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No one would ever guess when meeting Paul Auerbach that he was born and raised in New Jersey; but there it is in black and white on page one of his now legendary 56-page CV. There was something about Paul that exuded northern California and worldliness: from his wardrobe illustrating a very fit human usually in a Stanford Team Doc logoed performance t-shirt, to his intimate manner of speaking about humanitarian medical efforts around the globe, to his expert management of gnarly marine envenomations. His CV reflected the life of a man who squeezed the extra hours out of every day, usually by donating sleep, and honestly, by his family loaning him to the world to get it done. If you ever get the chance, page 56 alone is worth a look; it is where the movie “HAFE: The Story Behind” appears.

Paul’s education, life, and career took him across the country and around the world. If you were lucky enough to have more than one conversation with him, you learned that his family occupied his heart such that even if you never met his kids or his wife, you knew what they were up to and actually felt like you knew them. Reading through that CV, long enough that you must set aside time to do so, it leaves the reader wondering what the unfinished projects were, how many ideas never made it from his brain to a proposal and how many lightbulbs never even fully formed into ideas, similar to how after his death, composer Leonard Bernstein left the world wondering how many more great symphonies could be heard if he had more time. Because of Dr. Auerbach’s passion for mentorship, the fields of Wilderness and Disaster Medicine do not have a shortage of new contributors and pioneers, and in that way, Paul’s work will continue. Since the news of his recent passing, I personally have received no fewer than five correspondences on different ways to honor Paul by advancing education, writing and service. We can rest assured, Paul is proud. 

To memorialize a man like Paul Auerbach probably requires a two-volume book, not unlike his famous textbook Wilderness Medicine, now in its 7th Edition. Instead, this piece will try to paint an overview of the man many refer to as the Father of Modern Wilderness Medicine and provide remembrances that exemplify the impact he had on individuals, our Wilderness Medicine community and the world. 

Paul completed his undergraduate and medical education at Duke University in North Carolina, where he played Division-1 tennis, competed as a wrestler and was a musician! His medical training included an internship at Dartmouth-Hitchcock Medical Center and EM residency at UCLA. He worked as an emergency physician at UCSF and Temple University Hospital in Philadelphia, was Chief of Emergency Medicine at Vanderbilt University Medical Center, and finally ended up at Stanford Medical Center in 1991, where he held multiple roles, including Chief, and where he remained for the duration of his career as Redlich Family Professor.

Paul with a patient in Port-au-Prince, 2010
Photo credit : Chuck Liddy

Along with his team from Stanford, Paul responded early to the Haiti earthquake of 2010. As told by Jay Lemery, MD, FACEP, FAWM, Past President of WMS:

In 2010, I had the chance to see Paul in action in Haiti. It was a desperate situation-- the aftermath of a devastating earthquake, in a densely populated urban landscape. Paul was there organizing humanitarian relief before most NGOs arrived and about a week before the US military. He led an indefatigable effort, providing care, leadership, and confidence under dire conditions. It's an overused word, but he was truly heroic, and his actions embodied the highest attributes of medical-care providers at their very best. It was only years later that I understood how this experience took a significant toll on his psyche. I think he left part of his soul in that hospital courtyard in Port-au-Prince, but I know he never regretted a second of the time that he was there.

As told by Mel Otten, MD, FAWM, long-time friend and colleague, Past President of WMS:

I’ve known Paul for 40 years and during that time he was always that energetic, very fit, funny guy with a genius for new ideas related to medicine. He would constantly have new ways of doing things or medical inventions which always sounded fascinating to me. I think his best idea, other than the idea of wilderness medicine which I told him would never work, was organizing a group of medical responders for Haiti after the earthquake. Most teams take a while to get to the scene of a disaster. Paul mobilized his group in a short time which made me think that he had been planning this for a while. He and the others did good work in Haiti. After he returned, I noticed a change in him. Like combat, disaster response changes people, some for the better, some for the worse. I remember talking to him soon after he returned and some of the rough edges had been smoothed off. He was more introspective, more compassionate, more caring and more committed. Still the same old Paul in many ways but definitely changed for the better. Paul was one of a kind: “after him they broke the mold”.

