Friday, 22 April 2022

Glencoe's Low Level Cragging

Stunning Spring weather so I took a run up Glencoe to visit some of the roadside crags. "The Bendy" has many routes. I did routes at either end and one in the middle with Gary Latter back in the 1980's and Gary and Stork did some other ones. The Bendy is a great Spring and Summer morning venue and has a tremendous big swimming pool below it. Midge hell at night though. Sad to see the old Rannoch Club Doss debris after the fire. As a rescuer we were there a few times taking club members out who had broken legs on the wooden ladder climbing down into the gorge to get to the hut. Often on return from Clachaig.

Below this is the really good little "Dry Gorge Crag" an excellent evening crag which catches the sun and has easier less bold routes than the Bendy. Up the dry gorge is "The Squirrels Crack" and opposite a nice but short crack route that I did with Mark Tennant which about HVS 5a/b. Further up is the bold blank crag that Garry Latter did a few routes on.  I think these routes are in the new outcrops guide and some are certainly in Garys selected climbs guide Scottish Rock Vol. 1 South. If you want to study the images closer just click on them and open up a bigger size.

All that remains of  "The Rannoch Doss" a once well used and secretive hut below Allt na Reigh
Bang in the pic centre at the top of the wall is the final groove (with a peg runner) of "Simmering Psycho" E3 6a Davy Gunn lead and Chris Ducker (Fionas Brother) 1998
The left side has a cracking E2 5b that I did with Mark Waugh as second. In the middle wall are the E4 6a's that need RP's and have exploding crimps!  I did a FA of one with Gary and the others I think he did with Stork. There is a dry platform below so no need for wet feet. Quite a pool and roaring waterfall across from you.
The Dry Gorge Crag. A great little micro crag. Maybe 10m in height. Right to left. The grey wall on the right with a very thin crack is "Crimp" needing a couple of RP's is E2 6a and crimpy. Left again is the very well protected "Sin Nombre" E1 5b a bomber crack for cams and mid sized stoppers. Left again across the black streak is "Ascolatre" E1 5c again good pro but a bit thuggy. Then left is an alternative direct start to the same finish which is maybe 5b/c. FA's Davy Gunn with Chris Ducker and others.
Slightly further up on the same side as the dry gorge crag is"Crack Route" HVS 5b FA Davy Gunn and Mark Tennant. A damp little number but well protected with cams and nuts.
Even further up on the left side is "The Squirrels Crack" by - you guessed it, the Edinburgh Squirrel climbing club.  No give away at HVS 5a/b it used to have a peg runner at the overhang and is fairly well protected but no belay at the top so its a sit and squat job or leave a rope far back. You can get to this route from the top of the dry gorge by scrambling in from the high point.
Garys Crag has a few hard routes but no gear. Multiple bouldering matts might suffice as they are "highballs"
Looking up into the bowels of Beinn Fhada in the middle is a slot. The right side has a detached pillar with a route called "Triple C Special" HVS 5a. You can take it that it's pretty much ungradable much like KAK it's V-Diff neighbour lower down which in the old english would be XS. Both would be nice for those liking a JH Bell style such as Chimney Route - Severe Aonach Dubh "where the last 20 feet are on rock"!!
Looking across from the top of "The Squirrles Crack" to Allt na Reigh home of  Downie's Barn (on the right of the cottage) which is often mentioned in Alastair Borthwicks book "Always a Little Further". This later became Hamish MacInnes's workshop when he started making ice axes and stretchers so is a bit of Glencoe's history. Under the old road bridge (this is a new one) used to be another doss which in my day the donkey jacket clad "Black Frank" lived in. He was a dirtbag climber who lived rough and climbed hard in the 1970's and who's favourite ice tool was shortened wooden grivel axe with a bent pick he had shaped over a gas stove.

Wednesday, 2 March 2022

À la recherche du temps perdu - or getting an MOT?

When to the sessions of sweet silent thought

I summon up remembrance of things past,
I sigh the lack of many a thing I sought,
And with old woes new wail my dear time’s waste …
Shakespeare Sonnet 30

