Traveller Story: Medical Evacuation During COVID

Listen to episode #16 of NAVIGATE to hear about an emergency evacuation off the Matterhorn mountain during COVID-19.

Mile High Medicine – Matterhorn Evacuation During COVID:

 

Julie Saunders

0:00:04 – 0:00:17

Hello, and welcome to the NAVIGATE Podcast. I’m Julie Saunders and I’ll be your host today. Today I’ll be talking to Chris Shirley. Chris is an independent security consultant and joins us from the UK. Hi, Chris. And thanks for taking the time to talk with us today.
Chris Shirley

0:00:17 – 0:00:24

Hi Julie, no problems. It’s lovely to be talking to you from here in not so sunny London.
Julie Saunders

0:00:24 – 0:0:28

For our listeners, Chris, can you tell us a little bit about yourself and your professional background?
Chris Shirley

0:00:28 – 0:00:53

Yeah, sure. Yeah, I think kind of my security safety risk management background started with joining the military as a as a young 20 something back in 2004. I spent 12 years, all in total, as a military policeman and as a war rooms commando officer, and then left to work with the BBC, and, and charities, NGOs in hostile environments.
Julie Saunders

0:00:53 – 0:01:04

So with your background, Chris, and your broad travel experience, and then one of the reasons we’re talking with you today is about a trip that you were on where unfortunately things didn’t go to plan. Can you tell us a little bit about this trip and and what you were doing?
Chris Shirley

0:01:04 – 0:01:51

Yeah, sure. So I was climbing the Matterhorn mountain from the Italian side, which is the the mountain that the Toblerone chocolate bar is shaped upon – the big pointy looking one that you see in in photos quite often. We tried to climb in the Matterhorn for three successive years and always got weathered off, or just the route was too busy at the time, so we couldn’t kind of fit in very well. So this was the third year which were attempting it. And I had quite quite a big tumble approximately 50 meters so I’m told, and woke up in hospital with with a shattered leg, broken rib and traumatic brain injury. Having seen the helmet that absolutely saved my life, it’s now in two or three pieces.
Julie Saunders

0:01:52 – 0:02:11

Wow. Okay, gosh. So taking a step back, Chris, before we do go into that part of your story. So can you take us through maybe some of your planning and your preparation  for the trips. So obviously, it is a significant climb that you talked about. You know, so I imagine that planning and preparation stage is quite significant?
Chris Shirley

0:02:11 – 0:04:02

So we’ve been we were, we were in the same group of teams that we’ve been using for the last few years. So we were pretty well prepared beforehand. But this time we were we decided to go travel a little bit lighter, so carrying less equipment to base camp. And to do more time, at at altitude to acclimatized faster. So this year, we were better prepared than ever. We’d we’d join luckily joined the mountain during a weather window where – that was unexpected. So people, the mountain wasn’t very crowded. And we were able to more or less kind of get to the Carrel Hut, quite free.

But unfortunately, that was the next morning, the weather window closed. And so we had to descend in really gusty icy conditions, making it even more precarious. But that we got down from that fine. And then not wanting to fly back to UK, we we hung around for another day and just did some traditional climbing and I had my camera with me. And so decided that I’d go and take photos of the teams that have been climbing and just get something for for their social media and something which, you know, we could use for use for the future to inspire us the next year.

But like I said, I had a mistimed step, tumbled for 50 meters, completely wrote off the camera. So the camera was entirely destroyed and woke up and had to get aero-medded to hospitals some 30 miles away over in Aosta. And yeah, it’s quite a quite long experience, which led straight into the pandemic. So you could argue the recovery has taken many, many more months, because there was no access to physio, there’s no access to, to see the surgeon and the medical team on a regular basis. So yeah, it’s been somewhat drawn out.

Julie Saunders

0:04:03 – 0:04:22

Yeah, okay. And so, Chris, before you climb a significant mountain like that, had you thought through your contingency plan, should things go wrong? Do you know did you have what it would look like on paper? You know, this wasn’t the first time that you’d climbed the mountain ? Did you have that contingency plan in place?
Chris Shirley

0:04:22 – 0:005:41

So I actually trained the other climbers with me, I trained them in emergency first aid. So having having done quite a lot of emergency first aid over the last few years, my first making sure that, you know, we were adequately prepared for this. I wanted to train them all in emergency first aid or upstate techniques, which I knew they would, would hopefully pay off if anything happened, which it did happen. It did pay off because they were they did come to my aid when I was when I was unconscious after the fall. In terms of contingency, we all had insurance, thankfully.

