Wilderness First Responder
7am on May 12th, instead of waking up on a train that was on its way to Raton, NM as I had done in previous years, I was loading up Teddy’s Honda Civic. Well, he was the one playing Tetris with my footlocker and pack and fretting over how to keep his TV from getting smashed. I just stood there amazed at how packed his car already was and that he could fit my luggage in there too. This was my first time driving to Philmont and the option of fitting “just one more thing” was dangerous because I knew I wouldn’t have to drag all my stuff through two train stations by myself. But I had curbed that temptation pretty well and everything managed to fit.
I had met Teddy the previous summer at Philmont. I had never really made more than casual-in-passing friends with backcountry people before so when I first met him I didn’t think anything of it. But I kept running into him all over the place. I finally got fates hint and befriended him. We had kept in touch over the offseason and when we found out that we were both taking the Wilderness First Responder course at Philmont, he offered to pick me up on the way there. He had accepted an internship that started right after his Philmont contract ended so he was planning on just moving there right after Philmont. This is why his car was extra full complete with a TV. Now that my things were added to his already full car, it was time to endure the endlessness of Kansas.
Kansas is indeed the most boring state to drive through. Once you go beyond the 50 most eastern miles of the state, it is as flat as they say. Yes, flatter than a pancake. The grain silo towns every 20 miles look exactly the same. Several grain silos on the right with two train tracks next to them, roads to the left that veer off at a slight angle from the highway with a church, a bank, a school, and a Dollar General in view from the highway. If it weren’t for the fact that these towns had different names, I would have thought we were just driving in circles...somehow. The roads are pin-straight so geometrically that wouldn’t have worked. Probably the most interesting thing we saw was a motorcycle brigade that went on for a good half mile. Basically, it’s a good thing we had Spotify and managed to find interesting enough topics to talk about for most of the 10-hour car ride.
We arrived in Raton, NM in the early afternoon. The time zone change had granted us an extra hour in the day so it felt like we had the whole day still ahead of us. Teddy was planning on dropping a lot of his belongings off in a storage locker and had found the only locker place in Raton that was open on Saturdays. At least that’s what the website said. We sat at the gate trying to get in for at least 10 minutes with no luck. The office was inside the gate and they weren’t answering either of the phones listed on the website. He finally gave up and we drove the final 45 minutes to Philmont.
The Wilderness First Responder Course (WFR) was being held at the Philmont Training Center (PTC) across the street from base camp. All of the students were being housed there for the week before the tents on camping headquarters (CHQ) side were set up. Conveniently, it was close to the classroom. We were able to spend the rest of the day setting up our living areas in our oh-so-spacious tents. It was an exciting day because I got to see old friends from past years as they showed up. Less convenient, we had to take the 15-minute walk all the way over to CHQ for meal times because the PTC kitchen was closed. I spent the evening with a group of people including Teddy and his tentmate, Jon. We talked about the coming week and summer. Someone shared a rumor that we would have to read 100 pages of the textbook a day for this WFR class. I laughed nervously. That couldn’t be true. Right?
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The first day was mainly powerpoint lectures. And 60 pages of textbook reading at the end of the day. It was also Mothers Day, which meant I got to skype my family and my brother Kallen, who was on a mission. Teddy let me use his laptop to skype after dinner. By the time it was all set up and working, it was nearly 7pm. I was sitting in front of the classroom at a picnic table and a few of my friends were sitting nearby doing their reading. I tried to enjoy the time talking to my family and brother, who I hadn’t seen in nearly a year, but I started getting antsy after half an hour. I kept looking over at everyone else getting their reading done knowing I was falling behind by the minute. After an hour, I couldn’t stand it anymore. I apologized for being so distracted and explained my predicament before hanging up. I went over to the other table to join everyone else but one by one, they all were finishing up and going to bed. Soon, I was left alone with more than half the reading left to do. I was tired and angry but plowed through the reading as fast as I could.
There were a few more powerpoints the second day of class but before I knew it, we were thrown into roleplay situations to test the knowledge and skills we had learned. We practiced simple diagnosis most of the day. Everyone had been split up into three groups the first day and each group took turns being the responders and patients. When it was my turn to be the patient, Tom took my group out and painted bruises on us and gave us a scenario of what happened and what the responders were supposed to find in their exams. Overall, the day was fun and not too overwhelming until our homework was assigned. 100 pages of reading.
