That time WFR actually came in handy.
by Eliza Stein; illustration by Abi Censky
At 2:00 a.m., in the middle of Idaho’s Clearwater National Forest, over an hour from cell service and the closest town, Sumner checked Paul’s pulse again. 98 bpm: a bit high, but healthy. She shined her flashlight into his eyes, seeking his pupils, but he recoiled. I tightened my grip on the sides of his head. If Paul moved his head too much, he could damage—or further damage, we didn’t know—his spinal cord. His twenty-foot tumble over boulders and logs could have been straight out of my Wilderness First Responder Textbook, which was now packed away in a basement in Colorado. I could feel his blood, already beginning to congeal under my fingers. I’d forgotten to put on gloves, failing to properly isolate myself from this stranger’s potentially disease-carrying blood.
* * *
Katherine, Sumner and I were on the tail end of a two-week backpacking trip in the Canadian Rockies. It seemed that we had encountered every possible obstacle: we’d had to reroute because of dangerous grizzly bear activity and hazardous terrain, our new trails had been washed out during massive flooding three years earlier and we’d slightly underestimated our food rationing. The one obstacle we’d managed to avoid was an injury. Satisfied with this outcome and counting our blessings, we decided to make a celebratory detour to the pristine and isolated Weir Creek Hot Springs on our way back to Sumner’s home in Bozeman, MT.
The hot springs were a half-mile hike in from Idaho’s State Highway 12, about 70 miles in either direction from the nearest town, nestled in an easy-to-miss turnoff just past mile marker 142. A handful of different pools lined the creek, collecting hot spring water that trickled down from the valley walls. We hiked past the first pool, large and hot tub-like, where a group loudly socialized and sipped beers. The pool they sat in was raised off the ground and rested on the slope, one side nestled into the hill and the other exposed to a steep drop-off into the creek below. The group was gone before nightfall.
Farther up the valley, we found a smaller pool with no one in it. We soaked for hours in the perfectly warm water, cooking dinner, even making brownies, without emerging from our oasis. We decided to call it a day when our fingers and toes had reached their maximum prune state. We were in our sleeping bags before dark. Despite several long days and short nights prior, it took me longer than usual to fall asleep that night. Finally, after snapping some constellation photos and sufficiently engaging with Sumner’s spurts of sleep talking, I drifted to sleep.
I was the first to stir when a new group of partiers arrived around midnight. They laughed, splashed in the hot tub pool a ways below us, and cracked open beer after beer. I was furious. Didn’t they know that there were people trying to sleep out here? Hadn’t they any respect for the wilderness experience? Soon Katherine and Sumner were rolling around in their sleeping bags, too, trying to tune out the noise.
At 1:30 a.m., someone fell. We heard the rocks sliding under him. Then yelling.
“Don’t go down there!”
“Someone call 911!”
The three of us sat up and we looked at each other. It didn’t need to be said. Sumner was an Emergency Medical Technician (EMT), and Katherine and I were Wilderness First Responders (WFR). I suggested that we put on warm clothes and I grabbed the first-aid kit from my backpack. We began our walk down to the group.
The partiers were at the same pool that had held the beer-drinking group that we passed on the way in. When we reached them, we announced our medical certifications at high volume for several seconds until they registered that they were not alone. Paul—whose name we’d been able to make out through the shouting—had fallen backwards off the exposed edge of the pool and tumbled 20 feet over rocks and logs, finally landing in the creek below. Several members of the group had made their way down the steep, moss-slicked slope to Paul’s side. Someone propped him upright. They were all naked.
As we made our way down the slope, we could see blood on Paul’s body, some on his head and shoulders. The smell of beer was overwhelming. Katherine stepped behind Paul and put her hands on the sides of his head, taking a firm grip to stabilize his spine. Sumner began asking him questions, her voice calm and firm, but I detected a quiver. She had worked for a year on our college’s Emergency Medical Services team, but most of her calls were dangerously drunk students. This was her first time using her certification in a backcountry setting. The closest I’d come to a medical emergency was acting out scenarios in my WFR training almost two years earlier.
Paul responded to Sumner’s questions with a series of grunts. His lip was split open, he was missing several teeth, and his friends informed us that he was at least five—no wait, maybe eight, okay more like ten—drinks in. The naked partiers yelled and tried to grab Paul, some wanting to hug and comfort him, others prepared to drag him out of the creek and down the trail. Sumner and I less than politely reminded them that Paul had a possible spinal injury and could not be squeezed, no matter how lovingly. For the second time that night, I suggested that we all go put on warm clothes. The partiers stumbled up the hill to their respective piles, and we finally had time to think.
Paul was not in good shape. His limited responsiveness was a red flag—he’d clearly hit his head, as indicated by an abrasion on his scalp, and a serious head trauma could have caused bleeding in his brain. If this was the case, we needed to get him to a hospital as soon as possible. Paul also had a split lip, missing teeth and he was plastered. Any of these factors alone could have inhibited his ability to answer Sumner’s questions, let alone all of them combined. We were only a half-mile from the highway, but moving Paul in his current state was out of the question. We were at least an hour’s drive from cell service. Two of Paul’s friends had left to drive to the ranger station twenty miles away, but it was difficult enough tracking down an open ranger station at 4:00 p.m. on a weekday, let alone the middle of the night. The first-aid kit hung limp at my side, full of Band-Aids and blister care supplies.
