The Leader

Getting Ready:
WEMT Students Learn from the Best

By Kerry Brophy
Reprinted from The Leader, Fall 2002, Vol. 18, No. 1

  Mark Crawford
  Mark Crawford's colorful array of achievements include a Purple Heart and numerous Air Force Commendation Medals.
Mark Crawford’s office at the Wilderness Medicine Institute of NOLS in Lander, Wyo. sits amidst packets of syringes, medical textbooks, anatomical models and backboards. As an action movie blares on a TV screen near his desk, Mark admits, “I can’t work unless there’s some noise in the background.”

Crawford, WMI’s Wilderness EMT Director, could probably work through just about anything. A former U.S. Air Force Pararescueman, he spent 22 years parachuting into situations that would make most people’s stomachs churn. He once jumped from a plane 600 miles off the Pacific’s Midway Island to a Japanese tuna fishing boat where a fisherman had eviscerated his lower abdominal wall while landing a swordfish. Crawford and his team jumped in during high winds and high seas, hit the water, climbed on board, debrided the patient’s abdomen, and started him on IV antibiotics.

Crawford joined the Air Force in 1974 after a rigorous selection and training process involving everything from jump school to free fall practices and scuba training. He went on to graduate with honors from the U.S. Army Reconnaissance School and the Pararescue Medical school.

Over the next two decades, Crawford’s career took him everywhere from Florida highways, where he flew into auto accidents, to a mission called Catch A Falling Star, in which he and his team caught U.S. satellites as they traveled through the sky.

In 1993, his medical work brought him to Somalia, where his injury during a mortar attack won him the honorable Purple Heart. A mortar shell had landed outside his team’s hangar, mowing down his crew and injuring 27 people, including Crawford. His work over the next hours to treat his team members in a ravaged medical facility put into practice everything he’d learned about handling a crisis.

Today, as Crawford teaches WEMT students how to work under pressure, he draws from these very real, often very dangerous, experiences. When students ask how you get an IV into a burn victim, Crawford can tell them because he once had to treat 15 Taiwanese fisherman after their ship’s boiler room blew up. He also knows, perhaps better than anyone, how to handle critical incident stress, which is the heart-pounding, high-pressure reaction medical professionals must deal with when facing an accident scene.

Wilderness medicine students may not have to wear night-vision goggles during a rescue to avoid being shot, but the pressure of treating someone far from the nearest medical facility is always intense. In getting his students ready for this, Crawford adopts many of the training procedures he used in the military, including moulages, or scenarios designed to model an accident scene.

“WMI’s way of teaching an EMT is a hands-on approach,” says Crawford. “It’s the same as we had in the military. We’d come up with a concept, prepare, and walk through the scenario, then run the scenario and do fake medical treatments. We’d do this up to 11 times for each concept and make sure the training equipment was the same as the operational equipment.

“I set up scenarios to push people to their limits and beyond. The goal is to have two thirds of the class attain a height they never thought possible and think past just putting on a Band-Aid.”

Crawford’s philosophy is that the more real a scenario is, the better. At WMI he’s worked to create elaborate scenes that take hours to set up and use everything from fake blood to minor explosions and traumatized role-playing victims. Everyone in the group has the chance to step up and lead the mock-rescue — Crawford doesn’t believe in letting anyone sit out on the sidelines.

“People have a breaking point — the dark, claustrophobia, noise — so during the course we offer all of this so students realize it’s not a game.”

For many of Crawford’s students, the Wilderness EMT is a life-changing experience. A number of his students have gone onto physician’s assistant or medical school after the course. And his own experiences are an inspiration. At least three of his students are on their way to becoming Pararescueman.

Crawford’s career at WMI seems fairly routine for a guy who spent 22 years jumping from planes and saving lives. But Crawford is quick to say that his job is still exciting — now he gets to teach others how to do the saving.