Diary of a Ski Patrolman: Week 16

It’s nearly the end of March.

It seems as if just the other day I was walking down the slopes of Okemo with orange discos bound together by rope, getting the trails ready for snow. And then the snow came. It came in huge amounts, in lucky storms strung across the days and months that have now begun to fade into memory. Memories like that of the countless patrollers skiing down the mountain on my first sweep — a crimson field united in purpose and form. Splashes of powder against my legs, my quickening heartbeat as I see crossed skis stuck upright in the middle of Lower Arrow, the tug of compassion I feel when I first hear a cry of pain from a patient.

I wrote this winter to help remember my place at Okemo, and to invite others to live in the world that I have found here — a snowy, sometimes cold, but always enjoyable place.

My first patient, on a day which now seems distant, was on Jolly Green Giant. This is a cruising trail that I enjoy, but on that day it became a trail of heart-pounding, cold-sweat anticipation. It was a trail of snow, and a trial by fire. It was my chance to prove myself, and a chance to fail. Everything rushed through my mind: clear the spine, assess the patient, radio the hut, treat the patient, radio the first aid room, package the patient and transport. The procedure was clear — but all of these thoughts came at once, an unstoppable flood.

I came upon my patient near the base of the trail, pulled up my sled below her, and stomped out of my skis. My hands were already moist inside my Nitrile gloves. “Hello, my name is Josh, I’m with the Okemo Ski Patrol. Can I help you today?”

“Yes, please, I fell and it hurts here,” she said, pointing to her collarbone. “I’ll take a look at that in just one second, but first I need to clear your spine — I mean, I need to make sure that your back and neck are not injured, so let me know if anything back here hurts,” I said, as I began pressing my fingers against her spine, first working my way down and then back up, making sure to be both quick and thorough. In our training, clearing the spine was so simple, and understood by “patient” and patroller.

In reality, it became weird. “Why do you need to feel my spine, it’s my collarbone that hurts!” She said this with panicked urgency, thinking that I probably didn’t understand what the problem was. I realized then how different it must be to be the patient in real life, to have real pain and real fear, lying on a snowy slope depending on the help of someone you have barely met to safely treat you and take you down to further care.

It was then that I realized that patrolling was just as much about treating the patient as a friend as it was about treating their ailment or injury. It’s not just about slings and swathes, box splints and backboards. It’s about treating people with compassion and skill, when they are vulnerable and afraid.

This was but one patient of many who taught me there were more things at play than it appeared. I’ll remember a young woman whom I found on Mountain Road with an injured wrist. She was holding her wrist with her mitten lying beside her, and as I walked over to face her and introduce myself, I saw her tears. Between tears and with a pained tone of resignation she said, “My wrist. . .it hurts. . .so much, I, I think it’s. . .broken.”

“Well, I’m not quite sure, yet, what’s wrong with your wrist, but don’t worry, I will take care of you, okay?” As I said this, I wished that my words would calm her, and ease her pain. I am not sure if they did, but she at least nodded at me, and allowed me to proceed.

It was the first time I had a patient visibly in pain. It was, I think, especially unnerving to me because I have never broken a bone, and luckily have never been in huge amounts of physical pain, despite my silly tendency to vault over picnic tables and run up walls. I know what pain is like, but I did not know what her pain was like. I did not know what she was feeling. That unknown was terrifying. She taught me that even though I sometimes cannot relate to my patient’s physical and emotional feelings, I can still be calm and steady. I splinted her wrist without delay.

From another patient in pain I learned that we are all very young. I arrived to an accident on Quantum Leap to find a middle-aged woman on her back, looking at the sky with dark eyes, likely fixed on the fact that the afternoon had not turned out so well, not well at all. I introduced myself, and proceeded to clear her spine, and assess her injuries. At first, all was well — until I reached one of her shoulders. I pressed gently but her face contorted in pain. She couldn’t lower her arm all the way down from over her head. Hmm, I thought, this looks like a dislocated shoulder. Yes, I remember the blanket roll from training! So I prepared a blanket roll just for her, and then asked her to sit up with my help, so that I could tie the blanket in place and from there transport her safely to first aid.

We counted together, “3. . .2. . .1. . .AH!” That last part was just her. And I stopped. Attempting to sit up caused her extreme pain. But for me to apply the splint, she had to sit up. There was no way around it. As I looked at her, lying back down to regain composure, I saw an expression on her face that I swear mirrored that of a young child. This is not to say that she was not right to have it — not at all. Rather, when we are in pain, I think we are all the same. We are all back to our childhood, our days of bumps and cuts and feeling helpless.

She was brave and together we overcame her pain and got her safely to first aid. But she still had that expression on her face that made me think of a child. I saw this expression countless times, on many patients, of all ages. I saw it on children, too, of course. It’s the face of a human in need of help, one that we all share — even the most “hardened” amongst us. I learned that we are the same when we are in pain. We wish to get out of it, we wish to have help. And I am just glad that this season I was able to so often replace that pained expression with one of relief, and on the best days, one involving a smile or two.