Doctor knows how to take a hike

By Michael Blackman
Office of News and Publications

In the world of wilderness medicine, where scrapes and sprains are as plentiful as blisters and bruises, Dr. Victor Vines recommends you never leave home without the ubiquitous healer of all things broken, torn and battered:

Duct tape. 

"Splints and a bunch of duct tape," said Dr. Vines, class of '84, and an avid camper, trail biker and mountain climber. "You always want those."

Especially duct tape. Because, said Dr. Vines, "You can tape the splints, fix or cover blisters, close skin lacerations, make an eye patch; you can even make a harness and build a litter.

"And you can repair every piece of camping and backpacking equipment with duct tape."

Welcome to wilderness medicine, which Dr. Vines, a North Dallas obstetrician-gynecologist, said is roughly defined by its educators as "medicine that is practiced where access to emergency transport is more than an hour away."

And that doesn't always mean the boondocks.

"You could be in the city, anywhere, say down on the Trinity River, and somebody gets snake bit," Dr. Vines said. "You might as well be in the jungle."

You make do with what you've got, however remote you are. It's the heart of wilderness medicine. 

Dr. Vines is a member of the Wilderness Medical Society, a nonprofit, 3,000-member organization formed in 1983 by three California physicians. Its mission: To advance health care, research and education related to wilderness medicine. According to the society, "Wilderness medicine topics include expedition and disaster medicine, dive medicine, search and rescue, altitude illness, cold- and heat-related illness, wilderness trauma, and wild animal attacks." 

Dr. Vines, along with fellow physician and UT Southwestern graduate Ed Clifford - class of '86, a general surgeon in Dallas - was introduced to wilderness medicine 12 years ago while taking a course on glacier climbing at Mount Shasta (summit: 14,162 ft.) in Northern California. Their accumulated knowledge proved valuable three years ago when Drs. Vines and Clifford took some 10 members of Southwestern's class of 2004 to Colorado for a climbing trip on Mount Yale and Mount Princeton. 

"While on our trip two guys got separated from the group during a thunderstorm, replete with lightning hitting within 100 to 200 yards of our location," Dr. Vines said.  "After we found them soaked and cold to the core, we had an impromptu lecture about group safety dynamics in the mountains, lightning dangers and avoidance, and management of hypothermia."

Over the years he's frequently used his wilderness-medicine skills on Boy Scout trips and other youth outings. 

"We always had foot clinics - abrasions, blisters, sprains," Dr. Vines said, "and minor lacerations, nicks and bruises." 

With today's "dramatically improved" first aid kit that (besides duct tape) includes such medical fix-its as super glue - "with super glue you don't have to do sutures in the back country" - wilderness medicine has become ever more practical.

Just how practical Dr. Vines learned firsthand last summer when he was biking down a mountain in Banff, Alberta, Canada. 

"I was back in bear country - by myself," he said, allowing that going solo might not have been among his more sparkling ideas. Though Dr. Vines doesn't remember exactly what happened, he believes he hit a rock and flew over the handlebars. Knocked out and bloodied, "I was bear bait." No bears came sniffing, but he suffered serious cuts on his face and above an eye. "I was pretty messed up." 

Other cyclists eventually found Dr. Vines. Utilizing their wilderness-clinic skills (including use of a cellphone), they stabilized him, then transported him 200 yards away to a flat spot so a helicopter could pick him up. As they carried him on a litter provided by the copter crew, Dr. Vines said, "I was quizzing them about their wilderness medicine techniques. The rule is, someone is to remain at the head of the litter as a buddy to talk to you, keep you calm as you're being transported."

His companions laughed at the axiom. 

"At 230 pounds, you don't get a buddy," one said. "It's taking all of us to carry you." 

Dr. Vines, a Lubbock native who did his internship and residency at St. Paul University Hospital, has been practicing in Dallas since 1988. He's lucky, he said, if he can get away for three or four outdoor outings a year, which often include piling gear and 20 friends in an old school bus and going camping.

But don't count his wife, Tammy, and daughters Gable, 20, and Molly, 16, as passengers aboard that bus. 

"They're tolerant," Dr. Vines said. "They're just happy if I come back intact, but don't make them go - ever."