I surveyed the group. There were seven of them, including Paul, and all appeared to be in their twenties. They worked at the Lochsa Lodge, twenty miles down the canyon from where we were, still over fifty miles from the closest hospital. The only woman in the group had driven to the ranger station with a companion—at least she wasn’t slurring her speech like the rest of them.
We made our decision within 10 minutes of arriving on the scene: we would use our emergency beacon. It was a SPOT device, a plastic square about the size and shape of an old BlackBerry phone. It had no screen and only five buttons, one of which was labeled S.O.S. This button was covered by a lift-able flap to avoid accidental activation. We’d brought the beacon on our backpacking trip for situations exactly like this, except, in the extremely unlikely case that we’d have to use it, we thought we’d be in the rugged wilderness of British Columbia fighting off grizzly bears or cougars. It almost lay forgotten in the glove compartment at the Weir Creek Hot Springs trailhead, but at the last minute we grabbed it and threw it in a backpack. Now, I lifted the flap to expose the S.O.S. button and held it down until a green light flashed on the beacon. Our GPS coordinates were en route to a satellite, which would bounce our location to the local Search and Rescue team. I watched the green light flash a few times before returning the beacon to my coat pocket. Now, all we could do was wait.
The SPOT has a convenient setting that allows users to program up to two emergency contacts into the device. We knew that as soon as we pressed the button, our emergency contacts would also get a call, activating a phone tree among our parents that we had meticulously planned out before our departure two weeks earlier. Katherine suggested that we find a way to contact them and let them know that we were okay. She was nervous they would think we were in danger and have no way of contacting us. I placed my hands behind Katherine’s on the sides of Paul’s head and assumed her position. Katherine left for the Lochsa Lodge, where she’d heard that there was possible cell service and a pay phone, taking a partier along to help her find her way. Sumner and I, along with the three remaining partiers, stayed with Paul.
I held Paul’s head steady between my hands while Sumner periodically checked his vitals. He’d started shivering—after all, he was naked in the middle of Weir Creek. While the creek collected some warm water from the hot spring, it was certainly no bathtub. Sumner was having a hard time evaluating Paul’s pupils. I gave it a shot, too, but he immediately closed his eyes when I shone the flashlight at him. I tried again, with no luck. Although we couldn’t see his pupils, his other vitals seemed to be stable for the time being. But we still had no idea if he’d sustained any injuries we couldn’t see. If Paul had a brain bleed or any other internal bleeding, his condition could severely decline at any moment.
One partier stayed by Paul’s side the whole night, and it became clear that the two were best friends. He was crude, sexist and a little bit racist, directing racial slurs at Paul in a way that was supposed to be compassionate. But he made Paul smile. And he kept Paul awake, a feat that I never imagined could be so exhausting. It was the middle of the night, and the poor guy was drunk. When he closed his eyes, we yelled and splashed water on his cheeks until he looked up at us. Each time took more and more effort, but we would not allow it to be the moment Paul’s eyes stayed closed for good.
The three remaining partiers took turns standing on rocks in the creek, keeping us company. They told stories that made Paul smile. Like the rest of them, Paul was a seasonal employee at the lodge. He was 28-years-old and from a small town in northern Montana. Some of his co-workers had told us that Paul might have been on some kind of anti-psychotic medication—he just seemed kind of off, they said. But he was a brother to them. Someone said that Paul was the heart of their group.
Around 4:00 a.m., Paul stopped shivering. This was a sign that his mild hypothermia had progressed to moderate. The next level, severe hypothermia, could be fatal. We needed to move him out of the water.
In a Wilderness First Responder course, a handful of topics are introduced with: “Hopefully you’ll never have to do this, but in a worst case scenario…” What Sumner and I did next was one of those cases. Paul had a possible spinal injury, which meant that he needed to remain immobile. If we moved him, we could damage his spinal cord, potentially paralyzing him for the rest of his life. But if he stayed in the creek any longer, he could die of hypothermia. He was slipping away from us, and we had no way of knowing when help would arrive. We had to move him out of the water. The only dry place we could put him was on top of the slope he had tumbled down—far too dangerous terrain for us to carry him up while keeping his spine stabilized. We would have to evaluate whether we could release control of his spine. While it was in the scope of our medical training, even my WFR instructor had never done this before.
The alcohol had begun to wear off, and Paul was responding to us more reliably. While I continued to hold Paul’s head, Sumner, having the highest medical certification, performed a spinal evaluation, feeling along Paul’s spine for deformities and tender spots. She reported no deformities, and Paul grunted that he felt no pain. After Sumner finished her evaluation, we traded places, and I performed another. I also detected no deformities, and Paul still denied any pain. We vocalized our decision: we would release control of the spine.
“Don’t you fucking move my friend! You’re going to paralyze him!” The most belligerent member of the group was yelling at us from above.
