Students Summit Mountain Rescue Training

By Christopher Austin

In 2009, then-Army Lt. Col. Matthew Welder was assigned to a Special Operations team on a mission in the mountains of Afghanistan. They were 8,000 feet above sea level, some suffering from altitude sickness, when they came under fire. One soldier was shot in the collarbone; the bullet exited through his chest and damaged his lungs. There were miles of rocky terrain between the Special Operations team and a proper hospital, making an airlift the only option to save his life.

Air Force Capt. Rachel Antone practices her climbing skills on a rocky
cliff in the woods outside of the Army Mountain Warfare School in
Jericho, Vt. (Image credit: courtesy of Navy Ensign Jasmine Scott)

Welder was no stranger to taking care of wounded in difficult situations. Four years earlier, just 88 days after he graduated from the Uniformed Services University of the Health Sciences (USU) as a nurse anesthetist, he was assigned to a combat support hospital during the Battle of Fallujah in Iraq and had to manage two different rooms with multiple injured service members at the same time.  But this patient needed to be transported to one, something Welder had never attempted before.

The team secured the patient to a stretcher and ensured his body wouldn’t be jostled by the trip down the mountainside.  They loaded him into the helicopter where Welder assisted in surgery on the way to back to base. 

Welder is now retired and an associate professor in the USU Daniel K. Inouye Graduate School of Nursing (GSN), heading up operational readiness training to prepare current and future healthcare providers for the same environment he learned in.

“[If] you want to make a person ready to deploy, you put them in an environment that is outside of their comfort zone, and train them to be able to do the tasks required of their jobs,” said Welder.

As part of the Military Mountain Medicine Course, students are
trained in different forms of navigation. Their final assessment
involves navigating to various locations in the woods around the
Army Mountain Warfare School and performing tests of their rescue
skills. (Image credit: courtesy of Navy Ensign Jasmine Scott)

The operational readiness training course is composed of four segments, beginning with the Military Mountain Medicine course (M3C) where students are introduced to mountain climbing, rigging patients for transport, survival skills and navigation. This is followed up with the Cold Weather Mountain course for teaching survival skills in extreme cold weather; Avalanche 1 Training for preparing for, navigating and performing rescues in avalanche conditions; and the Dive Medicine course for performing water-based rescues.

The M3C training takes place at the Army Mountain Warfare School in Jericho, Vermont. There, USU medical and nursing students taking the elective are taught through lectures, classroom training, and simulations in the mountain forest.

“We were trained in climbing, rappelling, search and rescue, locating someone who was injured and figuring out a way to extract them from a wilderness environment when proper tools are limited,” said Navy Ensign Jasmine Scott, a second-year student in the F. Edward Hébert School of Medicine (SOM),  who took the M3C and Dive Medicine course earlier in the year.

While a large part of the course is the practical aspects of safe mountain climbing and descending, with a heavy emphasis on knot tying and pulley systems, it’s only a quarter of the lessons engrained into students. Welder explained that the course teaches four kinds of readiness: clinical readiness, or the ability to perform healthcare duties normally; operational readiness, preparation for work on deployment away from comfortable surroundings and readily available tools; physical readiness, being in shape to handle the stresses of working in a deployed environment; and emotional readiness, the ability to be resilient in the face of emotional stresses that come with taking care of injured on the battlefield.

An instructor helps one of the USU students land after they joint
rappelled down the side of a cliff. (Image credit: courtesy of Navy
Ensign Jasmine Scott)

Teamwork plays a major part in all four aspects of readiness, he explained. Particularly in emotional readiness since it is equal parts a personal journey as well as one a whole team goes through.

“We teach people how to tie knots and wear harnesses and [be lowered] down an 80ft cliff by one of their classmates. Most people are not comfortable with that,” Welder said. “So the first time they do this they’re overcoming a huge emotional event in their life. When they get down to the bottom, they do it again and again and again. It’s classic conditioning, exposing them to an environment outside of their comfort zone.”

For some, like Navy Lt. Mien Le, who is a nurse anesthesia student in the GSN that was just the case.

“I have a fear of heights. I never really go out to the mountains; this was my first time,” Le said. “This not only did this give me new knowledge, but new strength to overcome my old fear. Mentally and physically I feel much stronger. It’s all about the teamwork; overcome your fear to help not just yourself, but other people.”

Students attending the Military Mountain Medicine Course practice
 carrying a fellow student down a mountain on a stretcher. The
 course aims to educate students on how to treat injured when in
 rural environments, far from the tools they’re used to using, and
 extract the wounded to a hospital. (Image credit: courtesy of Navy
 Ensign Jasmine Scott)

The exercises that the students are put through mimic some of the trials that instructors like Welder faced while on deployment in mountain environments, including performing first aid and rescue operations while on mountain terrain, or sheer cliffs. In fact, all of the instructors have experience in such environments. In addition to Welder’s own experience in the mountains of Afghanistan, Army Col. (Dr.) Ian Wedmore, an assistant professor in USU’s Department of Military and Emergency Medicine, and co-director of the operational readiness training course with Welder, received training from the Army Mountain Warfare School before deployment to several locations including Afghanistan.  Emily Johnson, a civilian instructor with the course, has summited Mt. Everest.

Upon completion of the operational readiness training course, students are certified in wilderness, mountain, avalanche and water rescue for six years. While the course is an elective for students in USU’s SOM and GSN who want this certification, Welder believes that it should be mandatory for all students.

“People get very comfortable in the hospital and can perform very well, no matter their specialty, in that environment,” Welder said. “After 1500 traumas [while deployed], I got good, but there was this delta between situations where I knew what to do and ones where I didn’t. I want to reduce that delta for students. Will everyone be 100 percent prepared for combat? No, because until you’ve done it, you have no idea what it’s like. I want to get people the closest I can from graduation to be ready to care for wounded on the battlefield.

“Our mission is to save those in harm’s way, to help those on the battlefield,” he said. “That’s why we exist.”