Be. Here. Now.

??I have taught bushcraft and wilderness survival for many years. Most of the time it was for individual classes but I have been invited to teach for organisations like the Boy Scouts and the Irish Defence Forces. I was the presenter for the Survival School television programme from RTE. The curriculum was designed from my experiences with Jon Young from the Wilderness Awareness School and from Tom Brown who ran the Tracker School.

??I also included some of the concepts that I learned in my master’s degree in wilderness psychology. My particular interest came from a book by Gonzales called Deep Survival. He has several published books but I keep returning to his first book which had some profound concepts that will help someone working in remote and austere environments. Of the many insights found in his writings, it has been the Be Here Now concept that I continue to use in my medical practice as well as in my daily life.

Be Here and Now

??This means that you need to focus on the moment. Be aware of everything around you. It means that you don’t worry about what happened in the past. It means that you don’t fret about what happens in the future. Your whole awareness is now. Here. This is helpful in wilderness survival because research shows that as soon as people realise that they are lost, they run. They panic. They do irrational things. When I teach bushcraft, I tell my students that the best thing that they can do when they become lost is to hug a tree. No, this is not a hippy thing. This is survival. By hugging a tree, you force yourself to stay in one spot. You are here. It allows you to calm down and take in your surroundings. It forces you to take stock of your supplies and your resources. Then, once you are calm and have a plan, you can release the tree and start surviving.

??Children often survive longer than adults in wilderness emergencies. They instinctively know to stay put. Adults will panic and run. When you panic and run, you tend to get more lost, you lose valuable energy and you often injure yourself.

How does this help me as a Remote Medic?

??When we are treating critical casualties in austere and resource-limited environments, we are already working in a stressful situation. We may be working alone. We may be working with only our trauma bag of supplies. We may be hours or even days away from medical evacuation. Now we add to this stress the fact that we have a critical casualty and we are the only thing standing between the Grim Reaper and our patient.

??One incident that comes to mind is when I was working in South Africa on an ALS ambulance. We responded to a person-vs-vehicle accident in a township late at night. It was raining and when we arrived there were over 100 people in the area and some of them were really angry due to the accident. There was a BLS unit already on scene and they were doing what they could. I knelt down and started to do my assessment. It was a loud and to be honest, quite scary environment. I remembered the lessons from Deep Survival. Be Here Now. I focused on my awareness. I made sure that I knew what everyone around me was doing even though I was working on my patient. This allowed me to see that the BLS responder was not getting a BVM seal. It allowed me to take in unilateral breathing. It allowed me to follow my assessment protocols whilst taking in all of the information flooding my senses.

This approach has served me well in the 30+ years of being in EMS. I listen to Deep Survival every year to relearn those lessons. I would encourage you to incorporate similar concepts into your own medical practice. Be a better medic. Be. Here. Now.