Wilderness Medicine Externship

The Carolina Wilderness EMS externs returned to Landmark Learning again this year to see an insider’s view of wilderness medicine education. Ryan Circh is a fourth year emergency medicine resident from Johns Hopkins Hospital. David Amsalem is a fourth year medical student from Vanderbilt University. The externship is a month long rotation for senior medical students or residents with interests in wilderness medicine and EMS-related activities. The rotation is run out of Burke County under the guidance of Dr. Seth Hawkins. Dr. Hawkins is the Burke County EMS and Burke County Search & Rescue medical director as well as medical director for Landmark Learning. The externs work with Burke County EMS paramedics in the field and respond to EMS calls and rescue operations in the Linville Gorge Wilderness, Pisgah National Forest, Lake James, and South Mountains State Park.

The motto of the externship is “esse quam videri”, the state motto, meaning “to be rather than to seem”. All of the learning during the externship takes place outside the classroom. This year’s visit to Landmark Learning continued that tradition.  The externs had the opportunity to have an enlightening chat with the founder of Landmark Learning, Justin Padgett, about the history of the school and where he sees wilderness medicine education heading. They then followed a WFR course out to the beautiful forest surrounding the school for a nighttime scenario. The eager students quickly located their “victims”, with moulage in place and some victims stuck in the overflowing stream, the students got to work. Not more than a few moments into the scenario, reality hit hard. The group found themselves in a yellow jackets nest. Everyone had to quickly break roles and exit the area. At that point, after receiving 5-6 stings each themselves, the externs were put to work. Esse quam videri. One student had a history of anaphylaxis and was stung twice.  The externs took director medical oversight of the situation and helped the student back to the classroom. After several doses of Benadryl and close monitoring, the student remained stable and symptoms improved. Although the externs went home licking their wounds, it was certainly an evening they will not soon forget!