Abstract
In this issue of Wilderness and Environmental Medicine, McIntosh et al 1 summarize the search and rescue (SAR) activity over an 18-year period on Mt. McKinley, or Denali, the highest mountain in North America. This is an important and needed addition to the literature regarding the incidence of SAR activities on Denali and emphasizes many important points. The authors nicely summarize the climbers' demographics, guide status, nationality, medical complaints, mechanism of injury, cold and altitude injuries, and route information for whom the National Park Service (NPS) provided SAR services. They conclude that there is a wide variety of reasons for SAR activity, that certain groups have a historical higher risk of requiring rescue, and that overall the incidence of NPS SAR responses is low (1.16%). In this editorial, I offer the opinion that the new data, coupled with the recently published article by Heggie et al 2 addressing SAR activities in all US National Parks, suggests that the climbers who use Denali and the NPS which monitors their use, are good stewards of mountaineering in the park, have been effective at mitigating some of the objective risk inherently involved in mountaineering, and that the public perception of the high costs and incidence of mountaineering rescues is unwarranted.
There are multiple examples of the public believing that climbing is a high-risk activity generating a disproportionate overall number of rescues and cost to the taxpayer. The American Alpine Club succinctly summarized the debate in 2005 when it published “Climbing Rescues in America: Reality Does Not Support ‘High-Risk, High-Cost' Perception.” 3 Available data demonstrate that the fatality rates for mountaineers have decreased substantially over the last decades. In addition, mountaineering accounted for only 1.8% of all NPS rescues in 2003 and 2% of NPS rescues in 2005.2,3 In fact, in 2003 in Oregon (a state that requires all SAR activity performed be reported to the sheriffs), climbing in general was seventh on the list for activities most often requiring a rescue at 3.8%, just ahead of mushroom picking at 3.3%. 3 By comparison, SL, a US Park Service Ranger at Mt. Rainier National Park, reported a total of 10 616 registered climbers for the summer of 2009 with 19 upper mountain SAR incidents for a SAR rate of 0.1% (written communication, October 2009). While direct comparisons of Denali and Mt. Rainier cannot be made given the terrain, altitude, and experience level of the mountaineers, the percentages suggest a low incidence of SAR activity on multiple mountains. The current article adds further evidence to the fact that even in places with a disproportionately high number of mountaineers compared to other recreational activities (there are fewer hikers and boaters using Denali compared to other parks), the rate of SAR activity is low. Only 1.16% of mountaineers in an 18-year period required an NPS rescue. This is a remarkably low rate considering the altitude, latitude, and terrain on Denali. The low rate of SAR activity is a tribute to more than 1000 climbers who attempt the mountain each year and the NPS rangers who provide pre-trip planning advice, education at the ranger station in Talkeetna, and on-mountain advice to the climbers. While certainly there is variability on the need for rescue based on the climbers' country of origin, age, and climbing experience, overall the mountaineers who attempt Denali each year appear to adequately prepare for the hazards. This is a far cry from the reckless “risk-taking daredevils” that climbers have been characterized as by some public officials. 3
The low SAR rates also suggest that the educational activities provided by the NPS are effective and should be continued. Previously, McIntosh et al found that fatalities on Denali decreased by 53% after the NPS registration system was established in 1995. 4 This corresponds with the time frame when the NPS began conducting 60- to 90-minute audiovisual orientations for expeditions when they checked in. While no data exist to directly measure the effectiveness of the educational programs, they are generally thought to be some of the main reasons for the decrease in fatalities on the mountain and, as suggested in this article, the decrease in the number of accidents requiring a SAR response.3,4 As such, these activities should be continued and possibly emulated in other areas. Further study is needed to identify the most cost-effective educational process and determine if similar programs should be initiated on other high-traffic mountains. Perhaps a similar program in Yosemite would help decrease the climbers' environmental impact, increase their understanding of the regional terrain/weather patterns, and increase their understanding of the unique challenges of this park. Denali is unique in that the vast majority of climbers must register with the NPS to access the mountain. As such, research on the NPS educational mountaineering programs may be best accomplished there. The data may provide further incentive to expand their programs to other areas.
Other areas in which the NPS have implemented change include the requirement that climbers' submit a resume of their previous climbing activity. This is reviewed by experienced NPS climbing rangers who can suggest alternative routes that may be more appropriate for the climber's experience level. This is not possible on all mountains; however, targeted, high-traffic peaks with technical terrain may benefit from this approach. There are certainly mountaineers who believe that a federal agency should not tell them which mountain to climb or which route to take. Currently, the NPS does not mandate which route a party may attempt on Denali. They do suggest alternative routes that may be better suited to expedition members' skill level and provide valuable information from years of cumulative experience. While this may be perceived as unnecessary meddling, I would argue that it is good preventative medicine. Patients frequently present to their healthcare providers for screening prior to beginning a new exercise program, starting a new job, or advice on therapies. As a physician, I would be remiss to suggest an overweight, deconditioned climber is prepared to attempt Denali. I would suggest he start with a more reasonable goal and build towards Denali as his or her conditioning improved. As important as a climber's medical condition is his/her mountaineering experience. Having professional climbing rangers give advice on the best route given a party's experience level likely prevents unnecessary risks and therefore SAR events.
While great strides have been made in decreasing the incidence of fatalities on the mountain over the years, more can be done. The climbing community should be vigilant about adequately preparing for the rigors of such a serious mountain. People with limited experience should consider using a professional guide service when attempting Denali. Educational programs should be continued; however, they should be thoroughly studied to provide data on the most effective way to inform mountaineers on the subjective and objective hazards and to determine which programs are most effective at mitigating risk. The NPS should continuously strive to balance “interventions” (ie, education, suggestions on climbing routes) with a “hands-off” approach allowing mountaineers to fully experience Denali in all its might and challenge. Finally, both the NPS and the mountaineering community should continue to counter the public perception that climbing SAR activities are “high risk and high cost.” Data continue to emerge that directly contradict this belief and should be disseminated whenever possible. Continued research should be completed in an effort to support the conclusions that climbers are responsible stewards of the mountains they so enjoy, they minimize risks to a great extent, and are not a disproportionate drain on national SAR resources.