Today has started as a stunning cold sunny March morning so I decided to walk back after dropping my car for its MOT. An enjoyable wander where I bumped into an old climbing and rescue colleague and we chatted about all things mountain. In conversation he said, by the way I must thank you again for saving our lives, me and my belayer 27 years ago. Not quite what I expected! Among the many boxes of memories some locked away, it took me back to the night in question and especially the guys who I was with. Great guys and sadly one, Millsy, no longer with us.
Paul Mills "Millsy" and Rescue 137 Sea King
The night in question was late February, bitterly cold and moonlit to the point of making a head torch largely redundant. Al, a very experienced local climber had set off earlier that day with a local lad learning the winter ropes. Their route was North West Gully Stob Coire Nam Beith. NW Gully is a modest 450m grade II/III winding its narrow way up past "the Pyramid" and "Sphinx" and if taken direct can be a bit harder on steeper ice. The rock architecture is fantastic and although the route is 450m in the guides, its actually a lot longer than that to the summit and feels quite alpine in scale. That day it was bullet proof neve and in great condition. No mobile phones back then and no great shakes to be a little late back so Al's wife was not too concerned when he wasn't home by five o'clock, although like myself we often started early and expect to be back 4 o'clock-ish.  However, when they had not come back by Eight she phoned Hamish. He wasn't at all concerned as Al was experienced and no point in calling the team out when they were probably just finishing late. She however felt something wasn't right so called him back again at Nine to get the same response. Meantime, as one of Al's friends she called me and asked what she should do, so I said I would get a couple of the lads next door and we would go have a look. I radioed the team and said three or four of us were going up for a nosey to put her mind at rest. My neighbours at that time were Peter (Chalky) White on one side, and Paul Mills on the other. Chalky was a forecaster with the SAIS, ex RAF MR, and a damn good mountaineer and rescuer. Paul "Millsy" was working as an independent MIC after leaving Glenmore Lodge and at that time was staying in a wee damp hovel of a cottage next to Tigh Dearg which has since been knocked down. Gary Latter was in it before him. Someone else came out as well but I cannot for the life of me remember who!
Pete "Chalky" White.
Wearing the safety gear of the day building Glencoe Mountains new chairlift 1990
We set off up into the corrie moving pretty fast as it was now about ten pm at night, and made our way around the right of the corrie to near the "Rognon" a raised feature on the West side up towards Hidden Gully, and started shouting. Faintly we heard shouts back and could just about make out that one was injured. This changed things a lot and we moved into rescue mode, called up the team and asked for a SAR helo. Millsy and I headed down towards "the Gate" and around as we were a bit lower and started soloing up NW Gully. By this time its getting on for eleven. We climbed up until we reached the right fork of NW and a variation finish, and Chalky was able to direct our lights to the shouts and a faint beam of light he was able to see. The right fork goes up the Sphynx to the Mummy where there is a hard pitch up to the shoulder. This is probably old fashioned grade IV, short and steep and a bit of a sting in the tail after a long climb. We got to just below their belay at about midnight when SAR 137 a sea king, the first we had seen as the Wessex had just been retired, arrived in the hover above us. It was horrendous from downdraught and blowing snow and bitter cold. We could tell Al's leg was very badly broken, Tibial plateau in pieces, and tibia open # out the knee after a fall and crampon catch. And the young belayer hypothermic and in a poor state, going down fast. The helo stayed in the hover above us for about 40 interminable minutes for a highly technical winching operation from difficult ground. John Greive could be seen in the door and was ready to be winched down if needed to help. The winchman did a fantastic snatch rescue courtesy of a knife and balls of steel. We never again doubted the Sea King after as previously we thought it wouldn't be up to the job like the Wessex.  

That left us in the gully smothered by spindrift and frozen with a back climb of 350m+. Bugger the abseiling as too cold. The gully we found had loaded up with slab to a depth of about 50cm or more from the hover and a funnel effect from the summit slopes so we had to be careful.  Its a complicated area but we knew it as well as anyone so headed down, but wanted to avoid the steeper section of NW Gully above Isis Buttress. I knew a shortcut down a narrow corridor left of Isis. I remember going first into the gully facing forward both axes placed and a whump and roar as it went off below my feet, I had to climb over the crown wall with Millsy following. We didn't give it much thought as shit happens. Down into the corrie where we met Chalky and whoever, and in the wee small hours as the light was coming up we descended back down the path to the Elliot's. The Elliot's were all in bed, the team had gone home so it felt a bit of a let down, but nothing for it but home for a brief sleep and for me at that time back up a hill to Ski Patrol at Glencoe where Pete Weir was manager.

Al's tough,  and a long rehab after reconstruction at Raigmore followed.  The young belayer survived but only just and would certainly have died that night if out any longer, as might Al. It's a dilemma often occurring in mountain rescue where experienced folk are late and no one wants to embarrass them by calling out a rescue team too hastily, and when is the right time to worry and take action? There are no right answers and I have put my own wife in that position when late back from a new route and she was calling John and he rightly said we would be fine as I was with Arthur and Andy and surely we couldn't all be dead!  He was right. And of course John had good keen instincts and saved many lives by taking no chances and getting the team out early on many future occasions when leader. Hamish made a call that night, and we as our brothers keepers made one too. There is no right and wrong and such are the heavy  burdens of a rescue team leaders role. The public are probably unaware just what a big responsibility that is in teams like Glencoe and Lochaber, and in my own time as both deputy leader and team leader I also had to make them on occasion.

Post Script:
I felt I need to get this tale down. Surviving 10 hours hanging on a rope with a shattered leg with a relatively novice young climber freezing to death while also cajoling the novice to stay with it and encourage them to survive took a lot of courage from Al. Not all survival stories are on the telly, and courageous men walk among us, and even on days your car is in for its MOT you might meet one.

PPS: Since publishing this I have discovered the 4th person was Al's son Malcolm who was a second generation rescuer and good climber who has recently retired from MR.

1987 A sad outcome for two climbers killed by an Avalanche in NW Gully.
MR can be brutally pragmatic

Tuesday, 22 February 2022

Reflections on Rescue Medical Care

All of us had an interest in first aid. Some more than others. I was an early school leaver with no qualifications other than cutting down trees and hard work. Then I was persuaded by Fiona that I was clever and bored at school so should do some adult learning and get some qualifications, so I decided I wanted to become a doctor. Along the way I collected qualifications in human physiology, pharmacology and eventually became one of the first UK paramedics. I never got to be a doctor but I did get invited into the Royal College of surgeons Faculty of Pre Hospital Care as a founder member and BASICS full member.  Life is journey and I would never swap these early years in the woods and the people I met for any degree, or the adventures life brought later. Some of the best of which was my time with Joint Services Mountain Training and the folk I met and had fun with.

