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Maybe you're having a bad day on the river. Something hurts! Something isn't working the way it usually does! Something looks funny! You'd like to have a doctor in your drybag right now, but the doctor is far away.
Well, the next best thing might be a book by someone who knows wilderness medicine, a book that can lead you through the proper assessment and treatment of your problem. Here are the 10 Best. They should be read before you pick up the paddle and leave home miles behind. Most of them can then be stuffed in a drybag and carried as a reference. All of the authors further recommend you expose yourself to some medical training appropriate for extended trips into remote areas.
Medicine for Mountaineering
edited by James A. Wilkerson, MD, Fourth
Edition, 1992, 416 pages, suggested retail $16.95 (5.25" x 7.75" format).
Published by The Mountaineers Books, 1011 SW Klickitat Way, Suite 107,
Seattle, Wash. 98134; (800) 553-4453.
With the first edition published in 1967, Wilkerson's ground-breaking
editorial effort ranks as the grandfather of wilderness medicine books. Unlike
some grandfathers, this one has managed to stay young by going through several
updating editions. Don't be put off by the title. Very little is going to
happen out there on rivers and oceans that Wilkerson and friends haven't
foreseen and covered adequately. Written by physicians to prepare responders
"for the medical problems that may be encountered in mountaineering and other
wilderness activities," this book has been carried in thousands of canoes and
kayaks. Presupposing, in many instances, that the reader has some prior
knowledge and training might make Medicine for Mountaineering difficult for
the raw medical amateur to use. It remains, however, a premier resource for
the assessment, treatment, and prevention of problems in the wild outdoors.
Mountaineering First Aid
by Martha Lentz, Ph.D., RN; Steven Macdonald, MPH,
EMT; and Jan Carline, Ph.D., Fourth Edition, 1996, 144 pages, suggested retail
$10.95 (5.25" x 8.5" format). Published by The Mountaineers Books, Seattle,
Wash.
First published in 1972, this little book fills in some of the gaps left by
the presuppositions of Medicine for Mountaineering. The procedures are based
on a step-by-step approach, taking the rescuer from trip-planning through
assessment and medical care to rescue. Summary checklists make the book handy
to use, and humorous illustrations clarify as well as entertain. As an
introduction to outdoor medicine, this book serves as an excellent resource.
Wilderness Medicine
by William Forgey, MD, Fourth Edition, 1994, 244 pages,
suggested retail $14.95 (5.5" x 8.5" format). Published by ICS Books, 1370
East 86th Place, Merrillville, Ind. 46410; (219) 769-0585.
Doc Forgey has been so active for so long in wilderness medicine some folks
just refer to him as "Doc" and expect you'll know who they mean. Changing
medical technology and the growing availability of non-prescription medical
supplies have produced many changes in this book since the first edition came
out in 1979. It remains definitely one of the best, a no-nonsense guide to
treating problems when the "Doc" is far away. Each of the treatments
recommended by this book are looked at from three viewpoints: what first aid
measures are necessary, what non-prescription items can be carried to help
with the treatment, and what prescription medications, if you can get them,
would be useful. Detailed instructions for just about everything you can
imagine--from pre-trip medical planning to suturing shut a gaping wound--are
included. Doc is refreshingly unafraid to get-down-and-get-dirty, as in the
"dissection method" of fishhook removal: "...we have to resort to what will
probably be a difficult experience for the victim and surgeon alike."
Medicine for the Backcountry
by Buck Tilton and Frank Hubbell, Second
Edition, 1994, 192 pages, suggested retail $14.95 (6" x 9.25" format).
Published by ICS Books, 1370 East 86th Place, Merrillville, Ind. 46410; (219)
769-0585.
This is a great book! As co-author I felt deeply obligated to say that. For
more than 25 years SOLO, a training center in New Hampshire, has been offering
wilderness medicine programs, and this little book was originally written as a
text for the school's two-day course, now expanded for a much higher level of
medical response. Without presuppositions, it starts from the moment the
accident occurs and takes the reader along through a complete assessment and
treatment of the most usual wilderness problems. Scenarios from real-life and
illustrations help the info come alive. Easy reading, with brief outline
summaries of each chapter, make this book useful for anyone who travels where
doctors are not around. Chapters on drowning, diving emergencies, and
dangerous marine life are especially appropriate to water-borne activities.
And, unlike many outdoor medical books, a heavy emphasis is placed on
preventive techniques. A healthy addition to any outdoor library.
Medicine for the Outdoors
by Paul S. Auerbach, MD, Second Edition, 1991,
347 pages, suggested retail $14.95 (5.5" x 8.25" format). Published by Little,
Brown and Company, Ordering Dept., 200 West Street, Waltham, Mass. 02154;
(800) 759-0190.
