Volume , Issue

At some point during my extrication – covered in vomit and holding my intestines to my abdomen – I started to shiver. Starting deep in my core and radiating out to my extremities, the involuntary shaking was a persistent reminder that the 17-degree weather in Virginia’s backwoods was not something to take lightly. I felt my shivering intensify slowly over the next half-mile or so. All of a sudden, a bright light flashed my eyes and I heard the voice of one of my rescuers, “Real world. Hey man, is that real shivering? Are you cold?” Another voice echoed from somewhere else above me. “Yeah, like real world, his lips are blue now and he looks dead.” With the safe words (“real world”) spoken out loud, I broke my character, no longer acting like the airplane crash victim I was supposed to be. Trying to smile weakly, I nodded and croaked out “Real. World. I. Am. Frozen.”

With that, I was welcomed to the Wilderness Medical Society’s first-ever advanced resident elective. 

 

Ten residents signed up to be the guinea pigs for the new two-week rotation in the Jefferson National Forest north of Roanoke, Virginia. We hailed from emergency medicine, family practice, and EM/FM programs; from Arizona to Philadelphia, and even added some international flavor with a resident from Canada. In all honesty, I think most of us signed up strictly on the concept that the rotation was an excellent excuse to get away from the everyday grind of the hospital and do Wilderness Medicine (WM) for a couple of weeks. What we probably didn't grasp prior to arriving was the depth of experience we were going to obtain during our time in the outdoors. 

<iframe src="https://player.vimeo.com/video/218489558?h=1f87321ad0" width="640" height="360" frameborder="0" allow="autoplay; fullscreen; picture-in-picture" allowfullscreen></iframe>
<p><a href="https://vimeo.com/218489558">Moulage - 2017 WMS Resident Elective</a> from <a href="https://vimeo.com/user51921879">Wilderness Medicine Magazine</a> on <a href="https://vimeo.com">Vimeo</a>.</p>

Our elective was built to start half way through the four-week medical student rotation, just in time to help out with the final practicum for the students’ Wilderness First Responder Course – the night scenario. After a quick dinner we were scuttled to the back room where we all proceeded to get moulage applied to our bodies, laughing out loud at the instructor's ability to create the injuries we imagined. While some of us eventually experienced some mild hypothermia in the outdoors while playing patients, the students did a fabulous job triaging, packaging, and transporting us to safety in a truly real world extreme environment. As thanks for us helping them out with their training, they even had the sauna warmed up and hot chocolate ready! 


The following weeks had a smorgasbord of activities. We had lectures on the bread-and-butter wilderness medicine topics, like altitude and envenomation, but also some great resident-oriented talks on education and activity design. The latter topics helped us focus our skills as educators and became very handy when we had to develop a learning experience for the medical students. We also were in charge of leading journal club with the students, integrating evidence based medicine and small group discussions. If you think lectures are boring, or you would prefer to listen to recorded didactics at 1.5-times speed on your computer, think again. I’ll take listening to lecture-discussion while sitting in front of a roaring, wood burning fireplace in a log cabin any day of the week! 

While we did have long days of lecture, it wouldn't be a wild med rotation without some outdoor fun mixed in. There were various planned and spontaneous events throughout our time at Wilderness Adventure at Eagle Landing. Some of the highlights were: 

- Guided caving at the New River Cave Preservation, which resulted in many residents squeezing through tight spaces, saying hello to some bats, and exploring an underground stream in       search of waterfalls. 
- Rock climbing and repelling practice in the outdoors, providing some awesome routes and views for both beginners and experts alike. 
- Hiking along the Appalachian Trail and other incredible areas of Virginia. 
- Swift water rescue practice/intro, with some real life “patients” to retrieve from the nearby river. 
- Spontaneous excursions including hiking, mountain biking, trail running, and fly-fishing. 

One of our final tests was to create an activity for the students in the last week of their rotation. With the combined efforts of our international and diverse group of residents, we created the first ever adventure race at this elective. The students were split up into teams of four and unleashed on the open format course. Twelve checkpoints were littered around the hiking trails that surrounded the lodge, half of them being unmanned with wilderness medicine board-type questions the goal, while the other half were manned by residents to help with various challenges for the medical student teams. From suturing and fire building, to proper CPR and splint building, each team was able to put to the test the information and skills they had developed over the past three weeks. When all was said and done, there was resounding applause and approval of the race by the students. Prizes included items like waterproof matches.

For good measure, our final days in Virginia were spent backpacking along the fabled Appalachian Trail. Some of the residents had their outing cut short because of an in-service exam, but others were assigned as mentors for groups of medical students. Each student group had been tasked with planning their backpacking trip from the ground up in the prior weeks. The mentors were there to give advice, supervise WM scenarios while hiking, encourage good decision-making, and discuss real life backpacking with them as the groups explored the beautiful backcountry surrounding us.   

This two-week elective in the countryside of Virginia was a blur of valuable education and outdoor fun. Not only did we have great opportunities to grow and experience new things in wilderness medicine, but also we were able to practice and expand our abilities as resident educators. Some of the best parts were getting to spend time with amazing medical students, some of who had never experienced the outdoors like this before. When all was said and done, our group was eternally grateful to the WMS crew and the experience they provided us. I have no doubt several of us will use this as a jumping point to either take wilderness medicine back to our own residencies or perhaps become more involved on a national level in the future. 

You Might Also Be Interested in


Into the Wild She Goes: Part 2

Hannah Loewenberg, MD, EMT9/8/2023

A journey through alternative pathways in medical education


2023 Virginia Student/Resident Elective Recaps

Molly Enenbach, DONeelou Tabatabai, DO6/19/2023

Learn all about the experiences of several students and residents


Student Corner: 2017 Student Elective

Emma Hopkins5/8/2017

An electric buzz filled the wooden, log-fuelled cabin...


Student Corner: WM Resident Elective

Tanner Gronowski, DO Chief Resident, Doctors Hospital Columbus, OH 4/17/2017

A recap of the WMS' first-ever advanced resident elective...