Desert RATS is my first US multi-stage race and it is already winding down. You might think that Colorado and Utah would be less spectacular than some of my more exotic sounding travels, but this is not the case at all. The scenery of the Southwest is so varied but consistently vast, and majestic, and grand. Sprawling, green cattle ranches abut steep, red sandstone cliffs which sharply transition into rolling alpine. The heat permeates the air in waves and the breeze doesn’t cool down until well after sunset. This is the desert, and it is awesome.
  
Stage 1
The staging of the race occurs at the Gonzo Inn in Moab, Utah. This is a funky motel in the heart of this funky town. Race check-in goes smoothly. I am used to the routine by now: check runner’s pre-race medical clearance forms, race and medical briefings with runners, staff meeting, try to get to bed early to bank some sleep before the long race week.
I sleep really well in the plush hotel bed, and it’s a blur of activity in the morning as racers and gear are loaded up and driven far into the desert. The field is small at this race – only 16 runners. After rushing to the start, we then rush off to our respective checkpoints. It’s ungodly hot at the random corner of nowhere where the checkpoint is set. A surprising amount of work goes into setting up. There is a large tent to try and erect, and then stake down. There is a table to open up and find a place in the shade for. There are numerous plastic jugs of water to slide out of the tailgate of the car. Then for the grand finale there are at least two tupperwares of food, sunscreen, bug spray, hand sanitizer, and cutting boards to organize out on the table.  And finally the camp chairs to also find a place for in the shade.  Anyway, we had an hour or so to sit in our desert palace before the first runner breezed in. The leader seemed to make the heat and distance inconsequential. We started getting radio calls that folks were lost out on the trail. So resources were mobilized to try and find them. Except for the lead runner, most everyone else was hot and miserable. Participants trickled in throughout the day, and finally our sweep (volunteer who folllows the last runner on the course) on his fat tire bike rolled into our checkpoint. All runners had been herded through at this point, and it was time to start breaking apart this monstrosity of a coddle-station, oops I meant aid-station.

  
 Our first camp was just a square of desert in a sandy parking lot. But lots of effort had been placed into making it feel like a home away from home – large shade tents had been erected with camp chairs strewn about, there was a camp kitchen set up, and hot food was waiting. I set up my brand new tent for the first time. And after a brief comedy of errors, I had a quaint little shelter. I had settled on the Sierra Designs Flash 2 after obsessive gear hunting, and have been thrilled with it. My peaceful sleep was interrupted with the patter of drops on my rain fly. The natural lullaby soon turned into a torrential downpour complete with wind gusts and flashes of lightning. The thunder got more intense until I was nearly startled out of my sleeping bag when the the sound reverberated through the canyon almost simultaneously with a blinding crack of light. Eventually the storm subsided and I was left with both wonder and a little fear. And I was also left questioning why the hell I didn’t get out of my tent and into my car. I figured it would be a pretty big faux pas (and incredibly ironic) if the wilderness medicine fellow died of a lightning strike while on a wilderness medicine trip. Interestingly enough, I read part of the text book chapter on lightning the next day at the checkpoint, and I found out that I am a believer of a good portion of the myths that exist regarding this interesting natural phenomenon. Apparently lightning is not actually attracted by metal objects. And you are safe in the car not because of the “grounding” effect from the tires but actually because of the Faraday cage created by the car’s metal external structure. It was an eye opening chapter. And also humbling to realize that I was in the majority in terms of people that have absolutely no true understanding of lightning or the injuries that it could potentially cause.  

Stage 2
So day 2 started bright and early. We rode out in tandem to another aid station out in the middle of nowhere. We had absolutely no radio contact or cell phone service all day – communication black-out. Which is really goooooooood for races where you need to know how racers are doing medically and in the case of possible evacuation. Some racer decided not to go on and slumped down under a tree, so we had to drive out in the desert to get her.  Thankfully this runner ended up being totally fine medically.  Everyone was once again pretty hot and miserable when they came through the checkpoint but there was a lot of determination to finish. Not a single racer dropped out at my station.  After we were down to one racer still out on the course, I went for a walk with Reid, the race director. It was nice to at least stretch my legs and see a part of the course. What the runners have been experiencing is certainly beautiful but also hotter than Hades. It was finally time to get back to camp and set up my little tent. By the way, my rental Chevy Impala ended up being an off-road beast! But seriously, it could get anywhere that those little subaru station wagons could….  You can see it looking strong in the picture below of our aid station.