Nepal and Wongchu
Sherpa Memorial Hospital

Known affectionately in Nepal as “Dr. Paul,” he was a founding director of the Nepal Ambulance Service which later became a key entity in responding to the earthquake of 2015- in which Dr. Auerbach returned again as a first responder. Most recently Dr. Auerbach, along with Dr. Eric Johnson and Dr. Luanne Freer, founded the Wongchu Sherpa Memorial Hospital fund. I would say this was Paul’s “passion project”, but as he told me once, “It’s all important.” The Wongchu Sherpa Memorial Hospital is set to officially open this fall in the Solukhumbu region of Nepal, an area deeply lacking any access to healthcare. Service to others and making the world a better place was at the center of Paul’s endeavors. 

As told by Dr. Om Rajbhandary, Founding Member of the Nepal Ambulance Service:

Back in 2010 we embarked on a mission to establish EMS in Nepal with the support of Stanford Emergency Medicine. This is how I met Dr. Paul Auerbach. I was impressed with his way of setting goals and mapping out a pathway to establish a new concept. He was the one to inspire me to move forward in my philanthropic journey with passion and determination. He loves Nepal very much. His commitment was also to support social entrepreneurs. One of his Nepali friends, Wongchu, had a dream to have a community hospital in Khamding, North of Kathmandu Valley. He requested me to support this project in the year of 2015. At that time, I realized how deeply he is connected with Nepal. To support his passion and his goal to establish a community hospital I offered my company’s services voluntarily to survey the area, establish a feasible design, and estimate a bill of quantity.

Later in 2018, he visited Nepal and requested me to execute the construction of Wongchu Sherpa memorial Hospital. I always thrive to keep my philanthropy work and business separate but in this case because of Paul I accepted to execute the project. He always introduced me to others as a saver and rescuer of the project which makes me feel more humbled and responsible. I am happy that the hospital is now functioning and serving the community and my sincere thanks to the team of Wilderness Medical Society, Himalayan Yokyu Foundation, and a very committed lovely young girl Lakpa for all their dedicated hard work. Paul wanted to visit Nepal again for an official inauguration of the hospital, which sadly didn’t come to fruition. However due to his able leadership, guidance, passion and the involvement of all of us, the hospital is much closer to serving humanity in a better way. Upon viewing Paul’s passion to serving humanity and his dedication in establishing the community hospital, it has brought togetherness among all of us to follow what he truly desired and while cherishing all the great memories together, this is a tribute to him! “When someone you love becomes a memory, the memory become treasure.”

As told by Michael McLaughlin, WEMT, Co-founder Musa Masala during the 2018 WMS Trek to the Wongchu Sherpa Hospital Site:

Morning was peacefully passing on our quiet mountaintop as we stared out at Mt Everest, not so far off, but yeah, not quite so close. Suddenly it disappeared in a cloud of dust as two helicopters descended practically on top of our heads at over 14,000 ft above Tengboche. Paul laughed as we rolled around trying to retrieve the gas cans that had been blown over the side of the mountain/hill. We needed that gas for our flight! Tourists had landed for lunch wearing oxygen masks from Kathmandu; they could not be bothered with us or our gear. When Lakpa Sherpa, Phula Sherpa, myself and Paul finally got our chance to fly down the valley, Paul snapped photos of us and was completely unaffected by all the commotion and his dust-covered friends. 

This was the Paul Auerbach that started the WMS? Wrote everything you need to know about chigger bites and avalanches? After we landed, we went straight up to the Wongchhu Sherpa Memorial Hospital site. Last time I was there my tent was where the main building now stands. Paul met everyone and was going over the plans. We filmed him talking about the hospital while wearing an outlandish outfit. Somehow, he made it work. While he may have had eclectic fashion taste, he knew how to talk to the camera. Afterwards he hiked with the Musa crew as we told him our vision. He seemed to jump in with both feet! Boom, Paul is here! How can I support you? 