Way back in through the mist of time as a young mountaineer and volunteer rescuer I remember after yet another harrowing mountain rescue wondering what more I could do for the broken often quite young folk we evacuated. Frequently they were in acute pain and circling the drain hole of life, where survival was at best 50/50 and some sadly not making it home. Mountain Rescuers whether medical/clinically minded or technical have to make two immediate choices on scene. Is it better and safer for the patient (and rescuer) to first rescue the patient from the scene before medical interventions, or is it a critical situation for the patient where immediate medical intervention must take place before rescue from the scene in order to save the patient’s life.

3 Avalanche Victims injured Twisting gully. Hamish overseeing and me doing the splinting. 1977

Let’s be clear, rescue from the scene with good basic first aid is the default position and one which mountain rescuers in Scotland are very adept. But back in the early 1980’s nothing much had changed in the application of basic first aid in the UK for decades. Ambulance service staff were a transport service with limited interventions and the same was true for search and rescue. Pre Hospital care was in its infancy. Changes in the UK were on the way, often reluctantly by the establishment, and those adopetd based on taking the better aspects of the American DOT Emergency Medical Technician and Paramedic programmes for pre hospital care (think Emergency Care on the Streets by Nancy Caroline) and ATLS the American“Advanced Trauma Life Support” course for accident and emergency doctors coming across the pond.

Late 1980’s I was already as far up the ladder as I could go for “First Aid” and was lucky to be invited onto the first Scottish and only the second UK ATLS course. ATLS is a structured approach to managing trauma. I had also done some college courses and gained qualifications in human physiology and pharmacology to help with  background knowledge as a Paramedic and for my next stage which was Advanced Cardiac Care including paediatric care and a course with BASICS the British Association of Immediate Care Specialists. After some clinical placements at that time requiring 40 intubations and at least 40 emergency cannulations this allowed me to become a state registered paramedic of which there were probably only half a dozen in the UK by 1991. I was maybe first in Scotland? I know of a couple of SAR aircrew who also came on board but I am not sure if they were before me. Later came the Health Professions Council (HPC) which I successfully registered with as a Paramedic. The public randomly attribute being a Paramedic to all providers of emergency care, but in fact it is a protected title and those that use it are trained beyond the level of most, and it's not easy to get registered. Its illegal to call yourself a Paramedic if not registered.

Taking this structured and algorithmic ATLS approach to treating immediate life threats (AcBCDE) reducing pain and reducing complications from hidden injuries unseen using a proactive approach to managing and immobilising a patient (a form of packaging) then perhaps we also could reduce both mortality (deaths) and morbidity (long term consequences) in the mountains as well? It was worth trying. The challenge was applying this in a hostile mountain environment safely, with benefits to the patient, and no delay in rescue or rescue safety compromise beyond that already acceptable to a group of skilled mountaineers. This also required other rescuers coming on board and acting much like the core group of practitioners you will see at any major trauma in a UK A/E dept with folk working simultaneously on various aspects of care.  In addition for mountain rescue, also aspects of physical rescue from the scene such as belays, ropes etc need taken care, so it's an integrated approach.

The rescue team leader takes overall control of the rescue including the evacuation, this leaves the medical folks to treat the patient, often led in much the same manner as an A/E trauma but without the monitors and scanners. I have to pay tribute to Hamish MacInnes for supporting this, and to John Greive who took over after Hamish retired and at a time when, and for almost a decade after, there was a big increase in rescues overall and in particular victims with life threatening trauma. Patient centred care with John leading from the front and co ordinating some very difficult rescues leaving me to treat the patients worked well. 

While this article is about the medical aspects it should never be forgotten that mountain rescue is a team business and strong leadership medically and of the rescue in general gets things done safely and timely. There were times when objective dangers nearly changed the outcome, such as avalanches but these are best talked about over a dram not an article.  I like to think this team approach might just have made the difference for a few poor souls.

Me patching up on Central Buttress with Andy Nelson who is now GMRT Leader asking is it Henna or Blood

Many of the team's first aiders became BASP EMT’s and were very adept at managing a patient well with my advanced skills not always required or appropriate. One skill I had which I used more frequently than any other was to give intravenous pain relief with strong opiates or similar medications. Sticking a needle or “Cannulation” into a cold frightened and distressed patient was a skill I was strangely very good at and gladly so for many folks who went from high pain scores to comfortable while enduring long tortuous evacuations over rough ground or down long climbing routes such as North Buttress hanging beneath my legs for 500 feet in bad weather when no helicopter could fly.

As a paramedic I had a range of resuscitation equipment and analgesia to bring to the patients. While I could and did intubate, these poor souls were often too far gone, but close attention to maintaining the patient’s airway and delivering oxygen were crucial.  I had the first ever defibrillator in MR delivered in 1990 from Marquette via RL Dolby. Some ridicule from many in MR circles ensued with comments of “all you will give them is a curly hairdo” from the legendary Mick Tigh.  However, within a year the defib was in action several times and on one occasion the Laerdal FR 1 delivered 27 shocks to a patient before her heart re started.

