Broken Skipper—What We Did Wrong

The first aid and survival kit we were carrying when John fell.

The first aid and survival kit we were carrying when John fell (compass, knife, matches, etc., were in a different pocket).

Okay, picture this: You’ve just crashed a long way down a flight of log steps a long way in on a hiking trail and smashed down onto a stump; you’ve analyzed the situation and realized you’ve broken your femur (a potentially fatal and definitely excruciating injury); you’ve moved into a safer and marginally more comfortable position and stabilized the leg as best you can; and you’ve hung tough for the 45 minutes it takes until the EMTs manage to fight their way along the trail to where you are lying, thinking that if you can just hang on until they arrive you will get some relief from the pain.

And, finally, there they are, with their beautiful bag of supplies! Finally, you think, relief.

Only to be told that EMTs are not allowed to give you so much as an aspirin, even once you’re in the ambulance. So now you have a further 5-hour ordeal ahead of you while they carry you out of the woods and then drive the hour it takes to get to the hospital. 5 hours that seem like 5 years while you suffer the worst pain you’ve ever felt in your life.

No Pain Meds, What Were We Thinking?

It’s weird, we’ve always made sure we have painkillers in the boat’s first aid kit but we’ve never thought to add them to our hiking first aid kit. I guess we assumed that rescuers would carry them or that the person left standing would run back to the boat to get them; which, in hindsight, are actually not very smart assumptions. But we learned our lesson the hard way and from now on some of the good stuff will be in our backpack for all excursions. So that is what we did wrong in this situation.

Isn’t There More To It Than That?

But wait, you ask, wasn’t the fact that the fall happened at all a mistake?

Yes, you’re right, since the definition of accident is “lack of intention”*, or, I guess you could also say in this case, “lack of attention”. Yes, John’s attention wandered—this is his mea culpe, not me putting words in his mouth—and he was thinking about something else when his foot hit that invisibly moss-covered, incredibly slippery wooden log. But who hasn’t let their attention wander? I know I have.

However, John and I have learned from this accident—an accident where the outcome was way out of balance with the mistake made, since most people sprain an ankle in this sort of situation, not smash their femur—learned that the same attention we take when hiking in Greenland or Baffin Island, where the consequences of a slip could be even more catastrophic, is the same level of attention that we should be taking whenever and wherever we are. Newfoundland, to us, feels like home, and so we let down our guard.

The Fall-out (So To Speak)

And now we have to live with the emotional—no longer just intellectual—realization that horrible things like this can happen just like that and even in our own backyard. So I’ve warned John that he will have to wear a fully padded suit, sort of like the Michelin Man’s, while hiking from now on—he thinks I’m kidding!

Onward and Upward

But put all that aside. The bottom line is that John survived and, really, the rest we can and will deal with: get pain meds, practice awareness, overcome the fear, and enjoy every single day that we have together.

Caution

There are, as we understand it, medical conditions where administering analgesics to the sufferer can make things worse or even cause a death. It is up to you to decide whether you will carry pain killers into the wilderness or use them in the event of an accident. We are not making recommendations in this post.

*Free Online Dictionary

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Meet the Author

Phyllis

Phyllis has sailed over 40,000 offshore miles with John on their McCurdy & Rhodes 56, Morgan's Cloud, most of it in the high latitudes, and has crossed the Atlantic three times. As a woman who came to sailing as an adult, she brings a fresh perspective to cruising, which has helped her communicate what they do in an approachable way, first in yachting magazines and, for the last 12 years, as co-editor/publisher of AAC.

15 comments… add one
  • Ken Page Mar 22, 2013, 3:06 pm

    Not in any way to make light the dire situation you guys were in when this fall happened, but would a pint of Jack Daniel’s have helped?

  • Dick Stevenson Mar 22, 2013, 5:39 pm

    Ken,
    I would have to do a bit of research to get the lingo correct for a long answer, but the short answer is “no”. Alcohol is a very complex drug which affects the central nervous system (among other systems) and may/will make interpreting of vital signs and diagnosis more difficult and has a good chance to make the patient worse, especially if shock is a possibility.
    Dick Stevenson, s/v Alchemy

  • Marc Dacey Mar 22, 2013, 6:14 pm

    Coincidentally, I am taking a “Marine Medicine” course over this weekend, so we will probably cover this off, but I would imagine the primary reason for “no liquor” is that alcohol is a vaso-dilator; if you have internal bleeding or a broken bone has torn a vein or artery…it would be worse. It’s also why you don’t give a shot of brandy to a hypothermic person…you will defeat their attempts to warmn up by effectively throwing all their body’s “windows” open in January.