After dinner, my group of friends, Teddy, Jon, and Heather went to the Baldy Pavillion where we tried to read. One of our mutual friends, Melanie, had just arrived to start her job so she joined us and read her own novel. Occasionally, someone would look up and comment on something they had just read and then we’d all start talking and get off track for awhile. We all found out the Jon can read at an unhumanly speed so he was done after a couple of hours. Teddy wasn’t far behind him. Heather and I just accepted the fact that there was no way we were going to finish the assignment. My brain had turned to mush and trying to cram all that information into my head in one sitting wasn’t possible.
Day three was even more hands-on because we got to spend a bit of time practicing splinting techniques. Heather and I, along with another girl, Arizona, were in a group together having a grand ol’ time splinting each other's arms and legs. The best part of the day was only 40 pages of reading. It was also the last day of reading which came as such a relief. There was other homework assigned which involved reading scenarios, giving a diagnosis, and creating a treatment plan.
The days began to blend together and I felt like I was living and breathing WFR. As exhausting as it was, I was really enjoying it. One day was focused on wound cleaning and irrigation. Fun fact: pigs have skin that is closest to human skin. So what did we use to practice wound cleaning? Pigs feet. Everyone was split up into teams of two and given a pigs foot with a slice in it. The wound was packed full of dirt, pebbles, and grass. It was fascinating to use tweezers to gently pick out the big stuff, and use a syringe to flood the rest out.
The first big simulation was set out that day as well. When we came back from lunch, the divider the middle the room had been closed--something none of us had seen up to that point. Three groups were formed and assigned various roles. The first group was taken out of the room to be patients, another was assigned to be operators on a phone, and the last were the first responders. The operators and responders were paired to work together. The catch was, the responder could only describe what they saw going on with the patient while the operator gave instruction on how to treat the patient. I was a responder and Heather was my operator. We were told that there were a bunch of patients on an airplane and we were being sent in to treat them.
The “airplane” was set up on the other side of the divider. The responders were instructed to treat the first person they came to. I was near the front of the pack so I went to a guy who looked like a complete mess with food down the front of his shirt and completely oblivious to the chaos around him. The room was loud with patients yelling and a sound recording of airplane noises. I later found out that there were also strong smells but I had them tuned out. I began talking to my patient. He gave me a glazed over smile but anything he tried to say was incoherent. I called Heather and began explaining the situation and she started giving me instructions of what to do. The more I began to inspect him, the more he began to become aware of me and his surroundings. I tried to take his blood pressure but the cuff seemed to be broken and he kept trying to take it off. He started becoming interested in my medical bag and wanting to play with its contents. Other than his mental status, everything seemed fine. Heather was stumped for awhile but then began realizing he was intoxicated and there really wasn’t much left for me to do. At this point, he was trying to grab my phone so I let him take it and talk to Heather as I packed my things up. All the other patients seemed to be attended to so I spent the rest of the time keeping him entertained and out of the way of the other situations.
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| Stage blood left on the road. |
The next simulation I was an assistant. This time we were given a pile of tools we could use including stretchers. We could use anything in the pile but we had to take it with us and couldn’t come back to get anything. My partner and I grabbed a few things and waited with the rest of the people. We weren’t told what had happened and had to find the scene which was somewhere outside. It was found quickly by the sound of frantic screaming down the road. The first patient my partner and I came across had two broken legs, a large pool of blood around her, and she appeared unconscious and not breathing--surprisingly good acting on the girls part. Frantically, we discussed what to do and without thinking began CPR. One of our instructors came by and stopped us asking what our plan was. It didn’t take long for us to realize that this girl was probably too far gone and even if she didn’t have open wounds, CPR wasn’t going to help. He advised we move along so we hung our heads and walked closer to where more patients were. A car looked like it had crashed into a tree and several other patients lay in critical condition nearby. A few other people were loudly trying to interrupt, a vlogger was trying to get in on the action. We went to a group of people surrounding a patient who were about to put him on a stretcher.
As a break from simulations, we had other hands-on activities like creating carrying mechanisms out of various materials. Most of the ones I rode in were uncomfortable and/or scary. We also had an activity in which we had to work in teams to move an unconscious person with potential spinal injury from tricky places while still giving as much spinal support as possible. Smaller, short sims involved individual scenarios like dehydration, anaphylaxis, and collapsed lung. FYI, epinephrine does not help a collapsed lung. That was a fun one to act out.