Rod MacIntosh now course director BASP EMT on his EMT course 1999 doing treatment on steep ground. After being delivered by a sea king I managed to get for the scenarios

Around 1991 Tony Cardwell and I, through BASP  the British Association of Ski Patrollers started the BASP Emergency Medical Technician Course. For some 14 years we took turns as course directors. We had the course endorsed by the Royal College of Surgeons (Ed) to give it a bit of clout and for many years pre “Cas Care” it was the go to course for advanced medical care for mountain rescuers and ski patrol. It still runs to this day which Tony and I are very chuffed about. These EMT’s were/are the backbone of medical provision in Scottish MR and none of my advanced training could mean anything without these fellow team players. Often my role was medical team leader keeping a close eye and only stepping in if I had some intervention they could not give such as (rarely) a chest decompression, or when things were going a bit South (a very rare requirement) and my having slightly more experience and diagnostic skills might change the treatment. I take my hat off to them as a very skilled bunch capable of making a difference if I was there or not. Apart from the obvious medical skills one obvious advantage I often had was being very fit and a strong climber so could always get to the patient needing care be it Clachaig Gully or 5 pitches up Swastika or Central Grooves the tale of which I have also hyperlinked.

The other aspect of taking advanced medical techniques to the mountains is medical equipment that’s up to the job. The kit for immobilising fractures had not changed much for decades. Some teams still had Thomas splints but with pre hospital care there was a rethink and re design of some kit. Quite a lot of pre hospital medicine was influenced by dated military practise and some of the equipment. For example, MAST or “Military Anti Shock Trousers” squeezed blood into the patients core like a G suit but then they bled out more (letting the tap run with the plug out) or fluids used to replace lost blood volume increased blood pressure but were not the only true colloid which is blood carrying oxygen, and so morbidity was increased as they bled out. The pre hospital treatment of shock we took and applied was to plug all the holes you can see by looking at the patients back, front, left and right, maybe apply a tourniquet or coagulation dressing, and a helicopter as fast as possible to a surgeon at the local hospital constantly being updated directly or via the Police so that their A/E and surgical team were ready.

Geoff Lachlan, Dave Sedgwick, Brian Tregaskis and Belford staff were great support on and off the hill and Dr David Syme then medical doctor to the mountain rescue committee was tremendous support in supporting trials of new kit to me with a view to making them standard MR issues if worthy. Also no article would be complete without acknowledging the tremendous support from within BASP from Dr Ian MacLaren consultant in A/E Monklands and the late Dr John Scott London HEMS both who encouraged and trained me over the years. In particular "the doc" Ian Maclaren who was huge support and always there at the end of the phone for a debrief after a difficult resuscitation. Later players coming into the mountain pre hospital trauma side from the clinical/medical were such as Ian Macconnel then resuscitation officer at Wishaw General who crossed to the light after helping out on EMT courses and being rescued (it's ok Ian so was I!). Ian later joined GMRT and took over as medical officer from me when I left. My last ALS course was by invite from him down to Crosshouse hospital to see how I compared to the hospital pro's. I think I did ok as I passed, despite a hangover. It's well worth asking him to describe running a defib refresher for the teams EMT's at the old Glencoe Police station while a local worthy was locked up in the cells. The noise from the Laerdal Heartstart 2000 put the offender of his head, it's a very good tale.

One vital bit of kit I was pleased to introduce first to mountain rescue was the American “Hartwell" Vacuum Mattress. Spinal injuries are not uncommon in fallen mountaineers.  Before the vacuum matt we had no way of immobilising these life changing injuries. We were also the first to routinely apply extrication collars which when used appropriately are life and limb savers. I am absolutely sure GMRT saved many people from devastating life changing injury by the careful handling and immobilisation of their spinal or neck injury. I also had LOTS or “Level One Trauma Splints” sent across from the USA and some of these excellent splints are still in use. Other notable imports were the Colorado “Wiggies” casualty bags to keep the patient a bit warmer and the first Pulse Oximeters to monitor SpO2.  
Trussed up like a Turkey and going no where. Packaged!

LOTS splints in action

SpO2 is not so reliable in mountain injuries due to cold and the oxygen dissociation curve moving left, but it also gives a pulsatile flow rate (HR equivalent) and a wave form to monitor how strongly the blood is flowing and the heart is beating. This also proved useful when reducing fractures into alignment to ensure blood flow. A useful tool in the context of other checks. I am very pleased that maybe my skills and the equipment brought to bare made a difference. What I hope you take out of this is that at the time of my training, pre hospital care was in its infancy and up a mountain advanced medical care thought impossible. Speaking purely about the rescue team I was involved with I can with some pride say they bought into the concept whole heartily and along with the teams leaders and enthusiastic first aiders/EMT’s we achieved a quality of medical care and patient centred decisions which was ahead of its time. Chapeau to all those folks, some of whom are still rescuing the day and night shift.

