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Fall 2004 Issue
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    Little Things are Big in Patagonia
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    You Can't Translate the Word "Wilderness"
    New Wilderness Legislation
    NOLS Wilderness Ethics Go Global
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The Young and the Adventurous

The NOLS alumni featured in this section aren't sitting on their laurels. They're qualifying for the Olympics in cycling, working at a medical clinic in the Dominican Republic, climbing the Seven Summits, and circumnavigating the U.S. on a bicycle.

Laura McGladrey
Laura McGladrey
WMI Instructor, Nurse Practitioner

Laura McGladrey was working alone in a Dominican Republic medical clinic when she really began to see the need for international wilderness medical training. The nurse was treating people who walked in with severe diabetes, chest pains and injuries from car accidents. “I’d think, what am I supposed to do out here without any help?” she recalls.

An instructor for the Wilderness Medicine Institute of NOLS (WMI) and a certified nurse practitioner, McGladrey got used to being the only ambulance in town. “At NOLS, our point of reference is the wilderness,” says the nurse. “But for [many countries] everywhere they are is wilderness medicine.” It’s all about improvising, says McGladrey, who even had to use a surfboard, towels and duct tape to transport someone to the hospital during her recent five-month stint in the Dominican Republic. “We called for an ambulance,” she says of the incident, “but they said the ambulance was gone. Nobody knew where it was.”

In the U.S., emergency medical response means taking care of someone until the EMT crew arrives. This isn’t the case everywhere in the world. Many developing countries, says McGladrey, don’t even have an ambulance system. And once patients do arrive at the hospital, things are different there, too. Food isn’t provided at most hospitals in the Dominican Republic, and patients also have to buy their own medical supplies, including sutures, antibiotics and lab work. The reality, says the nurse, is often that if you can’t afford these services, you can’t have medicine. “We saw fungal infections, lice, tooth abscesses,” she says. “If you get a tumor and can’t afford to have it out, you just leave it.”

McGladrey, 30, has been an instructor for WMI since 1999 and has combined her nursing practice with teaching wilderness medicine abroad. She has taught for WMI in Patagonia, training local guides and outfitters, and also organized a Wilderness First Aid course in Spanish for Dominican guides. This training, she says, isn’t just for the mountains. In Patagonia, the army often performs rescues, but they’re not trained in medicine. The challenge isn’t just getting patients out of the wilderness, but getting them all the way to the hospital.

The nurse believes these training programs are making a difference. “The guides in Chile are becoming the people in that community who know about health care. They become the specialists.” Meanwhile, in the Dominican Republic, the nurse says the guides she helped train are now the most concentrated group of medical professionals in their town.

McGladrey, whose mother is a nurse, says she grew up “pushing wheelchairs.” But she hesitates to tout the difference she’s made for patients, even though she no doubt has made an impact in her years in the medical profession. McGladrey, however, will admit to teaching other people how to save lives. “I think we WMI instructors don’t always get to be out saving lives, but when I look back at students I’ve trained and hear their stories, I have a sense that there’s this whole army of people who are out saving lives.”

In her medical work, the international traveler has to reconcile with the emotional aspects of remote medicine. “I really came to appreciate that there was more [to my work] than people hurting,” she says. “I struggled to think that when I left, I don’t know who’s manning the clinic — there’s still people sick, there’s still people dying. But in the midst of meeting people, you’re in relationships with people and loving them.”

McGladrey has memorized a quote from Helen Keller that keeps her going through the tough times: “I’m only one, but I am one, and just because I can’t do everything doesn’t mean I won’t do the little part that I can do.”

And in the end, says the nurse, “the fact that I’m here is better than no one being here.”

-Kerry Brophy

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