    Still, all this proves that adage that the greatest danger to sailors is land!

  • Kettlewell Mar 22, 2013, 7:36 pm

    Frankly, I’m impressed with what you did have with you, and how well you managed. I have also hiked and climbed all sorts of places where the chances of rescue were remote and my own philosophy is that it is simply part of the risk we take. Yes, you could have had painkillers, but you didn’t and you survived, didn’t you? Most people do. Yes, it was horrible while it was happening, but in the end it didn’t really make much of a difference. Chances are you will be that much more careful next time, meaning that carrying additional emergency supplies will be that much more a waste of time, energy, and hassle. For example, really strong painkillers are a red flag every time you cross a border, or are stopped by local police in a place you may not speak the language. I have been in some pretty extreme pain before (completely severed my Achilles tendon so that my foot was just flopping on the end of my leg) and I find now it is in the past and I don’t worry about it once it is over. You coped, you did good!

  • Colin Speedie Mar 23, 2013, 7:33 am

    I don’t think you did anything much wrong – at all. We’ve all taken our eye off the ball at some time in our lives, generally with less than serious consequences – to err is to be human.

    Looking back through this series it seems to me that you were both very well prepared indeed, certainly far better than we would have been.

    So thanks for such a valuable reminder to think things through more carefully before setting off into the woods – which we’ll act on.

    Best wishes

    Colin

  • richard s. Mar 23, 2013, 7:58 am

    as i seem to recall, i believe you said you used your sat phone to summon the emt’s ? even then you still must have the correct dialing info or is it 911 throughout the developed western hemisphere ? did you also have gps to direct the emt’s ? also, i’m wondering about maybe a firearm or two ? a goodly dose of tylenol or even motrin would at least take the edge off the pain…do you have a back-in-commission date ?

    richard in tampa bay, s/v lakota

  • richard s. Mar 23, 2013, 8:15 am

    i just answered a couple of my questions above with a quick review of your earlier posts in this series…i see you had your cellular phone and used that to direct the emt’s…good you were in range

    richard in tampa bay
    s/v lakota

  • Nick Hallam Mar 23, 2013, 8:22 am

    Are EMTs what we Brits would call paramedics? In our islands, the paramedics (or to us older folks ‘ambulance men’, though they now arrive on motorbikes, cars, helicopters, or on foot if you’re up a mountain, and are as likely to be ambulance women as men) are very highly-trained, carry a fabulous amount of kit and this definitely includes a wide array of pain-management items. I don’t understand why your EMT folk are not permitted or trained or equipped for basic pain control. ‘Grit yer teeth, boy – you’ll have forgotten all about it in a year’s time’ is a poor substitute for modern paramedic practice, surely?

    Best wishes for continuing recovery: I bet you’ll be looking long and hard at those jack lines on deck, plus any other trip hazards!

  • James Hallett Mar 23, 2013, 8:32 am

    When we go down to the sea in boats and and seek adventure , an element of risk taking is inherent. There is a point of prudent preparation and avoidance of unnecessary and unrewarded risks, but to blame yourselves in the Newfoundland accident implies that you can somehow become riskless; despite the jolly image of John in a Michelin man suit, that would undermine the joy in adventure.

    Best wishes – James

  • RDE (Richard Elder) Mar 23, 2013, 9:56 am

    Funny what you run into when you are having huveos rancheros at Noras restaurant in Jackson Hole WY.
    Denny Emory was the delivery skipper for Hinkley back when they were still building gold plated sailboats. He now has a company that specializes in emergency medical kits and related safety equipment for blue water sailing. http://www.oceanmedix.com/

