Artistic Footprint

I haven’t been a patroller for very long, nor have I seen incidents of severe trauma on any significant scale. But here’s what I’ve learned from what I have experienced so far:

First and foremost, I don’t need a paycheque to motivate me to help people. I applied for this job because I enjoy being in the shit. The constant state of readiness, the jump-to as the radio goes, the booking it up a mountain on a sled. It’s a rush. I like the challenge of assessing and diagnosing and… well to put it plainly, “not killing your patient.”  But the barebones of it is that people come up here and spend a lot of money to ride. I want them to keep coming back and earning a love of the sport.

The first thing I can say about it is that training, the years of simple to more complex courses, the practice, the protocols, the scenarios, the extrications… It all goes out the window when I get to a call. Which of course is why the training is so important.  When I learn, the information just sits atop my skull, slowly seeping into my brain like a water into a sponge until it’s something that comes natural to me. And that way, when I arrive at my patient, I don’t have to think about what to do, I just do it. (try to) it may not always be the right thing to do, but it’s better than nothing at all. I’ve been to a few calls where I somehow did follow every procedure I learned in course, but I don’t remember doing it. That is what I define as good training.

I would consider assessing a patient to be like drawing a flow chart in my head. You ask questions, get some answers and go down a road, crossing off the things that stop you, and making note of the things that are important. “Is he breathing ok?” “how far did she fall?” “How is this person reacting?”

But I guess most importantly, I’ve only spent like 4 weeks in training how to “save lives” but really, I am only capable of sustaining life until a real paramedic gets there. The trick for me, is stimulating self-repair. The human body is actually a pretty stupid fucking thing sometimes. For example anaphylaxis, or an allergic reaction, is the body “killing itself trying to protect itself” It opens up all your veins to dump blood into your tissues and swells around your trachea… eventhough things like peanuts aren’t damaging it at all. Or shock – the body reacting to a frightening or traumatic event. Like if you were to fall on your ribcage (may or may not have happened to me) your intercostal muscles tense up, effectively “spinting” the damaged bones. Little would your body know that it was “splinting” your ability to breathe. Not necessarily the most strategic plan when trying to keep yourself alive, but is also an explanation for why spinal patients can get up and walk around, and wind up a paraplegic the next day, because their muscles splinted their affected vertebrates.

So I think that the most important, and most influential intervention happens in the first 10 seconds of a call. The first thing I try to do is speak in a confident, upbeat, and often comical voice, even if I’m shitting myself. Because as soon as the patient sees that red jacket and someone who is competent (or at least is pretending to be,) Immediately they go from deterioration to improvement. The dread, worry, and pain levels drop just because you’re there.

The next thing I do is I usually give them a white lie. Another thing that stimulates self-repair and helps them relax. I downplay their injury, tell them I’ve seen worse or that it’s not as bad as it feels. I remember getting to one call at the bottom of the bunny hill where a foreign girl had just fallen on her ski. She said that her leg felt “wet” and that she just needed a bandaid. “Pretty easy call” I thought. But I remember asking her if her pants were normally red, which they weren’t. I rolled up her pant-leg seeing more and more blood until I reached her knee, which, to be honest, was a shocking and horrifying sight (it was my first, alright??) What happened is that her knee was bent, her skin taught when she landed on the edge of her ski, which split the flesh like ripping a tent. The subcutaneous fatty tissue was cauliflowering outwards. But I didn’t flinch. That’s how I knew I could handle blood and gore. I didn’t look away or make a gross face. I remember my head went towards her knee to get a closer look, and my hands immediately when to cover the 4″ gash that went as deep as it could go. Her surrounding friends immediately put hand-over eyes and gasped and “oh-my-god-ed” And thats when I knew that the first thing I should do is cover the wound and to tell her that she can not look at her knee. For all she knew, it was just a little cut. The skin was cut so cleanly that only a few nerves were severed. Hell she went for another run before calling me! But had she been able to see the damage that had been done, her reaction would have been far more sobering and far less humble.

That’s the other interesting thing about the body. How the Nervous Systems interacts with the body and each other. The Sympathetic Nervous system is an automatic system that works with your heart, stomach, bowels, and gland secretions. In Traumatic events, such as confronting a giant bear, or accidentally finding yourself in a knife-fight, your body is stimulated by this nerve in something coined as “fight or flight” – as in get the fuck out of there (although of course we all know not to run from a bear) or stab that dude first before he stabs you. The Parasympathetic Nerve system is the exact opposite. It’s the one that stimulates the secretion of dopeamine and the craving of grabbing a beer after a long day of work. The “Feed or Breed” system. What’s most interesting is what happens when you get an owie. When that happens, your homeostasis, the harmonious “ecosystem” that is your body, is threatened. Your blood pressure will go up or down as your arteries and veins contract or relax, and you’ll feel the effects of things like endorphins or adrenaline. When you snap your tib-fib (lower leg bones) and you can’t handle the pain, your sympathetic nervous system may shock the neighbouring Vegus nerve which causes you to vomit or piss yourself, which indirectly helps you relax (I mean come on we all feel better after we puke or after dancing to the bathroom). At the same time, if you’ve broken a limb and you’re helpless, hours away from any form of help, the endocrine system in your body has the ability to turn pain off as a survival tactic by flooding the spinal cord with endorphins. People have been known to shatter their lower limbs and yet crawl, days away to safety and not scream in agony until the moment rescue arrives.

I was first on scene to a woman who had been smacked in the side by a reckless tuber, snapping her humerus. Not so… Humerous for her…  Not a significant injury, she still had blood flow to her hand (most of the time, if she would have just relaxed a bit). But she was just howling in pain. A very low pain tolerance which made the call a lot longer, louder, and more emotional than it needed to be. We made the call of entonox (laughing gas) and for an ambulance to meet us at the top. It literally took about 2 hours to get her from the bottom of the tube park and into the patrol hut, still howling away in my ear beneath the entonox inhaler (which of course she wasn’t getting any of because she was hyperventilating)… probably scaring people in the parking lot. One thing I noticed is that when the paramedics arrived, regardless of how caring and patient they were with her and her obsessive teary screams, I instinctively watched over their every move in a protective way. Something about being with her for so long, and eventhough it was only a limb-at-risk, part of my treatment seemed to fall on the fact that outside forces could hurt her more – including the paramedics. (which of course was not the case at all, they were far more professional than I was)

Overall I’m not going to lie. I get paid in bad weather and have been known to pray to promethius for fire and Ullr for snow. I would love it if every day people came up here and royally messed themselves up and kept me busy and happy. So if you are reading this and are not a close friend or family member of mine, ie a valued reader of this website, please come up and throw yourself off cliffs so that your graciously donated corpse can be my specimen. I will try my best to keep you alive. For everyone else, wear a fucking helmet.