And that’s something that’s I think especially with the current pandemic, something that’s even more needed now, because the situation is really a lot more dynamic than what it was, prior to the pandemic. We all had safety equipment we all had, we all knew the route, we were very well rehearsed in what we were going there to do and we all knew the risks. for something to happen at the end of an expedition is, is, is quite rare. But I’m looking back now after some 19 months after the accident, and I’m starting to see human factors which I think led up to the, to the fall, which was, you know, pre incident indicators, which you could use to, to predict something happening, I guess.

Julie Saunders

0:05:42 – 0:05:57

So you had a team around you. It’s, as you say, you were trained and knew the drill if something did happen. And so they then helped you get down from that mountain or there was a rescue service that came to you to then take you to that to it to a hospital?
Chris Shirley

0:05:57 – 0:07:10

 

Yeah, so I was unconscious, I was bleeding. I was I was having labored breathing, so I wasn’t I wasn’t there to. I’m a 100 kilos chap – climber so you know, I was I was then 100 kilo dead weights for the three people to then start manhandling, which thankfully they didn’t, you know, because I’d worked with them to make sure they kept me in position. The Matterhorn’s got excellent 4G signal. We had a satellite communicator with us for the the peak where the signal kind of drops off over 4000 meters but we’re in range of 4G signal. So we were able to call friends, were able to call the mountain guide hut, who then arrange the aeromed evacuation for me back to the nearest hospital, which has got some excellent doctors who see climbers regularly flown at short notice to their hospital, who fall in the in the Alps in the matter on the Matterhorn other places. So they were they were pretty, they were pretty swept up with everything they needed to do to me. They stabilized me, kept me alive, put me put me on ventilation and did everything to to get me through to the next phase, which is repatriation back to the UK.
Julie Saunders

0:07:11 – 0:07:34

So it certainly sounds like you, so you had a swift rescue off the mountain and then obviously, a quick transfer to to a tier one hospital, which is vital in those situations. I know the work I’m involved in, getting that assistance quickly is important. But getting the right service the first time makes makes all the difference to patient outcomes. That certainly sounds like it. It may have saved your life in this instance.
Chris Shirley

0:07:34 – 0:8:28

Yes, yeah, I’ve done some previous mountaineering in Kyrgyzstan, which was a lot more remote. So you know, for this thing to happen so near to – the helicopter was with us, I think within 15 minutes of the phone call. So it was it was really as far as as far as the golden hour goes, I think it was pretty much in hospital on ventilation, you know, with I think transfusions at the ready with – well, within an hour or so hugely lucky in that situation. Like I said a mountaineering expedition in Kyrgyzstan, I did the same year would have been many, many more hours, vehicle transit to an aeromed evacuation site. So yeah, so I count my lucky stars, but also obviously we took the risk on knowing that there was robust evacuation procedure in place as well.
Julie Saunders

0:08:28 – 0:09:02

Were you surprised by the complexity of what else is actually involved? You know, once your plan does have to stand up, I know you may not have realized it at the time with such significant injuries. But, you know, it’s it sounds like you’ve done some drills though to to help the team know what the situation is. But when something obviously significant happens, sometimes logistics or weather or other things can come into into play. So you were you surprised by the complexity of what was actually involved to to not only get you off of the mountain but into a hospital and then start your your recovery?
Chris Shirley

0:09:02 – 0:11:04

Yeah, the repatriation back to the UK actually was a bit more complex than I realized, I mean, I was I had a traumatic brain injury at the time. So I was I thought I was in Afghanistan and I didn’t really recognize the people around me and would come up with random random sayings from time to time. But thankfully my my girlfriend works in like global assistance so thankfully she was able to manage it. She spoke the language that you know that the company, the repatriation companies, understood and could translate to you know, feel what that meant to my family and in my personal situation. So I think without without her I would have been in a much more difficult place because we’re looking at I think 25,000 pounds for repatriation from from Italy, which was was, I think it was maybe a two hour helicopter ride – no, sorry a plane ride – in a small Cessna back to Gatwick Airport and then a transit, you know, in a private ambulance to the hospital. So I think when you add on the distance and more complexity to that, actually, it’s you’re talking quite a few people as a support team to get you just back to your home country. So I’m now I’m much more aware of that now. And I think I consider it’s not more than the point of wounding, but just having a confirmed clear route back to the you know, to your to your home country or home soil is something now I’d be looking at for, you know, for any remote trip, I mean, even in the in the post COVID landscape, when borders of borders can close, within hours, spontaneous public disorder can, as we’ve seen happen, you know, in tourist areas, so I think I think now I take a much more strategic view of being able to get back to back home, safe and sound.
Julie Saunders

0:11:04 – 0:11:28

Yeah, it certainly takes often a team of people with those varying logistics and medical expertise, isn’t it to, to to plan and navigate, like you say things like COVID, and border closures and that sort of thing to get people home quickly, where it’s needed. So so you were first taken to a hospital in Italy? Did did you stay there for a period of time before being repatriated back to London?
Chris Shirley

0:11:28 – 0:12:48

Yes. That was about 10 or 11 days in a Aosta, in Italy. So they obviously they were most concerned about the brain injuries. So there was three lesions on my brain, and that’s bleeds, bleeds in the, on the brain, a shattered leg as well, which they they operated on to stabilize before, you know, I was able to be repatriated back to the UK. And that was just a very quick operation, just a steel bar, a metal bar inside of the tibia, the shinbone because it was, it was so badly shattered. And then, and then more or less, you know, as soon as I was able to breathe on my own and able to talk and converse with people, then we were, then we’re looking at repatriation. But in the meantime, my, my, my girlfriend and friends flew out to be, you know, by a bedside, because one thing we weren’t aware of was in Italian hospital, for example, you provide your own nurses. So your insurance will pay out for for nurses to be able to support you. Whereas, obviously, the main difference in the UK is it’s, you know, that’s part of the part of the NHS. So peculiarities like that I wasn’t really aware of until I had to go through it.
Julie Saunders

0:12:48 – 0:13:06

Yes, that’s exactly right. The the levels of nursing care vary great greatly around the world. Did your assistance company help you with that? And did did they inform your family? Is that how your family found out or it was your teammates that were involved in that process?
Chris Shirley

0:13:06 – 0:14:34

So my teammates informed next of kin. We had an agreement that in case, you know, in the event of something happening is that we would inform these people in this order as to as to what we’re doing or what happened, and then people would would obviously be able to support as and when. But I think, for me, it was a real kind of global affair because my girlfriend flew flew from the UK, had friends, friends in Dubai, who were also trying to manage my repatriation. I think a friend in America as well was was aiding and supporting in engagement with the insurance and the assistance companies. So it really was something that was on effectively home home soil, you know, Italy was only a few 100 miles flight away, but it really did become quite a logistical challenge to get me back to the UK. And it was, it was a really a shattered leg and a brain injury, which you know, which looking back now is, it really isn’t as complex as it could be. I’ve got a friend in hospital at the moment with a shattered pelvis after a paragliding accident. You know, I think how lucky I was to escape such minimal injuries for quite a big tumble, but still, how much how much friends and family had to really do and manage and engage on my behalf or yeah, probably much more alive to it now than I’ve ever been.
Julie Saunders

0:14:34 – 0:14:59

Yeah, for sure. I mean, clearly with your significant injuries at that the start, like you say, you were unconscious at the time. I imagine it was it highlights the importance of having a next of kin in place and having that network around you to be able to make some serious decisions. Like you were saying, you had surgery whilst you’re in whilst you’re in Italy. I imagine there was a lot of important decisions being made by your next of kin, your girlfriend or your close family members.
Chris Shirley

