“Unprecedented” was a popular buzzword of 2020. Not only did it apply to the pandemic, but for the four full-time WMS employees who live in Austin, Texas, it also applied to the ice storm that wreaked havoc on the state the week leading up to the WMS 2021 Winter Conference. We were dealing with continuous days of historic low temperatures, boiling water advisories (when water was actually available), extended power outages, a week of school closures, frozen and broken pipes, and food shortages due to impassable roads. We called upon the improvisational and adaptive skillset often necessary in wilderness medicine as we navigated, what to us was, a foreign environment.

Another unprecedented event was that this was the first virtual WMS winter conference, and with nearly 900 registrants from 24 countries signed up, there was no time to slow down, despite our challenging circumstances. We had successfully executed our first virtual conference seven months prior, but we had new conference chairs, new speakers, more trivia, new wellness activities, more exhibitors, a new pre-conference, concurrent workshops, a new video contest, and various other elements that didn’t just make it an easy repetition. Not to mention the fact that Zoom fatigue has beset just about everybody and the summer conference set the bar high, so we knew we had to step up our game this time around to make the conference more engaging and meet higher expectations.

Thankfully, we had two tremendous leaders who had spent countless hours volunteering their time to make sure the event was of tremendous value to attendees. Conference Co-chairs Dave Young and Patrick Burns went above and beyond, pouring their heart and soul into the preparation and implementation of the event (plus, they are fun and kind, making them a pleasure to work with!). Coming up with fresh and interesting sessions is not an easy task, but the variety of topics was one of the most complimented aspects of conference. From climate change and ultramarathons to edible plants and women-specific issues in the wilderness, Patrick and Dave worked tirelessly to secure speakers who were passionate about a diverse array of topics.

Speaking of diversity, this was a major initiative of the 2021 conference planning committee. The WMS Board adopted a values statement last year focusing on inclusion and has been devoted to overcoming the historical myth that, “the WMS is for white males.” The significant increase in people of color and female speakers, plus an eye-opening lecture from Avinash Patil on Diversity in Wilderness Medicine, embodied the Board’s commitment to inclusion. The wilderness is for all, and our organization needs to be representative of the demographics of the greater medical community. Justice, Equity, Diversity & Inclusion (JEDI) Chair Roople Unia encouraged participants to complete an anonymous survey that was emailed out in order for the WMS to better understand its members and how to better serve their diverse needs. For the minority of people who still struggle to see the need for these efforts, Roople said it best: “It’s not about being PC or earning a participation trophy, it’s about eliminating structural bias and removing barriers to pull from a bigger pool of excellence.”

One other potent recurring theme throughout the conference was environmental protection. Speakers Jay Lemery, N. Stuart Harris, and Hanna Linstadt shared how medical professionals have the power to influence the availability and quality of outdoor spaces for generations to come through advocacy, interaction with patients, and policies within individual practice.

One attendee commented on the conference’s attention to social justice issues, saying, “I especially enjoyed that this conference tackled some issues that may seem controversial but really shouldn’t be controversial in a group of outdoor medical professionals.” After all, If there is no wilderness, there is no Wilderness Medical Society.

WMS conferences aim to provide very applicable and practical takeaways. When asked about the information learned that will be incorporated into an individual’s practice, the lecture that appeared the most frequently on the survey was, “Spinal Cord Protection” by Seth Hawkins and Jason Williams, which emphasized that spinal cord protection in wilderness settings should be goal-oriented rather than technique-oriented. The speakers covered the evidence-based, spinal trauma guidelines, which are somewhat controversial in that they maintain there is no requisite role for spinal immobilization, backboards, or rigid cervical collars in any out-of-hospital care.

Here are some other notable conference moments:

• The return of the Global Health Symposium pre-conference – Expert speakers such as Christopher Van Tilburg, Tony Islas, Catherine Coss, Bill Forgey, and Michelle Devlin helped kick the conference off on the right note. It was an inspiring day with a focus on how to truly meet the needs of communities around the world and serve them well, while also respecting the local culture. With nearly 100 participants, the impact of this training will be far-reaching.

• For the conference workouts, trainer Katie Dotson brought us high-intensity workouts from Camp Gladiator. Our favorite moment was when someone used skis for the weight-lifting portion. Another great example of improvisation to achieve a similar response to standard equipment!

• During her lecture on ultramarathon medicine, speaker Brandee Waite answered questions from the audience while briskly walking on her treadmill. While a few attendees preferred the traditional setting (sitting speaker), most of the audience felt inspired by her dedication to staying active.

• The ongoing dialogue through chat was once again one of the most praised benefits of conference. Some attendees mentioned that it was more interactive than live conferences because pre-recorded lectures allowed the speakers to be communicating with attendees during the presentation. One member shared, “The interactions between attendees in the chat was really valuable and provided for better opportunity to ask questions and network, particularly for someone like me who is shy and outranked in knowledge and experience by [other] practitioners in attendance.”

• The GME Mini-Lectures are always a crowd favorite and the winning lecture this year came from Miguel Pineda, “Nature vs. Narcotics.” He offered a side-by-side comparison of envenomation and natural poisoning toxidromes that imitate and can be easily mistaken for those of synthetic ingestions. Aubri Charnigo’s “A Wilderness Reading List” created quite a buzz as well, and even birthed an idea for a new WMS member benefit – a wilderness medicine book club. Stay tuned for more information coming soon.

• This was the first conference where we transitioned hands-on workshops to a virtual setting, and we had obvious concerns about sacrificing quality; however, Martin Musi & Darryl Macias knocked it out of the park with “Everything Ice Axe” and “Wilderness Survival.” Both instructors clearly put hours into filming real-life demos and planning for ways to involve the attendees in the discussions. Both speakers are highly engaging and have a wealth of knowledge (and for more from Darryl, be sure to check out the WEM! Live podcast).