Wait…Should We Call 911?
The Ride
It started out like any other ride day. A few text exchanges that involved a meeting place, a time, and a rough plan. It was our backyard. The trailhead, a 12 min drive for me and a 7 min pedal for Stacy. We used to be work colleagues and ride together often but I hadn’t seen Stacy in awhile and I was looking forward to catching up. It was a grey 43℉ PNW March day and in notorious Stacy fashion, we climbed (more like grunted, huffed and puffed) up a trail everyone else in their right minds only rides down. As I watched Stacy ascend like a billy goat, attempting pitches and switchbacks I genuinely didn’t think were rideable, I commented to Stacy on her inherent bravery and willingness to tackle challenges head on.
At the top we opted to descend a discrete, infrequently traveled trail that I’d been wanting to check out. We approached the first crux of the trail, a very steep, narrow, rocky shoot, and set our bikes down to scope line options. I felt the familiar butterflies in my stomach as I stared down the rocks, contemplating line options. We chatted about the pros and cons of the various lines and I ultimately decided on a line that went straight down the guts with a pinched, steep rock maneuver at the finish.
As we walked back to our bikes I told Stacy the line I was going to ride. “OK,” She said, “I’m not sure, I’ll just have to feel it out.” Upon hearing her comment, I thought to myself, “I do that sometimes, but I don’t like that I do it, and I never suggest that strategy to others especially on such a sketchy section of trail.” But I also knew Stacy is a very strong and intuitive rider and I wasn’t there as a coach, but as a friend. So I said nothing. We grabbed our bikes and prepared to descend, “Don’t mess up,” Stacy called, “Cause I’ll be right behind you.”
I dropped in, navigated the move without incidence, then heard the unmistakable sound of a crash followed by screams of pain and panic from Stacy. “I'm hurt! Bekah, I’m really hurt, I can’t move my leg!”
The Crash
I immediately ran up to Stacy where she was lying a good 10’ below the rock move, bike below her and I knew what had happened. At least, I could visualize the crash, but I had no idea what was going on with her body. She was lying, crumpled, on her right side, feet lower than her head on the steep slope. She was panicked, in immense pain, and unable to move her left leg, which fortunately was on top of her right leg. My Wilderness First Responder (WFR) training kicked into gear and I did a rapid ABC (Airways, Breathing, Circulatory) test. Clear. I proceeded to scan her body, both visually and physically to look for and feel for additional injuries other than her chief complaint of pain in the thigh area and concern regarding her inability to move her left leg. I told Stacy to take deep breaths and reassured her she was going to be OK. I asked what happened and what she was feeling.
I tried to stay and appear calm, but I was also panicked. As I palpated her legs, arms, and back I was terrified I’d discover a compound fracture, a dislocated knee, or another traumatic injury. I worried I didn’t know enough and couldn’t properly assess the situation and was going to miss something crucial. But continued to reassure Stacy she’d be “OK” to take deep breaths, and we’d get out of this.
The Deliberation
Stacy was completely lucid. A&Ox4 (alert and oriented to person, place, time, and situation) and her astuteness proved to be crucial in describing our location in the upcoming hours. We talked about what to do. She tried to move her leg and there was a gross crunchy and clicking sound we both heard from her knee. She was in so much pain she couldn’t move her left leg at all, but was able to wiggle her toes, had a pedal pulse, and could feel the tapping of my fingers on her toes - all good signs. I didn’t want to move her for fear of a potential spinal injury or further aggravating a potentially broken femur. We debated. The thought of calling Search and Rescue (SAR) and requesting an evac seemed out of the question to both of us. We ride all the time. “I never get hurt” Stacy said through grimaced teeth. We are more likely the people to come across injured riders than be the ones injured ourselves. The idea of calling SAR didn’t fit with the image we both had of ourselves: tough, strong, and adventurous. It couldn’t be that extreme of an injury, could it? We tried again to move. Nope. It wasn’t going to happen. I gave Stacy 600mg Ibuprofen, took a more thorough set of vitals, and started making phone calls.
The Call
The first person I called is a mutual friend who lives directly at the bottom of the trail. The thought was: 1) activate some local folks to get up here to provide help to bring blankets or a sleeping bag and perhaps we could get her out without calling in SAR. It still hadn’t 100% clicked in my head that we needed a backboard and professional help.
No answer - Spring Break. Dammit. The second person I called, Nina Jimenez, is a good friend of Stacy’s and lives and works close by. Again, no answer but I left a message. The third call was to Stacy’s husband - no answer. The fourth call I made was to Lisa and John Rust, who are on the local SARs team, Crag Rats, but based in Oregon, and we were in WA. They impressed upon me the urgent threat of a potential femur fracture and it was at that point the severity of the injury finally clicked. We were not walking out of there. I got off the phone as quickly as I could after a hurried “I’ll send you a pin with my location” and called 911 for the first time in my life.