0:15:00 – 0:16:34

Yes, yeah, well, I was in a coma. So I was in an induced coma for the first eight days from when I landed and got to hospital. The the paramedics on the flights didn’t believe that I would make it to hospital with the head injuries that I had. So it was it was critical getting into the into the hospital and then straight into a coma, I think to give me the best possible chance of recovery. But I think probably one thing that will be with me is is is knowing from multiple friends that the surgeons are saying that as you know, the Glasgow Coma Scale, the, the degree of responsiveness that a person can give, I was at the lowest point, a GCS score of three, which is I think, technically lowest, the lowest you can be before you actually, you’re actually dead. So not something I’m keen to highlight, but the ability to bounce back from something as you know, as as bad as that was, was important. But also, as I just said, just just knowing that you’ve got someone dependable that you can call upon if you need to, who can then manage the flurry of communications that come in, because with the advent of social media, word spreads fast as soon as these things happen, and your your next of kin can very easily get overwhelmed with with messages of support, or, or offered kind offers and all sorts. So it’s, it really is like a multi dimensional thing. It requires multiple people.
Julie Saunders

0:16:34 – 0:16:57

Yeah, so certainly, you know, we certainly find that it’s it’s not only the customers that we look after, it’s certainly the network around them. Because it you know, it obviously affects that their loved ones around them and the decisions that you’re having to make. So yeah, definitely understand that. So I assume when such a significant event occurs, your mind does go over what could have been done differently. Is there anything that stands out to you?
Chris Shirley

0:16:57 – 0:19:06

Yeah, so it’s funny you say that, because I’ve, after the accident have have grown a real interest in the human factors of risk, and, you know, safety and security. And I think I’ve gone through the situation many times, in my mind, especially in the hotel, trying to figure out, you know, what, what learning could be drawn out of it. So that, you know, I don’t put my my family, my friends in that position again, nor myself, but I think human factors is something which I hadn’t, hadn’t really considered to the full extent previous to that. So we this is a third year running that we’ve been trying to climb the Matterhorn. And when we when we got the weather window closed. You know, we were, as you can imagine, pretty shocked, pretty gutted about not making the summit again. So I think that’s that led me to sleepwalk into taking more risks than I should have been doing. I wasn’t roped on to, to a belay partner when I was taking photos. I was clearly in a position where I should have been secured to something else. And I put it down to an altered mindset from failing to summit for the third year running. So it’s got me thinking a lot deeper about how how human factors can increase your risk, risk appetites without us realizing it. And I think the term sleepwalking into the risk take taking encapsulate it as best as I can think of at the moment because it wasn’t it wasn’t a conscious decision. Not to take that much risk. It was something I think my my mindset was focused on the lack of sumitting, and what I could do to make sure the trip wasn’t a complete waste. So I think that’s something which particularly applies to media and charities, because you know, that the focus on the mission or the task can sometimes outpaced the protocols that were there to keep everyone safe and secure. So I think there is a direct correlation between the two.
Julie Saunders

0:19:06 – 0:19:29

Yeah, okay. Interesting. And is there a way of in preventing you from getting into that? So you know, sleepwalking, like you say into into more risk taking it is it? So it’s not quite complacency that you’re talking about? It’s it’s sort of an altered state, if you like, of not necessarily getting the reward that you were looking for? Have I understood you correctly there?
Chris Shirley

0:19:29 – 0:21:15

Yes. Yeah. It’s good question. I think how. So I came up with this concept of the guardian angel when I was working with a charity in Mosul a couple of years ago, and the guardian angel role was was somebody who was outside of their project outside of the mission, whose sole responsibility would be to think of the team’s safety and security so they couldn’t be given any task. They couldn’t be given any anything other than just simple observation, you know, for situational awareness so that the outside situation didn’t start to impact on the team safety. I think it’s something which I’m going to I’m going to carry on because the guardian angel role, it’s, it’s quite useful to kind of keep yourself from getting pulled into, you know, the situation, somebody who has the support of the rest of the team who can speak truth to power, who can, you know, say the awkward make make reference to the awkward elephant in the room and just be the person who is free from peer group pressure to look after the team’s best interest. Because certainly, when we were, you know, operating in Mosul, the, the scope creep to take on more risk than you were you were equipped to deal with was certainly ever present, you know, we could always you could always get, look at what other people were doing it how other organizations are doing it and get drawn into doing this doing it the same way or with the same taking on the same mission without necessarily having the same resources to call upon if it does go wrong.
Julie Saunders

