Higher education - Albuquerque Journal

Higher education

Jason Williams, left, director of UNM’s International Mountain Medicine Center, and IMMC faculty member Dr. Dane Abruzzo ride in a helicopter during a Diploma in Mountain Medicine winter training session several years ago. (Courtesy IMMC)

Copyright © 2022 Albuquerque Journal

Winds were blowing 30 to 40 mph in the mountains above Silverton, Colorado. The temperature was 15 degrees on the thermometer, but you don’t want to think about what the windchill factor had to say about it.

Oh yeah. It was also snowing as if the clouds had a quota to meet.

You couldn’t ask for more perfect conditions. Not if you’re teaching a course in mountain rescue and medicine, as paramedic Trevor Mayschak was in Silverton last month.

“I actually like it when we get adverse weather during a course,” said Mayschak, 31, a faculty member with the University of New Mexico’s International Mountain Medicine Center. “I say those are our full-value days. Getting to practice these techniques in real-world situations is a really good training opportunity. We probably got 3 feet of snow over two days.”

Into the storm

Mayschak is talking about Feb. 22 and 23, the final two days of IMMC’s winter session in its Diploma in Mountain Medicine course, a program designed to train medical professionals in advanced mountain medical skills.

Nine people – two paramedics, a nurse, a physician’s assistant, four emergency physicians and an orthopedic surgeon – were enrolled in the winter session, which entails nine days in the field.

The first six days in the Sandia Mountains featured alpine rescue instruction, such as how to get someone out of a crevice; teaching on proper medical care in an alpine environment; and helicopter rescue training with the Bernalillo County Sheriff’s Office and the Bernalillo County Fire Department.

“We work on setting up a landing zone and communicating with a helicopter,” Mayschak said. “We practiced getting in and out of a helicopter, which included a short haul. A helicopter picks up students and moves them at the end of a 150-foot rope linked to a harness.” It’s a short ride but plenty high enough.

Then the class shifted to Ouray, Colorado, about an hour’s drive north of Silverton, for a day’s work in vertical ice climbing. After that, the class moved to Silverton and into the storm.

“The storm started during the avalanche rescue portion of our training,” Mayschak said. “But the bulk of the storm happened on our final day, a large-scale rescue scenario. We had four simulated patients – two mannequins buried in snow and two live people acting as patients.”

UNM Diploma in Mountain Medicine students prepare a “patient” for evacuation while training in a snowstorm in Silverton, Colorado, in February. (Courtesy Trevor Mayschak)

Students and instructors maneuvered through the snow and the wind to complete the exercise.

Challenging weather conditions can create a more authentic situation for mountain medicine students, but it also keeps instructors on their toes.

“We have to constantly assess and mitigate risk,” Mayschak said. “On our avalanche rescue day, we had to change the training location to avoid driving in dangerous conditions and also so we could practice techniques in terrain where we were not in danger of an avalanche.”

Because too much realism can be a bad thing.

“We bring the students into these discussions because it provides them a framework for making decisions in the future,” Mayschak said.

Evolving vision

The International Mountain Medicine Center is located in a house on Columbia NE, a residential street southeast of UNM’s Law School. A life-size mannequin, taking a break from being buried in snow, sits in a chair just inside the front door.

There’s a kitchen here, a conference room in the back and space on the grounds to store the kind of equipment you need to get into the mountains for rescues and medical treatment and to get patients out of the mountains to hospitals.

IMMC, founded in 2016, evolved from the vision of paramedic Jason Williams, 36, who previously directed UNM’s Emergency Medical Services Academy, which offers training for first responders on up to paramedics. Both IMMC and the EMS Academy are part of UNM’s Department of Emergency Medicine.

Williams was teaching mountain medicine through the EMS Academy but saw a need for an entity focused on mountain medicine and rescue education.

“I sort of formed (IMMC) out of my brain, along with friends involved in mountain medicine,” he said.

IMMC offers a number of programs.

The Alpine Helicopter Rescue Specialty Course is intended to support health care professionals who are, or aspire to be, part of an alpine helicopter rescue and EMS team.

IMMC’s Custom Medical & Rescue Course is designed for specialty groups, such as military units, who want to do medical rescue and/or adapt clinical practices to the outdoors.

The center also offers courses such as Wilderness First Aid, Wilderness First Responder (Refresher) and Wilderness EMT Upgrade. IMMC’s Wilderness & Austere Medicine Fellowship is a yearlong commitment aimed at giving fellows experience in search-and-rescue emergency medicine situations locally, nationally and internationally.