Dr. Auerbach avoids unnecessary medical terminology to produce an easy-to-
read, easy-to-understand book that is nicely balanced between a bare bones
approach (the very basics) and an exhaustive approach (everything you could
possibly imagine going wrong). A few problems arise when a recommended
treatment falls short of meeting the needs created by some patient's
emergencies. This book states boldly, for instance, "Never move the neck to
reposition it" (if you suspect the neck may be broken). Not a bad idea most of
the time, but sometimes patients do better when their neck is gently and
properly aligned. Just make sure you have been adequately trained before you
try it.
Waterlover's Guide to Marine Medicine
by Paul G. Gill, Jr., MD, 1993, 255
pages, suggested retail $12 (8.5" x 5.5" format). Published by the Fireside
division of Simon & Schuster, Rockefeller Center, 1230 Avenue of the Americas,
New York, N.Y. 10020.
Dr. Gill writes well: his style is easy, unpretentious, informative,
understandable...and fun. Each chapter begins with an interesting quote from
seafaring literature before Waterlover's Guide rolls right into the basics of
life support, then on to common traumatic injuries and environmental
emergencies. It's full of practical wilderness wisdom. Following a successful
dislocated shoulder reduction, Dr. Gill advises: "Your patient will break out
in a beautific smile..." Informative chapters include Shipboard Dentistry,
Seasickness, Diving Medicine, and Fish Poisoning. Approaching topics with few
assumptions, Dr. Gill helps prepare the untrained to take care of themselves
and their friends. This is not a book of high-sounding medical jargon and in-
depth treatments. It is an extremely practical book and, as the title implies,
a quick reference for appropriate care.
Far From Help! Backcountry Medical Care
by Peter Steele, MD, 1991, 241
pages, suggested retail $14.95 paperback, $19.95 cordura packcloth (5" x 7"
format packs easily). Published by Cloudcap, P. O. Box 27344, Seattle, Wash.
98125; (206) 365-9192.
Dr. Steele brings over 30 years of work in wilderness medicine to the printed
page in 23 chapters of "plain English" covering everything from Preliminary
Information through Serious Conditions to Common Ailments. His wealth of
wilderness experience is evident in this book as well as in several others
including Doctor on Everest (1972) and Medical Care for Mountain Climbers
(1976). Dr. Steele builds pervasively on a foundation of simplicity and
improvisation, both of which are key elements in wilderness medicine. And he
insists, with complete appropriateness, that successful treatment in the
wilderness is much more a result of knowledge and ability than proper
equipment. His literary trademark has become an economical style of writing
that may leave the medically uninitiated at a loss with some treatments. As a
reference for folks who have some prior training, this book may prove
extremely valuable. A lot is covered in a few words, and the packcloth edition
is virtually indestructible.
Atwater Carey Guide to Marine Medicine
prepared in cooperation with the
Marine Medicine Institute, 1994, 102 pages, suggested retail $2.95 (5.5" x
4.25" ring-bound format). Atwater Carey, Ltd., 339 East Rainbow Blvd., Salida,
Colo. 81201; (800) 359-1646.
Definitely the most compact of wilderness medicine books, this little jewel
shines with succinct and reader-friendly advice on the assessment and
treatment of dozens of injuries and illnesses, all related to water-borne
activities. Even if you've never taken a pulse, the info in Guide to Marine
Medicine will lead by the hand to successful management of your patient.
Unique sections include Advice to International Travelers and Recommended
Drugs.
NOLS Wilderness First Aid
by Tod Schimelpfenig and Linda Lindsey, 1991, 356
pages, suggested retail $12.95 (5.25" x 8.25" format). Stackpole Books, P. O.
Box 1831, Harrisburg, Pa. 17105; (800) 732-3669.
Intended as a text for the first aid section of National Outdoor Leadership
School (NOLS) semester courses, this book will help train any outdoor
enthusiast to 1) prevent, recognize, and treat common wilderness medical
emergencies, and 2) stabilize the severely injured and ill for evacuation.
Some of the info you won't find in many other books includes camp hygiene, the
effects of stress on rescuers, and emergency procedures for outdoor groups. It
is, as it should be, a reflection of the way NOLS does things, and it serves
as an excellent resource, providing a sound basis for making critical judgment
decisions about patient care in the wilds.
Wilderness First Aid
from the National Safety Council, 1998, 350 pages,
suggested retail $19.95 (8.5" x 5.5" format). Jones and Bartlett Publishers,
40 Tall Pine Drive, Sudbury, Mass. 01776; (978) 443-5000.
The National Safety Council has long been setting standards for excellence in
urban safety and injury education and now take their initial step into the
world of wilderness medicine. Written by a team of doctors, Wilderness First
Aid offers exceptional illustrations and capsulated information spread through
the book under the headings of "What To Look For" and "What To Do." Self-
recognized as a beginning book with suggestions for more training for those
"who plan to increase their skills beyond the introductory level," you could
have a much worse introduction.