Insights from Molly Salter

Submitted 2022-09-01

Climbing is dangerous sport, and the discipline of bouldering carries multiple hazards. The risk of falls is high, and injuries can be common. The Peak District is one of Europe’s outdoor climbing and bouldering epicentres and as climber myself, I have been acutely aware of the cautionary tales surrounding injuries that happen in the carved-out gritstone of South Yorkshire. It should not have been a surprise, therefore, when on my first shift as a medical student on resus, a patient was rushed in following a climbing fall from 16 feet, sustaining a fractured pelvis and possible spinal damage. However, his accident took me by surprise – a fit young person with potential life-threatening, and probable life-changing injuries was a situation that felt too close to home. Nevertheless, I was part of the medical team assisting him. I listened to the paramedic debrief, was assigned my role in the emergency team huddle, and gathered the equipment necessary for IV access.

On reflection, I have found that climbing itself prepared me both physically and mentally for my experiences in the Emergency Room (ER). Often, the penultimate move at the top of a boulder problem is the scariest. Not only does it require physical skill and strength, often acquired over months of training. You’re one move away from success, satisfaction, and relief. It can take dozens of attempts to get it right, and only one wrong move for it to all go wrong and take a fall.

This is how it feels to stand face-to-face with a patient in critical condition. It was uncertain as to whether our patient was bleeding into his pelvic cavity and therefore his haemodynamic status was precarious. My team were relying on me to gain prompt venous access in case IV fluids were required. I felt a surge of adrenaline as the cannula slipped into his antecubital vein and maintenance fluids were hooked up. I was left with the realisation that this seemingly basic and routine procedure has potentially life-saving implications. All levels of medical professionals are vital to life-saving care, from the medical student gathering equipment, to a consultant assembling and managing a multidisciplinary team, therefore training and competence at all levels are fundamental. Medical school is a long road, skills are slowly gained across years of learning and experience. It is not only clinical knowledge and skills that are required in practise, recognising personal limits, and keeping faith in your abilities is one of the most undervalued but pertinent learning points I have found throughout my training. Life-saving care in resus is nerve-wracking and a cool head is essential.

My experience of rock climbing has taught me that it’s possible to train yourself into a calm state of mind. Taking slow breaths on the wall, visualising success, and having faith in your abilities are transferrable skills to many aspects of life, including a career in emergency and life-saving care. I am continually challenged through bouldering: learning new techniques and bettering my skills. These skills are compounded by the tangible demands of a high-intensity sport. It requires physical strength and resilience, time spent training and committing to a demanding schedule. I have seen how a baseline fitness is vital for work in the ER. Running between emergencies, restraining aggressive psychiatric patients, and carrying out cardiopulmonary resuscitation leaves even the most experienced staff exhausted.

Climbing, for me, is also a vital part of my emotional wellbeing. It takes my mind off the wards and onto the wall. When you’re climbing, you can focus on nothing but the sport, the adrenaline, the danger. Life-saving care can be emotionally draining, so it is crucial to maintain interests and a social life outside of the work we do. Not only does bouldering mean I am physically fit and mentally detached from the ER, but I am also surrounded by a group of supportive friends from group of diverse educational and professional backgrounds. It enables me to relax and decompress. Speaking to those close to me acts as an outlet for the stressors of the day and I am reassured by those who care for me and my wellbeing.

Finally, I am not afraid to ask for help. I know that as I slowly progress from medical student to junior doctor, to eventually being a consultant, I will have people around me, both professionally and personally, who I can lean on when I need the support. A career in emergency medicine will be mentally demanding, physically draining, and undeniably rewarding. I will approach this career path with determination and humility, knowing that I have the resilience and skills that come from years of dedicated effort. With the right drive and strategies to cope with a challenging career, all students can become the calm, capable professionals they aim to be.