Morphine and Cyclizine on board then package. Hartwell Vacuum Matt in use below Ossians cave
One of my first mountain rescues was an avalanche when about 16 so in 1972 when I was a team apprentice and mad on climbing. I wasn’t allowed to be full member until I was 18 and could be insured. The climbing I did as a youth gave my parents many sleepless nights not least of when rescued hanging at the end of a rope November 1972 on the North Face of Aonach Dubh with Euan Grant and two others, all stuck when the rope ran out in an icy gully. It was kind of fitting that my last Glencoe mountain rescue was also an avalanche where 3 folks had lost their lives and I probed and found the last victim.  As a medic and climber I was oblivious to background issues and driven by sticking to the guidelines that have proven to save lives such as ICAR’s for avalanche victims. When seeing these ignored by another agency, I would speak my mind. This often brought me into conflict with them and sometimes other rescuers. In the heat of battle/rescue things happen, and its important to talk about them and learn for the next time. Fiona was struggling to continue to support me. 30 years married 3 kids and wondering if her husband would come back and if she was to be a single mother takes its toll. Families need 100% confidence that their partners rescue colleagues are their “brothers keeper”  and she began to doubt this. I knew I could look after myself up a mountain having soloed some big routes and survived some epics and lost friends, but it was just plain not fair on the family if they were scared of loosing their dad. I still miss it though, that sense of tribe and sense of purpose. Ski rescue certainly has it moments and digging an avalanche victim out still alive was a bonus rarely enjoyed in mountain rescue.

A probe find by the author. Yet another sad tale of mountaineers not "being searchable"

The unsung heroes of MR are those back home. Seldom acknowledged, they get no fancy gear allowance, free dinners or the kudos of membership of an exclusive tribe. And it is exclusive. Don’t imagine it's easy getting out of a warm bed on a bad night to wander over the Aonach Eagach looking for someone. Rescue team members need exceptionally good hill and mountain skills and not everyone has them, or is a good fit to an often very close knit group.  I was fortunate that my rescue colleagues were often my climbing partners and so working together on a rescue was easy. I would say it’s still mostly the same and I see a very dynamic and young rescue team in action now and doing a great job. It’s good to know there are folk willing to bust a gut to go out in all weathers and make a difference. Also these folks now have access to TRIM something not available to my generation. Stress did take its toll at times. PTSD and Talking

Day shift work, no head torch required

These days I still rescue from the mountains on day shift with Glencoe Ski Patrol. That as mentioned also has had it’s moments, but that’s another story. I have let my Paramedic registration lapse as at 62 I don’t feel my clinical skills are sharp enough and the yearly CPD is a toil. I do complete the ski patrol training requirements and annual refreshers so not all my skills are lost, and new ones are found as things change.  For the last 10 years I have run avalanche rescue courses and become a trainer for Recco. I am also a pro member of the American Avalanche Association and an Ortovox avalanche safety partner. I train MR teams in Recco and advise on other aspects of avalanche equipment and rescue. Oddly to just about every other team than the one I was in for 38 years! Joking aside, they have a plethora of knowledgeable folk of their own.  Climbing is still a big part of my life and I still bike and ski. Goals for 2022 is to still send onsight a 7a sport route in better style. I had an epic on the Tunnel Wall route “Uncertain Emotions” but still doing ok sending the odd  6c/7a and V6 so life in the old dog yet.

Me contemplating getting my leg over the "Snotter" 6b+ last year

Thanks to all my colleagues past and present and most especially my family. And safe rescuing to all those on the 24 hour shift that is mountain rescue and of course the hard working ski patrol pro's on hard dayshifts 

Here's a selection of pictures from a collection of many. All survived!

Sean, Malcolm, Ian, Frazer and Paul waiting on the yellow taxi.  Rock climber both lower legs #

Pneumothorax see the air around the eyes, surgical emphysema and frostbite

North Buttress in winter. Direct spinal injury and lowered by Andy Nelson on ropes for 500ft between my legs this wasn't comfortable for the patient or me! Rescue from the scene due to bad weather.

As above with bony injury obvious.  Good recovery though

Keep your ice axe in your hand while self arresting

Warthogs go into the ice not your palm

Wearing a ring rock climbing

Pattern Bruising - what lies beneath?

The stranger side of MR

Sunday, 20 February 2022

A Rough Slightly Tongue in Cheek Guide to Snow Science

Snow science seems to be in vogue and nothing wrong with that. But - most folk are not avalanche forecasters just Joe average trying to make good decisions. I like to simplify it when discussing so here’s a white board session from a  picture taken on a course I ran some time ago when the powerpoint projector failed and I had to cuff it:

Mountaineers are seldom "searchable". At "The Gate" Glencoe. Spot Probe Finds 😢

  • The avy forecast is an area forecast. The local risk may be different + or –
  • Read the forecast and its nuances, snowpack history and snow profile – and the blog. They have done 80% of the work for you. You decide the rest
  • Terrain choice is a big deal, Angle, Aspect and Altitude, Complexity, Commitment and Consequences
  • Water becomes ice or something along a continuum
  • Snow has branches which break up if transported by the wind
  • More wind more break up, denser pack i.e Slab
  • Graupel is not hail which is a laminate but is a ball of softish ice. Graupel are ball bearings with similar effects with new snow on top. They also eddy into rock features causing local weakness. Rocks can be Islands of safety or a landmine. 
  • The deeper you go down the snowpack the less cold it gets until at ground level its zero or just above. Mice shrews and invertebrates live there. 
  • Water vapour rises through the snowpack.
  • Crystals can grow/regrow in cold conditions either on the surface as hoar or within the snowpack as hoar/re growth.
  • Avalanche forecasters measure the snow temperature every 10cm. If the temperature is greater than 1c in 10cm going up the snowpack then the snowpack is getting weaker. Less then overtime it will eventually get stronger, Strong gradients grow facets, weak gradients make rounds.
  • In rain, thaw, warmer weather crystals round off sometimes joining to each other.
  • Wet snow is Water logged snow and can flow like a concrete river down gullies, corries and obvious slide paths. Beware spring thaws or after heavy rain.
  • Wind blown slab snow shears or collapses on a layer underneath and just like rice crispies there's a snap, crackle and pop
  • Whump is the sound of air escape from under the slab, the snap.  If it doesn’t pop go buy a lottery ticket as your lucks in.
  • Windslab most often requires a trigger. You are the trigger and the pop!
  • Snow pits should be kept simple. The SAIS and other forecasting services in alpine countries do the heavy lifting. They are only relevant for the couple of  square meters where you dig. They are good places to take stock, talk and communicate. The data might confirm what you see but also might not. Its hole in the snow. The armpit test is fast and repeatable. Dig out a small hole and above cut out as deep a column as you can with a ski end, pole or shovel. Pull on it to see if the surface slab is bonded to the underlying snowpack.
  • The progression of survival probability such as % survival at a given time is a statistic. You could survive a couple of hours if in the miracle headline group, but more likely dead from hypoxia in less than 4 minutes. Bear in mind of ski patrollers getting to fully buried victims in alpine resorts fast, giving BLS with fast helo access and ALS from dedicated SAR Docs, and taking the victims to specialist centres, most victims do not survive to discharge
  • A shovel is an airway opening device
  • If you are not searchable your fucked 
  • That's about it really

Wednesday, 26 January 2022

Avalanches, PTSD and Talking

First Published winter 2014 

Forgive me if the dates are out for the events below. 36 years of this shit melds one event into another a bit, and I didn't keep a diary. However my memory is imprinted with the thoughts and things that happened, and what's below is a snippet of bad things and perhaps the only ones that could be written about, as others are too messy. I hope it helps those who are struggling and makes them realise they are going to be ok as they are normal.  Take care, your families need you whole.

Incidence of PTSD after being avalanched

I have been reading a book on trauma. Not physical trauma but the trauma of stress and anxiety from a normal person being exposed to an abnormal event and having major psychological issues often years later. Dealing with disasters such as Lockerbie the RAF has an excellent and pro active approach, and the struggle to come to that point after generations had refused to acknowledge this form of trauma is at the heart of the book. The common term these days is PTSD.

Reading the book evokes many memories for me, and in particular some not very good ones. While I no way would say that I saw or dealt with anything like a big air crash, I had my moments finding friends dead, watching friends get killed at work and removing pieces of what used to be someone from debris of one type or another, including helicopters. These moments were overcome with the support of friends, family and mainly my stoical and loving wife and immediate family. We the rescuers get some acknowledgement, but I don't know how the partners our immediate confidantes put up with it as there is nothing there for them but hassle. Family are the real heroines and hero's of medicine and rescue.

In the 1990's the UK medical profession was still burying its head in the sand about PTSD and certainly in civilian MR to have acknowledged a problem was not the done thing. At that time I was very much the main medical provider in our local MRT and on my first year as deputy leader. This had been the worst period I could ever recall for a series of fatal accidents and very serious injuries. I had become a full BASICS member and done their pre hospital courses, and with doctors advanced trauma/medical courses, and had already done the first pilot Scottish ATLS course under Ian Anderson at the Victoria Infirmary. With A/E electives, and done ambulance service placements on the first Paramedic response units in Dundee and Motherwell via the Scottish Ambulance Service. I already had 20+ years of attending accidents under my belt.  But the winter of 93 onwards were a succession of putting into practise many new skills for the first time, including the first use by an MRT of a defib. Pain was treated by IV opiates, and that winter I decompressed my first tension pneumothorax and also got a Royal Marine resuscitated who went on to live a meaningful life. His name was Simon. You remember the names of the success's. It's easy, as there aren't very many!

Winter 93/94 was a difficult year coming  through with a new start Hamish having retired and new leadership, but the stress's of that process had taken a tole and there was a cost to good folk who didn't deserve to be hurt. That summer was as busy as the winter, and as autumn came early at the end of September the mountains already had heavy snow. October we were at a helicopter crash involving aircrew from PGM, folk that we all new well having worked with them on films for Glencoe Productions. It  had a rotor strike on the hill above Ballachulish. I will not forget finding a pair of legs sticking out of the peat in torchlight. When the snow came in storm depth two folk were buried in an avalanche and dead in Summit Gully. Two weeks later after four day search we find a young man dead in an icy gully after a bizarre series of events involving a "medium".  She turned out to be correct on the location! Then the traditional Xmas and New year "come up and get me" flashing lights, followed by severe winter blizzards leading to extended road closures. At this time I was working as the solo ski rescuer/patroller at Glencoe Mountain on weekdays, so was often rescuing skiers by day and climbers by night and night were often broken as we had Esther my daughter newly born.

