Volume 28, Number 4 - Wilderness Medical Society

FALL 20 

11 

Volume 28, Number 4 

Flying After Diving 

Dilemmas, Decisions and Descent on Mt. 

Whitney 

Healthful or Harmful—Taking kids into the 

wilderness

INSIDE 

Flying after Diving 

5 

Dilemmas, Decisions and 

Descent on Mt. Whitney 

8 

Footprints for Kids: 

Healthy or Harmful? 

Taking kids into the 

wilderness 

12

WHAt'S iNSidE 

EditoriAL StAFF 

Wilderness Matters 

Arthur (Tony) Islas, MD, FAWM .................................................................................................................................. 4 

Flying after Diving 

Neal Pollock, PhD ....................................................................................................................................................... 5 

Dilemmas, Decisions and Descent on Mt. Whitney 

Whitney S. Alexander, MS4 ........................................................................................................................................ 8 

Footprints for Kids: Healthy or Harmful? Taking kids into 

the wilderness 

Debra Stoner, MD, FACEP, FAWM .......................................................................................................................... 12 

Trail Mix: Nutrition for Adventurers 

Mary Howley Ryan, MS, RD and E. Wayne Askew, PhD ....................................................................................... 14 

Wilderness eNews 

Nancy Pietroski, PharmD .......................................................................................................................................... 16 

Great Gear 

Amazon Kindle 

Greg Juhl, MD, FACEP, FAWM ................................................................................................................................ 18 

TNTC Was Too Much for Me! 

Lynn E. Yonge, MD, FAWM ...................................................................................................................................... 19 

Society Matters .................................................................................................................................. 20 

2011 Annual Meeting Recap 

Meet the Members 

Sam Schimelpfenig, MD 

Committee Updates 

Diploma of Mountain Medicine 

Cliff Notes 

Ali Arastu .................................................................................................................................................................... 26 

Kindred Spirits ..................................................................................................................................... 27 

A DAN Intern in Cayman 

Jenna M. Wiley 

Bringing Wilderness Into Your Community 

Brian Simon, RN 

Book Review ........................................................................................................................................... 30 

Wilderness Medicine 

A quarterly magazine published by the 

Wilderness Medical Society 

Christopher Van Tilburg, MD, FAWM 

Editor-in-Chief 

Jonna Barry 

Managing Editor 

Seth C. Hawkins, MD, FAWM 

Senior Editor 

Debra Stoner, MD, FAWM 

Associate Editor 

Larry E. Johnson, MD, PhD 

Assistant Editor 

Edward (Mel) Otten, MD, Publications 

Committee Chair 

Contributing Editors 

Nancy Pietroski, PharmD 

Sam Schimelpfenig, MD 

Editors Emeritus 

Edward Geehr, MD 1984-1986 

Howard Backer, MD 1986-1991 

Eric A. Weiss, MD 1991-1994 

Karl Neumann, MD 1994-2002 

WMS Editorial Office & 

Advertising Sales 

Jonna Barry 

1505 N Royer St 

Colorado Springs, CO 80907 

Tel: (719) 330-7523 

Fax: (801) 705-1483 

Email submissions to jonna@wms.org 

Design & layout: 

CoPilot Creative 

301 E Pikes Peak Ave 

Colorado Springs, CO 80903 

copilotcreative.com 

The Wilderness Medical Society makes no 

representations regarding the legal or medical 

information provided by the individual authors in 

Wilderness Medicine magazine. 

The goals of Wilderness Medicine 

magazine are to: 

1. Provide timely information regarding Wilderness Medical 

Society news and activities. 

2. Provide a forum for exchange of ideas and knowledge regarding 

wilderness, environmental, and travel medicine. 

3. Disseminate wilderness medicine information to the wilderness, 

outdoor, and travel community. 

Wilderness Medicine (ISSN 1073-502X) is 

published online quarterly in January, April, 

July, and October by the Wilderness Medical 

Society, 2150 South 1300 East, Suite 500, 

Salt Lake City, Utah, 84106. Submit request 

to reprint Wilderness Medicine in whole or in 

part to copyright.com. 

©2011 Wilderness Medical Society. 

All rights reserved. 

WILDERNESS MEDICINE // Fall 2011 

3

WiLdErNESS MAttErS Arthur A. (tony) islas Md, MPH, CAQ – Sports Medicine, FAWM, President WMS 

As you read this, the hot, bright 

days of summer are fading to the 

golden hues of autumn. We at the 

Wilderness Medical Society have 

had a great summer. Our Snowmass 

conference was phenomenal and 

the pre-conference Disaster and 

Humanitarian Response course was 

an outstanding success. Thanks to 

all who helped make the program 

happen and special thanks to 

conference Co-Chairs Chris 

Tedeschi and Chris McStay. 

There were some changes in the WMS leadership that occurred this year at Snowmass. 

Here is a re-cap. Eric Johnson, who has stayed on an extra year at the request of the board, 

has now officially rolled off. Eric is a legendary figure and a great friend. He will be missed 

on the board and we thank him for his dedication to the Society. We introduced two new 

board members to the Society. The WMS would like to welcome Marion McDevitt, DO 

and Greg Stiller, MD to the board, and we know that they will both be invaluable assets 

to the Society…they already are! Congratulations to Brad Bennett who has been elected 

to the Secretary position within the Society and, as such, is now also the Director of the 

Academy of Wilderness Medicine that oversees the Fellow and Masters Fellow programs. 

Jay Lemery is now our President-Elect. Jay is the current Treasurer and also the Chair of 

the Meeting Committee. Congratulations to Jay who will be a phenomenal president. 

Lastly, it was great to see all the students at Snowmass! Our future looks bright, if they are 

any indication, and, though it is sad to say goodbye to our previous student representative 

Cathy Chamberlin, MS4, I am excited to introduce our new student representative Ali 

Arastu, MS2. Congratulations to Ali and all the best to Cathy. 

Our summer meeting marks the beginning of our fiscal and planning year as a society, and 

this year it is easy to feel that we are growing and evolving. Our publications, educational 

materials, committees and conferences are all at such a high level that it would be easy to 

just sit back on our laurels…but we are not. We have a very busy year ahead of us. 

The Desert/SAR Directors Meeting will take place November 3-7th in Tucson, Arizona. 

Then we’re on to Park City, Utah, February 3-8, 2012. 

Our Everest CME Experience runs April through May of 2012. 

We will be in Whistler BC, Canada July 13-17, 2012, for the 6th World Congress of 

Wilderness Medicine. 

November 3-7, 2011 

Desert and Travel Medicine 

Conference, Tucson, Arizona 

February 4-8, 2012 

Wilderness and Mountain 

Medicine, Park City, Utah 

April-May 2012 

WMS Everest CME 

Experience-South Side 

July 13-17, 2012 

6th World Congress of 

Wilderness Medicine, 

Whistler, BC, Canada 

wms.org/conferences/default.asp 

There is so much going on – if you are interested and are not yet involved in a WMS 

committee now is the time. I encourage you to get involved, take on a task and make WMS 

– your society – it will be better for that. I hope to see you at any or all of our meetings/ 

events this year. Until then, enjoy the autumn. 

In Peace, 

Tony Islas 

WMS President 

4 WILDERNESS MEDICINE // Fall 2011

flying 

after 

Diving 

Neal W. Pollock, PhD 

and trip planning 

Modern air travel has made distant locations accessible 

to many divers. Flying before diving creates virtually 

no risk (outside of the possibility of mild dehydration) 

for near sea level destinations. Since flight ends with 

compression, the tissues of fliers will be relatively 

undersaturated with inert gas immediately upon 

landing, thereby accumulating inert gas to re-establish 

equilibrium with the ambient (surrounding) pressure.

Flying after diving, however, increases decompression stress since 

ambient pressure is reduced below that experienced by the nonflying 

diver. A typical commercial aircraft cabin altitude of 8,000 ft 

(2,438 m) provides a pressure of approximately 0.76 atmospheres 

absolute (ATA). Consider a diver completing a dive to 66 ft (20 

m; 3 ATA). Returning to the surface at sea level pressure involves 

a three-fold pressure reduction (3.0:1.0) from the maximum 

depth of the dive. An 8,000 ft cabin pressure would generate a 

greater decompression stress because of the four-fold pressure 

reduction (3.0:0.76). As an additional hazard, unexpected cabin 

depressurization, while unlikely, would generate even greater 

decompression stress on any fliers having dived recently. 

Divers Alert Network (DAN) and Undersea and Hyperbaric 

Medical Society (UHMS) held a workshop in 2002 to review 

the available data addressing flying after diving (FAD) and 

decompression stress. Consensus guidelines were produced. The 

guidelines apply to flight at cabin altitudes of 2,000 to 8,000 ft 

(610 to 2,438 m) and to divers who do not have symptoms of 

decompression sickness (DCS). Altitude excursions to less than 

2,000 ft are considered mild enough to not warrant inclusion 

(providing some wiggle room for moderate post-dive travel, 

generally ground-based or possibly short, low altitude interisland 

flights). Any diver with symptoms should seek treatment 

prior to flight. Symptoms may include pain in joints or muscles, 

numbness, tingling, paralysis, or compromised senses. 

The explanatory text of the guidelines stipulates that the 

recommended preflight surface intervals do not guarantee 

avoidance of DCS. It is important to appreciate that longer 

surface intervals will reduce DCS risk further 1 . 


Photo by Neal W. Pollock 

With that understanding: 

For a single, no-decompression dive, a minimum 12-hour preflight 

surface interval is suggested; 

For multiple dives per day or multiple days of diving, a minimum 

preflight surface interval of 18 hours is suggested; 

For dives requiring decompression stops, there is little evidence 

on which to base a recommendation, a preflight surface interval 

substantially longer than 18 hours appears prudent. 

The limited data concerning flying after decompression diving is increasingly problematic 

with the growing popularity and complexity of technical diving. The uncertainty 

is not limited to this subspecialty, though. Even when research data are available, it is 

important to understand that the physiological impact of any dive can vary. For example, 

decompression stress will increase when inert gas uptake is enhanced by exercise and/ 

or relative warmth during the descent or bottom phase or when inert gas elimination is 

impaired by minimal physical effort and/or being cold during the ascent and stop phase. 

Decompression safety would be optimized by a diver remaining cold and inactive during 

the descent and bottom phase and warm and mildly active during the ascent and stop 

phase. Practically, this conflicts with the understandable desire to be warm throughout. 

Current decompression models - in table or computer form - do not address these realtime 

variables. 

