Over the next few months we'll all be spending a lot more time indoors trying to limit the spread of COVID-19. We've been in touch with members of the mountain medicine community to ask them for suggestions on how to manage. Here's David Hillebrandt, a GP based in Devon who has been at the forefront of mountain medicine in the UK for many years, to share his thoughts...
Three months ago if you asked a Diploma in Mountain Medicine (DiMM) candidate or holder what they had got out of our diploma most would grunt a bit about interesting physiology or learning from our guiding team but on further questioning their faces would light up and they would mention the friendships crossing barriers of professional grade, international borders and cultures. This peer support is now even more important.
Since COVID-19 reared its ugly head (do viruses have heads?) several people have contacted me to say how they now realise that the diploma put them in the right mindset for coping with the concept of working in a resource poor environment. Many of us have worked in such an environment and are not unfamiliar with making difficult ethical decisions. Skills of improvisation and thinking out of the box are vital to pass our course and will be vital over the coming months.
Many diplomats come from a background in anaesthetics, intensive care, emergency medicine and general practice. They are already on the front line and can see what is coming. Some have already had patients die of COVID-19 infections and some have already had the infection themselves and are hopefully emerging with a degree of immunity. We also have diplomats with skills in infectious diseases, public health and disaster medicine and we can draw on their knowledge.
We are entering a time when CPR, for a time, will become a thing of the past but those with major incident training will understand the concept of doing the best for the most and hopefully this principle will give them reassurance when they look back on this pandemic. Although on paper it is easy triage is an emotive skill and I suspect it is one GP's may struggle with if we start to find some patient groups are offered terminal palliative care in the community.
Our local Devon BASICS is very involved with the resource planning for community care and some of us are dealing with cases on a daily basics. We are a strong mutually supportive team and have already developed systems of mutual and group support. Some of our planning in the early stages was done on shared kayak trips. Climbs had been planned but frustratingly these important forms of mental and physical relaxation are now not possible. We are sharing ideas. One person keeps pigs, one is a birdwatcher. Simple but important pleasures. With my age and medical history I have opted out of direct patient contact but still find myself busy supporting colleagues by taking some admin jobs off their shoulders and being available on the phone.
My sympathy lies with those of you who are city based so cannot get out for a rural bike ride or bumbly walk. If it gets to you phone a friend even if it is only to share a loud swearing session. Use the BMMS email group to share ideas on the best climbing books and videos (Valley Uprising?), plan future routes and mountain projects. We must look after each other but make some time to send thoughts to our colleagues from the amazing international mountain medicine community some of whom are already working at more than full capacity.
When it is over the crags will feel steeper, the uphills longer, ski runs will pound your weak legs and rucsacs will feel heavier. We will have lost some of our physical fitness but at least we will be able to go out in the hills with our friends again.
Part 3 of "Isolation" can be found here.
Please get in touch if you'd like to take part in other "Isolation" posts!