That afternoon we met the builder of the hospital, Om, who worked tirelessly, together with Paul, Luanne, Eric and the team from Himalayan Yokpu Foundation, to make this project come to fruition. Greatness meeting greatness. What a lesson. In one day, we saw what a person is capable of when they have the knowledge, will and courage to move forward. You could go on for pages, because each moment was unique to Paul; you felt it. An enormous help and mentor to Musa Masala, we talked for over an hour earlier this year and I shook realizing how much he was facing. He chose to continue helping us, the hospital, and others while knowing what was coming. What a magnificent life.  

As told by Lakpa Sherpa, Chairperson at Wongchhu Peak Promotion and Himalayan Yokpu Foundation:

With a heavy heart, I must admit we've lost one of our guardians. I was deeply influenced by the personality of Dr. Paul. My late father, Mr Wongchhu, used to remember a few of his friends who believed in his dream and Dr. Paul was one of them. His contribution and restless effort for the betterment of Nepalis is unforgettable. His advice, ideas, suggestions, and the art of leadership will always be retained in our organizations.

 I met Uncle Paul for the first time in 2012 with my father. Since the first meeting, he guided us like a parent. Dr. Paul was very close with me and our institution. He used to visit Nepal once a year for social work and trekking. He was the one of the people who taught my father to dream for a better society. Dr. Paul had started a medical camp in collaboration with Stanford University in Solukhumbu, Nepal- the same place where a 15-bed hospital is being built in memory of my father. While we were going through the pain of losing a parent, Dr. Paul Auerbach, Dr. Eric Johnson, Dr. Luanne Freer stood up to build a hospital in his memory. They were the ones who always looked after us. We have plans to inaugurate the hospital this Fall with the presence of everyone but unluckily Dr. Paul left us early. However, we'll be missing him.

Dr. Paul has always been supportive. He improved our way of doing business and worked restlessly for the success of Wongchhu Sherpa Memorial Hospital. In recognition of his contribution and support, we at Wongchhu Peak Promotion and Himalayan Yokpu Foundation are planning for some work through which he would be always remembered. On behalf of our organization and associated members, we would like to express our heartfelt sympathies to his loved ones. May his eternal soul rest in peace. We miss you, Dr. Paul.

Paul in Nepal, with Michael McLaughlin, Luanne Freer and Lakpa Sherpa

Wilderness Medical Society

This tribute appears here in Wilderness Medicine Magazine published by the Wilderness Medical Society (WMS) solely because Paul Auerbach, along with Ed Geehr and Ken Kizer founded the WMS in 1983. In its founding documents, the WMS’s purpose was stated as: “to encourage, foster, support or conduct activities or programs concerned with life sciences which may improve the scientific knowledge of the membership and the general public in matters related to wilderness environments and human activities in these environments.” Nothing like it existed. Paul’s vision was unique among medical societies because the organization transcended the usual hierarchy of medicine. The WMS was open to anyone with an advanced degree in the biomedical or life sciences, not just doctors. It also had a membership category for those without advanced degrees. With that vision, Paul and the other founding members created a community of outdoor enthusiasts in the medical field, now 4,000+ members strong, who are bound by the privilege of joining our passion with our profession. More than most medical professional societies, the glue of the WMS lies in service, the tenet that guided Paul Auerbach’s professional and personal path. The WMS meetings, notoriously held in beautiful places and casual enough to encourage networking across hierarchies, have hosted the beginnings of a myriad of collaborations and relationships that have changed so many lives. This is the work of Paul Auerbach

As told by Tom “TK” Kessler, MD:

I remember receiving a mailing in 1983 just after detailing to the Coast Guard announcing the founding of a new society to focus on wilderness medicine, “This will never fly" was my impression. When it did succeed, I eventually joined due to my interest in austere and humanitarian/missionary medicine. That led to a decade of supporting the medical student elective in wilderness medicine begun by William Forgey with James Liffrig doing much of the initial groundwork. Although the society has sharpened a focus on expeditions, endurance sports, and technology it continues as a tribute to the foresight and energy of Dr. Auerbach. May you have wisdom in your task and emphasize the positive joy which radiated from Dr. Auerbach.