Doing this stuff and going home to your family as if nothing has happened is not "normal"

John Greive was the leader of the team from 1993. A very good mountaineer with an intimate knowledge of Glencoe, John had strong instincts and quickly these gut instincts would ring alarm bells if things don't feel right. A lot of lives have been saved because he has run with these. John and I made an unlikely pair as the new leadership. I can honestly say that he was an exemplary leader. Often last off the hill or last onto the SAR helo to get off the mountain until sure his troops were safe, and willing to fight any "jobs worth" who interfered with patient care or caused delay in someone getting help. Victims sometimes need that kind of advocacy in mountain rescue. Cut through the bullshit and bureaucracy and get them help, then deal with any fall out later.

GMRT in action at an avalanche BEM. John Greive Team Leader

So, when in February 1994 John is on the radio saying a group (who were not climbers) had walked up into the entrance of  the access corrie to the Buachaille and not returned, the wife of the missing walkers is at the Kingshouse and things don't feel right to him - then believe me you stop eating your tea and take notice. A father, son and friend had gone for a look up into the Corrie and not returned. The preceding days the head wall had been loading, but climbers had come down it and as its a couple of thousand feet to the entrance then we thought and hoped the missing folks were just stuck in the dark.

A group of us including Steve Kennedy, Pete Harrop and Malcolm Thomson were in the lead with Hughie, Wull and Kenny Lindsay and others team members strung out behind. We went into the entrance gully and were in among broken wind slab avalanche debris, we then worked our way up to the little re-entrant that comes down from the "Dwindle Wall" side. I was all for getting stuck in and starting a spot probe search. Steve stopped and said he wasn't happy and I remember saying "come on lads lets just get stuck in" when Steve said "listen" and then shouted "avalanche!" I hadn't heard or seen anything, but folk were scrabbling up the rocks out of the gully and I followed suite although at first it seemed surreal, the rumble and huge blocks from a  monster of a big wet slide flowing past and up the sides like the tide lapping our feet as we scrambled up soon made it seem pretty damn real. Steve's instincts saved the lives off about seven Glencoe MRT that night. We jogged off the hill high on adrenaline and retired to Clachaig for a dram. We were shaken badly by how close a call it had been.  A lot of wives and kids nearly lost their partners and dads and as deputy leader I should have been less complacent.  It was that close to tragedy its hard to believe we got away with it and one of those things we thought best kept quiet as it was so nearly a further big tragedy to what now apparently lay beneath the snow. Next day we were up the hill again, and the slab debris had about 40ft of hard wet frozen snow debris on top. Hard to probe, hard to dig. The RAF MRT came and helped and put in a huge amount of work digging and trenching. Due to being fairly near the road the TV crews could access the scene so we were under their watchful eye. Four days of hard work and we had to give up as it was too deep. The 3 walkers remained buried.

Adrian "Hands" lands an anti sub heavyweight CAB on the A82 to take us to an avalanche BEM 1992. 

A few days later truly a massive blizzard strikes, roads are closed and we get a call that three climbers are missing from Curved Ridge. We parked the yellow rescue trucks bang in the middle of the A82 at the Kingshouse junction and  SAR 177 with Adrian "Hands" as pilot land on.  I was first on as observer up front, with Ronnie Rodger in back, we fly around the mountain on what is a blue sky morning with feet deep snow covering everything.  John suggests we fly the East face "Ladys Gully" Central Buttress side but we see nothing at first.  I get "Hands" to overfly the Chasm which you could have skied down.  The Devils Cauldron was filled level. Snow depth for that about 180ft (that spring it was fun to climb up the 180ft snow chimney and the back wall of the Devils Cauldron). We got winched out below Central Buttress at about "Pontoon" the rock climb, and start to zig zag the slope when Ronnie finds a glove then a few feet further down a crampon. We know we are on the right track and call up the team who included Mick Tigh who offered his climbing clients as spot probers. After a couple of hours Tony Sykes who was then in his first year in the team shouted he had found something. He was right under the rocks of Central Buttress. Blue sky had gone and we were now in a blizzard, but in about an hour we had dug out the three victims all on top of each other in a tangled mess of trauma and equipment. The following day early morning I am back up to the ski rescue and passing the Buachaille and looking across at where three other folk are still buried and it clicks that at any point in the next weeks/months John or I will get a call to look at something nasty in or poking out of the snow. Something happened at that moment and I still remember it. Like my happiness switch clicked off and a knot in my stomach.

Living next to the vehicles gave me the task of keeping them clear. 
Often 3 or 4 rescues each weekend in the 90's. Pre mobile phone.

