Renewing a Longtime Skill

After recovering so well from my August back surgery, I have been eager to return to favorite responsibilities and challenges.

Am I ready?

    To walk the dog, take a longer hike, kayak, garden and mow the lawn?

How do I return without injuring myself?

   I have no sciatica pain, but strained muscles along the surgery site and a tender three-inch scar: how do I listen to my body now?

How can I be of service at this time in my life?

   A more complex question, but important to me, and my service has always included physical challenges.

What about recertifying my Wilderness Medicine First Responder status?

Known as WFR (woofer), this certification is granted only after a rigorous 10-day immersion into deep first aid and emergency response training. In wilderness, a WFR may be the only medical attention available for hours, even days. To retain WFR status requires recertifying every two years, usually a three-day weekend, in which participants first pass the written exam, and then spend two-and-one-half days in outdoor scenarios—sometimes the victim, sometimes the responder.  I had until the end of 2022 to take a three-day training from the National Outdoor Leadership School. A mid-November training was located nearby. I signed up.

To get a permit for guided camping on U.S. Forest Service land, one leader needs to be a WFR. To get insurance for the wilderness trips and quests PeerSpirit has offered, a WFR needs to be on staff. Question #1: I am now officially retired from that work. Do I really need to do this?

Answer #1: Yes. Around home and outdoors, family and friends count on me to respond to any level medical emergency. In my neighborhood, I am part of the informal emergency response during storms and power outages. My skills are useful to people I love and care about. As long as I have stamina for the rigors of training, I want to keep recertifying.

Question #2: Am I up to the task? The only way to find out was try. I registered, found a simple AirBnB nearby, and began studying.

Twenty-five students ranging in age from 22 to 73 (me) and two instructors arrived at Camp Indianola Methodist Camp the morning of November 18. We were an even mix of men and women dressed in outdoor gear preparing to spend most of the day outdoors practicing rescue scenarios.  Heavy frost covered the ground. Our meeting hall was an old wooden, not very well heated building. We sat in a large semi-circle on chairs behind folding tables.

Indoor classroom at the Indianola Methodist Church Camp

We introduced ourselves by name, number of recerts we had done, and something interesting we learned this last week.

I said this was my twelfth recertification and the thing I had learned in the wee hours of the morning was that my longtime co-guide, friend, and sister WFR had just passed away after a long battle with cancer. It was important to me to speak Deborah Greene-Jacobi’s name into a circle of guides on the day of her death.

My instructor was honoring and sympathetic and as we moved on, part of me was doing this certification for Deb as well as for myself.

The young man sitting next to me said, “Geez, I was not even born the first time you did his training!” (I later learned from the NOLS office that they don’t exactly keep records on who has done the most certifications “but there are only a handful of people who have certified as many times as you have!”) 

After the check-in, we took a 50-question multiple choice test. We needed a score of 70 to continue: I got a 94. My mental confidence was boosted: now for the physical challenges.

After an injury or illness, it takes a while to resume body/mind confidence, especially for those of us in the over-70 bracket. Though my surgeon said I had coped pre-surgery “like a trojan,” I realized how essential it was for me to get on my bike and ride distance, get in my boat and paddle, don a daypack and hike. I have always had strong body confidence and am determined to regain that sense of physical selfhood.

This course would require me to bend, lift, kneel on the ground, endure cold conditions. How much was I my “old self?” And what are the capacities and limits of my “new self?”

Once scenarios began, the outdoors became our debriefing/teaching classroom.

In those three days, combining lecture and small group scenarios, we covered burns, hypothermia, lightening, drowning, acute mountain sickness, gastroenteritis, evacuations, infections, broken bones, interfacing with front country EMS, and so on. A third of the students would be chosen for a scenario and go with one instructor to receive information on how to roleplay their situations.

The rest of the group paired up, went to find our patients with a minimal amount of equipment and proceeded carefully through our patient assessments to determine why the patient was in trouble and what we might do about it. In the scene shown below we found a patient in extreme pain with a broken femur that we had to splint and get ready for evacuation.

In one scenario four of us created a femur splint for a patient.

 

 

Wilderness medicine is defined by illness or injury occurring greater than one hour from definitive care. There are many challenges to wilderness medicine: the environment may add to the problem (cold, heat, darkness, etc.), the patient’s condition can change over time, equipment for treatment or evacuation must be improvised, decisions are often made without outside contact.

 

 

Most of the participants were staff for schools and outdoor programs, Fish and Wildlife Service, U.S. Forest Service and adventure tourism companies. We all can be responsible for big decisions in difficult situations. As always in these trainings, I am enormously impressed by the caliber of people doing this work.

In another scenario (this one in the indoor classroom) we worked in groups of 5 to practice cleaning and closing an open wound.

Demonstrating fine examples of steri strip would closure

 Answer to Question #2: Yes. I did it. I brought my renewed physical self and experienced guide self to the course. I opted out of only one activity: litter-bearing a pretend victim off the field. I returned home a bit stiff and tired, but with my body confidence restored in my ability to continue being of service in this way.

My dear friend and co-guide, Deborah Greene-Jacobi, and I hiking May 2022. Her battle with cancer was valiant and determined. She taught me so much about so many things. I will forever miss her. She died the morning I began my WFR training.