I recently got back from a backpacking trip outside of Roanoke, Virginia.  There is a really neat month-long elective held each year in association with the Wilderness Medical Society for medical students, residents, PA students, and other medical personnel.  It was held in Tennessee last year, and I got invited to come down and lecture. The students have a field practicum at the completion of their month that is basically a 3 night backpacking trip with a smattering of wilderness medicine scenarios thrown in.  I was set up to go last year but the camp where they were staying at ended up getting evacuated due to an ice storm and other inclement weather.  So I was pretty excited when I got asked to be a mentor for the trip this year, especially since I have never been to the area in Virginia where the elective was moved to.

I actually got all of my gear together 2 days ahead of time so that I could do the necessary scouring and purging.  I luckily have a ton of backpacker food – I binge-bought it from REI when they were having a big sale because I always need it for the races I travel to and work at.  I recently bought a new backpack which is almost 2 pounds lighter than my previous pack and a bigger capacity.  And I got a cute little JetBoil stove recently that I have yet to try out other than firing it up in my apartment.  So I’m doing what you’re not supposed to do – trying out numerous pieces of new gear on an actual trip where I’m kind of in charge of other people’s safety.  But that’s wilderness medicine right??? Going out there and just figuring it out.  And it worked out pretty well during my fellowship year for me so what’s the worst that could happen….

Spoiler alert: There were no gear mishaps.  Just rain.  And cold.  And mist.  And more rain.  And real world medical scenarios instead of the cheesy hypothetical situations that I was supposed to present to my students.

But I’m getting ahead of myself.  The trip up to Virginia was beautiful!

I met my group of students that first evening so that we could go over the plans for the weekend.  This trip is kind of their final exam for the course, so they were expected to have picked an appropriate route for their team’s experience, planned out their meals, and prepared a first aid kit to bring along.  My group of 6 students had 2 girls who had never been backpacking before.  Which is great!  I love introducing people to the awesomeness that is backpacking, aka having an agenda that includes nothing but hiking all day and eating all day, and then getting to sleep in a cozy sleeping bag outside.  That being said, I was a little concerned that some of the daily mileages were a little ambitious for folks without much experience.  It’s hard to know how much guidance to give, and how much leeway to give the students to just figure out things on their own.  But I figured as long as we were safe, and everyone was okay with coming into camp in the dark possibly, then onward we would go.

It was about 40 degrees the next morning when I awoke at 0’dark thirty and crammed the last few items into my pack.  Our route had us shuttling a lot of cars and while I was waiting to be picked up, I peaked at the weather app on my phone and saw a big nasty goober of rain and possible convective activity heading our way.  The first portion of our trip had us walking up a steep and muddy trail to a ridge line where we would be exposed to the elements until we made it to our shelter.  When we all got together, we had a little group pow wow and the (wise) decision was made to amend our route so that a. We weren’t going to be in an area without any possible shelter when the bad weather rolled in, and b. Our group wouldn’t roll into camp at dark.  I was actually pretty pleased that the group was able to take into account the new information, and adjust the plans accordingly.

And after another hour or so, we were finally on the trail.  I introduced the group to “rolling lead” as we hiked so that we would all stay together and be able to keep an eye on the newbies.  It was slow going uphill with lots of breaks for snacks, but that’s okay, that’s how I usually roll anyway.  It started raining on our slow climb up to McAfee’s Knob.  It’s apparently supposed to be a really beautiful view but all we got was fog and mist.  Still pretty cool looking:

  
After bagels and beef jerky, we continued to head towards our home for the night – Campbell’s Shelter.  We were sooooo fortunate to have a shelter for this evening (complete with a little porch!) because the rain continued throughout the day and evening.  Everyone’s attitudes were great as we set up a tarp, sleeping spots, and outdoor kitchen.  It was such a luxury to not have to set up tents in the rain.  There is no way to not get everything soaked in that scenario and I feel like our morale may have suffered a bit in that situation.  One of our students even managed to get a fire started with wet wood and leaves – I was so impressed.  I will never again underestimate the power of Vaseline soaked cotton balls for their stellar fire starting abilities.  There was a nearby stream to get water from, and the students got to experience the underwhelming taste of iodine or bleach treated water.  My JetBoil worked great, and my foil pouch of food was amazing!  If you haven’t experienced ramen noodles or other highly processed salty food while backpacking, you have no idea just how mind-blowing such simple concoctions can be.  The fog continued to roll in and the woods were super spooky:

One of the girls in our group ended up cutting her finger while trying to cut the bark off of some wet wood.  I think the students must have been inundated all month with pop-up pretend medical scenarios because it took several tries of her saying “Real world guys” before anyone finally took a look at her finger.  Her platypus for carrying water was the perfect device for irrigating the wound, and they had wisely put superglue in their medical kit.  Wilderness medicine at its finest!

I slept like a baby in my down cocoon and morning brought more mist and rain.  Our plan was to backtrack on the Appalachian Trail the way we came, and to either stay at another shelter or set up tents off trail if the rain let up.  As we were packing everything up, I noticed that one our group members didn’t eat any breakfast.  He said he was a little queasy but wanted to press on.  We started hiking and our march was interrupted by a Wilderness Medicine version of hide and seek.  The group got a little far ahead and spread out, so a few of us quick ran off into the brush to hide.  Time to practice some modest search and rescue techniques.  After a lot of whistle blowing and an impromptu game of sardines, everyone was back together, and cursing me for their “learning opportunity.”  A little further down the trail, I noticed that our queasy kiddo went from pale to green to gray.  Not the progression that I was hoping to see.  He wasn’t able to eat or drink anything and I really didn’t like the way he looked.  So our crew was confronted with the real world scenario of how do you decide when to evacuate.  It’s a tough decision.  We weren’t far from civilization so it’s always tempting to keep pushing forward.  But when you have someone hiking with a heavy pack in cold & wet weather and they look a little worse each mile, it’s time to get out.  An unanimous decision was made to walk out to the cars so that our “patient” could get warmed up, get some rest, and hopefully be able to keep down some fluids at least.

We all made it back to the lodge safely.  With everyone promising to keep an eye on our sick group member, I headed back to the little instructor’s cabin.

The next morning brought more rain but thankfully no more nausea or dry heaves.  We all wanted to try and salvage the trip so the decision was made to make a day hike to Dragon’s Tooth.  Despite the soggy weather, it was a really fun hike.  There were some more technical sections of the trail which involved scrambling on the slippery rock.  We once again had absolutely no view of the surrounding countryside, but that did not detract from the trip at all.  I would love to come back to this area again when there is actually decent weather to see what I was missing though.

  

Pizza bagels and s’mores over the lodge fireplace made for a pretty excellent finale to our abbreviated backpacking trip.  I really liked the group of students that I spent a few days with, and I wish them all well.  Most of the kids were 4th year medical students so in just a few weeks it will be match day and they will find out where they will spend the incredibly tough and stressful years of residency.  I hope to see them on some future wilderness medicine adventures.  As for me, it took me an extra day to get home to Orlando because of the terrible weather in the Southeast.  Apparently a tornado touched down about 60 miles away from us.  Yikes.  But no one died on my watch, and hopefully a few people were inspired to continue to live part of their lives in the great outdoors.