The discomfort, inconvenience, cost and potential complications associated with DCS 

are best avoided by conservative practice. Prudent planning would include shallow, 

conservative dives on the final day of diving and a preflight surface interval of 24 hours 

or more. Anyone with symptoms should contact the DAN Emergency Hotline (+1-919- 

684-9111) and seek treatment prior to flight. 

Proceedings of the flying 

after diving workshop are 

available for free download 

from DAN at www.dan.org. 

DAN offers interns a way 

to participate in diving 

medical research projects 

and data collection. The 

program typically runs from 

mid-May through August. 

Interns are students 

recruited from colleges, 

universities and medical 

schools. See page 27 to 

read a report from one of 

the 2011 Dan interns, Jenna 

Wiley. Check out the intern 

program overview at www. 

diversalertnetwork.org/ 

research/projects/intern 

Recommended Reading 

Sheffield PJ, Vann RD, eds. DAN Flying After Recreational Diving Workshop Proceedings. Durham, NC: Divers Alert 

Network, 2004. 

Neal W. Pollock, Ph.D., is a research director at DAN and a research associate at the Center for Hyperbaric Medicine and 

Environmental Physiology, Duke University Medical Center, Durham, NC.

ilemmas 

ecision 

nD Desc

, 

s 

ent 

on mt. 

Whitney 

Whitney S. Alexander, MS4 

Photos courtesy of Whitney S. Alexander 

We Were at 12,500 Feet 

on Mt. Whitney. My climbing partner, Lee, and I had ascended 

quickly and camped higher on the mountain than we originally 

intended, breaking the cardinal rule of sleep low, climb high. 

Wind gusts were making our three-season tent seem like a wimpy 

tarp. The sun quickly descended behind the summit peak to the 

west of us and left us with bone-chilling cold. Although it was 

late May, the mountain was firmly set in winter. Iceberg Lake, 

the body of water situated not more than a few dozen yards north 

of us, was frozen solid. Unfortunately, we discovered this when 

we tried to find a source of water that did not involve using up 

precious fuel. 

We had been at this location about an hour, after a long day 

capped off by an unexpected 50-degree slope up a frozen waterfall 

to our current campsite. What we wanted was sleep and warm 

food, but neither was on our immediate horizon. We found 

ourselves struggling against the wind, exhaustion and decreased 

oxygen to get our tent anchored into the soft, pillowy snow. Each 

stake had to be buried a foot into the snow and covered with 

large rocks, which were difficult to come by near this frozen alpine 

lake. When we finally got the tent anchored and the sleeping pads 

painstakingly inflated, we crawled inside to the relative warmth. 

Lee fell asleep instantly. However, my mind was racing. Too many 

things had put us at high risk for disaster. We had a three-season 

tent in fourth season weather. The gully running between the 

granite cliffs to the summit looked much steeper than I originally 

thought. And our rope was tucked safely in the car five thousand 

vertical feet below us. 

Later, when we could not melt the snow beyond slush because of 

a malfunctioning stove. There was no hope of a warm meal. We 

started to weigh our options. Option one: run through our fuel in 

a nearly futile attempts to melt enough water for a summit push 

the next day, eat the ready-to-eat snacks we had stashed in our 

packs, and endure the winds fiercely assaulting our insufficient 

tent. Option two: descend that same steep frozen waterfall hoping 

the soft slushy snow had hardened in the shadow of the east face 

of the mountain, camp below the tree line, and if nothing else 

have a warmer night’s sleep even if warm food would not be on 

the menu. 

Lee was getting increasingly nauseated and had an escalating 

headache. He asked me, “Medically, what do you think we 

should do?” 


9


He could be nauseated and have a headache from dehydration. 

Solution: hydrate. Problem: nothing to hydrate with. Even more 

concerning than the idea of dehydration was the possibility of 

acute mountain sickness (AMS). Solution: either descend or 

stay at this elevation for a day, postponing the summit attempt. 

AMS, the most common high altitude illness, manifests itself 

similarly to a hangover with headache, nausea, lightheadedness 

and anorexia. It is primarily a clinical diagnosis, especially when 

at altitude away from medical technology. The solution to mild 

AMS, Lee’s possible diagnosis, is either descent to a lower altitude 

or maintaining altitude for about a day with limited physical 

exertion in addition to symptomatic treatment of headache and 

nausea with NSAIDs and antiemetics, respectively. More severe 

sickness can be treated with oxygen and acetazolamide. If more 

conservative treatment is chosen, the person should be carefully 

watched for symptoms indicating progression to high altitude 

cerebral edema, or high altitude pulmonary edema, with altered 

mental status or dyspnea at rest. 

I did not have much time to think about it. The sun was already 

past the summit ridge and it was quickly getting dark and cold. 

I thought about our lack of water and of Lee’s possibly declining 

health. I thought of my own trepidation about that steep gully 

without any rope, of the wind that would no doubt make a 

night’s sleep difficult, and of the lack of a warm meal. Water is 

life-sustaining and a warm meal is spirit-sustaining. It has the 

ability to make a frigid night tolerable and is comforting when 

sitting on a windswept plateau waiting for the morning to come. 

Perhaps most importantly, I could not help but hear the voice of 

my father, a former mountaineer himself, telling me to promise 

him that I would always listen to my gut. 

“Safe climbers live,” he said, quoting the young mountaineer, 

Mogens Jensen. “Bold climbers die. You can always come back to 

the mountain, but only if you’re alive.” 

Normally indecisive, I said, “We’re gonna descend.” 

As slowly as we had set up camp, we took everything down and 

packed it away in no more than 15 minutes. Sleeping pads got 

deflated less vigorously than normal and stuffed in packs. With 

the rocks off the stakes, they pulled out of the snow with minimal 

effort. On went our haphazardly stuffed packs and crampons, 

and we bid farewell to the elusive summit. The snow covering the 

frozen waterfall had hardened just enough that our crampons got 

good purchase, and we sidestepped our way to the gentle slope of 

the lower gully. In 45 minutes we descended 2500 feet, much of 

it glissading on snow too firm to be comfortable, to Lower Boy 

Scout Lake. The lake was crisp and not frozen over. We found a 

site to camp behind a large boulder, shielding us from the much 

lesser winds of lower altitude. Miraculously, our stove started to 

work, not at its best but better than before. We not only had a hot 

meal but also celebrated our decision to descend with a cup of hot 

chocolate. With our appetites sated and Lee’s headache beginning 

to subside, we both slept soundly and warmly with only the sound 

of the whispering wind to lull us to sleep. 

Whitney Alexander is currently a 4th-year medical student at Temple University in 

Philadelphia. She is originally from Portland, OR. She hopes to do a wilderness medicine 

fellowship after completing an emergency medicine residency. She rock climbs whenever 

time allows and mountain climbs whenever geography allows. 


11

Footprints for Kids 

Taking Children 

into the Wilderness: 

Healthful or Harmful? 

Debra Stoner, MD, FACEP, FAWM 

Children develop a unique set of skills and maturity when exposed to 

outdoor activities that challenge them. No one can argue the merits of 

outdoor adventure but how often do we, as parents, think about the 

risks involved and how prepared are we to cope with tragic outcomes? 

Shirley and her fifteen-year-old daughter, Louisa, were returning 

from an early spring hike in Mount Baker National Forest when they 

decided to take a shortcut by sliding down a snowfield, something they 

had done many times in the past. Using black plastic bags they rode 

toboggan, style down the slope and right into an open unseen trench 

that had formed in the snowfield. Plummeting into a world of rocks, 

ice and water, they both required technical rope rescue and helicopter 

evacuation. Shirley sustained several fractures and hypothermia. 

Louisa, who assisted her mother, sustained hypothermia, minor cuts 

and bruises. 

A nine-year-old British girl was killed after falling out of a raft into fast 

moving river water. She was participating in a family whitewater rafting 

trip while on holiday in Turkey. It is unknown if she was wearing a 

personal floatation device or helmet. Local experts stated the grade of 

difficulty should have excluded children under the age of twelve. 

Susan took her two-year-old son Luke and six-year-old daughter 

Elora to visit a popular tourist site in the Cherokee National Forest in 

southeast Tennessee. They were all attacked by a single black bear. Luke 

was the first to be attacked and Susan, using rocks and sticks, fended 

off the bear only to be dragged off herself. As bystanders rendered aid 

to her mother and brother, the bear killed Elora, who apparently fled 

during the commotion. Both Susan and Luke survived but required 

surgery for serious injuries. 

Despite having experience, using reputable services or being in a 

populated area, parents and children sustained unintentional injuries 

as a result of an outdoor adventure. The question is: “Would any of the 

above parents have ventured out if they had known the outcome of the 

day?” Probably not. None of us would knowingly put our children at 

risk, but don’t we do this every time we expose them to the outdoors 

where our ability to modify dangers is restricted due to the very austere

“ 

Unfortunately, we don’t make daily decisions that 

involve outdoor adventures with the aid of hindsight. 

environment we seek to expose our children to? Although risk 

is accepted and recognized, the reality is seen only in hindsight. 

Unfortunately, we don’t make daily decisions that involve outdoor 

adventures with the aid of hindsight. 

Unintentional injury remains the leading cause of death in children 

age one to fifteen years no matter what their activity according 

to a 2005 study by the National Center for Injury Prevention 

and Control. Non-wilderness-related outdoor activities are better 

studied. According to the CDC, between 1990 and 2000, 147 

children ages fourteen and younger died from playground-related 

injuries. Of them, 82 (56%) died from strangulation and 31 

(20%) died from fall to the playground surface. Most of these 

deaths (70%) occurred on home playgrounds (Tinsworth 2001). 

Wilderness adventure risk and injury is a complex problem not 

well studied when it comes to children. There are few studies 

looking specifically at pediatric wilderness deaths. One study from 

the Departments of Family Medicine and Pediatrics, University of 

Washington, Seattle, Washington, in 1998 looked at all deaths of 

children between twelve months and twenty years of age involving 

a wilderness recreational activity in five western Washington 

counties between 1987 and 1996 and found the following: Of 

40 cases meeting inclusion criteria, 90% involved male subjects 

and 83% of victims were thirteen to nineteen years old. Hiking 

(33%), swimming (20%), and river rafting (10%) were the most 

common activities. Death was most often by drowning (55%) 

or closed head injury (26%). No victim was alone. All children 

younger than 10 years of age were accompanied by an adult, in 

contrast to only 26% of individuals ten years or older. Only four 

victims had drugs or alcohol in their system. No victim wore a 

personal flotation device or helmet, and only 5% had foul weather 

gear. Although nearly one third of victims were transported by 

airlift, more than half of the victims were dead at the scene. 

