Wilderness Doctor

A few years ago, Dr. Will Smith was finishing his shift in the emergency room at St. John’s Medical Center in Jackson, Wyoming, when he got an urgent call. Seventeen climbers were injured by lightning in nearby Grand Teton National Park. The incident occurred as the climbers neared the 4,200 meter (13,770 foot) summit of Grand Teton, the park’s tallest mountain. One climber was already dead—a lightning bolt threw him off the mountain. The others were badly burned. And seven of them couldn’t walk.

Smith sprang into action: It was up to him to organize a rescue effort and get the survivors medical care. In addition to working full-time at the hospital, Smith is the medical director for the National Park Service. Smith, plus park rangers and emergency medical services (EMS) providers, reached the injured climbers by helicopter. Rescuers strapped each climber into a harness attached to a 46 m (150 ft)-long rope. They were then airlifted off the mountain and rushed via ambulance to the hospital. It was the most complicated rescue in the park’s history, says Smith, but the 16 rescued climbers survived.

Each year, more than 300 million people visit the U.S.’s 59 national parks. Smith helps establish guidelines for the parks’ EMS providers to follow. He recently spoke with Science World about how he works to save parkgoers’ lives when accidents occur.

There are many ways that park visitors can get into trouble. Sometimes, people get too close to a moose or bison for a photo. They end up getting attacked and injured. People also get hurt while hiking, biking, and backcountry skiing. The weather in the Tetons can change quickly. When that happens, people can get hurt and stranded, such as when the sudden thunderstorm injured the climbers on Grand Teton.

I grew up on a 22,000-acre cattle ranch in Wyoming. If one of the animals was injured or ill, I helped it get better. I thought I’d like doing the same for people. My senior year of high school, a teacher encouraged me to take an emergency medical technician (EMT) class to learn more about anatomy and physiology. I liked it so much I earned my EMT certificate while in high school.

In college, I majored in biology and premed—a track toward becoming a medical student. After I graduated, I worked as a paramedic. Paramedics are similar to EMTs but have more training and skills. Being a paramedic really helped me learn even more about treating patients before they get to a hospital. Eventually, I went to medical school and then completed my residency, or postgraduate training, in emergency medicine.

While finishing my residency, I joined the U.S. Army Reserve. I have been deployed to combat zones in Iraq and Kuwait. Those experiences prepared me for the job I have now. Taking care of people injured in combat is often similar to taking care of patients in wild, remote places. You have to act quickly, you often don’t have the tools you’d have at a hospital, and you face dangers that affect how you care for patients.

I’ve adapted some of what I learned in the military treating combat injuries to a nonmilitary setting. For example, tourniquets can be real lifesavers. These devices, which you wrap around an injured limb and tighten to stop people from bleeding to death, can make a huge difference for patients when you’re far from a hospital. Tourniquets don’t weigh a lot, so they’re easily portable, making them great tools for wilderness medicine.

The first rule in this type of situation is: Don’t freak out. Knowing what to do will help you stay calm. There’s no substitute for being prepared. So get trained in wilderness survival. It can give you confidence if there’s an emergency.

Also, don’t go into the wilderness alone. Traveling with others ensures someone can help you if there’s an accident. And when you head out into a park, always tell someone where you’re going and when you’ll be back. That way, they’ll know when and where to look for you if something happens.

I like that I get to use my medical knowledge to help people in challenging situations. For example, a couple of years ago, a man went into cardiac arrest on a backcountry ski trip. His heart suddenly stopped beating, and his wife called 911. Typically, if you suffer cardiac arrest in the wilderness, help doesn’t arrive fast enough. But we got there just in the nick of time and gave him an electric shock that restarted his heart. That was a career highlight for me. Being able to save a life in difficult circumstances keeps me passionate about what I do.