What a wilderness medicine course actually changes

I took the NOLS Wilderness First Responder course outside Tucson. Ten days, eighty hours, most of it spent on the ground in the Sonoran Desert.

The format is scenario after scenario. Someone lies down in the gravel with a made-up injury and you work the problem in front of instructors who have done the real version of it. You learn the patient assessment system and then you run it until it stops being a list you are reciting and becomes something you do.

Airway, breathing, circulation first. Then the long tail. Spine, shock, wounds, dislocations, altitude, heat, cold, and what to do when the evacuation is twelve hours out and the weather is coming in.

What the course changes is your sense of distance. Before it, a long way from the road means inconvenient. After it you catch yourself doing arithmetic without meaning to. How long to carry someone out of here. Who goes for help. What is in the pack and what is not.

Most of what I learned I have not needed. The parts I have needed came up without warning.

If you spend time in the mountains with other people, take it.