipment or hardware or sticks and branches. Maybe duct tape. Maybe ice. I made a splint for a broken wrist (both bones) out of three bandannas and a National Fisherman magazine, back when that publication was much thicker and large-format, and used two long-sleeve shirts for the sling-and-swath. This was for a Matinicus kid on a school field trip off Isle au Haut a couple of decades back. It was 3:30 a.m. and he’d fallen out of the upper bunk aboard a steel boat. We packed the homemade splint full of ice, and it served to minimize the pain for the lobster boat ride to Stonington, and on the long haul over the frost heaves up Route 15. We managed.
Wilderness medicine is a mindset. It is more than a set of protocols and procedures, and far more than a few companies that teach raft guides and park rangers how to make first aid equipment out of lawn chairs and trekking poles. It is the attitude — useful on a remote island just like on a hiking trip — that we ought not consider ourselves helpless. We must respond with care, with compassion, and often with some considerable haste, because somebody’s in pain. It’s about a few medical basics and a respect for common sense. We can’t just turn away and say, “Hey, it’s not my job.” But in order to respond calmly and safely under conditions like that, we need to practice.
When New York City paramedics have to carry patients six blocks to the rig, because the snow is so uncommonly deep that the ambulance cannot park near the patient’s home, they are practicing back-country medicine. When a cyclist breaks his collarbone in a fall, and he or a fellow rider makes a sling out of a bicycle inner tube, it’s the same idea.
I remember the instructors and mentors we had back in the early days of Matinicus Island Rescue, when we were all new to both EMS and this world of extreme outdoors-people. It was intimidating, to be sure, this subculture of super-heroes. Some were military. Some were brain surgeons. Some of the folks you meet in wilderness medical training go up and down Denali like it’s a walk in the park. They paddleboard around New Zealand on their day off, or they kayak to France for supper, or it seems so, anyway. They ski like madmen and they fear no mountain cliff, no whitewater river. They are the “Special Forces” of first aid. I realized early on that I was way out of my league.
Among these heroes was Dennis Kerrigan, wilderness medical equipment improviser extraordinaire, swift water rescue instructor, Maine Guide, ski patroller, paramedic, and a man who truly loved the outdoors and most every way to have fun therein. He was, by the way, not intimidating, despite his expertise. I recall him being a hell of a nice guy. We lost Dennis recently. I wish I could have thanked him for all he taught us.