Volume , Issue

One of the most valuable benefits of WMS membership is the ability to apply for candidacy for the WMS Diploma in Mountain Medicine (DiMM), which is an internationally recognized certification. The crux of this multi-week certification pathway is a one-week course of alpine rescue skills on a glacier. Previously, this course had been held on Mount Rainer, but this year’s course was moved to Mount Shasta (4322 m), the most voluminous stratovolcano in the Cascades with the largest permanent glacier (Hotlum) in California. The mountain and surrounding area are part of the Shasta-Trinity National Forest. This summer, the weather in the Pacific Northwest has been unusually hot; daytime temperatures in the valleys exceeded 40°C. Additionally, very dry conditions due to a multi-year drought spawned many wildfires burning across the American west and northwest. For example, the Bootleg Fire has burned over 160,000 hectares in southern Oregon and is still growing as of this date.


The DiMM Alpine Course was convened at the SWS Mountain Guides headquarters in Mount Shasta City on June 26, 2021, by course director Andy Rich (AEMT and University of Utah Assistant Professor). Assistant Instructors were Andy Anderson and James (JB) Brown, both experienced mountain guides and instructors. The course was limited to eight DiMM students who had all successfully completed the first three one-week phases of the DiMM certification: Winter Rescue, Summer Rescue, and Rock Rescue. By chance all eight were physicians: five emergency medicine doctors, one trauma/critical care surgeon, one OB/GYN-oncologic surgeon, and one critical care anesthesiologist. After reviewing the expectations for the week-long course, inventorying our gear, setting up tents and trying out our camp stoves, we had an introductory lecture on glaciology and the hazards of glacier travel. Our instructors also clued us in to the basics of the “Leave No Trace” principles of wilderness travel which include packing out all waste off the mountain. We then drove on forest service roads to the Brewer Creek Trailhead on the lonely eastern slopes of Mount Shasta (2200 m) where we made camp for the night. The next day we hiked to what would be our basecamp for the next several days of training at 3050 m which everyone considered our first test of physical stamina. With all the personal gear, food for six days, water, crampons, ice axes, and climbing gear, most packs weighed over 25 kg and in some cases more for those that had packed injudiciously.


After a night of fitful sleep tormented by mosquitoes, we broke camp and started our hike. We rapidly passed through the pine forest into the scrub near tree line and started up volcanic scree into our first snow couloir where we kicked steps into the soft snow. After an exhausting climb lasting over three hours with our heavy packs we arrived at our next basecamp (known locally as the “Hotlum Hilton”) at 3050 m, from which we could easily view the summit of Mount Shasta and imagine the potential climbing routes to the top. The Hotlum Glacier could be seen approximately 700 m above us, with prominent seracs and ice falls, where we would eventually learn and practice crevasse recue and practice safe glacier travel. But first, we had to learn to walk with crampons and to use our ice axes for belaying and self-arrest. These skills were acquired on a conveniently located tongue of the glacier a few meters above the “Hotlum Hilton.”

Stopping the fall, Hotlum Glacier on Mount Shasta

In the crevasse, holding on for dear life

 

One and one-half days were spent practicing use of crampons, self-arrest, constructing snow anchors, glacier movement in rope teams, and moving patients down and across a low-angle glacier. On the following day, we hiked the 700 m up to the Hotlum Glacier and along the way we observed hummingbirds at an altitude of 3400 m! We filled our water bottles from glacial melt and proceeded to climb, using crampons and ice axes, and then stopped to form rope teams as we encountered our first crevasse. Once reaching an area at about 3700 m, we began to practice crevasse rescue in a conveniently located shallow crevasse. The first step was to locate and mark all crevasses in the immediate area of our drills, to avoid a rescuer being swallowed by a bottomless crevasse. During the event, at least one rescuer fell into a covered crevasse while attempting to extricate a rope team member from a known crevasse. This, our most important day of the course, ended after descending the Hotlum Glacier back to the “Hilton” only to find the entire forested valley below our basecamp filled with the smoke from two rapidly expanding forest fires, either of which could have impeded our egress off the mountain and through the surrounding wilderness areas. After a discussion of the risks and benefits of continuing the alpine rescue course as planned and obtaining additional data from the US Forest Service and the Mount Shasta City Fire Department, we collectively reached the conclusion that the most reasonable course of action would be to descend the mountain in the morning, drive back to Mount Shasta City, and to continue the alpine rescue course, albeit on rock, in local parks and wilderness areas located away from the danger zone. The most proximal forest fire to us was the Lava Fire, which burned over 12,000 hectares on the northern slopes of Mount Shasta.

Smoke from the Lava Fire rising over Mount Shasta

On the fifth day of the course, we descended the crumbly volcanic scree slopes and a snow couloir to reach the trail in the scrub terrain near tree line. Unfortunately, our packs were still ridiculously heavy due to the need to pack out our tents, stoves, and climbing ropes that had been carried up the mountain by porters. More than one choice word was uttered by our team as we sweated and carefully considered our next footstep where a misstep could have resulted in a fall, twisted ankle, or worse injury. Mercifully, after two hours, we were off the volcanic scree and into the scrub where a real trail could be discerned. We found ourselves in the coniferous forest and soon we spotted our vehicles.

Our team of DiMM Students ready to descend from the “Hotlum Hilton”

During the two hours we were allotted to shower, re-acquaint ourselves with the use of indoor plumbing, and to wash our clothing, Andy Rich came up with an alternate training plan to allow us to complete our course sans glacier. We spent the next two and a half days practicing the skills of crevasse rescue, albeit on rock, and refreshed our previously learned skills from the Rock Rescue Course, incorporating team building, steep angle rescue, and hand-held radio communication. This culminated in an all-day rescue scenario in the Castle Craigs State Park. Due to the growing Lava Fire on Mount Shasta’s northern slopes, the second cohort of the DiMM alpine rescue course would instead be held on Mount Hood in Oregon. It is to the great credit of our lead guide, Andy Rich, to design an acceptable conclusion to our course and simultaneously plan for the follow-on group of DiMM students, seemingly without missing a beat.


When we departed company on the last day of the course after a well-deserved meal in a Mount Shasta City restaurant, all eight of us had become teammates, good friends, and more mature rescuers thanks to the skills we learned throughout our DiMM courses. This was due in no small measure to the competent, consistent, and humble instruction by Andy Rich, Andy Anderson, and James (JB) Brown. Now, it is up to each of us to decide how we will utilize the mountain rescue skills we acquired over the last several years of our DiMM training.

Farewell dinner

You Might Also Be Interested in


Afghan Evacuation, Austere Medicine, and the COVID-19 Pandemic

CPT Terri Davis, MD, FAWM9/22/2022

One doctor's account of assisting evacuees during COVID.


Norovirus in the Grand Canyon

Thomas Myers MD / Medical Advisor for Grand Canyon National ParkBrad L. Bennett PhD, Paramedic, MFAWM / Military & Emergency Medicine Department, USUHS8/5/2022

Transmission, prevention, and treatment in the backcountry


Canoeing with Tornadoes

Lynn E Yonge, MD, FAAFP, FAWMWalker Plash, MD, FAWM7/29/2022

Danger from the sky during canoeing expedition


Thermodynamics of Oral Hypothermia Treatment

Aaron R. Billin, MD, MS, FAAFP, MFAWM6/1/2022

Thermodynamics of the Oral Treatment of Mild Hypothermia