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Doctor on the Col – Expedition Medicine

Written by our expedition doctor Nicola Cochrane , who was the expedition medic on one of our Everest Base Camp Expeditions in 2016.

Everest Base Camp - Prayer Flags

Let’s Go Outside:

It’s a natural instinct to crave the outdoors when working day to day in offices and institutions with a frenetic eternal demand on your attention from emails, telephones and humans.  Or it is for me. Since I started working as a doctor, I have explored a host of outdoor pursuits in my free time from holidays backpacking and trekking to SCUBA in Donegal, walking in Wicklow, running the N11 and running trails over hill and dale.
I have moved away from under or over water over years with insufferable cold blue fingers and found perpetual motion works for me. Free time is limited though and work, family, traffic all contrive to confine us.

So imagine combining work with leisure.

Expedition Medicine …. Eureka!!!

A number of years ago, I spotted a very small ad in a medical journal looking for expedition doctors for an Irish expedition company to accompany their clients. Intriguing. I read further, anticipating long lists of specialist qualifications. But no. They stated an enthusiasm for GPs.
I work as a GP but also have worked for several years in a Local Injuries Unit seeing minor trauma, fractures, sports injuries and lacerations and so I applied.

It is the best Classified Ad ever written. I have travelled with Earth’s Edge to amazing places and met the most fantastically eclectic groups of Irish people. It is quite an experience to walk the hills in Ireland with people months before we all meet at Dublin Airport and I know now that it is impossible to guess who will glide through the experience and who might need a little help. I haven’t used all the extensive Medical kit we bring and I am very glad about that. The kit has gear for emergencies I hope we never experience. And yet I do suspect that good luck comes with good preparation. People have generally put so much thought and effort into their fitness and gear that they could handle anything.

Being the doctor in a large expedition is an odd dynamic. Worlds away from a GP practice as you trek a dusty path or wait in the pitch dark outside a portable toilet enquiring if the going is good to fair. It takes the edges off and yet maintaining trust that you will deliver the goods when things go wrong is part of the package. I have learned a lot about people’s perception of the medical profession. It’s a valuable insight. I love the camaraderie and am endlessly engrossed by the snapshots of other people’s lives.

Everest Base Camp - Tea House

Most of us expedition doctors have good levels of fitness. I would say it’s essential. We need to be fresh, no matter the effort of the day and versatile with time, to ensure people get support when something physical is compromising their trek. Card playing skills help – mine need work. We must be fearless when approaching local edible delicacies, as I have noticed we are the unofficial tasters of the team. Water and toilets must be experienced, bedding checked for mice and smaller beasties. I have slept with a few little compañeros under my bed without too much objection. Ability to sleep soundly is a valuable quality to maintain a chirpy tone.

Irish Guides

Teamwork. It’s an underrated skill. We have sometimes met first at the airport as team members of Earth’s Edge. I have no idea how they find these heroes. The Irish guides are everything to the expedition. They have rucksacks like Hermione in Harry Potter pulling out miraculous spare kit at every turn. They need the strength of 10 men and the speed of light.
They know all mountain terrain and weather and can anticipate time to food within 60 seconds. I think they never actually sleep, one eye and ear ever alert for someone needing assistance. They have been everywhere in the world but never boast. They seem to delight in every aspect of nature this planet has to offer. Guides sometimes discover ‘little’ problems with the itinerary or locale and manage to translate it as an advantage to our experience. They have uncanny abilities to charm airport officials, find lost passports and negotiate vegan lactose free meals from unlikely places. They never feel the cold. They tolerate doctors but have no personal need for them and I guess they strap up their own fractures like MacGyver. Respect.

Intrepid Explorers

There is no demographic unrepresented by Earth’s Edge clients. Young and old, all shapes, sizes and genders. They all share a passion for travel and new experiences. Some I meet at the beginning of their first long haul trip and many have travelled more than David Attenborough. They travel light or extremely well kitted and I feel so curious about ‘what’s in the bag’ sometimes I could burst. We’ve had fashionistas appearing with a jaunty flourish at an outdoor breakfast table close to Kilimanjaro summit, clean amongst a dusty crew and tough salts with weathered gear who adapt and mend other’s new kit as it falls apart in timely fashion. The most hilariously unfettered member we had was a medical student from Canada, Vince (now following his dream training as an anaesthetist to work in trauma and high altitude medicine). He turned up in Tanzania in flip flops, shorts and carrying an umbrella ready to climb Kilimanjaro. Things appeared by magic for Vince and he was the greatest asset to that trip and the finest entertainment you could ever imagine. Some come from hi tech offices and some from outdoor worlds but so far, every group blends seamlessly with a harmony which seems implausible. Although I have travelled with a few couples, I would guess there are more pioneers who join the group knowing no one at first. In fact, I suspect it’s a lot more fun to come alone with no preconceptions. It’s interesting though, how many people have relationships with others who have no interest in expeditions and a testament to those relationships and their versatility. I have offered medical help to people who have never needed a doctor before and those who have been balancing their lives with extraordinary health challenges and I am always overwhelmed by the gratitude expressed for the little things I do. It is impossible to describe the satisfaction gleaned from solving a problem. No thanks are necessary. I will never be surprised by the conundrums we sometimes face. Expect the unexpected – we are taught as undergraduates. It’s not wrong. No one has given birth yet but life is long, who knows?

Kilimanjaro Climb - Barranco Wall

Planet Earth

I want to see every inch of it. I want to meet all cultures and experience their traditions, cuisines, check out their clothes and joke with their children. World music on buses is quite a thing and listening to Justin Timberlake on a Sherpas smartphone speaker in the Himalayas is an unexpected pleasure. Mountains are my favourite. White water sounds dangerous and I can listen to other people’s tales but wouldn’t watch a YouTube video. White knuckle watching. A risk averse traveller is a bonus to any group. Someone must do the worrying. I never realised what a mammy I am, until someone stands too close to the edge. I have snatched Sherpas and Maasai from danger (they hadn’t even realised their peril).

Kilimanjaro - From the National Park

I hope to visit Tanzania again and climb Kilimanjaro. No monkey will eat my lunch. I will keep moving. I will keep learning and watching Howard Donner videos. If I am l lucky and my family tolerant, I will go everywhere Earth’s Edge has to offer except perhaps the white water rafting. It’s a great life as an Expedition Doctor – if you keep your feet on the ground.

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