The wife of the missing father and son came to stay in a Bed and Breakfast just around the corner from me, and was waiting for us do do something when the thaw came. It was to be a very long wait.  The local vicar was very good with her, and "chapeu" to the local Police in particular Sgt Kenny Lindsay who acted as her link to what was happening. Knowing she was waiting on resolution was a constant burden for her and for us. Meanwhile climbers fall off and get killed, injured and skiers break bones including the UK head of marketing for Sainsbury's who breaks his back on the Fly Paper and who I have to deal with. Thankfully he made a good recovery, but not many folk get a private ambulance to the airport for transfer to a spinal unit. It was a fantastic ski season with sun and 6 weeks of skiing back to the car at Glencoe

The RAF teams have an odd probe of the big tip over the coming weeks, but nothing is found. Then one day early April a walker phones the Police as he says he smells something. John calls us out and though there is no smell (maybe we are used to it) we have a probe around as the level of debris has reduced by about 20 feet. We find victim one at a depth of 2 meters. An hour later and a bit away we find number two. Number two's recovery - something happened inside me. I didn't get upset by physical trauma having seen plenty (and suffered some myself) and had by this time been on the recovery of well over a hundred fatal victims just in the mountains never mind the other stuff. I stayed digging for the next hour until we found number three at the very spot we had been standing the night we all nearly got buried. This wasn't a troubling scene visually, yet somehow it broke something in me as there was a big pocket or space around the victim. I dropped my probe, didn't speak to anyone and just walked off the hill. I crossed the bridge at Lagangarbh and the local undertaker had three grey fibreglass coffins open with the lids off leaning against the stock fence at the side of the path. I glibly remarked that trade had been good this winter. Three weeks later I got a donation of £350 for the team in the post from him.

GMRT Stalwart Walter Elliot and the late Alan Findlay digging deep

I walked past the coffins, up onto the road and thumbed a lift to Clachaig where I got pissed on Scrumpy Jack and had to be taken home. What Fiona, Esther and Duncan made of this slobbering drunk I have no idea, but I can just recollect Fiona laying me on the couch and taking off my boots and covering me with a blanket. At some point in the night I tried to get up to bed and fell down the stairs breaking all the pictures on the way down. What patience and tolerance my family must have.

I moved on from the above (I thought) and until five years ago was still involved in MR and dealt with many more horrific events including people burning in helicopters and finding another two climbing friends (Dougie and Bish Macara) dead. It all diminishes you, but by that time I had a better coping mechanism and new about debriefing, and the pub!

I was fortunate that from 1994 I had many good friends in the team who were not frightened to call me an arse if I got decisions wrong, and also support me as I supported them when some events became overwhelming. You know who you are - so thanks guys.  It wasn't until I left the rescue team which was in Jan 2009 after yet another triple fatal avalanche (where I found the last victim by probe) that I realised that since 1994 my happiness button had faulty wiring.  In the intervening years folk would say of me at times that I was a driven man.  I would drive myself into the ground physically running and racing my bike and seemed to cope with the extreme stress of life and death decisions yet I would get random  anxiety attacks over very minor things. My local GP sent me to speak to someone who over a few months talked me back over things until a light went on what my head was telling me, that I had been feeling like undertaker in winter, not a medic. With rethinking and knowledge of this faulty thought imprint I was sorted, the light back bright, and I was released from a thinking trap that winter equals death and loss. 

When it  all works and a life is saved then it's worth it

Dealing with nasty things has a cost. It's all very well being in a rescue service, but you are also volunteering your family for it, and they are the foundations for you at the sharp end. Don't take that for granted, and make sure they get recognition and be sure to be aware of colleagues who might struggle. It's not a weakness. It's simply not normal to deal with abnormal disturbing events and not have a normal reaction. When your head's sorted you can still deal with tough shit and know you are ok.

Why am I sharing this now? Winter 2013 was a nasty one for avalanches. The emotional toll on some of the rescuers dealing with the avalanche that took our cycling buddy Chris has hit some folk hard and I had my own involvement with that. Even as a ski patroller there was no avoiding the toll with the loss of Danny in an avalanche off the West of Glencoe Mountain and the events both leading to this, and the toll on friends and ski patrollers after. I had my own complacent re visit of the white room and an injured hip and spine to deal with, but had the time to be an ear to listen to folks and easily conclude that 2013 would fuck up some folks.

2014 was the shittest winter weather I can recall in a while, although paradoxically the sheer volume of snow made everyone wary, so despite the most recorded avalanches at least no one died. The baggage of 2013 like a rollover lottery carried over though, and I think its time we all recognised that it's human and normal to suffer after abnormal events. Help is out there and books like the one mentioned de mystify what happens to us. Maybe if folk like me are more open about it then the subject gets an airing and folks who are struggling can get the support they need.

Trauma. From Lockerbie to 7/7

A newer local MR rescuer said to me this winter "all you do is run around looking for beepers - what do you know about digging up avalanche victims".  Not a lot I said, other than it requires no brains. Avalanche education and prevention gives me more satisfaction.

Post Script.
I realise this blog post makes uncomfortable reading.  It certainly wasn't comfortable to write. It has been a work in progress from 2013 when a member of a local MRT came to see me very troubled by some events.  Then another had a tough time with depression, and in the meantime a few folk couldn't put some events behind them and every conversation was dominated by a specific avalanche event.

My purpose in this blog post is to show there is nothing wrong. That asking for help is not a weakness and that your family can only take so much and give so much.  Help is available but has to be sought. If not for your sake then the families. To not be troubled by the pain of misfortune from the loss of young lives -  now that would be abnormal!