The Injury and the Search and Rescue Process

Me, Cuong, and Luna at the start of the day!

With the effects of COVID-19 having taken over much of American society as we knew it, trail running for most people became an opportunity to seek out new adventures and enjoy ‘social distancing’ in a way that pushed limits without the experience of racing. This was very much my approach this spring and this summer as well, having completed a self-supported 50K in Portland on BPA Road with 14,000 feet of elevation gain and then a solo push in mid-July on the 32-mile Loowit Trail circumnavigating Mt. St. Helens.

Opportunity came knocking when a local trail runner friend Cuong reached out to me about running around The Three Sisters of central Oregon. While each of the sisters themselves is quite a hefty challenge, the circumnavigation is generally considered relatively pedestrian for those with some ultrarunning experience in the pacific northwest as it is a 48(ish) mile route with about 6,000 feet of total elevation gain. In July 2020, Dylan Bowman nabbed a fastest known time (FKT) in just over 8 hours in what he called a “jog,” and that FKT was quickly lowered by over 50 minutes just a week later by Colton Gale.

Me, Cuong, and a third friend Luna planned to run the route as a fun adventure, with a 12-hour goal in mind. During our pre-planning calls the three of us had briefly discussed our escape/safety plan if anything were to happen. Having researched the route a bit, we knew there were several trails that were used as arteries to the main route we would use and knew that many of those had quick access to towns like Sisters and Bend. That said, during our Zoom calls, we quickly brushed this aside as we had full confidence that the day would go smoothly with a fantastic weather window and all three of us in great shape. Perhaps that’s a little bit of foreshadowing…

Just after 6AM on July 25th, 2020, the three of us set out from the Lava Camp Lake trailhead on the Pacific Crest Trail and headed due south towards the mountains. For the first 5.5 hours, things went really smoothly. We stopped often for pictures, refilling water from fresh cool glacial streams, and even taking a dip in the creeks along the way. Shortly after our quick dip in the creek, my legs were feeling refreshed and we started cruising along a smooth downhill section of the Green Lakes trail, averaging about a 9 minute pace and cresting over the 23-mile mark on my GPS watch.

Running along the Green Lakes trail early in our run

With Cuong cruising along just ahead of me, we merrily scurried along a section of trail that was busy on a Saturday morning of day hikers mostly coming in from nearby Bend. On a small turn that I’ve probably seen on hundreds of trails before, my right leg skimmed along the top of an otherwise unremarkable rock and my body went airborne. In that short second, I felt and heard a ‘pop’ in my right knee. Before I had even stopped rolling on the ground from the fall, my mind had already concluded that something bad had happened. I sat up in otherwise no acute distress and first tried to shake off the fall. Cuong was ahead of me and turned around, thinking it was just a normal fall like all trail runners have experienced dozens of times before. At first I tried to convince myself everything was okay, but as soon as Cuong told me to try and get up and shake it off, I bent my right knee and immediately flinched in terrible pain. Something was definitely wrong.

Luna was only a minute or so behind and caught up to me sitting on the ground. All three of us quickly had the intuition to realize that a splint was probably needed but none of us was necessarily resourceful enough to think of what to do or how to do it. Some super kind passing hikers offered up some tape and a cold pack, but the tape wasn’t enough for a splint of any kind and I knew I was in trouble regardless. I guess we should have thought a little more about that escape plan?

Sitting on the side of the trail waiting for SAR while my right knee starts to swell. Yes, those are all scabs and cuts from previous falls :-)

Even knowing we were relatively close to a trailhead, my experience as a pharmacist and having been on emergency teams in the past made me recognize that regardless of anything else I would need a higher level of medical care. Turning my phone off of airplane mode, I was gracious to find that I had one bar of cell phone coverage and dialed the Deschutes County Sheriff’s Office to seek further guidance. After a quick conversation with the dispatcher, we concurred that deployment of their search and rescue team was the most logical response. I was instructed to call back using 911 so that dispatchers could ping our GPS location.

Luna trudged ahead to the trailhead with the same kind hikers so that he could look at options for transportation, as we were close to a trailhead that was over 1.5 hours away from our original starting location. Cuong stayed with me as we initially sat by a creek and then found a way to drag my silly body to a shady spot off the trail. A conveniently passing hiker also coincidentally was an orthopedic surgeon. After a quick assessment of my symptoms, his differential diagnosis pointed almost immediately towards a tear or rupture of the patellar tendon (more on that in a future post).

The first search and rescue team (of three) reached me about 2.5 hours after my initial call to 911. The team included multiple medical personnel and a county sheriff. They were able to quickly determine that generally I was safe and healthy with little to no nerve damage, as I was still wiggling my toes and still had sensation in my lower right leg, despite the pain in the knee. They got me into a splint and then into a stretcher, with what looked like a huge mountain bike tire attached to the bottom. After ensuring I was secure, they started rolling me down the trail in a team of four carrying the litter.