  
Stage 3
Today was a good day for the runners. It was a much shorter distance and everyone seemed to be in good spirits. It is amazing how quickly people start to acclimate to the excessive heat. I noticed the same thing at races both in Cambodia and in Sri Lanka. Day 3 always seems to be when people start to actually race rather than just try and get through the suffer-fest. It was joyful to witness the runners cross the finish line with big, goofy grins.  Once people are past the finish line, I think it is really important as a race physician to kind of always be watching from a distance. This may sound like I’m bordering on creepy stalker territory but it truly is an important tool to truly assess how folks are doing. If no one knows that you’re watching, they tend to exude the actual degree of their suffering – not the degree that they want everyone to believe (or pity them for). I have seen so many individuals really suffering, but then put on a brave face when I put a hand on their shoulder and check in with how they are feeling. On the flip side, I also see racers wandering around, doing quite well handling their own business, who just crumple when I enquire about their well-being. It’s just like the ER though – sometimes you have to watch someone while hidden in the doorway before you really get a handle about what’s going on.  
Our camp was really neat after this stage! We were right on the Colorado river, and were able to take an icy cold dip after everyone was safely into camp. The water was so cold that I literally had a hard time getting a full breath in after fully submerging myself. A few staff members along with one of the racer’s husband a racer went for a hike up along one of the many ridge lines. We were rewarded with amazing views as well as a renewed empathy for the heat that the runners were experiencing each day. 

   
 
Stage 4

“Expedition stage” aka ultra day. It ended up being a 19 hour day in total, with about 14 hours spent at the aid station. One of the first things that we noticed as we were getting the aid station set up was the fact that there were cows all over the place. They must have been free range the majority of their lives as they were extremely startled to see us. I guess it was a little extra company though throughout the day. Due to the lengthy nature of the day, I ended up taking several walks. Most of the time it was just wandering 15 minutes down one of the dirt roads, and then meandering back. I tried to go for a little run as well. Partly to offset at least a portion of John Graham’s amazing camp cooking, but also because I had to get the ants out of my pants. As mentioned previously, one of the runner’s has her husband, Peter, here with her. Peter was an awesome support crew – it is really wonderful to see that level of support for your spouse. Plus, he is just a ton of fun and incredibly generous. When he would show up at our aid station, we would be treated to good music, cold cokes, and hilarious stories.  
  
It was an incredibly long day for the runners. I was worried about how people would fare in the heat. With the serious race medical issue, hyponatremia, sometimes you have to worry about the slower runners. These individuals are out on the course much longer than other participants meaning that their water consumption is likely going to be much greater. However, it is thought that with their overall slower pace, these runners may be consuming too much water for their level of exertion. I also worried that the heat in general would prove to be a major obstacle to those trying to conquer this long stage. I was pleasantly surprised with not only the degree of health of most of those passing through, but even more so by the racers’ spirits. Everyone was determined to finish and somehow also happy to be out on the course. What amazing mental fortitude is possessed by distance runners….

We drove back into camp well after dark, but there was hot cocoa and grilled cheeses waiting for us! One of the runners, Gene, offered out a little tutelage regarding some of the constellations, and I learned a lot about the universe in general. The milky way was visible this far out in the desert! I am not a touchy-feely kind of gal, but it was really emotional to watch almost all of the runners stay up to cheer everyone in. You would see this tiny head lamp from far away, and the cheering and cow-belling would start. What a wonderful accomplishment! I actually got goosebumps when a group of 3 women skipped across the finish line after a trying day together. 

View from camp:

  
Stage 5 (Rest!)
Today was a designated rest day for the runners. We were supposed to have a late start but unfortunately it was way too hot to sleep in. My tent felt like a sauna when I finally stretched and opened my ways. A lazy morning ended in an insanely awesome camp brunch. Bacon and breakfast quesadillas and salsa-poached eggs, oh my! I went on a happy little hike with my fellow race doc, Kai,  and one of the racers to a set of tiny waterfalls. I can’t even describe how cold the water was. Maybe this picture will do it some justice:
  
Most of the Desert RATS entourage spent the afternoon at the river. There was a tent set up where racers could get massages and we also had a mini food and beverage tent. It was pretty relaxing (and awesome) to just wade around in the river. We were shuttled back to camp where we had our last camp dinner.  There was a slideshow put together by the racer director’s brother after dark. There was a lot of laughter and joking while the pictures flashed up before us. It was good to see there finally be some camaraderie between this group. I am so excited to go to bed. Last night out in the desert! Tomorrow we return to civilization in all of our smelly glory!!!
Stage 6 (Finally)
Last day – whoop whoop. We had absolutely incredible views from our checkpoint this morning. What do you think – not a bad view from my office….
  
I was really touched today by one of the racer’s determination. This is a woman who has been extremely fit and gifted in racing her whole life. As she has gotten older, you can feel her frustration at not being able to compete at the level that she used to. On this particular day, she not only took a fall out on the course but also got lost as well. She was nearing the cut-off time for this stage, but refused to give up. She passed the cut-off time for this stage, but refused to give up. I went out on the course to check on her, and she was all blazing will and tears of frustration but still with a steady gait. I let her finish her own race, and made sure to meet her at the (already torn down) finish line. I hope that 30 years more now, I have half of that level of fitness or determination.

I drove my dusty rental car back into Moab, and checked back into the Gonzo Inn. The shower and subsequent air conditioning felt incredible. I don’t think you can truly appreciate how good a shower feels until you have spent 6 days sweating in the dust and heat with numerous applications of sunscreen and bug spray. The obligatory racers’ “banquet” was soon followed by drinks at a “dive bar” (funny, where I’m from, most dive bars don’t have a cover charge…), but then it was finally the moment I had been waiting for – Bed Time! Another race trip completed. More sunburns sustained and more friends made. Stay tuned for my next adventure!