  • Ernie Reuter Mar 23, 2013, 10:19 am

    Nick, as an EMT I here in Vermont and a member of 2 squads 1 of which is a mountain backcountry team, not all EMT’s are able to administer pain meds. The term “EMT” is often given to any medical responder that comes along.
    Here in VT, ,EMT-B’s are the basic and are able to do basic life support….ABC’s…airway, breathing and circulation, wound care and splinting…… Not much more. The next level up is the EMT I level which can start IV’s for medication administration and fluids as well as give a limited number of medications, none of which are pain related. The final and highest level of training is a Paramedic. He or she has the ability to do many advanced interventions including the admin of various pain meds. So John…..the level of medical care that arrived at your scene likely did not have pain med admin in their scope of practice. When we have mountain calls here in VT, we have everything from firemen running up the mountain in their bunker gear (which is a big no no), all the way up to Paramedics. It really depends who is available at the time and……the severity of the call that comes in. In a perfect world, we have a couple of B’s to help stabilize, an I to get the IV going and then a Medic to administer the pain med both on the scene and on the carry down. So all of this being said, as soon as one crosses the border to NH or Maine, or up to Canada, all the state certifications are different and the scopes of practice change as well.

    So I would say the bottom line would be to try to be as prepared as possible to take care of yourself with at least some mild form of pain relief until the crew arrives and…..hope that the cert level that comes is able to lay on the heavy stuff to make your ride down a bit more comfortable.

  • Kevin Mar 23, 2013, 12:47 pm

    Were they unable to provide an a basic pain medication or was it due to fears regarding internal bleeding, hypothermia, or shock? I would always be cautious about anything that might increase blood-flow if you are bleeding externally or possibly internally. I always have ibuprofen with me, I might have provided it to someone in your situation without thought toward the consequences. I am fortunate that emergencies tend to make me very calm and deliberate and that I can usually act with great care or great speed. It might not have occurred to me once thrown into “rescue mode” that internal bleeding might be accelerated by pain medication or alcohol. I clearly need to do some reading on that. Also I am not sure that the average person should be carrying anything much stronger than ibuprofen away from the boat. Any medicine that is part of your EDC (everyday carry) should be understood by the person carrying it.

  • Phyllis Mar 24, 2013, 8:16 am

    Thank you to everyone for the comments.
    The EMTs (I don’t know if they were fully trained paramedics) told us they were not allowed to give out painkillers, ever. When John was transferred from Clarenville to St. John’s the next day, a nurse had to go along in the ambulance in order to dispense the pain meds. So various jurisdictions have different standards, as Ernie reported.
    Though there are situations where taking a painkiller might be contraindicated (and booze is always contraindicated in an accident, plus it’s way heavier to carry in a pack than a small bottle of pain pills!), we will talk to our doctor about what we might carry in our pack that could be taken in such a situation (fingers crossed we never need it). Just to take a bit of the edge off. Though nothing is without complications – too much Tylenol will damage your liver, etc. – so we wouldn’t give it out to anyone we met along the way.

  • Simon Wirth Mar 25, 2013, 5:50 am

    Thx Phyllis for the good reminders.
    It’s to easy to forget the dangers of doing something you like at a place you feel at home.
    And regarding the painkillers and different levels of training, it is never an easy subject. In Switzerland, most foot based mountain rescue teams are mostly mountain guides. Sure, the do special coreses and all, but their primary function is to get every where in every weather.
    For everyday accidents in good weather, as most accidents are, Switzerland uses the advantage of it’s small size and REGA (www.rega.ch if someone is interessted) with their helicopters cover everything. And there is a reason why they cary a near equivalent of a intense care station on board.

    Anyway, thank you for the good thoughts and reminders, I allways greatly enjoy reading your thoughts.

  • Paul Padyk Mar 25, 2018, 1:07 pm

    As an emergency medicine physician I cannot overstate that alcohol is the worst possible substance to take when injured. In addition to all of the reasons already accurately stated, alcohol alters mental status in unpredictable ways and confuses the evaluation for head injury. Sure, in this case John’s injury seemed like an isolated leg injury but if he were to have been sleepy when rescue workers arrived then a head injury would have to be in the list of significant injuries also, further complicating a challenging evacuation.

    In my opinion, it is reasonable to carry a small amount of oral narcotic pills for just such an event. With severe pain as John experienced, the usual prescribed dose of hydro- or oxycodone 5 – 10 mg would likely diminish the worst of the pain without significantly altering mental status. As with everything, whether to medicate or not is always a judgment call after thoughtful evaluation of the benefits and risks.

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