As we celebrate Independence Day and reflect on the values of independence, freedom, and adventure, we invite you to delve into the incredible career and experiences of Dr. Sarah Spelsberg. Sarah’s journey perfectly embodies the spirit of making a difference in remote settings.
“Then something happened that would change my life. One day I came upon a rescue in progress with the San Miguel County SAR team.”
Dr Sarah Spelsberg has felt at home in remote locations since childhood when her parents encouraged her to explore the wilderness.
She is currently working with World Extreme Medicine to help put together the courses for the new Graduate Certificate in Extreme Medicine at Northeastern University in Boston, whilst also continuing part time work with the Mayo Clinic – and beginning an Emergency Medicine residency at UNC Southeastern.
“The idea of medical school never went away, but I was having the time of my life with the team, getting to take care of people, which I’d always wanted to do.”
I grew up in Rochester, Minnesota and went to college in Madison, Wisconsin. Both locations offered plenty of outdoor experiences. My parents were big on activities like sailing and getting out into the wilderness. On the weekends from when I was about 12, I’d grab a backpack and sandwich and head off into the woods just to walk around and explore and get away from everything. And yes, I often got lost!
After college I thought about medical school but having something of an ‘existential crisis’ instead I took off for a year to ski in Colorado. Then something happened that would change my life. One day I came upon a rescue in progress with the San Miguel County SAR team. I didn’t want to get in the way but I asked if I could do anything to help – they said yes, go help those guys, hold that rope. So I did. After that they invited me to start training with them and join the rescue team. That year off somehow became eight years.
The idea of medical school never went away, but I was having the time of my life with the team, getting to take care of people, which I’d always wanted to do. Showing up on people’s worst days, helping them and making them feel safe and reassuring them you’d get them out of that situation. But then came another pivotal moment. I injured myself and it looked like I wasn’t going to be able to do the rigorous work. I decided to go to PA (Physician Assistant) school.
My first job, which I loved, was at the Mayo Clinic, in the department of orthopaedic surgery, but I missed emergency medicine and wilderness medicine; all the classes and training I was doing, I just wasn’t getting to use those skills.
“During my time here I ended up getting a reputation for some extraordinary medevacs!”
I literally wrote letters to the farthest US healthcare outposts I could find and asked them if I could come there and work. And then I got a call from Dutch Harbor, Alaska – the mail had finally gotten there and they’d received my letter.
During my time here I ended up getting a reputation for some extraordinary medevacs! Not infrequently a very complicated patient needed transport to a tertiary hospital with say a pneumothorax or fractures – once or twice someone who’d got stabbed. If there’s no medevac, there’s no way to get them there, so I’d be calling around to the coastguard or the national guard. If it’s a life threatening issue they would send transport, but then they need a provider with the patient as they don’t have a medical team. And I would have to fly with them. I flew with them so much they started joking about getting me my own flight suit.
Sadly, over the years a couple of fixed wings and helicopters have gone down and crews lost, so I was always aware that I was risking my life and the life of the flight crew to save one person. I felt the weight of that but I knew I just had to do the job to save the person in front of me.
One time we had battery and power issues – no power on the helicopter and I had a guy on a vent, on medication drips, with a monitor. I had to think fast. Well, okay if the batteries fail then we’ll be analogue. I told the crew, if this happens, you’re going to bag valve, you’re going to watch this, I’m going to push meds.
Situations could be desperate. The time I sat on the floor of a cargo plane, the only transport available – and only available after I shouted at the company who’d sent him to me in the first place, using things in my backpack and pocket to mitigate the situation. And then the young person who’d been impaled, losing so much blood I had to use medication to slow the bleeding. I appealed to the medevac company – they said they’d never heard me sound so desperate so the dispatcher got clever, diverting a plane. The patient got the blood he needed in the nick of time.
In the middle of everything going on in Alaska I decided I wanted to go to medical school, I wanted a degree that people recognised, I wanted to be able to work anywhere in the world, I wanted to know more so I could do more to help patients. I studied hard; I was logging into classes at 3am! I graduated this year, in March.
“If I hadn’t hurt myself in Colorado I’d probably never have left search and rescue. I’m glad for everything I’ve learned since then because I like being able to make a difference in an extraordinary environment.”
While I was in Alaska I ‘met’ Mark Hannaford on social media. He told me what he was doing with World Extreme Medicine, he said what I was doing was really cool – and he told me to come to the conference! A lifelong friendship was born.
I’ve spoken at some of the conferences and this year I’m there again, this time with Dr Joseph Dituri (aka Dr Deep Sea) to post the research findings from Project Neptune 100. And I’m also the CME (Continuing Medication Lead) assisting with the Medwar – a medical adventure race, with delegates going to different stations, figuring out different problems, doing different interventions.
Kindling the flames of innovation
When Joe Dituri asked me to be his medical lead for Project Neptune 100 it was because of my experiences in managing complicated issues in extreme situations. (Dr Dituri lived in an underwater habitat submerged in a lagoon in Florida for 100 days and conducted daily experiments in human physiology and using new technology).
Joe felt confident that I would help mitigate minor things that could arise that might become big things if not tested and treated. I put together a medical kit with butterfly ultrasound, EKG, EEG, pulmonary function testing, and a battery of ways to get his vital signs. And I sent him with a basic expedition kit so if we decided he needed to take certain medications he would have them. I coordinated all the specimen collection and data gathering, I scuba-dove down to the habitat – it was the ultimate house call and I loved the adventure of this project.
Ablaze with motivation
If I hadn’t hurt myself in Colorado I’d probably never have left search and rescue. I’m glad for everything I’ve learned since then because I like being able to make a difference in an extraordinary environment. A lot of these people I flew with for hours – once even past an erupting volcano! And then they walked out of hospital a few weeks’ later. Sometimes in hospital you don’t get to feel the joy, the satisfaction, the win of what we do. But all the risks, everything you sacrifice, when you send that woman or man home to their family, and someone gets to keep their husband, their father, their wife, that’s a huge win.
When you go to remote places, push your boundaries, you can be the difference for that person. Which is why I got into healthcare in the first place.
Catch-up on our other ‘Stories that Spark’ feature pieces here: