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Saturday, December 13, 2008

Book Review: "Mountain Rescue Doctor"

Imagine having to stick a breathing tube down someone's throat. And imagine having to do that without accidentally breaking the person's teeth or inserting the tube into their esophagus. Then imagine doing this while kneeling on sharp rocks on a narrow ledge, while a hovering rescue helicopter sprays you and your patient with dirt and debris.

Endotracheal intubation is one of the most difficult medical procedures an ER doctor performs, and that's within the clean and controlled hospital setting with skilled assistance at hand. But Dr. Christopher Van Tilburg has also been forced to intubate in much less than ideal backcountry conditions as a member of the Hood River Crag Rats, the oldest Search & Rescue team in the U.S.

Christopher Van Tilburg is not only an ER, ski patrol and emergency wilderness physician, he's also an excellent writer. I've spent the last few days reading Mountain Rescue Doctor: Wilderness Medicine in the Extremes of Natureduring every spare moment (even at a red light, I must admit) and highly recommend this book to anyone who enjoys SAR stories.

Along with insights into the ethical challenges a wilderness physician faces and the tools and techniques of emergency backcountry medicine, Tilburg describes a number of suspenseful missions. One account involves a call to Columbia River Gorge, where he intubated a patient who'd fallen off a cliff. Another chapter concerns the rescue of an injured and hypothermic man who'd fallen onto a logjam. Dr. Tilman also writes about rescuing cliff divers with back injuries, rushing to rescue a trapped climber within the "Golden Hour," treating the victim of a rattlesnake bite, and participating in a grisly body recovery at the scene of a mountain plane crash. Tilman has been involved in numerous high-altitude, winter missions, including a much-publicised search for three missing climbers on Mt. Hood.

After finishing the book, my only disappointment was that, in certain cases, the reader is left wondering what happened to the victims Dr. Tillman worked so hard to save. Did they survive? Then I happened across a blog post by the author, in which he states, "Yes, several chapters don't really say what happens to the patient. That's part of the deal with mountain rescue missions: we hand off the patients to a helicopter or ground ambulance crew and sometimes we never find out the end result." As any member of a SAR unit knows, that statement is very true. The last we sometimes see or hear of a patient is when they're whisked into the sky in a litter, spinning at the end of a 200-foot rope.

To learn more about the author of Mountain Rescue Doctor, visit Christopher Van Tilburg's website at

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