0:21:16 – 0:22:06

Okay, so it’s almost that risk versus reward balance gets affected in some of these situations. Yeah, yeah. Okay. You know, obviously, we talk to travelers from all sorts of backgrounds, and it’s certainly not the only ‘new to travel’ customers that benefit from, you know, our risk management strategies, strategies, and it’s, you know, it’s the importance of talking to that seasoned traveler, which I know slightly different to what what you were saying, there, but you know, you think you can get familiar with your surroundings and like you say, it was your third attempt to climb the summit. It can change dramatically. I imagine there’s an array of factors that affect you what whilst on a mountain, you know, from emotional distress to altitude or weather. Yeah, I’m sure there’s a myriad. So there’s this the the idea of a guardian angel roll sounds perfect for a situation like that.
Chris Shirley

0:22:06 – 0:22:08

Yeah, I think as well as is, as, as the pandemic hopefully relents, you know, fingers crossed, that travel will travel will come back to the same degree that it was prior to the pandemic. But I think one thing that will most definitely have changed is us our skills for travel, you know, the ability to have that connection with the outside environment. And notice when things are changing without, changing around, you know, not necessarily for the better. So I think, not necessarily going to the far flung places, again, or the most remote, the most challenging straightaway is something which we almost just need to almost relearn how to travel again, I think before we start taking on the kind of risk we did before the pandemic, and it taking, being being aware that we will have experience skill fade, and that we can’t just just jumped back on the treadmill at the same speed again, we need to almost like ease yourself into into travel again.
Julie Saunders

0:23:08 – 0:23:32

Yeah, it’s so true, isn’t it? That’s that’s almost slow burn back into into travel with a very changing landscape and and I suspect it will continue to change, that the pandemic isn’t something that will go away quickly, and maybe never will. And so it is going to continue to change for us, isn’t it? So? Yeah, definitely. Very true. So Chris, pulling you back into your professional life again, is there a top tip that you would give to people traveling to high risk areas?
Chris Shirley

0:23:33 – 0:25:00

Yeah, I think having an adequate contingency plan and when I say contingency plan, I mean, a real contingency plan not just if this happens, we will do this, if this happens, we will do that. Something that has actually stood up the test of people looking into it and being critical of it because essentially, a whole whole team whole team isn’t marked by their one person’s risk, risk appetite, it’s a whole team’s risk, the collective risk appetite. So making sure there is an adequate contingency plan for when it all goes wrong. I mean, point in case I feel I can stand there in front of people now and say, I was really lucky at times that you know, I had a mountain an accident on my doorstep essentially and friends who I trained to look after it well, but if that had been somewhere remote or challenging, you know, I don’t think I would be I would be talking to you on this podcast right now, Julie. It’s, it’s something which you know, it can’t really be paid lip service to any more anymore as in you can’t really just say, you know, we’ll make it up. If we encounter it, we’ll make it up. It’s I don’t think that’s good enough anymore. It needs to be something which is, is watertight, is something which can stand up to, you know, a pressure test or something, if it does go wrong has to be called upon.
Julie Saunders

0:25:00 – 0:25:03

Chris, where can people find out a little bit more about you and your work?
Chris Shirley

0:25:03 – 0:25:29

Thanks, LinkedIn, or my websites hausofhiatus.com, which is got all a lot of my photography, a lot of my design work, but then also writing and writing an audio for the risk consulting that I do. It’s a bit of a jumble of everything, but hopefully looks, looks looks good enough to take a peek at.
Julie Saunders

0:25:30 – 0:25:50

Thank you, Chris. It’s been an absolute pleasure to talk with you today. And thank you for being so open and, you know, obviously talking through what’s been a significant injury, and a challenging journey to recovery and hearing how your contingency plan did stand up through for a very serious accident. So, thank you very much, and I wish you all the best in your continued recovery and really appreciate your time.
Chris Shirley

0:25:50 – 0:25:52

 

Thanks for having me. Julie’s much appreciated.

As a follow up episode to our Mile High Medicine series, guest host Julie Saunders interviews adventure enthusiast Chris Shirley about his intense first-hand experience with medical evacuations. From a 50 meter fall on the Matterhorn mountain through to an aeromedical evacuation and hospital recovery in a foreign healthcare system, Chris shares what it’s like to stand up your crisis plan and exactly how complex an international evacuation can be. Especially during a pandemic.

Listen to the end of the interview to hear what Chris recommends to all adventurers and the lessons learned he’ll incorporate into his trips moving forward.

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