Medicine for the Outdoors
Medicine for the Outdoors

Dr. Paul Auerbach is the world's leading outdoor health expert. His blog offers tips on outdoor safety and advice on how to handle wilderness emergencies.

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Medical Care for Ultra-Endurance Desert Racing 3

This is the third and final installment of the tale by Dr. Grant Lipman of Stanford University about his recent experience with Racing the Planet:

Day 3 finds us high up on the dunes nestled in the skirts of the Andes. The campsites are selected for amazing views. It is always fantastic to look up and see the skyline punctuated by 6000 meter volcanoes. The medical team has three of four doctors gearing up for the waves of competitors coming our way, with Dr. Alice out after medically evacuating a sick competitor to Calama. We eat and rest early, then will work for the next seven hours. There are sure to be some nasty feet. There are several athletes whose GI bug got the better of them, and are being brought in for intravenous hydration and recuperation. One fierce athlete made a poor decision to drain a blood blister and developed concerning symptoms of aggressive cellulitis, so Dr. Jay made a wise medical decision and we pulled him to administer a course for IV antibiotics. I wish he had known to never drain a blood blister. It represents a deep injury to the dermal plexus of vessels, exposing it to bacteria can cause an infection, which in turn can rapidly spread to cause an infection in the bloodstream.

The salt flats go on, seemingly endless. The daunting flatness of shining white in the baking heat puts the "smack-down" on folks. There was some unusual rain a few weeks ago (the first in 30 or so years) and the hard crusty pan has a rare soft layer underneath. So, a foot will punch through to the shin, then have the shards of desiccated old seabed scrape along the skin as the foot is pulled out of the muck. We have renamed Dr. Jay, “Dr. Death, the Killer of Dreams.” He has personally witnessed four or five people collapsing literally at his feet from exhaustion. I don’t know whether to insist he never return to these races because of the carnage that his presence seems to elicit, or rather, put in a ballot for his role as future medical director because he gives such fantastic care. By the end of the long day (50-mile course), the attrition rate hovers about 15%, about average for a Racing The Planet event.

Truth be told, desert racing is much more than running. It's about staying healthy, good nutrition, getting rest, dealing with altitude and hygiene, and maintaining all these important behaviors and habits for a week. If I had a dime for every finely tuned athlete who told me, “I'd feel great if it wasn’t for my feet,” I would have flown home first class.

Racing The Planet is not for the faint of heart, and the Atacama Crossing is arguably the most challenging of the events. That being said, one brave soul walked the entire race wearing Crocs (without any blisters), one Chilean athlete ran it without socks (and showed off his perfect feet every night), and a few completed it after coming off the couch without training. While the former couch potatoes had a level of suffering greater than most, they crossed the finish line with smiles.

If any of you are interested in taking part as a volunteer, competitor, or medical support person, see

Preview the Annual Meeting of the Wilderness Medical Society, which will be held in Snowmass, Colorado July 24-29, 2009.

Join me from January 24 to February 2, 2010 for an exciting dive and wilderness medicine CME adventure aboard the Nautilus Explorer to Socorro Island, Mexico to benefit the Wilderness Medical Society.

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About the Author

Dr. Paul S. Auerbach is the world’s leading authority on wilderness medicine.