My leg gets splinted by SAR team 1

Search and Rescue team leaders preparing to lift me and add a rolling wheel to the bottom of the stretcher

Very quickly after they started rolling me, the search and rescue’s team 2 arrived to provide further support. During my conversation with them, I realized that without any other knowledge of a situation or how severe a rescue could be, multiple teams are always sent out. This is to minimize fatigue on the team members and to provide a multitude of expertise along the way. Team 2 and eventually team 3 would ultimately tag out on the stretcher every 10 minutes or so as we rolled down the trail over rocks and roots and along a single track that crossed streams and dropped about 500 feet in elevation from where I had gotten injured to the trailhead nearly 3 miles away.

It took about 2 hours to get me extracted off the trail and I was safely at the trailhead thanks to the amazing all-volunteer team of about 15 or so individuals that came out for my rescue. Having determined that I wasn’t necessarily in acute distress, Cuong, Luna, and I determined the easiest and most convenient option would be for us to safely drive back to Portland for me to seek a higher level of medical care.

Even when injured and getting evacuated across a river in the wilderness, you should probably try to keep a positive attitude!

I’ve had many people ask me about the search and rescue process and what other resources I utilized or could have utilized during the injury process. First off, my kudos goes to Cuong, a super experienced trail runner, and Luna, a knowledgeable nurse, for their preparation style and planning pre-run. Thinking about an escape plan has always been an afterthought to me until now but it’s something you really need to keep in mind. If something happens, where can you divert safely? If there is nowhere to divert, do you have the tools to allow you to stay warm and stay hydrated and fed if you are stuck? Luna’s preparation came in the form of having maps downloaded to his phone. Using apps like CalTopo, AllTrails, or Gaia can be lifesavers for navigation in the backcountry (quick shout out to JT Lehman and his company Alpenflo for the navigation class I took in June!). As JT has also highly recommended, take CalTopo maps and have them printed so that you have a backup when your phone battery dies.

I have to think about some of the tools I had in my pack and some of the tools I probably should have considered in the future. For one, I am most thankful that I bought a Garmin inReach device and pay just under $30 a month for subscription. Those naive to the inReach and Spot GPS-type tracking devices, these allow for satellite communication to the outside world without cell service and most of these devices have an S.O.S. button that immediately reach out to emergency services. One item I have consistently forgotten and won’t in the future is just a basic first aid kit. While I realize a first aid kid wouldn’t have magically produced a SAM splint, I have had so many cuts and dings along the way in trail running that would have been much more safely controlled with just some basic items like an ace bandage and some antibacterial cream.

Lastly, a brief discussion on the Deschutes County Search and Rescue team and about search and rescue around the country. The team I worked with was an all-volunteer team working closely with the local Sheriff’s department. The team has a wide variety of specialties and resources and many are absolutely avid trail runners or hikers with an affinity for the outdoors. Some are skilled skiers, mountain bikers, or climbers and others have been trained in using ATVs and snowmobiles or extracting people from extremely dangerous situations. While my situation was relatively uneventful, this team was prepared for the worst and came in with enough supplies to camp out in the wilderness overnight if necessary. The Deschutes County team has over 100 volunteers and typically conducts about 125-150 rescues per year.

Volunteers of the Deschutes County Search and Rescue Team

And the cost to me for my rescue? Zero. Deschutes County’s team functions essentially at a financial loss, but some of their funds are recouped through recreation fees and local and municipal taxes and funds to the forest service and other local parks and recreation sites. Not all search and rescue teams and not all states are created equal, however. Do your research and have a basic preparation that calling for search and rescue could cost you a significant amount of money. While doing my research (after the fact, of course), I stumbled upon this recent article about the cost of search and rescue teams across the country and how understanding local laws could help you maybe reconsider your preparations before venturing out for an outing in the wilderness. If you are based out of a state like Colorado, consider purchasing the CORSAR card which helps to support search and rescue efforts across the state.

I consider myself to be extremely lucky to have been on a popular trail with cell phone signal and a multitude of kind and generous individuals that came together to help me out in a time of need. Realize that you can never be too prepared for these situations but having a few key items can make a huge difference.

Finally, I’d like to take this opportunity to once again thank Cuong and Luna for their friendship and support. My extreme gratitude, most of all, goes to the volunteers and employees of the Deschutes County Sheriff’s Office Search and Rescue Team. I tried my hardest to thank each and every one of them during the rescue process and attempted to crack [terrible] jokes and keep a good attitude during the rescue. Their efforts throughout the year in an area of the country chock full of adventure often goes unrecognized.