The second to last day there were big two sims back to back. After the group of people chosen to be actors left, the rest of us were split up into two groups. From there, we were each assigned to a sim and once we were done, we were to switch to the other one. The first sim I was assigned to was a camping scene where the group got struck by lightning. It was quickly apparent that no one could hear, assumedly due to the lightning strike. This made the triage and evaluation process a new kind of complicated because we had to assess and treat a group of people who were hurt, scared, and couldn’t communicate normally. It really made me stop to ask myself what questions were most important to ask the patients. The second sim involved a group of people trapped in a storm in a flooding a river who were clearly suffering from hypothermia. This was a little harder to imagine because, in reality, it was a very warm, sunny day. But the people acting out the scenario did a fairly convincing job of being cold anyway.
After those two situations, I was pretty exhausted. The group of responders and actors I was with all gathered in the nursery building which had been our treatment area for our hypothermic patients. Siri and Tom, who had been the instructors overseeing our group, sat us all down on the colorful carpet for a debrief. After they lead us through a review of the situations we had just gone through, Siri gave us a speech that hit most of us pretty hard. “Tomorrow is the last day of this course. You’ll be doing one final simulation and then that’s it. It won’t be pretend anymore. People’s lives will actually depend on you. Those people will be expecting you to know what to do. Are you ready for that?” The weight of that reality sat hard on my chest. I choked on the lump in my throat and willed the tears stinging my eyes to stop. A few may have fallen anyway.
In the morning, the written test was administered. I wasn’t super worried about it. I’d taken a practice test and felt fairly confident. It was the final sim I was nervous and excited for. I was curious if I’d be picked to be an actor for it though because I hadn’t been chosen to be one in any of the other big sims. Sure enough, after everyone was done with the written test, the actors were announced and I was one of them. I was secretly relieved but also felt a little guilty that I was basically getting out of the hardest sim.
While the group was prepped and given assignments for what was coming, the people chosen to be the actors were taken outside and prepped as well. We were told that we were going to be driving out to the stockade and acting out the aftermath of a vicious bear attack. A few people were asked to go back in and say that too many people had been taken to be actors but were supposed to end up with problems once they got out to the scene so the team had to deal with patients within the crew. The rest of us were invited to go grab anything we thought we would need for the rest of the day and then drive together to the stockade immediately.
Once we arrived at the stockade, the possible roles were announced. I quickly volunteered to be the patient who had taken the brunt of the mauling from the bear. I sure was excited to be covered in a whole package of stage blood. Gratefully, a box of trashed clothing to choose from was provided so I didn’t ruin my staff uniform. After choosing a shirt and a pair of shorts, I went to one of the small rooms in the stockade wall to change. Once everyone had a role to play, we were each placed in position in and around the stockade. I was taken a little way down a path and told to lie behind a bear box that was sitting under a tree. Once a “go” was given, I was to squeeze the bag of stage blood which was attached to a tube taped to my arm. If the bag ran out, I would be “dead.”
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| Post-bear attack. |
As I lay there, I heard the commotion begin as the responders arrived. I was determined to run the bag out before anyone found me but the triage team was well put together and I was found right away. The guy who found me quickly began putting a tourniquet on my arm. In the realness of the moment, he took no thought in how tight he was putting it on. Although I tried to stay in character, the pain of the tourniquet snapped me out of it and I told him to loosen it a little. Thankfully, one of the teachers walked past right then and confirmed that it didn’t need to be on tight. I went back to my best in-shock, lowered level of consciousness impersonation and let the rest of the evaluation happen around me.
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| There was no way to wash up before lunch so I used a plastic bag to cover my hands. |
As fake as the scenario was, in some ways, it started becoming real for me. I really did feel my consciousness slipping just a little bit and the minutes began to blur together. Eventually, a stretcher was brought and I was loaded onto it and taken to the treatment area. People came and went as they tended to me and others while I lay there, nearly falling asleep. Finally, time was called and the scene halted. Everyone gathered back inside the stockade for lunch before we headed back to the classroom.
Back at our classroom, we had a debrief over the simulation and the whole week. Then our certificates of completion, certification cards, and a few other goodies were handed out. All while I was still covered in fake blood. But I was elated to have accomplished so much in the past 8 days.
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