It is difficult to summarize the risk of serious injury in the wilderness 

because studies on events per participant hours are lacking and 

people misjudge risk. A good example is the heightened fear of 

wild animal attacks, which are rare, compared to a lesser fear 

of serious injury from falls, which are more common. In the 

Trailside Guide book Parents’ Guide to Hiking & Camping, Rick 

Wilcox, a White Mountain SAR member, answered the question 

“what…is the biggest mistake that parents make when bringing 

their children into the wilderness?” with this immediate answer, 

“Overestimating the physical and mental capabilities of their 

children.” 

Risk is part of a natural life. All risk should be calculated and 

assessed as reasonable concern is healthy. Interventions that lessen 

risk should be employed when possible such as direct supervision, 

use of safety gear and training. Each of us must choose the risk level 

we are comfortable living with and remember serious accident 

and injury are rare and over-inflated fears do not mitigate risk. 

Recommended Reading 

1. Brett Nunn. Panic Rising. Seattle, WA: Sasquatch Books; 2003. 

2. http://www.cdc.gov/injury/index.html 

3. www.cdc.gov Tinsworth D, McDonald J. Special Study: Injuries and Deaths 

Associated with Children’s Playground Equipment. Washington (DC): U.S. Consumer 

Product Safety Commission; 2001. 

4. Trailside Guide; Parents; Guide to Hiking & Camping. New York, NY: W.W. 

Norton & Co; 1997 

5. LM Newman, DS Diekema, CD Shubkin, EJ Klein, L Quan. Pediatric wilderness 

recreational deaths in western Washington state. Ann Emerg Med. 1998; 32:687-692. 


13

ail 

ix: 

utritioN 

or AdveNturers 

Mary ryan, MS, rD anD 

E. WaynE aSkEW, PhD 

BAckcouNtry Gourmet 

WeekeNder style 

Many of us old timers can remember our 

first backcountry freeze-dried meal as 

something with a “weird artificial taste” 

and unrecognizable as a food item with a 

portion size even a couch potato would 

find lacking. Freeze dried hydrate-andeat 

products are, fortunately, much better 

now and can be found in abundant variety 

at outdoor specialty stores. There are even 

companies like Mary Jane’s Farm that offer 

delicious, organic just-add-water options 

for the backcountry. These dehydrated addwater-and-heat 

products targeted to the 

backpacker are great convenience items for 

a quick grab-and-go long weekend outing 

but can leave some of us camp cooks feeling 

a bit obsolete. 

We thought it would be a good idea to 

come up with some meals for a weekender 

that do not include commercial freeze-dried 

meals. We call this a backpacker’s guide to 

easy-to-prepare whole food items that will 

make your fellow campers think you are the 

Rachel Ray of the backcountry! The good 

news is the trend towards healthier and 

better tasting convenient food options. We 

need go no further than the grocery store to 

find them. 

One of my favorite parts of a weekend trip 

is that there is usually pack space for some 

fresh veggies that travel well. My favorites 

are garlic cloves, gingerroot, carrots, onions, 

snap peas and hot chili peppers. Hikers can 

also bring their own particular favorites 

such as jicama, small heads of cabbage, bell 

peppers and even grape tomatoes (stored 

in a plastic coffee mug) – all great choices. 

It is amazing how adding even one fresh 

ingredient can transform a backcountry 

ration into a gourmet delight with an array 

of bioactive nutrients too! 


ANd from our mAilBoX 

A GreAt NeW reciPe! 

Some of my favorite backcountry meals are simple with lots of options for variation 

– pasta, quick-cooking or pre-cooked rice, ethnic favorites, and soups during cooler 

weather. 

› Gnocchi potato dumplings are available in sealed pouches that are heavier than 

dried pasta but cook in a few minutes and taste great tossed with some prosciutto, 

pesto and Parmesan cheese. 

› Rice noodles tossed in a sauce made with peanut butter, soy sauce, garlic, ginger 

and cayenne pepper then topped with toasted peanuts makes a killer Pad Thai. For 

a weekender pack, bring along a fresh carrot and some green onions…and, for the 

backcountry foodies, a fresh garlic clove and chunk of gingerroot. 

› Masa harina, the traditional corn flour used to make tortillas, tamales and other 

Mexican dishes, mixed with some water makes delicious thick, hearty tortillas or 

the base layer for a Mexican bake topped with re-hydrated bean flakes, dried chilies 

and cheese. Add a fresh chopped Anaheim pepper and some cilantro! 

› Smoked salmon travels well–though it is stinky for those venturing into 

griz country. 

› Wild salmon, tuna and chicken chunks are now widely available in foil pouches. 

Add these to pasta, quick-cooking rice, bulgur or whole wheat couscous for onepot 

meals with Cajun, Mediterranean, curry, or Mexican spices and dried veggies. 

› Pesto is so beyond basil and pine nuts these days. Mix your favorite fresh herbs, nuts 

or seeds, fresh garlic, and olive oil. Add cheese to individual dishes for a versitile 

sandwich spread or, when mixed into hash browns, for a savory breakfast option). 

› Peanut butter is still a backcountry staple for many of us but now almond, cashew, 

sunflower nut and other options are more readily available and found in stores 

alongside their peanut cousins. Don’t forget a drizzle of honey. 

› Trail mixes can be jazzed up with wasabi peas or peanuts, chili-spiced dried mango, 

candied ginger, curried cashews, dark chocolate chips, and assorted nuts, seeds and 

dried fruit. 

› For a high altitude trek where water is limited and quick clean-up a must, good old 

boil-in-a-bag Tasty Bites or the generic versions available in places like Trader Joe’s 

are awesome on top of pre-cooked rice. These spicy Indian- or Thai-inspired meals 

are high in sodium making them a great choice for long, hot, sweaty days but not 

so great for everyday fare. 

Though I suspect many WMS adventurers have long foregone the freeze-dried options 

reminiscent of rehydrated salted sawdust, I also know we tend to stick with what we 

know works for us in backcountry environments. We hope these ideas will tweak your 

old standbys and invite you to share some of your favorite backcountry meal ideas 

with us. 

Mary Ryan, MS, RD (mary@beyondbroccoli.com) is a nutrition instructor at the Bastyr University in Seattle and 

has a private nutrition practice, “Beyond Broccoli.” She is the author of the popular book NOLS Backcountry 

Nutrition: Eating Beyond the Basics. 

My favorite outdoor recipe 

also comes from my cultural 

motherland—Scotland! My 

husband raced Enduros (endurance 

motorcycle races) and we like long 

backpacking or mountain biking 

treks, but got to the point where we 

just couldn’t eat one more power 

bar. I had been reading a lot of my 

favorite author, George MacDonald, 

a Scottish Victorian writer, who 

often commented on people eating 

“oatcakes.” I thought those might 

be the “original” granola bar, so I 

did some research. The one below I 

have tweaked with several variations 

listed. They taste great and last 

about 2 weeks on the shelf. They 

freeze well, so I will make a big 

batch and take out several at a time 

as needed. 

Happy eating! 

Megan Lykke, MD 

Mancos, Colorado 

scottish oAt cAkes 

½ teaspoon baking soda 

½ cup boiling water 

1 ¼ cups sugar 

2 cups rolled oats 

2 cups flour (see variations below) 

1 teaspoon baking powder 

1 teaspoon salt 

1 cup oat bran 

1 ¼ cups shortening 

Add the baking soda to the boiling 

water and let stand until cool. 

Using a mixer, combine all other 

ingredients together in a large bowl, 

adding the shortening last. 

Add the water mixture to the batter. 

Stir until combined. Roll out on 

floured surface to about 1/8 inch. 

Cut with round cooker cutter. Bake 

in 350˚⁰ oven about 10-12 min until 

just starting to turn brown. Cool on 

wire rack. Yummy plain or with a 

little Nutella spread.

nvironMent // outdoor // 

/ cPr // Backcountry // t 

/ eMergency // eMs e 

/ outdoor WiLdErNESS 

// sar 

// resc 

ackcountry MEdiCiNE // travel Wilder 

/ eMs education // envir 

/ rescue // avalanche // 

cP 

Take the Sting Out of 

Centruroides in Early August, 

the FDA approved Anascorp, 

Centruroides (Scorpion) Immune 

F(ab´)2 (Equine) Injection under 

priority review as an orphan drug. 

Centruroides scorpions are found 

primarily in Arizona and their 

venomous stings can be fatal, 

occurring most often in infants and children. Anascorp’s approval 

was based on a randomized, double-blind, placebo-controlled 

study of fifteen children and safety and efficacy data from over 

1,500 patients in various trials. It is licensed to the company Rare 

Disease Therapeutics. www.fda.gov/NewsEvents/Newsroom/ 

PressAnnouncements/ucm266611.htm 

Nefarious Northern Exposure: 

Wilderness Students Victims 

of Bear Attacks In two separate 

incidents in July and August, 

young students were injured 

or killed by bears. In the first, 

a group of teens participating 

in a NOLS course north of 

Anchorage, Alaska, were attacked by a grizzly sow with cubs that 

seriously injured two boys. In the other, a teenager was killed by a 

polar bear while on a trip to the Svalbard Archipelago in Norway 

run by the British Schools Exploring Society. Several other 

members of the group were injured and evacuated to a hospital. 

www.wyomingbusinessreport.com/article.asp?id=58857 

www.abc.net.au/news/2011-08-06/teen-killed-by-polarbear/2827116 

Hot Off the Press: Outdoor Emergency 

Care, Fifth Edition The long-awaited new 

edition of the text used by the National Ski 

Patrol has arrived. Developed by experts 

in outdoor emergency care, the book is 

part of a set of extensive resources used 

for the OEC curriculum, which contains 

applicable baseline knowledge and skills as 

set forth by the US Department of Transportation Emergency 

Medical Technician (EMT) National Standard Curriculum for 

the nonurban environment, and exceeds the knowledge and 

skill level of the US DOT’s Education Standards for Emergency 

Medical Responder (EMR) Training. It should prove very 

useful for a variety of emergency first responders who work 

in outdoor settings. www.bradybooks.com/store/product. 

aspx?isbn=0135074800 

It Wasn’t Such a Civil War View 

saws of many sizes, gruesome 

bloodletting devices, and the 

medicine used by doctors to 

help soldiers block out the pain 

like opium, ipecac and whiskey. 

A series of photos of surgery and 

medicine during the American 

Civil War was released by The National Museum of Civil War 

Medicine and the National Library of Medicine. Appreciate how 

sophisticated military medicine has become in 150 years! 

www.dailymail.co.uk/news/article-2021188/Civil-warsurgery-The-grisly-photos-wounded-soldiers-treated.html 

or this: www.cbsnews.com/2300-204_162-10008746.html 


sar 

// rescue // 

avalanche 

ravel Wilderness Medicine 

ducation // environ 

e-NeWS 

aNd More 

onMent 

Compiled by Nancy Pietroski, 

// 

PharmD 

outdoor // sar 

r 

// Backcountry // 

travel 

Subterranean Contagion In 

the June issue of Wilderness & 

Environmental Medicine, Dr. 