GPS coordinates are helpful when there are roads or mapped trails to your location. We had neither in our favor. We were on the hillside of an unmapped zone, an area few people are familiar with, on a trail that exists on no map, and where the only trail signs read, “shhh, the plants can hear you.”
Nina called back. I held the phone to Stacy’s ear and she explained how to access our location. The next two hours consisted of me sharing my location, communicating with the local SAR and EMS dispatches, and continually holding the phone up to Stacy’s ear so she could describe how to get to us. “You go through the first gate, cross the bridge, cross the creek then go right. If you get to the second gate you’ve gone too far.” Yep, that’s about as clear as you could be out here. As I was mid phone communication, shooting off pins and sending texts, Stacy said, “I don’t even have my phone. I would have died out here.”
I started to shiver. It was cold. I looked at Stacy. She was turning pale. I took another set of vitals. Stable. But I was worried about shock. I took off my thin windbreaker and laid it over her then set about making a fire. One of the items I always carry in my pack, in addition to a small first aid kit that lives inside my bike frame, is a lighter. I wanted to make the fire close enough to Stacy so she’d feel heat but not too close such that it was a fire risk to her. We were stuck on an insane slope, much of which still had grass growing so my prospects were slim. But I managed to get a fire going about 8” away from Stacy, and when the wind blew her way it offered some relief and kept my fingers functioning. I have Raynauds, a vaso constricting disorder that causes my fingers and toes to go numb as soon as I even so much as think about getting cold. As worried as I was about Stacy, I knew that if I lost the ability to function, we were really screwed.
The Rescue
Before I knew it, Nina was calling back asking for clarification on where we were. I said I’d run up to meet her at the junction. I stabilized Stacy as much as I could, stoked the fire, and sprinted up the hillside. Nina arrived with a sleeping bag and warm company. This allowed me to then sprint down the trail and meet our other friend who was trying to figure out how to access us from the bottom. No sooner had we gotten back to Stacy than EMS called and said they were at the trailhead trying to figure out how to get to us. I ran back down the trail and guided them up. I carried the large med pack for one of the EMS as the trail was so steep it was a hand over foot scramble up rock and along what is essentially a game trail about 6-8” wide with a steep slope falling off to one side. Once the EMS team arrived things were a bit of a blur of neon yellow EMS support, spider straps, and IVs. A few crucial decisions, namely evacuation route and process needed to be made.
Going back down the way EMS came up was not a good option. The trail was hard enough to walk as an able bodied person and pretty unreasonable for a crew with a backboard. Up and out was the better option, but also required some serious trail navigation. EMS was pushing for a life flight helicopter to come in, but Stacy didn’t have insurance to cover such a trip. Our friend and local SARs rescuer gave the following counsel, “Stacy, you’re stable, and the pain has subsided thanks to the fentanyl. If you’re OK with a slower evac there’s no reason for lifeflight.” Sage advice. The helicopter stood down and the Klickitat SARs team slowly and safely evacuated Stacy 2 miles out to the most accessible road and loaded her into the waiting ambulance.
It took 2 hrs for EMS to arrive and another hour and a half to stabilize and evac Stacy. Pretty impressive considering the terrain was treacherous and access was tricky. The EMS and SARs team that arrived were excellent. They navigated the terrain without complaints and were professional and smooth in their actions. In Stacy’s own words, “They are real heroes.”
Stacy is now home and recovering. She had surgery to place a rod in her femur and she is being well cared for by friends and family. She will ride a bike again this summer. Stacy is still without a doubt one of the toughest and bravest people I know. If you know Stacy, you know she is notorious for her comment, “I’ll try anything once.” As she was being carried out on the litter, Nina commented, “Well Stacy, you’ve never done this before!” This is definitely a one and done.
The Learning and Thank Yous
My biggest take aways from this experience are the importance of staying present, using all potential resources available, and recognizing when you need to move quickly, and when you can breathe and take the time to make a logical and smart decision. All week I’ve been beating myself up because I felt like I should have recognized the severity of the injury sooner, and called 911 immediately. But as I’ve talked with more people about the situation, the order of operation made sense.
On behalf of myself, and Stacy, I want to extend an enormous thank you to Klickitat County 911 Dispatch, the Klickitat County Fire District #3, the Klickitat Search and Rescue, Nina Jimenez, and Lisa Rust. If the EMS parameidcs had not come out, we would not have had to rely on LifeFlight because her pain would have been too severe to stay in the sled for 2 miles of bumpy trail. If you would like to make a donation to the Klickitat SARS team, you can do so HERE.
My post next week will include more detailed suggestions on items to carry in your pack and ways to mitigate risk. But for now you can see what I was carrying the day I was out with Stacy. Not pictured are a multi-tool, tube, CO2, and tire lever that all live on my bike, in addition to water, a water filter, and snacks. This week I purchased LifeFlight Insurance. It’s incredibly affordable and now seems like a no-brainer. More on that and other preventatives next week. :)