A Caring Physician

Paul was the world’s doctor. On more than one occasion I received referral calls from Paul letting me know about patients needing care in the cities where I worked. A few years ago, a young woman with recurrent hand infections from a sea urchin envenomation had found his name searching for help online. It would have been easy enough for Paul to say, “sounds like you need an in-person evaluation – make an urgent appointment with your primary care provider.” But instead, the world’s expert on marine envenomations took on the case personally. She had returned home to Philadelphia, where I was working, and Paul was talking me through the case - on the phone - with what she needed in the ED after I had done my initial evaluation. “See one, do one, teach one”, as the saying goes. Years later, while I was working in San Diego, Paul’s wisdom was ringing in my ears when a 12-year-old boy with recurrent foot abscesses and osteomyelitis presented after a boy scout trip to Hawaii and turned out to have retained sea urchin spines.

Paul, a passionate of marine biology, on a dive trip
Photo Credit: Ken Kizer

The Man Behind the Name

As told by Brenda Tiernan, RN, FAWM:

I was lucky to be invited on several Auerbach adventures. Whether it be on the Inca Trail, the trek to base camp in Nepal, or in the Dolomites, those hikes were quite often hilarious and filled with laughter listening to Paul’s endless stories (embellished with passing years). Things about Paul some may not know…the man is a shopper! Glasses and hats were hard to pass up, sometimes in multiple colors. Rugs and thangkas made their way back after Nepal trips, much to Sherry’s [Paul’s wife] chagrin. Also, this fearless man who seemed able to take on the world was afraid of heights as evidenced by witnessing him plastered against a few cliff walls! He also couldn’t resist a good gelato, but who can? He definitely encouraged and expected you to be your best. Professionally, he convinced me to go for my FAWM back when it consisted mostly of MDs.

Paul’s affinity for hats on display.

Many people describe Paul Auerbach as intimidating, even colleagues who have known him for years.

“Intimidating at first but full of love and support. The world will not be the same without him.” Emily Sagalyn, MD, FAWM

I first met Paul at the Northeast Wilderness Medicine Conference in Ithaca, NY in Fall of 2007. When I met him, I was just out of my residency training and had no idea who he was until after the conference (this was pre-smartphones). Paul showed up in town the night after the scheduled events ended, sat down with a group of attendees, including one of the smartest infectious disease docs I had ever met (who was really a climber at heart) and within minutes, Dr. Auerbach and the ID physician went toe-to-toe expounding on larger-than-life real-world experiences in managing illness and injury around the world. There was name-dropping, mentions of the worlds’ highest peaks, diving injuries in exotic places and missions in far off corners of the world that were subject to diseases we had barely learned about in medical school. There is a term for interactions like this, but the subject matter of this particular pissing contest was so intellectually stimulating (and just amazing enough to require fact-checking) that instead of walking away, myself and the other bystanders just watched and listened and learned. In Paul’s case it was never just talk, just like his CV was not just filler. The next part of the evening, he sat there as one by one, we all took an opportunity to talk to him about ideas, projects, and goals. He graciously listened, gave advice, and made it clear he was available as a mentor. This interaction changed the trajectory of my life and I’ve watched the same happen with folks over and over again.

As told by Jeremy Kessler, MD, FAAFP, FAWM:

My personal interactions with Dr. Auerbach were special to me. I was always met with a friendly handshake, a warm smile and engaging conversation. He had contagious laughter and a unique personality to immediately connect with those around him. Dr. Auerbach was a master at captivating his audience with intriguing topics of discussion that stimulated deep thought for days following his talks. He had a charismatic and poetic way of conversing, with either an intimate group or presenting at a conference. A recurrent passionate theme of his was to follow your dreams. It was encouraged to push yourself to the limits, test your capabilities, surround yourself with the wonders of the outdoors and live life in the moment with your eyes wide open. Dr. Auerbach will be greatly missed and his vigor for life and enthusiasm for continued experiential learning will continue to have a lasting impact on this community.

