Abstract
On the 40th anniversary of the founding of the Wilderness Medical Society (WMS), it is appropriate to take a look back as we move forward. If wilderness medicine, a specialty devoted to the austere conditions facing humanity over the centuries, is the entire history of medicine, then the WMS is the product of thousands of years of human history. 1 As our perspectives on wilderness evolved over the millennia, an appreciation of wilderness emerged. By the mid-19th century wilderness was no longer the desolate and morally abandoned region noted in early Christianity. 2 Romanticism and American transcendentalism, the product of a backlash to industrialization and the scientific revolution, led to a more recognizable version of wilderness. These movements found beauty in nature, and evidence of God’s rational plan. Wilderness was to be venerated, and its preservation was paramount.
Throughout the 1860s and 1870s the call to protect tracts of land in the United States expanded, and Yellowstone was established in 1872 as the nation’s first national park. Yet, the growing campaign to safeguard wilderness in the United States was accelerated by the threatening implications of the 1890 census. The superintendent of the census described the West as having so many pockets of settled areas that the frontier no longer existed. 3 This seminal event influenced Frederick Jackson Turner’s frontier thesis and by the turn of the 20th century, the wilderness frontier—individualistic and rugged—came to define the essence of the American spirit. The Sierra Club, the Audubon Society, and the National Park System were established to counter the demise of the frontier. Numerous national parks were created between 1900 and 1935 and the Wilderness Society was started in 1935 by Aldo Leopold and others to preserve wilderness and form a buffer against urbanization.
In the post–World War II era, a confluence of factors resulted in significant advancements in all disciplines of science and technology, and particularly in medicine. Similarly, the nascent environmental movement, begun in the late 1800s, was catalyzed by Rachel Carson’s best seller Silent Spring. Its impact was swift. Two years after publication, the Wilderness Act of 1964 was approved by congress and shortly after, the first Earth Day was celebrated. These events led to a prolific exploration of humanity’s relationship to the environment. The time was ripe for the formation of a society devoted to research and education in wilderness medicine.
Charles Houston was one of the early researchers in wilderness medicine. Human endeavor into unforgiving conditions has always piqued the interest of adventurers and researchers, and Houston, a physician and lifelong climber (who published one of the earliest discussions of high altitude pulmonary edema), helped organize a meeting to discuss developments in high altitude in the United Kingdom in February 1975 at the National Outdoor Centre Plas y Brenin, Capel Curig, North Wales. 4 –6 The conference was successful, and in late October 1975 a larger symposium on a range of wilderness medicine topics—nutrition, search and rescue, cold injuries, backcountry survival, altitude problems, environmental health, and trauma 7 —was sponsored by the Yosemite Institute and organized by Houston and Stanley Cummings. 5 Not long after, Paul Auerbach did a medical student rotation in the Indian Health Service and was amazed by the array of unusual, that is, wilderness emergencies, he encountered. Because there was no central repository for literature on lightning strikes, snake bites, heat illness, and other environmental emergencies, Auerbach and Edward Geehr eventually began work on Management of Wilderness and Environmental Emergencies, a textbook first published in 1983 and which has become the standard in the field. Tapping into the energy and enthusiasm for the topic, Drs. Auerbach, Geehr, and Kizer founded the WMS. As Dr. Auerbach wrote in the preface to the fifth edition of his textbook, “When Ed Geehr, Ken Kizer, and I dreamed up the Wilderness Medical Society, it was not a brainstorm, but an obvious response to pent up demand.” 8
In commemorating this 40th anniversary, it is gratifying that Dr. Edward Otten offers a unique perspective into the founding of the WMS. 9 Dr. Otten’s insights and first-person account reveals the genius, creativity, and expansiveness of the original architects of the organization. In a world in which resources are increasingly limited and disasters are seemingly commonplace, it is fitting that we consider and recognize in our journal the remarkable effort made by those who founded the young and yet ancient field of wilderness and environmental medicine.