But the pearl of the programs offered by the center is the Diploma in Mountain Medicine (DiMM) course.

“It’s really tailored to high-end medical providers, people who know how to do medicine,” Williams said. “They learn about trauma care in the mountains, rope rescues, rescues on cliff sides.”

Rigorous standards

DiMM consists of a summer and a winter session. Both sessions require 25 hours of self-paced, interactive, online courses done over an eight-week period.

The summer session’s practical seminar is made up of nine days of intensive live training based out of Albuquerque. The winter session’s practical seminar involves nine days of live training out of Albuquerque, Ouray and Silverton.

Physicians pay $4,000 per session. Paramedics, nurses and advanced practice providers pay $3,500 per session.

“We are one of three programs in the U.S. to offer this training,” Williams said. He said that dating back to 2011 and its origins in the EMS Academy, some 200 people have done the DiMM training.

“It draws people from around the world,” he said. “We’ve had people from all over Europe – Italy, France, Sweden, Switzerland – and from Chile and as far away as Australia. The program and the standards are rigorous. Maybe 10 of those 200 have not passed.”

Williams, a Santa Fe native who grew up in Albuquerque, was practically born to direct IMCC.

His father, Gary, is one of the authors of the 1973 New Mexico Search and Rescue Plan and has served as leader of the Albuquerque Mountain Rescue Council and deputy chief of volunteers for the Bernalillo County Fire Department, to name a few of his roles in New Mexico’s search-and-rescue community.

Students in UNM’s Diploma in Mountain medicine program negotiate a knotty situation during a technical rescue scenario in April 2019 at a box canyon near Socorro. (Courtesy IMMC)

Jason Williams got his EMT certification through BCFD when he was 17. Like most, probably all, of those involved with IMMC, he combines a devotion to rescue work and medicine with a passion for the outdoors. He has rock climbed around the world and throughout the United States, but he says he prefers scaling granite walls in the Sandias with his wife, Courtney Bryan, to all other climbing experiences.

“The Sandias have a really complex terrain,” Williams said. “That’s why you have so many rescues there.”

He recalls a time about 10 years ago when he and Bryan, both members of the Albuquerque Mountain Rescue Council at the time, were notified that a woman had fallen off a cliff face while rock climbing in the Sandias. He and Bryan were put into the Sandias by helicopter and made their way to the woman.

“She was hurt bad, had multiple fractures and her lungs had collapsed,” Williams said. “We stopped bleeding, started IV fluid resuscitation, splinted fractures and packaged the patient for helicopter hoist extraction. We saved her life.”

It doesn’t always work out that way.

In 2013, Williams and Dr. Darryl Macias, now also a IMMC faculty member, responded to a rock-climbing accident in the Sandias to find that the victim, a friend of them both and an experienced member of the search-and-rescue community, had succumbed to his injuries.

“The unforgettable thing is, being in the rescue business and climbing, you have friends who die in the mountains,” Williams said.

Ongoing mission

Macias, 58, lost a climbing buddy, David Bridges, in one of the most storied of mountaineering disasters.

In October 1999, Bridges and mountain-climbing superstar Alex Lowe were killed in an avalanche on the south face of 26,000-plus-feet Shishapangma in Tibet. At the time, their bodies were lost in the mass of snow that swept them away, but remarkably their remains were discovered by climbers in 2016.

Macias was among the friends and family members who climbed the mountain to reclaim Bridges and Lowe, an expedition that makes up part of the recent documentary film “Torn.”

“We cremated their remains in Tibet and took some of the ashes home,” Macias said.

As a child, Macias lived in poverty-plagued East Los Angeles. His young life changed course when his grandparents brought him to live with them in Lake Arrowhead, California, in the San Bernardino Mountains, known as the Alps of Southern California.

Macias’ grandfather was a general practitioner, so it was during these formative years that his desire to be an emergency physician flowered and he fell in love with the outdoor life.

“I grew up skiing on my grandfather’s wooden skis,” he said. “I got in with people who were climbing.”

Macias was a guide for a time at Joshua Tree National Park in Southern California, and it was while teaching climbing there that he met David Bridges.

He earned his medical degree at the University of California at Los Angeles and has practiced medicine around the world, often working with disadvantaged populations. He teaches first aid courses to Sherpas at the Khumbu Climbing Center in Nepal, and he is the director of IMMC’s Wilderness & Austere Medicine Fellowship.

Mindful of friends he has lost in rugged terrain and high peaks, he takes his role with IMMC seriously and takes pride in the center’s work.

“Safety in the mountains is our mission,” he said.

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