A Great Teacher, Mentor,
and Friend

At WMS meetings, although Paul was the VIP in the room, he actively got his hands dirty. A little over a decade ago, at a summer conference, Paul personally organized a large group of authors with specific tasks to embark on the first of several WMS Practice Guidelines. The manuscript was probably written in his brain, but he was teaching this group of young wilderness medicine providers how to do it. It was all recorded, there were deadlines, and it was clear what the expectations were. That is just one example of how Paul Auerbach inspired productivity.

As told by Deb Stoner, MD:

I served with Paul on the Education Committee. As an iconic visionary, Paul gave space and encouragement to everyone to be the same. As a newcomer to the committee, I proposed a Community Education Lecture Series (CELS) for WMS practitioners to use in their communities to educate the general public. The committee’s reception was lukewarm but after the meeting Paul told me to “go for it”. I did and CELS was born. Without those three words of encouragement from Paul I might have dropped the idea into a crevasse. Paul did that for all of us...encouraged us to find our visions and the fortitude to climb the steep side of ‘Mount ItCanBeDone’.

As told by Jay Lemery, MD, FACEP, FAWM, Past President of WMS, co-author of Enviromedics:

Paul was an exacting mentor. When he invested in you, he expected excellence - anything less was a waste of his time... and yours! So after many conversations, Paul paid me the highest compliment, when he agreed to co-author a book with me. It was not an easy project. After a particularly rough period of writing, Paul laid into me, stating “You write like a 5th grader!” When I heard that, I started laughing... That was the wrong response. “You think this is FUNNY?!?" he responded with incredulity. "Welp...," I sheepishly replied, "last week you said I wrote like a 3rd grader, so I guess it's been a pretty good week!" We laughed about that one....albeit many years later.

As told by Will Smith, MD, Paramedic, FAEMS, FAWM:

My first memories of meeting the Wilderness Medicine legend Paul Auerbach were as I was beginning my interest in wilderness medicine around the mid 1990’s. To meet the man with his name on the premier textbook for the specialty was both amazing but also a bit scary. But, as soon as you encountered Paul, he put me at ease, as everyone was on the same level and just able to share similar passions for wilderness medicine. 

Paul’s ability to connect and enhance Wilderness Medicine among friends and collogues was one of his greatest gifts. I can remember after giving a little talk on technical SAR in the Tetons at a summer WMS conference in Snowmass, Paul came up and said, meet Ken Zafren (who I also knew was a legend in the field) and said I want you to help him write his next chapter in my textbook. The other passion I remember from my multiple years of knowing Paul, was his love of teaching students. He shared and grew the passions of all those around him. Especially the ‘newcomers’ to the field of wilderness medicine. 

Wilderness medicine has lost a great advocate, but all of those that Paul indoctrinated with his passion into the field will be able to carry on his name and passion.

Paul was generous with his time throughout his life. Before my time as the director of the WMS Student Elective, it was a long-held legend that Paul would come out specially to attend and participate during the final nighttime scenario that went on until 2 am in February in snowy southeastern Tennessee. I always told myself it was because his son was living in Philadelphia attending law school, but he happily came to Philadelphia to present at the Mid-Atlantic Student Wilderness Medicine Conference (MASWMC) in 2012 and 2014 (I checked his CV). He made it clear he would talk about any topic or run any small group session we asked him to. Falling in line with all Wilderness Medicine conferences, we allowed for ample opportunity to network informally and Paul always had to be dragged away, not wanting to deny any student the time he was willing to give.

Liz Edelstein and Paul Auerbach with 2012 MASWMC Organizers and Paul’s son Brian Auerbach (top). Paul answering questions and networking with conference attendees (bottom).