Ricardo Periera Igreja described 

the infectious disease risks to 

cavers. Albeit low in typical 

tourist cave visitors (2 million 

visits/year in the US), sport 

and expedition cavers are at 

higher risk for vector-borne diseases from bats (for example, 

histoplasmosis, rabies), rodents (leptospirosis), ticks (tick-borne 

relapsing fever), and mosquitoes. Cavers should be well prepared 

with proper clothing, vaccination, medication and other measures 

before embarking on their adventure below the Earth’s surface. 

Igreja RP. Infectious diseases associated with caves. Wilderness 

Environ Medicine. 2011:22(2):115-121. www.wemjournal.org 

Wilderness Medicine in the Air 

and Snow Two large conferences 

will be held this fall for outdoor 

safety personnel such as EMS, 

search and rescue, and ski patrol. 

The Flight for Life Colorado 

SAR Conference will be held 

September 16-18, 2011, at 

Colorado Mountain College in 

Breckenridge, Colorado. The National Avalanche Foundation 

will hold the 22nd annual National Avalanche School at 

Snowbird Resort in Utah October 23-27, 2011. The oldest and 

most acclaimed avalanche training program also welcomes other 

professions such as avalanche forecasters, mountain managers, 

and land management personnel. 

www.nsp.org/members/oms/membernews.asp#SurvWin 

22nd National Avalanche School www.avalancheschool.org 

Muzzle Measles Before You 

Travel On June 22, 2011, the 

CDC issued an official Health 

Advisory on measles cases in the 

US that were acquired during 

international travel. If you will 

be traveling internationally 

and don’t have the following 

evidence of measles immunity, 

make sure you get vaccinated: birth before 1957, documented 

administration of 2 doses of live measles virus vaccine, serologic 

proof of immunity or documentation of physician-diagnosed 

measles. www.emergency.cdc.gov/HAN/han00323.asp 

Smithsonian Visits Everest 

ER Molly Loomis, a writer for 

Smithsonian Magazine, trekked 

to the satellite clinic at Mount 

Everest Base Camp (17,590 

feet) to visit Dr. Luanne Freer, 

who opened Everest ER nine 

years ago. Dr. Freer described 

treating patients with high 

altitude illnesses and how improvisation in the thin air and 

freezing temperatures is often necessary. NOTE: Visit wms.org to 

learn more about the WMS Everest CME Experience happening 

Spring 2012. You can trek to Everest ER and see it in action for 

yourself! www.newser.com/story/120336/what-its-like-to-runan-er-on-everest.html 


17

GrEAt GEAr: 

Amazon Kindle 

Greg Juhl, MD, FACEP, FAWM 

I recently took a new Amazon Kindle on a climb of Denali. For 

those of you who don’t know, this is an electronic book reader. 

Books can be purchased from Amazon.com and loaded onto 

it; most new books are in the $10-15 range—more expensive 

than a paperback but less than a hardcover. I loaded mine 

with around 10 recent titles that have been on my reading list 

as well as around a dozen free classics, such as Twain’s Tom 

Sawyer and Sun Tzu’s Art of War. I also loaded up a wilderness 

medicine reference text, but never used this. I had wanted to 

get a board review text, but after reading the reviews online, 

it seemed that there were none that were well formatted for 

the Kindle. 

The device worked magnificently and at 9 oz was noticeably 

lighter than two dozen books. During travel days and while 

sleeping, I protected it with a padded case in a large Ziploc bag. 

I was worried about how the device would work at altitude and 

in the cold—the Amazon customer service folks certainly didn’t 

recommend Denali-type of conditions. The elevation ranged up 

to 17,000 ft; the daytime tent temperature was up to the 90s, 

and the nighttime temps were in the 0 degree range. The Kindle 

worked just fine through all of that. I really like the fact that I 

could read with gloves on, one-handed, in any position; I almost 

looked forward to storm days. The battery lasted pretty well; I 

went through about half of the battery in the first week. However, 

recharging seemed to take longer than expected. There is no backlight 

on the device, so you will need a light source if reading at 

night. A teammate had the black and white Nook, the competing 

device from Barnes and Noble; he seemed to have a much harder 

time with his battery life. Then again, he was also playing Sudoku, 

something not available on the Kindle. 

It is rare to come across something which will radically change 

what I carry into the backcountry. However, the Kindle is one of 

those things. I will never again take a book into the backcountry, 

but I will never be without reading material!

TNTC 

WAS TOO MUCH FOR ME 

The Environmental Council encourages members of 

the Wilderness Medical Society to be environmental 

stewards of their hometown ecosystems. This summer, 

I’ve been challenged to do that where I live. On a hot July day 

in Fairhope, Alabama, our family biked to a nearby cold water 

creek for a swim. After thirty minutes of swimming, a creek-side 

home owner shouted, “Do you know this water is polluted?” We 

certainly did not know. She said the creek was polluted with fecal 

coliforms. We quickly got out of the water and went home for a 

shower. We suffered no consequences from the swim but we were 

saddened by the pollution. A headline in the Fairhope Courier the 

following week confirmed what the resident told us: “Preliminary 

testing shows high levels of bacteria in Fairhope waters.” The 

mayor said water samples on multiple occasions showed TNTC 

(too numerous to count) enterococcus species from several 

locations in Fly Creek. 

Lynn E. Yonge, MD, FAWM 

I decided to become engaged with this problem because Fly 

Creek deserves protection. It has been an important asset to 

our community for many generations. Before there were air 

conditioners in the south, town residents would flock to its clear 

spring fed waters for relief from summer heat. My scientific 

training, position within the community and community 

involvement would help underscore the importance of protecting 

Fly Creek for esthetic and health reasons. 

According to the Environmental Protection Agency website on 

fecal bacteria, the primary sources of fecal contamination to 

surface waters include wastewater treatment plants, on-site septic 

systems, domestic and wild animal manure and storm runoff. 

At least four potential sources for the pollution have been 

identified. First, Fly Creek empties into Mobile Bay and is 

therefore subject to tidal influences. Contaminated water from 

bilges could move upstream on a rising tide from the marina 

located at its terminus. A second and more troubling possibility is 

a sewer lift station located within the flood plain of the creek and 

close to the site of contaminated water testing. The city maintained 

this is not the source, but local residents were not so sure. The city 

postulated a third potential source. They believe contaminated 

water may be leaking from faulty septic tank systems that existed 

before municipal sewer systems were put in place. Finally, there 

are cattle and farm 

operations located 

several miles upstream 

from the testing sites. In 

addition, there is a large 

urban white tail deer 

population residing 

within the watershed. 

I decided to hike the 

creek bed and look for 

signs of pollution. I 

started my walk moving 

upstream from the 

testing sites. The sewer 

lift station greeted me 

with the overwhelming 

stench of sewer gas, but 

I could see no signs of 

sewage overflow into 

Photos by Lynn E. Yonge 

the creek. The densely wooded creek bottom upstream was 

unusually pristine for a suburban waterway. I saw significant signs 

of white tail deer and armadillo populations. I also saw far too 

many water moccasins. 

After several miles of hiking, I came to a junction in the creek 

where a smaller tributary emptied in to Fly Creek. The difference 

in the appearance of the two creek beds at their confluence was 

remarkable. The two photos taken from the same spot show a 

rust-colored waterway merging with a natural-colored stream 

bed. Something is wrong, but I don’t know if it is the source of 

fecal coliforms. It could be something as simple as clay staining 

from an accidental building-site run off. Something about the 

distribution of the color did not look like run off silt to me. I plan 

to ask local environmental experts what the obvious differences in 

the creek beds mean. 

This is the first of a series about citizen stewardship for the 

environment. In future issues, I will tell you what the locals think 

and other steps taken to find the source of pollution. I also hope 

to eventually identify steps taken to correct the contamination of 

Fly Creek. 


19

SoCiEtY MAttErS 

28tH ANNuAL MEEtiNG ANd 

SuMMEr CoNFErENCE 

Our Annual Meeting and Summer Conference in Snowmass this 

past July welcomed attendees with a Meet and Greet Reception 

while a swinging jazz trio helped to put us in the mood for 

lively evening. This meeting served up clear blue skies, fresh 

mountain air and an exciting array of speakers, workshops and 

plenary sessions. A full to overflowing preconference workshop 

on Wilderness, Disaster and Humanitarian Response was so well 

received that we’ll be offering it again next summer in Whistler at 

our 6th World Congress on Wilderness Medicine. 

Several new and important changes were made during the July 

25th Board of Directors meeting: Dr. Jay Lemery, President-Elect 

was named Treasurer and the new Meeting Committee Chair. Dr. 

Brad Bennett was named Secretary and Director of the Academy 

of Wilderness Medicine. Dr. Loren Greenway is now the 

Associate Director of the Academy. Drs. Marion McDevitt and 

Greg Stiller were appointed to the Board. Ali Arastu was named 

our new Student Representative. 

A well attended Fellow Reception 

and Convocation saw 60 new 

inductees into the Academy of 

Wilderness Medicine, making a 

total of 214 WMS Members who 

are Fellows in the Academy. View 

a full list of Fellows at wms.org/ 

fawm/fellows.aspx! Dr. Loren Greenway was awarded the first 

Master Fellow honor, paving the way for future Master Fellows. 

His topic of study was Dive and Hyperbaric Medicine. 

We rounded out our conference with the Awards Ceremony 

(see next column) and Banquet. Charley Shimanski, Senior Vice 

President, Disaster Services, American Red Cross, delivered his 

timely presentation Calm AFTER the Storm – Stories of Post- 

Disaster Search, Rescue and Response. 

2011 WMS Recognition AWARdS 

The WMS Awards Committee, chaired by Dr. Ken Zafren, 

bestowed the following 2011 Recognition Awards. 

