Panic - A Risk Factor In Backcountry Rescue?

On March 6, 2009 I responded to a call for help at the base of a massive avalanche on the steep NW aspect of Gladiator Ridge north of Ketchum, Idaho.  My party was heading back home when I noticed the slide from Mushroom Ridge, on the opposite side of Westerhome Gulch.   While it only ran 100-200m, it was easily 500m wide.  As we took this in, we heard a whistle indicating someone was in serious trouble. Unfortunately, in addition to one person with a broken femur, there was also a fatality.  The official report details many of the causative factors; factors that we are taught to avoid in Avalanche Courses.  However, almost five years later I am still questioning if this particular death could have been prevented by proper preparation for an issue we tend not to focus upon - the acute level of stress these situations create.

Earlier that day, I encountered something extremely odd on our skin track.  After we skied an incredibly deep powder shot down the SW aspect of Gladiator Ridge, we were heading back up for a second time when we found that someone skied down the skin track, kick-turn for kick-turn.  Not only was it unclear why somebody would want to do this on such an incredible day, but it did not seem possible unless they were coming down with skins on.  It immediately bothered me because it looked like fear was involved.

Once I arrived on the rescue scene, the group informed us that there was still one missing from the involved party of four skiers. At this point, they had given up looking for him becuase there was no signal from his beacon. I immediately suspected that perhaps he was the one who came down the skin track. However, it was still unclear why, especially given the fact that he was still missing and seemed to have abandoned the rescue effort.  Amidst somber spirits, the rescue proceeded with medical treatment/evacuation of the injured and recovery of the body.  All four members were well known in the greater skiing community and they operated from within different areas of the sport.

The missing skier was ultimately located uninjured and alone in Westerhome Gulch.  He was a highly trained helicopter ski guide, with the qualifications most suited to respond to such a grave scenario.  Once I learned this, I decided I had to go back the next day and try to figure out what had happened to him, what he had done, and why.  Although I had seen plenty of death throughout my medical career, seeing it in my playground, in my ski touring paradise, made me very uneasy.  I needed to know what really happened so that I could learn from it and so that it would not happen to me in the future.  In retrospect, this process of investigation was my way of trying to find peace and to take away the most from the experience.

Early the next morning, March 7th, I got my gear ready at the base of the skin track and began to climb back up to explore the situation further.  I found that the last tracks going up were from my own party the previous day.  While we had covered up all traces of the track coming down, I vividly remembered where the track in question had entered our uptrack.  I climbed to that point and followed that track as it briefly traversed through the trees before it headed down again. 

I stood there perplexed and many questions raced through my mind.  He had climbed up, but he clearly never stopped to take off his skins.  Why?  Everyone knows that time is the enemy of those buried in an avalanche.  Did he think it would be faster than re-skinning at the bottom?  Why didn’t his tracks ever veer towards the debris field?  I continued down and was overcome with disbelief when I reached the point that he had stopped and put his skins on.  He was at the edge of the crown.  The avalanche had mostly pulled out to the ground. But I could now see that the hole from which the body had been recovered was only 100m below him.  He had been seconds away from her with her ski sticking out of the snow and she died of compressive (traumatic) asphyxiation that typically takes minutes.  A properly trained backcountry skier by any measure had turned around and walked away.  Why?

The official report states that he was concerned about hang fire.  However, three things did not settle my mind on this issue.  First, the avalanche had gone to ground between him and the victim and upon my inspection there were no other slopes of concern above.  Second, the search and rescue personnel from the helicopter skied the rocky slope in question.  Finally, he never went to assist any part of the rescue and fell completely out of communication with the others. 

My experiences in medicine and kayaking have led me to question: was panic responsible for this particular instance?

To effectively manage emergency situations, whether they be in the ER, operating room, or they are encountered during outdoor activities, participants must remain calm and focused.  Kayaking instructors teach beginners to manage panic by having them “count to three” before starting their roll.  Panic is an initial reaction to flipping upside-down in moving water and counting to three helps counter that response allowing the kayaker to set the roll up properly.  Not only does managing the panic response effectively help you to do the right thing, it helps everyone else involved in a scenario.  Speaking calmly to nurses and other staff during a medical emergency helps calm them so they too remain more effecive. 

Avalanches and the subsequent rescues in many ways are no different than what goes on in the hospital emergency room setting and the concept of a calm approach is no less important.  In this case, it appeared that the ski guide might have become incapacitated by panic, preventing him from doing what he was trained to do. If this was the case, not only did this powerful emotional response block him from participating in the rescue, it complicated the situation profoundly given that he went missing.

Perhaps this type of situation occurs more often than we think. If so, training rescuers how to cope with panic and stress must be taught.  Managing panic does not come naturally for most people. 

The group leader on Gladiator Ridge, a professional skier, told me she had heard about panic in this setting before.  She recalled a story in which a friend of hers was skiing with a partner in Alaska. On their approach, they had to cross a large exposed slope and the partner, who went first, was carried away in an avalanche.  Despite the fact that they were far from their vehicle, her friend turned around and walked to his car, rather than search for his partner. 

With this story in mind, when she found the ski guide who left the scene of their accident, an hour after the slide had occurred, she knew deep down he also had panicked. 

Each of us might think that this wouldn't happen to us. But without ever having had a panic attack, it is difficult for us to know how powerful they can be and how they can guide our behaviors.  Preparing for panic as a possibility is your best way to prevent one or to effectively manage the symptoms if one occurs. 

Panic is an extremely powerful reaction that can happen to any human being. Each of us has our own genetic tendency, but other environmental factors will play upon those and make us more or less susceptible at different times of our lives. In this case, the ski guide was experiencing high levels of anxiety related to a recent job loss.  Concern about providing for his family were heavily taxing his psychology. Did these issues play a role in his response?  Quite possibly.

Many other questions come to mind too. Was it possible he had had a previous experience with an avalanche that sensitized him to reacting this way to this incident? Was he afraid of the conditions earlier in the day? Did he remain quiet in the group and not speak up? Etc, etc. 

This incident raises many questions worth investigating, but my primary goal with this article is suggesting that the acute stress response, particularly panic, becomes a topic of discussion in every avalanche course. It is a standard part of many emergency related curriculums. It does not require any special equipment, yet it can save lives. 

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