March 2024, around 430 am, Taos NM.
The car heater hadn’t caught up with the pre-dawn chill of the Sangre de Cristo Mountains as I headed out for one of my clinical rotations in nursing school. Exhausted, I ran through my daily list of what papers needed to be written, what clinical reports had to be submitted, and what needed to get done for the different classes I was managing at our school. Nursing school in your 50s is no joke, but I was committed to getting my RN license, even with the many sacrifices it took to finish.
We had relocated from Texas to the northern New Mexico mountains, and I juggled my full-time work with Herbal Medics with an overly full nursing schedule, counting down days, assignments, tests….
Always tired, I feel like I was barely above water. Yet, I still had the same desire to learn as much as I could about medicine so I could apply it to a less-than-ideal setting.
Spring of 2017.
“What do you do when there is no higher care?”
It was the last day of the austere medicine course that Sam taught with Steve Pehrson, an emergency medicine doctor who defined that answer. I was part of an eager cohort that learned how to make activated charcoal in the field and the lists of drugs to address infections. We learned field suturing techniques, what a gunshot wound looked like or a broken leg … a crushed windpipe and the first steps to take.
At that point, I had already been looking at remote medicine trainings, helping behind the scenes when Sam taught the Wilderness First Aid/Responder courses, and wanting to know more. Then Sam created the Austere Medicine program with Steve. I was hooked.
Standing in a group of equally excited peers, I found that I wanted to know everything. Instead of being overwhelmed, I was more curious than ever. It was that day that I made the decision to go to nursing school to learn as much as possible.
Nursing is a whole new kind of tired.
So I went! Somehow I made it through while still working full-time for our school, teaching classes on weekends and some evenings. I started my Fellowship in the Academy of Wilderness Medicine, I joined a local search & rescue unit, began teaching Stop The Bleed classes, Wilderness First Aid certifications and still that question of what to do when we don’t have all the tools, don’t have enough resources continues to fascinate me.
Sam and Steve teach several intensive online remote medicine courses each year, and those are the deep dive into answering that question both with herbal medicine, emergency field medicine techniques and good planning/decision making. Every two years, students join us for ten days of even more intensive hands-on teaching in person.
I never imagined nearly a decade ago that I would be teaching austere nursing for helping in a situation when it could be days or weeks before a person could be retrieved, and how to maintain care of them during that time … the time after the medics need to step away to help someone else.
Pushing myself into unchartered territory to learn unconventional approaches to the worst-case scenario led me into and beyond nursing school and into the world of ‘wilderness’, austere or remote medicine. Its a liberating choice that completely changed my confidence level.
In 2 weeks, Sam and Steve start up the next fall session of Austere Medicine Acute Care. Anyone can jump in, and anyone can learn, just like I did, what to do if there is no higher care.
Austere Medicine Acute Care Course, starts online Sept 14th
Wilderness Herbal First Aid Course, on-site in Redlands CA, Oct 10-12th