Paul S. Auerbach Award: Eric L. Johnson, MD, FAWM 

Founders Award: Robert Norris, MD 

Education Award: Elizabeth Edelstein, MD, FAWM 

Research Award: Scott McIntosh, MD, FAWM 

Warren D. Bowman Award: Gordon Worley, RN, CFRN, 

EMT-P, FAWM 

Dian Simpkins Service Award: Reuben “Hill” McBrayer, 

MD, FAWM 

Eric L. Johnson, MD, FAWM Elizabeth Edelstein, MD, FAWM Gordon Worley, RN, CFRN, 

EMT-P, FAWM 

Wilderness & environmental medicine JouRnAl 

Recognition AWARdS 

For their outstanding contributions and commitment to the 

Journal, Editor-in-Chief Scott McIntosh and Associate Editors 

Tracy Cushing and Linda Keyes presented the following 

awards to: 

Outstanding Contributor: James Wilkerson, III, MD 

Outstanding Peer Reviewers: Howard Backer, MD, FAWM; 

Colin Grissom, MD, FAWM; Scott A. Weinstein, PhD, MD 

The Master’s Fellow Degree Program in contrast to the Fellow’s Program, 

which is a broad based or “Baccalaureate” program, is an educational offering 

focusing candidates on a specific area of study or “Master-level” program. 

Like most advanced degrees, the Master Fellow is a self-education study and 

requires an advisor to assist the candidate by providing insight and direction as 

the candidate works through his/her Master’s Fellow Degree Program. 

See more 2011 Snowmass 

Conference photos at 

wms.org/conferences/gallery 



elSevieR excellence AWARdS 

Wilderness & Environmental Medicine publisher, Elsevier, Inc., 

presented special awards to recognize outstanding members of 

the wilderness medicine community. The recipients were given a 

Nook Reader’s Tablet, preloaded with eBook contents of Paul S. 

Auerbach’s Wilderness Medicine, 5e and Medicine for the Outdoors, 

along with a variety of core emergency medicine eBook titles. 

Elsevier associates Kevin Lawrence and Helena Mutak were on 

hand to present the awards. 

Elsevier Excellence in 

Wilderness Medicine Award 

This award recognized Carol 

Denise Edwards, USAF Auxiliary- 

CAP, FAWM, for her exceptional 

commitment, energy and focus to 

saving lives, while acting as a guide 

and mentor to those around her. 

Wem PHoto conteSt WinneRS 

The WEM Photo Contest winners are announced below. In our 

Silent Auction during the Annual Meeting Banquet in Snowmass, 

all four photos were purchased and then donated back to the 

Society by Dr. Barry Kaplowitz of Miami, Florida. The proceeds 

from Barry’s generosity will go to the International Relief Grant. 

The 1st Place photo, River Clouds, by Dr. Conard will be on 

the cover of Wilderness & Environmental Medicine, Volume 22, 

Number 4 (December 2011). The other winning photos will be 

in the Wilderness Images section of that issue. Be sure to check 

them out. 

Elsevier Excellence in 

Education Awards 

This award recognized Ali 

Arastu, Justin Grisham, 

Susan Linney and Nathaniel Oz, 

outstanding students in wilderness 

medicine. 

HuMAnitARiAn Aid ReSeARcH gRAnt 

The first Humanitarian Aid Research Grant was awarded to 

Dr. Christopher Van Tilburg during the Banquet and Awards 

Ceremony at the Annual Meeting in Snowmass. Dr. Van 

Tilburg’s proposal was titled “Difficulty in Disaster Relief, Lessons 

from Haiti.” 

1st Place: River Clouds by Jon Conard, MD 

2nd Place: 

Color on the Boardwalk by Cory Fielding 

3rd Place: 

Maroon Bells by Jon Conard, MD 

4th Place: 

Mykines Island by Cory Fielding 


Meet tHe MeMbeRS 

Mike Cardwell has always been 

fascinated by creatures that others 

find terrifying. Although he spent 32 

years in law enforcement with the San 

Bernardino County (California). Sheriff’s 

Department, he also pursued the study of 

venomous animals, eventually becoming 

a recognized authority on rattlesnakes 

and their bites. He joined the WMS 

in 1985. After “getting to do all the fun 

stuff” like narcotics, homicide, SWAT, search & rescue, and 

counterterrorism, he retired as Chief of Specialized Operations in 

2004 and turned to biology full-time. He soon completed a fouryear 

radiotelemetry study of wild Mohave Rattlesnakes, a species 

well known for its highly toxic venom yet about which little was 

known of its natural history. Mike holds certifications as a NAUI 

Divemaster and NASAR SAR Tech-II and is co-editor of The 

Biology of Rattlesnakes (2008, Loma Linda University Press). He 

now lives in Sacramento with his wife, Denise, and is currently a 

graduate student at Cal State Sacramento where he continues his 

study of Mohave Rattlesnakes. 

Dr. William “Bill” Hoot is a radiologist 

from Ft. Worth, Texas. He attended 

medical school at the University of Texas 

Southwestern Medical School, and then 

completed his radiology training at 

Parkland Memorial Hospital in Dallas, 

Texas. He is a Fellow of the American 

College of Radiology, and earned his 

FAWM from the Wilderness Medical 

Society in 2010 – the only radiologist to 

date who has done so! Dr. Hoot enjoys wilderness photography, 

hiking, canoeing and fly-fishing (and currently holds the record 

for the largest rainbow trout ever caught in Texas!). He has been 

a scoutmaster for the Boy Scouts for the last 15 years, and it was 

during these trips into the backcountry that he developed an 

interest in wilderness medicine. A favorite wilderness destination 

has been canoeing and fishing the Boundary Waters and the 

connecting Quetico Provencial Park in Ontario, Canada. 

Dr. Gregory Stiller is an ED physician 

from Denver, Colorado. He completed 

medical school at SUNY Buffalo followed 

by a surgery internship at the University 

of Colorado and a residency in emergency 

medicine at SUNY Buffalo. Subsequently, 

he has completed three fellowships – in 

Ultrasound, Emergency Medical Services 

(EMS) and Wilderness Medicine. Dr. 

Stiller was also recently appointed to the 

Wilderness Medical Society Board of Directors. He was the 

assistant medical director of Erie County, New York, which 

provided medical direction to multiple EMS agencies. As the 

medical director of the Specialized Medical Assistance Response 

Team, Dr. Stiller was deployed to the World Trade Center on 

9/11/2001. Dr. Stiller is a wilderness medicine instructor and 

EMS educator, teaching locally, nationally and internationally. 

He enjoys many outdoor interests and is actively involved in 

mountain rescue through the Alpine Rescue Team. This fall he will 

be working as a physician for the Himalayan Rescue Association 

in Nepal. 

Ali Arastu is a medical student at the Keck 

School of Medicine at the University of 

Southern California, in Los Angeles. He is 

also the new student representative for the 

Wilderness Medical Society. His passion 

for wilderness medicine was born in the 

High Sierra range of California where he 

spent his summers backpacking, climbing 

and guiding as a mule packer for an 

eastern Sierra Pack Station. Following the 

completion of his undergraduate education at USC, he deferred 

entry into medical school for a year, and spent the time off from 

his studies hiking the entire 2,650 mile Pacific Crest Trail from 

Mexico to Canada and also spent a few months in the Himalayan 

region of Nepal, getting a taste of high altitude trekking and 

mountaineering. With a passion for scientific and recreational 

diving, Ali is also a member of the Catalina Island Hyperbaric 

Chamber crew, helping to treat diving injuries. After completing 

his education, he hopes to practice his wilderness medicine skills 

in the austere environments that draw us all to the WMS! 


23


SuMMEr/FALL 2011 CoMMittEE uPdAtES 

educAtion coMMittee 

Michael Caudell, MD, FAWM, Chair 

An important component of the mission of the WMS is to 

advance education related to wilderness medicine. The Education 

Committee continues to work diligently to accomplish this 

mission. Here’s how: 

Educational Products: Several fantastic resources have 

been developed and are available via the WMS Trading Post 

(www.wms.org/tradingpost/login.aspx). 

Teaching Simulations: These are case-based vignettes, 

designed to be implemented in the field to create a realistic 

and interactive learning experience. Each scenario presents 

a clinical problem and outlines the expected assessment, 

management and disposition pathway possibilities. Volume 

1 is available at the Trading Post; Volume 2 is in the midst of 

the editing process. 

Educational Presentation Series: This comprehensive 

PowerPoint series continues to do very well promoting 

wilderness medical education, serving as a teaching aid for 

medical professionals. 

Community Education Lecture Series: Promotion of 

wilderness medicine in the community is also one of the 

fundamental philosophies of the WMS. This PowerPoint 

series is intended to serve as a teaching aid for those reaching 

out to the nonmedical wilderness community. 

Student Education: We have the opportunity to have a 

significant impact on the future of wilderness medicine 

by encouraging student involvement and promoting their 

education. The educational products noted above are great 

tools to assist in this goal. We are continually striving to 

engage students and optimize their exposure to wilderness 

medicine. 

Outreach: We are looking forward to developing new and 

creative ways to accomplish this goal. One way is to establish 

a list of WMS members willing to serve as mentors for interest 

groups. Many members of the committee immediately 

volunteered to serve as mentors. You too can sign up! 

Student Elective: The annual WMS student elective 

continues to thrive. This month-long course, held in 

Tennessee, is scheduled for January 29 - February 24, 2012. 

Many committee members joined the effort to revise and 

update the syllabus for this fantastic course. Professionals 

with academic affiliations interested in volunteering as WMS 

faculty are welcome. 

Medical Student Standardized Curriculum: A Task Force 

has been established to develop guidelines for the curriculum 

of medical student elective rotations in wilderness and 

environmental medicine, with focus on: 

- WEM knowledge, skills, and attitudes (KSA model) 

- Must-should-can model for educational content 

- LCME/ACGME goals and objectives 

- Rigorous consensus methodology 

inteRnAtionAl coMMittee 

Chris Tedeschi, MD, FAWM, Chair 

The WMS International Committee continues to grow as WMS 

members combine their interests in wilderness medicine, global 

health and the ability to practice medicine virtually anywhere. 

This was best seen at the packed house during the Wilderness 

Medicine, Disaster and Humanitarian Relief pre-conference held 

this July during the WMS annual meeting in Snowmass. Over 

100 participants registered for the conference, which included 

didactic sessions and hands-on skills workshops geared to 

individuals responding to disasters and humanitarian emergencies 

both domestically and abroad. 

The committee was also happy to congratulate Dr. Christopher 

VanTilburg for his receipt of the first ever WMS Humanitarian 

Relief Grant, for his ongoing research and capacity building work 

in post-earthquake Haiti. The grant now enters its second year 

and will be open to projects worldwide. Application information 

is available at wms.org. 

A top priority for the committee in the coming year will be to 

find ways to introduce WMS members to clinical opportunities, 

research and teaching endeavors internationally. Our members 

represent a huge wealth of experience and specialized knowledge, 

and the goal will be to construct a strong network for sharing that 

experience. Stay tuned for new online resources and conference 

presentations geared to strengthening our international 

involvement. 