“Sir, you need to calm down,” I called back to him. I’d never used the word “sir” in my life, except for one time when I was pulled over for speeding. “We’re trained to do this. You need to trust us.” Did I even trust us? We’d done all of the steps just as we’d been taught, but we were ultimately making a decision that could change this stranger’s life forever.
Supported by me, Sumner and two of his friends, Paul rose to his feet. He moaned, but indicated that he wanted to keep going. Together, we stumbled up the slope, fraught with slick boulders and logs. The only thing that could make the situation worse would be if another person fell. But no one did.
At the top, standing next to the hot spring, Paul wanted to go home. It had been over three hours since his fall, and there was no sign that Search and Rescue was anywhere close, let alone that they had received our message in the first place. It was less than half a mile to the parking lot, and if help still hadn’t arrived by then, we could drive Paul to the hospital ourselves. At around 5:00 a.m., we began walking.
The trail was narrow, only wide enough to walk single file. Sumner led the way, shining a light ahead of her and pointing out obstacles. I followed, pointing my flashlight behind me. Paul’s arms were draped over the shoulders of the guy in front of him, and another held him around the waist from behind. They supported most of his weight as he stumbled down the trail. Ever so slowly, we moved forward.
We must have been walking for 20 minutes when we saw a bright light coming up the trail. It was the sheriff. Sumner ran ahead to meet him while we helped Paul sit down to rest. She returned, reporting that the ambulance was two miles out and the helicopter was in the process of landing. We should wait where we were. Everything was going to be okay.
We waited for 45 minutes. The group passed around cigarettes. An old co-worker of mine used to joke that every backcountry first aid kit should have a cigarette in it—before you do anything, you should stop, smoke a cigarette and clear your head. In a backcountry setting, if five minutes is the difference between life and death, the result will always be the latter.
Eventually, Katherine came running up the path. Apparently there’d been a miscommunication, and Search and Rescue was waiting for us at the trailhead. After sufficient grumbling and “What the fuck!”-ing, Paul was once again raised to his feet, and the rescue brigade continued onward.
Not five minutes passed before a team of medics came into view. They jogged up the trail, carrying a duffel bag with a white cross and wheeling what appeared to be a stretcher. As they helped Paul onto a backboard, we filled in the medics, clumsily clarifying that we were not part of this group, we’d just happened to be camped nearby. I watched one member of the team hold Paul’s eyelids open with his fingers while he shined a flashlight to check pupil dilation. I stored this technique away for safekeeping. The medic who appeared to be in charge congratulated the three of us, took down our contact information and Paul was wheeled away.
123 hours later, we would get a call from the medic informing us that Paul’s vitals had stabilized during the helicopter ride, and he became more responsive. Hospital scans revealed no spinal injury—our spinal evaluation had been correct, along with our decision to move him. Paul was treated for several broken bones in his face and discharged to the care of an oral surgeon, who would treat his missing and broken teeth. Paul was a very lucky man.
Katherine, Sumner and I returned to our campsite just before 5:30 a.m. We packed up our belongings and hiked to the car. A woman still slept in a tent set up across the creek, unaware of what had transpired that night. She would probably never know.
At the trailhead, the Lochsa Lodge employees sat behind a clump of trees. They were still kind of drunk, and the cops were still hanging around, so they were going to wait a few minutes before driving back to the lodge. Katherine, Sumner and I exchanged looks. There would not be another accident by Weir Creek that morning. After confirming with a state trooper that it was permitted under Idaho law, four partiers piled into the back of Sumner’s pick-up truck, the other two riding inside with us. As we pulled out, we caught a glimpse of two women talking to the sheriff and state troopers. At first I thought they’d been injured somehow, too. Then I saw the bong on the roof of their car. The sheriff pulled a gallon-sized bag of marijuana out of the car, held it up for all to see and shook his head. Inside our car, the rescue brigade hooted and hollered as we turned out onto the highway.
As the sun rose, the stench of stale beer began to settle into the seats. We arrived at the lodge at 6:15 a.m., just in time for two of them to catch their breakfast shift at the restaurant. Hugs were exchanged. One man, who’d helped us keep Paul awake, told us that his mom always said that there was no such thing as luck. It had always annoyed him, until tonight, when he knew that she was right. He thanked us for saving his friend’s life, and we told him that we couldn’t have done it without his help. He turned to go, and we watched the partiers saunter to their respective army tents, some still stumbling from the alcohol.
I wanted to vomit. The car reeked of beer, or maybe it was just the minerals from the hot springs. I couldn’t tell the difference. It smelled like the four hours we’d spent at Paul’s side. In the darkest hours of that night, while I held Paul’s head in my hands, I knew that I would remember this night for a long time. I just didn’t know how it would end. I could execute my WFR training perfectly, but all I could do was wait for more qualified help to arrive. When it became more and more difficult to keep Paul awake, I knew that the night had two possible outcomes. Only time would determine which outcome we’d all have to carry with us for the rest of our lives.
Katherine, Sumner and I drove away from Weir Creek Hot Springs with the windows rolled down, letting the smell of beer drift away until we couldn’t stand the cold any longer.