Lauren Auerbach, MD, PGY-3, LSU, New Orleans (for this article, prefers the title “Paul’s Daughter”) discussing the University of Arizona College of Medicine’s MedWAR:

When I went to the Maricopa ED to recruit residents to help out, I casually mentioned that Dr. Paul Auerbach would be there and participating. None of the residents knew I was his daughter (I was only a second year medical student at the time) and they were all blown away that I was able to recruit the Father of Wilderness Medicine and didn't know what witchcraft I had pulled to get him there. I let them think I was more impressive than I actually was and never told them my connection. We had an impressive resident turn out...

The second story involves the actual MedWAR. There was a station involving lightning strike victims that the students were able to work through really quickly, so in true Paul fashion, he decided to help improvise and made the "actors" (parents of some of the students) start acting out crazy things like biting off their tongue during a seizure and giving birth and ultimately dying. I was petrified that the poor first and second years would be terrified and turned off by the drama, but they LOVED it and of course Dad was the ultimate teacher. He was able to show them all sorts of tips and tricks that I still get comments about to this day. I can't say the same thing about our "actors" who had no idea how to "bite their tongues off".

Dr. Lauren Auerbach with her father, Dr. Paul Auerbach.

Over the years, Paul was both mentor and friend to me, often in the same breath. At meetings he always made time for a hike and took the opportunities on the trail to dive into big conversations and check-in by asking me the questions about career and life I didn’t necessarily want to be asked, but always appreciated, even if it took a day or a week to really appreciate it. Asking uncomfortable questions was not difficult for Paul. In 2014, early on in my relationship with my now husband and father of my children, Ryan gave Paul a ride to the airport after the MASWM. On the ride, Paul asked Ryan point blank if he was in this relationship 100% and if he wanted the same things and would support all the things Paul knew I wanted. Some people would have been intimidated; but Ryan was not. He answered the question, dropped Paul at the airport, and here we are. Along the way, as I’ve navigated my way through career and parenting, advice from Paul has run the gamut from “It’s all important.” to “Even the sweetest dogs are dogs; do not leave the toddler alone in the room with the dog, even to get coffee.”

As told by Christopher Tedeschi, MD, MA, FAWM:

In 2010, Kiran and I trekked with Paul, Sherry, and a group of friends through the Solu Khumbu region of Nepal. We were the first group to complete a route that terminated at the village of our guide and host, Wongchu Sherpa. Spending those days with Paul and Wongchu allowed us a backstage pass to a gorgeous trekking route and plenty of time to hear stories, mostly from Paul.

A few years later when Kiran and I were expecting our first daughter, I worried that outdoor adventure would take a back seat for us. I asked Paul how he found balance when he first had kids, and he told me a story about how his 2-year old-daughter fell out of a canoe during a family adventure, her diaper inflating with water as she bobbed along. I keep that memory with me when traveling outdoors with kids becomes a challenge and usually end up smiling. Now, I find myself inspired by Paul's tenacity and predilection for showing up and getting it done - whether trekking in Nepal, responding to an earthquake in Haiti, or introducing your toddler to the outdoors.

The world is brighter and more interesting because of the life of Paul Auerbach. Wilderness Medicine is a discipline that all medical students know about in 2021 because of Paul Auerbach. While most of us won’t go on to fill 56 pages of a CV, because of the man that did, many of us will carry on his vision through our work: serving and doing our best to live our best lives and to make the world a better place. 

To commemorate Paul's profound impact on the WMS and the field of wilderness medicine, the WMS Board of Directors recently established an annual summer lectureship in his honor. The Paul Auerbach Lectureship will seek to invite expert speakers on topics whose work complements the vision of the WMS, to be thought provoking, innovative, and to nurture the breadth of the WMS. Friends and colleagues Peter Hackett and Brownie Schoene will work with the conference planning committee to identify appropriate speakers with the first inaugural Auerbach Lecture to be held tentatively in the summer of 2022. We invite you to come alongside us in honoring Paul by making a donation to this lectureship fund or the Wongchu Sherpa Memorial Hospital as a sign of gratitude for all his contributions to the field of wilderness medicine.

Photo Credit: Ken Kizer