As always, the committee is looking for new members and new 

ideas. Our biggest resource is the enthusiasm, experience and 

insight of our members – and we can accomplish great things 

when we combine our strengths. Please send your questions, 

ideas and suggestions to Chris Tedeschi at ct2122@columbia.edu. 


ReSeARcH coMMittee 

Tom DeLoughery, MD, FACP, FAWM 

There continues to be strong interest in wilderness research. 

For the 2011 Park City meeting we had five excellent research 

posters and the Snowmass meeting with had five excellent oral 

presentations and eleven posters! Always rewarding to hear and 

read the good research people are doing. 

As always there were plenty of excellent submissions for the WMS 

Research Grants and the committee chose these winners: 

Hultgren Award 

Yeu-Shin Cindy Chang, Cleveland Clinic Lerner College 

of Medicine 

Long term follow up of community-based treatment for 

pediatric moderate acute malnutrition in rural Malawi 

Research-in-Training Awards 

Matthew D. Muller, PhD 

Postdoctoral Research Fellow, Penn State Heart 

& Vascular Institute 

Effect of Cold Air Breathing and Isometric Exercise on Left 

Ventricular Function 

Gwynn Curran-Sills, MD 

The morbidity and mortality associated with outdoor activity 

within Canadian National Parks 

Houston 

George W. Rodway PhD, APRN Award 

Effect of Sildenafil on Exercise Capacity in Older Adults at 

Moderate Altitude 

We look forward to hearing about the results of these important 

projects at future WMS meetings! 

Information about grant applications are at: 

wms.org/research/default.asp 

The deadline for next year’s grants is January 15, 2012. 

Research Committee Chairman: Thomas DeLoughery, MD FACP, FAWM; Research 

Committee Members: Aaron Billings, MD, FAWM; Colin Grissom, MD FAWM; Jay 

Gupta MD; Ben Levine, MD; Scott McIntosh, MD, FAWM; George Rodway, PhD, 

CRN, FAWM 

diPloMA in MountAin Medicine 

George W. Rodway, PhD, APRM, FAWM 

The WMS will be launching an exciting new program in 

association with the University of Utah and the University of 

Colorado – the Diploma in Mountain Medicine (DiMM). This 

program is designed to train participants in the essentials of 

mountain medicine and rescue in technical alpine environments. 

The diploma is ideal for doctors advising patients or accompanying 

groups traveling to high altitude areas, and for those who want to 

widen their pre-hospital care in mountain rescue. 

The international DiMM has set the standard over the past 10 years 

in Europe and other parts of the world for education of doctors, 

nurses and medics in mountain medicine and rescue. The DiMM is 

an internationally recognized course certifying that the participant 

has undergone rigorous training and testing. The WMS-backed 

US DiMM is currently under review for international approval 

by the medical commissions of the International Mountaineering 

and Climbing Federation, International Commission on Alpine 

Rescue, and the International Society of Mountain Medicine. 

Look for courses focused on the DiMM in the February 2012 

Park City conference and the summer International Congress on 

Wilderness Medicine in Whistler, BC. 

AttENtioN ALL MEMBErS! 

WMS Members On-Line Photo Library 

We have created an Image Library for WMS Members. 

After agreeing to a copyright and HIPPA statement, 

please upload and share your fabulous photos with 

other members! Images are categorized according to 

topic and should be very useful to members preparing 

presentations. Comments can also be attached to 

images. Our library is only as extensive as we build 

it so we encourage everyone to take some time to 

add their favorite photos to the library. Just sign onto 

www.wms.org then click the “Members” tab to check 

out the photos located in the Image Library. 

There are several more creative activities being 

considered or are in the early stages of development. I look 

forward to reporting their successful implementation! If 

you would like to get involved in any of the educational 

endeavors mentioned, or if you have other wilderness 

medicine educational interests or ideas, please email 

mcaudell@georgiahealth.edu. 


25

CLiFF NotES ALi ArAStu, StudENt rEPrESENtAtiVE 

KECK SCHooL oF MEdiCiNE, 

uNiVErSitY oF SoutHErN CALiForNiA 

I would like to first introduce myself as the new Student 

Representative for this fantastic organization that brings together 

those with a passion for both the wilderness and medicine. It is 

an honor and privilege and I look forward to representing and 

contributing the student voice. 

I write this note minutes after getting out of the kelp forest 

surrounding Catalina Island, my mind occupied with the possible 

marine envenomations and consequences of pressure changes 

that I learned about at the annual Snowmass WMS conference 

just a few weeks ago. For the students out there that happened 

to miss out on the conference, you must come next year for days 

full of amazing and inspirational people, fantastic lectures and 

workshops and an incredible wilderness begging to be explored. 

As we continue on with the year, there are several awesome events 

and conferences coming up. To kick it off, WMS is having a 

Desert Medicine Conference in Tucson, Arizona, from November 

3rd-7th. If you are interested in being a student volunteer, 

please contact me. On a separate note, medical students from 

Jefferson Medical College are hosting their own weekend 

conference. For more information, visit the website 

phillywildernessconference.org. 

For all the students out there, I’d love to meet you in person or 

through some channel of technology and talk about all things 

wilderness medicine. If you are interested in getting more 

involved with the Wilderness Medical Society, I hope you get 

in touch with me and we can discuss student committees and 

current projects that you can lead or be involved with. I also hope 

that all of the Student Interest Groups out there get in touch 

regarding past and future events. If you need help or ideas to start 

or revitalize the SIG at your school, let me know! You can reach 

me at wmsstudentrep@gmail.com. 

I am truly excited for the coming year of wilderness medicine and 

look forward to working with all of you fellow students. 


KiNdrEd SPiritS 

A dAN intern in Cayman 

Jenna Wiley 

The humidity enveloped my lungs as soon as I stepped off the 

plane. Adjusting from Northern California’s foggy weather to 

North Carolina’s summer heat was one thing, but the Caribbean 

would accelerate my acclimatization to a whole different level. At 

that moment though, I had more pressing thoughts on my mind. 

I landed in Grand Cayman as a member of Divers Alert Network’s 

(DAN’s) field research team, about to head to Cobalt Coast Resort 

to support a study of technical divers. Having just begun a research 

internship with DAN the previous week, my apprehension was a 

bit higher than preferable, not knowing exactly what to expect 

from a week-long research trip on a Caribbean island. 

I found out about the DAN research internship after reading an 

article in Alert Diver about marine envenomations and toxicology 

and stumbling across a description of the program online (http:// 

www.diversalertnetwork.org/research/projects/intern/index.asp). 

Interested in scuba diving as well as mountain search and rescue, 

I was happy to discover the partnership formed between DAN 

and Wilderness Medical Society. I immediately jumped at the 

opportunity to transition my interests into applicable research 

benefitting the safety of outdoor enthusiasts. 

Our goal in Grand Cayman was to study decompression stress 

in technical rebreather divers attaining depths often exceeding 

300 ft (91 m). Reaching such depths requires much vigilance 

on the part of the diver. Safety considerations include carrying 

bailout tanks with different gas mixtures and following defined 

decompression schedules upon ascent. All the while, the divers 

must keep a watchful eye on their equipment, staying mindful of 

oxygen toxicity and other potential physiological complications. 

As a diver descends, inhaled inert gas enters the lungs and 

disseminates throughout the blood stream, loading the diver’s 

tissues. Deeper dives and extended times at depth encourage 

additional gas loading into tissues until equilibrium with the 

increased ambient pressure is reached. Diminishing pressure 

during ascent forces the gas back into circulation where it is 

eventually exhaled through the lungs. If the ascent is too rapid, 

dissolved gas will come out of solution and form bubbles. The 

DAN team used portable ultrasound devices to scan the divers’ 

hearts once they surfaced, looking for bubbles circulating through 

the chambers. 


27


Relatively unfamiliar with cardiac ultrasound, my first visualization 

of bubbles was striking. I watched them stream through the 

right atrium and ventricle, particularly after subjects contracted 

muscles in their extremities. Bubbles are a manifestation of 

decompression stress but do not obligatorily cause symptoms 

of decompression sickness (DCS). DCS typically manifests in 

symptoms of numbness, tingling or pain in joints that usually 

result from bubbles accumulating locally in tissues. Bubbles travel 

from tissues to the right side of the heart where they are pumped 

to the lungs to be filtered. They may enter the left side of the heart 

via pulmonary shunts or by traveling through a patent foramen 

ovale (PFO), a variable-sized opening between the right and left 

atria present in about 25% of the adult population. Once present 

in the left side of the heart, bubbles will be pumped into systemic 

circulation leading to increased risk for serious, potentially 

paralyzing, DCS. 

In addition to bubbles forming from dissolved gas, air trapped 

in the lungs can expand too quickly from decreased pressure and 

rupture lung tissue, sending bubbles into systemic circulation. 

Arterial gas embolism (AGE) occurs if these bubbles become 

lodged in vessels and disrupt blood flow, particularly to the brain. 

Potential symptoms of AGE range from disorientation to blurry 

vision to lack of consciousness, even death. Decompression illness 

(DCI), the collective term for DCS and AGE, can occur even 

with conservative dive profiles and ascents. It is important to 

assess symptoms and seek recompression treatment if necessary. 

Bourgeoning interest in adventure vacations and exploring 

secluded dive sites leads divers far from shore. Coupled with the 

host of physiological stresses underwater, remoteness can create 

additional risk by limiting treatment options. Utilizing basic first 

response skills with an understanding of diving-related maladies 

can help alleviate the immediate emergency, but the injured 

diver may still require evacuation to the nearest hospital or 

hyperbaric chamber. Even while in Grand Cayman, a keen eye 

for indentifying irregular behavior and the ability to treat minor 

mishaps proved useful. 

My personal responsibilities as part of the research team in Cayman 

revolved around collecting data to help interpret the cardiac 

ultrasound scans. I documented detailed dive profile information 

to compare exposure risk to the transthoracic echocardiographic 

(TTE) data we obtained. Trained in phlebotomy, I also drew 

blood from the subjects to support a study being done by 

researchers from the University of Pennsylvania, comparing levels 

of microparticle fragments to the ultrasound data in search of 

decompression stress markers. This research has the potential to 

better determine specific physiological mechanisms of DCI. 

Keeping up with the data collection soon made me realize I would 

have to relish the opportunity for relaxation upon returning home 

and not whilst on a beautiful tropical island. When I was not 

preoccupied with venipuncture, observing ultrasound scans, 

recording TTE data, assisting with anthropometric measurements, 

or asking subjects to fill in daily health questionnaires, other 

conundrums often arose that needed resolution. This could require 

a phone call, a trip to a local clinic or brushing up on international 

shipping regulations. Thankfully, we also had opportunities to 

“inspect” the local underwater wildlife as well. No matter what 

the task, I learned the importance of flexibility and maintaining a 

level head throughout the entire experience. The continual activity 

taught me lessons I had not completely appreciated from reading 

about other scientific work in the field, and I am grateful to DAN 

for providing the opportunity to participate in such a study. 

I returned to DAN Headquarters in Durham, North Carolina 

after the week on Grand Cayman to continue my summer 

internship. With myriad projects occurring simultaneously, my 

time-management skills learned in Cayman continue to be tested 

as I delve further into the world of diving research. While keeping 

busy with helping to establish an Institutional Review Board, 

participating and assisting in various studies at the hyperbaric 

chambers at Duke University, reviewing scientific research papers, 

and refining my TTE skills to contribute to prospective studies, 

I cannot help but think towards the future. This experience at 

DAN has provided invaluable insights into ways I can incorporate 

my interests in dive and wilderness medicine into a profession. 

Jenna M. Wiley graduated from University of California, Santa Barbara with a B.S. in 

Biochemistry-Molecular Biology. She worked as a clinical lab scientist in San Francisco 

before becoming a research intern for DAN. 

28 WILDERNESS MEDICINE // Fall 2011


Bringing Wilderness 

Medicine to your 

Community: the 

Appalachian Center 

for Wilderness 

Medicine 

Brian Simon, RN 

In 2006, Dr. Seth Hawkins began work on a non-profit 

organization designed to promote quality wilderness medical 

care in southern Appalachia. In 2007 he formally incorporated 

the Appalachian Center for Wilderness Medicine (ACWM), and 

over the next half decade it has steadily grown in its capabilities 

to serve its community. It is a resource and nexus for individuals 

interested in wilderness medicine; a partner with other non-profit 

organizations, universities, training programs, and governmental 

agencies that operate in limited resource environments; a training 

center for services not otherwise available in the region; and a 

regional advocate for promoting excellence in wilderness medicine 

research, training and practice. 

The Center is a volunteer organization consisting of a Board of 

Directors and a Steering Committee, including individuals from 

all walks of life united in a common interest: to improve wilderness 

medicine within the region. The strength of the organization is 

in its participants and their desire to serve others and respond to 

needs within their community. 

ACWM offers many local opportunities to learn about wilderness 

medicine. One successful program that began in 2008 is the 

ACWM Southeast Student Wilderness Medicine Conference – the 

brainchild of ACWM Board members Dr. Henderson McGinnis 

and Dr. Stephanie Lareau. This conference, now entering its fifth 

year, has introduced the subject to almost a thousand medical 

students and wilderness enthusiasts in our region. Each spring, 

the Center partners with a different university to organize and 

present a variety of topics in wilderness medicine for this extremely 

inexpensive weekend conference. The host students gain valuable 

event planning and organizing skills and the community gains 

world-class wilderness medicine instruction. Classes presented 

have ranged from standard topics such as submersion injuries to 

regionally specific classes such as Southeastern Amphibians. 

Another initiative of the Center that has addressed a problem 

facing many communities across the country is the Regional 

Training portion of the ACWM website (www.appwildmed. 

org). Potential students often have trouble simply identifying 

what training is locally available. This non-partisan calendar lists 

all known wilderness medicine courses available within southern 

Appalachia and serves as a “one stop shop” for locals interested 

in beginning or continuing their education. ACWM offers a 

monthly bulletin that updates interested parties on regional 

wilderness medicine events. In rare cases ACWM will itself 

provide programs not otherwise offered in southern Appalachia, 

such as Advanced Wilderness Life Support, which was not 

routinely available in the region before ACWM established a 

course teaching this curriculum. 

ACWM has partnered with other non-profits to fulfill regional 

needs. One such collaboration, with the non-profit Friends of 

Seneca, will result in the replacement of prepositioned first aid 

caches at the popular and historic Seneca Rocks. These first aid 

kits are at key locations high on the rock and allow climbers to 

address immediate first aid needs prior to evacuation of injured 

patients from this multi-pitch landmark of Tuscarora quartzite. 

A second partnership, this time with the New River Alliance of 

Climbers (NRAC) in Fayetteville, WV, sprang from the need 

to address wilderness medicine education within the climbing 

community of the Southeast. The results of this effort included 

offering climber first aid clinics at NRAC’s annual fundraiser, The 

New River Rendezvous, and collaboration with local climbers and 

the National Park Service to plan search and rescue response to 

climbing injuries in the New River Gorge National River. 

These are a few of the activities ACWM has undertaken to promote 

quality medical care in the backcountry of southern Appalachia. 

Approaching its fifth anniversary, the group remains dedicated 

to continued innovative and needs-oriented regional service, in 

order to ultimately accomplish its popular tagline: “Disrupting 

Natural Selection in Southern Appalachia.” 

R. Bryan Simon, RN, FAWM, of Fayetteville, WV, is a former US Army infantry officer 

and Army Ranger, and currently serves as the Board Chair of the Appalachian Center for 

Wilderness Medicine (ACWM). He works along with his wife, Deb, as a traveling nurse 

and spends as much time as possible climbing and traveling abroad. 

For more information on the Appalachian Center 

for Wilderness Medicine, check out the website 

www.appwildmed.org, send an email to executive 

director Seth Hawkins at info@appwildmed. 

org, read their essay on wilderness medicine 

regionalization www.appwildmed.org/documents/ 

regionalWildernessMedicinefinal.pdf in the journal 

Wilderness & Environmental Medicine, or “like” them 

on Facebook. 


29

Revie 

three Cups of deceit: 

How Greg Mortenson, Humanitarian 

Hero, Lost His Way 

By John Krakauer 

I recently mentioned an upcoming trip 

to Asia to a colleague and he exclaimed, 

“Oh, have you read Three Cups of Tea?” 

I asked if he knew about the controversy 

surrounding the book and was relieved that 

he (and hopefully others) did not catch 

the excoriation of Greg Mortenson by a 

disenchanted Jon Krakauer in Three Cups of 

Deceit, a commentary first posted in digital 

form (for free) by Byliner Inc., in mid-April 

of this year, now available as a Kindle Single and paperback. 60 

Minutes gleefully cracked the story on April 17th, the day before 

the Krakauer piece, and it snowballed from there. 

According to Three Cups of Tea, after an aborted attempt on K2 

in 1993, Mortenson, separated from his climbing partners, had 

a chance meeting with villagers at the foot of the Karakorum 

mountains and an epiphany after which he founded the nonprofit 

Central Asia Institute (www.ikat.org) in 1996. The mission of 

the CAI is to build schools and promote peace with a focus on 

educating girls, especially in terrorist strongholds. The story, 

told in Three Cups of Tea was published in 2006 by Mortenson 

and David Oliver Relin and was an explosive hit, remaining 

on the New York Times’ bestseller list for four years. Stones into 

Schools: Promoting Peace with Books, Not Bombs, in Afghanistan 

and Pakistan, further tales authored by Mortenson, came out in 

2009. 60 Minutes and Krakauer (a former donor to CAI) accused 

Mortenson of lying about certain details in the two books and 

misusing the millions of dollars he has raised for the organization 

from sales of the books, speaking engagements and other sources. 

Among other misdeeds, they claimed he didn’t build as many 

schools as he professed and that they were in relatively safe areas, 

not those at risk of being commandeered by the Taliban. 

Fully expected to be swayed by Krakauer 

as his writing is so compelling, I instead 

found him customarily acerbic (and 

especially grouchy) and felt unconvinced 

and sort of sorry for Mortenson. With 

perhaps naive optimism, I believe that he 

is fundamentally a good person doing good 

deeds in an increasingly menacing world. 

He may come off to some as a shameless 

promoter (see www.gregmortenson.com), 

but how many people with such a high 

profile besides perhaps the Dalai Lama 

and Mother Teresa (when she was alive) 

don’t? Maybe Mortenson’s defenders and 

supporters are just more susceptible to 

hopeful stories than the vitriolic anger that Krakauer projects. I 

admit I am one of them. What I found much more eloquent and 

persuasive and didn’t read until after I had finished Three Cups 

of Deceit (and formed an opinion) was a rebuttal to Krakauer 

and defense of Mortenson by Scott Darsney, who climbed with 

Mortenson on the K2 trip. 

www.outsideonline.com/outdoor-adventure/media/books/Scott- 

Darsney-Questions-the-Accuracy-and-Fairness-of--Three-Cupsof-Deceit-.html 

The controversy still swirls. Lawsuits have been filed, awards 

withdrawn. Legions of articles and commentaries have been 

written. The major furor seems to have abated, although Outside 

Magazine continues the discourse in print and online. The bottom 

line is that more than 170 schools have been built with the support 

of the CAI and of brave people in small villages formerly cowed 

by bullies. Mortenson underwent open-heart surgery in early June 

and has not granted interviews or given lectures since then. 

Reviewed by Nancy Pietroski 

Telford, Pennsylvania, USA 


November 4-5, 2011 

Sun Valley, Idaho 

w 

FEATURING: 

Welcome to the Dark Side 

Steve Berry, NREMT-P 

What’s New in Wilderness Medicine & 

New Protocols for Field Management of Frost Bite 

Eric Johnson, MD, FAWM 

Avalanche Rescue Case Reviews 

Paul Davison, EMT-P 

Pain Management in the Wilderness 

Casey Turner, MD 

Mountain Tales 

Lou Whittaker 

Over 70 sessions of small, hands-on workshops including: 

OB & Neonate Trauma Sim 

Creative Splinting 

10 Essential Systems of Survival 

Dislocation Management 

Litter Obstacle Course 

Multiple System Trauma Sim 

Pediatric Head Injury 

Pelvic & Femur Fracture Sim 

Spinal Cord Injuries 

Pediatric Burns 

and so much more! 

Online Registration Available: August 1 

www.ski-mtn-trauma.com 

Facebook: Saint Alphonsus Ski & Mountain Trauma Conference 

ski.mtn.trauma@gmail.com 


31

SaVE 

The 

dAtES 

“At the base of a 3100 ft vertical drop, you’ll 

find an extraordinary place to land.” 

- Park City’s town slogan 

UpCoMING WMS CoNFERENCES 

FEB 

4-8 

2012 

WILDERNESS & MOUNTAIN MEDICINE 

CONFERENCE 

THE CANYONS, PARK CITY, UTAH 

CMEs IN THE ULTIMATE WINTER 

PLAYGROUND 

Join us in February for the WMS Winter 

Conference and experience the Greatest Snow 

on Earth! Leading the world-wide community 

in wilderness medicine, the 2012 WMS Winter Conference will 

provide the most advanced information in the fields of avalanche, 

cold injuries, high altitude illnesses and much more. Evening 

speakers and faculty represent a who’s who in the wilderness 

medicine community. 

The WMS will launch an exciting new program in association 

with the University of Utah and the University of Colorado – 

the Diploma in Mountain Medicine (DiMM), designed to train 

participants in the essentials of mountain medicine and rescue 

in technical alpine environments. The International Diploma in 

Mountain Medicine has set the standard over the past 10 years 

in Europe and other parts of the world for education of doctors, 

nurses and medics in mountain medicine and rescue. 

Whether you are a family practitioner advising patients, an 

accomplished expedition doctor working on your Fellowship 

in wilderness medicine, or just beginning to gain an interest in 

wilderness medicine, the WMS Winter Wilderness & Mountain 

Medicine Conference provides an exceptional opportunity for 

you to sharpen your knowledge and skills and form new and 

lasting friendships. Register online now wms.org/conferences. 

No ExCUSES! 

There’s Still Time to Register for the Everest CME 

Experience—South Side, Solo-Khumbu, Nepal, April- 

May 2012 

WMS and Peak Promotions are partnering to provide an extreme 

adventure CME course on Everest for WMS members only. Treks 

to Everest Base Camp will include two nights at Base Camp, an 

opportunity to work with the medical staff at Everest ER; and 

optional opportunities to climb through the Khumbu icefall, go 

to Base Camps 2, 3, 4 and experience a summit bid. Schedule and 

registration online now at wms.org/conferences. 

NoV 

3-7 

2012 

APr 

may 

2012 

JuLY 

13-17 

2012 

Desert Medicine Conference, plus 

Wilderness EMS Medical Directors 

Certification Course 

The Westin Resort & Spa, 

Tucson, Arizona 

WMS Everest CME Experience 

South Side Solo-Khumbu, Nepal 

World Congress on 


The Westin Resort & Spa and The 

Hilton Resort & Spa, Whistler, 

BC, Canada 

To view all activities for WMS Affiliates, see Affiliate Events 

at wms.org/conferences/calendar. Note: all items are listed as 

a community service and are not necessarily CME/FAWM 

approved. To determine if an activity is eligible for FAWM credits, 

please see eligible activities at hwms.org/fawm/eligible.asp. Visit 

wms.org/conferences/calendar.asp for direct links. 


Continuing 

Medical Education 

and Volunteering 

in Haiti.* 

Join Us — January 21-28, 2012 

*Earn up to 26.5 Category 1 CME Hours 

MEDICAL STUDENT MISSIONS 

501(c)3 non-profit organization 

Join us — www.medicalstudentmissions.org 

Write us — 109 East 89th Ave., Merrillville, IN 46410 

Call us — 219.765.3008 

Based in Haiti at the Centre de Formation Lévêque, Verrettes, the MSM program includes lodging, 

meals, 26.5 CME credits. This activity has been planned and implemented in accordance with the 

Essential Areas and policies of the Accreditation Council for Continuing Education through the joint 

sponsorship of The Wilderness Medical Society and Medical Student Missions, Inc. 

Students and professionals will work aside a world-renown faculty in travel medicine and global 

health, including, but not limited to the following: 

Christopher Van Tilburg, MD,: Program Chairman, is Editor-in-Chief, Wilderness Medicine, author of nine books, Past 

Board Member of Wilderness Medical Society, and active member of Mountain Rescue Association. 

David Shlim, MD, is director of Jackson Hole Travel and Tropical Medicine, Editor of The CDC Yellow Book and 

President Elect, International Society of Travel Medicine (www.istm.org) 

Col. Alan J. Magill, MD, is Program Manager at Defense Advanced Projects Research Agency, Associate Professor of 

Medicine & Preventive Medicine & Biometrics at Uniformed Services University and Editor, The CDC Yellow Book. He is 

Past President of the International Society of Travel Medicine (www.istm.org) 

William W. Forgey, MD is founder of Medical Student Missions, Board Member of the International Association for 

Medical Assistance to Travelers (www.iamat.org) , and Past President of Wilderness Medical Society 

Dirk Vermeyen specialist in the role of leaf doctors and voodoo in local health care. 

The all-inclusive cost is $1,950, which includes transportation within Haiti, room, board and CME. 

The program will take place from January 21 to January 28, 2012. Visit the website for specifics on 

the CME topics and for a comprehensive list of what is included in the program, as well as 

accommodation information — www. medicalstudentmissions.org. 

Medical Student Missions, Inc, is a 501(c)3 non-profit organization. All proceeds from this program support our mission to provide Learning 

through service opportunities for our volunteers to work alongside their Haitian counterparts in rural community health clinics. 


33

BoArd oF dirECtorS 

2011 - 2012 WMS BoARD 

oF DIRECToRS 

ExECUTIvE BoARD 

Arthur (Tony) Islas, MD, FAWM, 

President 

Jay Lemery, MD, FAWM, 

President-Elect, Treasurer, Conference Chair 

Colin Grissom, MD, FAWM, 

Past President 

Brad Bennett, PhD, FAWM, 

Secretary, Director of the Academy of 


Loren Greenway, PhD, MFAWM, CEO, 

Associate Director of the Academy of 


MEMBERS AT-LARGE 

Ali Arastu, Student Representative 

Aaron R. Billin, MD, FAWM 

Tracy Cushing, MD, FAWM 

Lance Ferguson, MD, FAWM 

Marion McDevitt, DO, FAWM 

Scott E. McIntosh, MD, FAWM 

Chris McStay, MD, FAWM 

George W. Rodway, ARNP, PhD, FAWM 

Sara Squyers, PA-C, MPAS, FAWM 

Robert H. Quinn, MD, FAWM 

Greg Stiller, MD, FAWM 

CoMMITTEES 

Academy of Wilderness Medicine Director 

Brad L. Bennett, PhD, WEMT, FAWM 

Awards Committee Chair 

Ken Zafren, MD, FAWM 

Continuing Medical Education Chair 

Hill McBrayer, MD, FAWM 

Conference Committee Chair 

Jay Lemery, MD, FAWM 

Education Committee Chair 

Michael Caudell, MD, FAWM 

Finance and Audit 

Jay Lemery, MD, FAWM 

Disaster Medicine Committee Chair 

Joy Crook, MD 

Environmental Council Chair 

Lynn Yonge, MD, FAWM 

International Medicine Committee Chair 

Chris Tedeschi, MD, FAWM 

Membership Committee Chair 

Aaron Billin, MD, FAWM 

Nominations Committee Chair 

Colin Grissom, MD, FAWM 

Publications Chair 

Edward (Mel) Otten, MD, FAWM 

Research Council Chair 

Thomas Deloughery, MD, FAWM 

Student Services Chair 

Ali Arastu, MS3 

Web Development Chair 

Jim Ingwersen 

ADMINISTRATIvE oFFICE 

Loren Greenway, PhD, FAWM, CEO 

Loren@wms.org 

Teri Howell, Administrative Director 

Teri@wms.org 

Wilderness Medical Society 

2150 South 1300 East, Suite 500 

Salt Lake City, UT 84106 

Email: wms@wms.org 

Tel: 801-990-2988 

Fax: 801-990-2987 

Jim Ingwersen, IT Director 

Email: jim@wms.org 

Tel: 719-492-2200 

Jonna Barry, Managing Editor 

Email: jonna@wms.org 

Tel: 719-330-7523 

Certify in Wilderness Medicine 

• Learn treatments for the most common wilderness injuries and illnesses 

• Manage live scenarios while earning CME and FAWM credits 

• Available to all medical professionals (PA’s, MD’s, DO’s, RN’s, PN’s, EMT’s and Paramedics) 

2011 AWLS Certification Courses 

New River Gorge, West Virginia / Abisko, Sweden / Queenstown, New Zealand 

Boulder, Colorado / Mount Hood, Oregon / Fort Worth, Texas 

Houston, Texas / Moab, Utah / Zion Park, Utah 

REGISTER NOW 

Visit www.awls.org or call 1-866-830-3394 


Expand your 

MEdical Horizons 

WILDERNESS MEDICINE INSTITUTE OF NOLS 

oFFErinGs For 2012 

skiing in the Tetons, id 

NOLS Teton Valley 

February 26-March 4, 2012 

Difficulty-Challenging 

sailing in British columbia, canada 

NOLS Pacific Northwest 

June 9-16, 2012 

Difficulty-Easy 

Backpacking in the Wind river range, Wy 

NOLS Rocky Mountain 

August 26-September 2, 2012 

Difficulty-Moderate 

Backpacking in the Galiuro Wilderness, az 

NOLS Southwest 

Fall 2012 dates TBA 

Difficulty-Moderate 

ExpEdiTions 

For MEdical proFEssionals 

Earn cMEs WiTH nols 

NOLS Wilderness Medicine Expeditions offer an unparalleled opportunity for physicians, nurses and EMTs who want to 

learn practical, hands-on wilderness medicine and decision-making in a true wilderness environment. Whether your 

passion is backpacking or sailing, deserts or mountains, we have an expedition for you. As you travel, you’ll apply your 

medical skills in case studies and scenarios with a focus on relevant environmental topics. For 45 years NOLS has 

helped people explore the world, join us! 

lEarn MorE 

Visit www.nols.edu/wildmedexpeditions for the full details on our courses or contact wmi@nols.edu 

or 866-831-9001 for more information. 

Brad Christensen/NOLS 


35

CoMBiNiNG Your ProFESSioN 

WitH Your PASSioN 

THE WILDERNESS MEDICAL SOCIETY’S 

2012 CME CONFERENCES 

ExCitiNG dEStiNAtioNS For LEArNiNG, 

EArNiNG CMES, ANd outdoor AdVENturES 

dESErt MEdiCiNE CoNFErENCE 

The Westin La Paloma Resort & Spa 

Tucson, Arizona 

November 3 – 7, 2011 

WiLdErNESS & MouNtAiN 

MEdiCiNE CoNFErENCE 

The Canyons Resort 

Park City, Utah 

February 4 - 8, 2012 

tHE 2012 EVErESt ExPEriENCE 

Khumbu Valley-Everest 

Nepal 

April and May 2012 

tHE 6tH WorLd CoNGrESS oN 

WiLdErNESS MEdiCiNE 

The Westin Resort and Hilton Resort 

Whistler, BC, Canada 

July 13 - July 17, 2012 

WMS.orG/conferences or call 

801.990.2988 for up-to-date info 

Namibia Sand Dune © Cyril Mazansky

Volume 28, Number 4 - Wilderness Medical Society

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