Wilderness Medicine Updates

Ep. 22 - Moose Mutlow: Yosemite Swiftwater SAR, Family Liaison Officer, and longevity in rescue.

• Patrick Fink, MD • Episode 22

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In this episode of Wilderness Medicine Updates, host Patrick Fink interviews Moose Mutlow, an experienced outdoor educator and search and rescue professional with nearly four decades of experience globally. Moose discusses his extensive career from being an Outward Bound instructor to working with Yosemite Search and Rescue, and his role as a Family Liaison Officer for the National Park Service. The conversation touches on the challenges faced by search and rescue teams, the importance of robust communication skills, and how to build resilience against trauma in high-stress professions. Moose also shares his personal experiences, reflecting on the value of mentorship, the significance of team dynamics, and the essential need for compassionate support during crises. The episode includes practical advice for those in the field of wilderness medicine and search and rescue, highlighting the necessity of emotional balance and continuous learning.

Connect with Moose:
Website
Blue Sky
Instagram
Substack
Book: Searching
Book: When Accidents Happen

Did you enjoy this episode? Contribute to YOSAR!

Links from the show:
The Stress Continuum
Responder Alliance
Quell Foundation
Dr. Nicola Lester: trauma informed practice

More Reading:
Ranger Confidential
Nature Noir
The Cold Vanish
The Last Season

CHAPTERS
00:00 Introduction and Guest Welcome
00:19 Moose Motlow's Background and Career
01:58 Challenges in Search and Rescue
02:58 The Importance of National Parks
05:23 Moose's Nickname and Early Career
07:07 Transition to the US and Outdoor Adventures
10:54 Search and Rescue Experiences
15:20 Swift Water Rescue Operations
19:38 Training and Mentorship in SAR
30:18 Role of Family Liaison Officer
45:24 Managing Emotional Burden as a Liaison Officer
47:12 Recognizing and Addressing Trauma
48:36 The Importance of Peer Support
49:44 Cultural Norms and Vulnerability
51:05 The Cost of Ignoring Trauma
53:37 Building Resilience and Longevity in C

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.



Patrick Fink:

Welcome back to Wilderness Medicine. Updates the show for providers at the edges. I'm your host, Patrick Fink. Today we have a real treat. I'm excited to bring you a conversation that I think will be useful, interesting, wide ranging. I'd like to welcome our guest today, moose Motlow, an experienced outdoor educator and search and rescue professional. With nearly four decades of experience around the globe, moose's career spans from his early role as an Outward Bound instructor to his position as a deputy headmaster in the Kalahari Desert, and even some time as a street performer. 2002, moose has been a member of Yosemite Search and Rescue or Josar, serving both as a technician and working within incident command. As Joss's Senior Swift Water Instructor and a Certified Rescue three International Technical Rescue instructor. He has provided extensive training internationally and accumulated more than 2000 days instructing in wilderness environments. Moose also leads the Family Liaison Officer training program for the National Park Service, facilitating and teaching critical crisis communication in national parks like Grand Teton, Yellowstone, and the Great Smoky Mountains. He's the author of two books when Accidents Happen, a text about the family liaison role and searching, finding purpose, laughter, and distraction through Search and Rescue, a personal memoir. Currently, moose is the senior projects director at Nature Bridge in Yosemite, overseeing, planning, designing and constructing the National Environmental Science Center, an environmental science learning campus within the park. Today I look forward to digging into Moose's background, the experiences that inform his path in wilderness medicine and his niche within search and rescue, the family liaison officer role. Welcome to the podcast.

moose:

Thanks for having me along Patrick.

Patrick Fink:

I'm excited to have you here. I had planned to begin our conversation with a little bit of a cheekier question, um, but the news recently doesn't have me feeling very cheeky. So let me begin by asking how you and your compatriots are faring in the face of pretty substantial cuts within the federal government. Are you getting bio? Okay.

moose:

Uh, within search and rescue, there was a rethink and, and so they can do emergency hires and get the supplementary people around for fire and emergency response, but it's a fluid situation. I have a, a number of, uh, colleagues who have changed their employment status, so it's a bit rough. I think it's rough for a lot of people. It's it, the thing about emergency services is you're aware, you dunno what you haven't got to, you haven't got it and you need it. So the gaps that may be out there we aren't fully aware of, uh, quite yet. Once we start scaling with more visitation. National Parks had the lot, had a fantastic record setting year, last year of visitation, and that that visitation was underwritten by understaffed national Parks. And, and so this year it's, again, it's gonna be challenging.

Patrick Fink:

That visitation has been up since Covid, right? Since the, what was the initiative like the Find Your Park or something

moose:

Yes. 2016 was this enormous year. What It became quite overwhelming and changed the way that parks are managed, somewhat parks like Yosemite came in with a more, uh, adaptable traffic management system and, and reg and registering to get in the park. And, and people are discovering the, or rediscovering. The value of being outdoors, the value of, of going to these amazing places and immersing yourself in a non-digital world for a few minutes, it's, it, it it at a time of stress. That's, there's amazing healing potential out there.

Patrick Fink:

Certainly, hopefully in, in their lack, those folks who have been cut will again be appreciated by the system and, and brought back into the fold when they realize that firing the only locksmith in Yosemite means you can't get into the sarc.

moose:

I, I think there are lots of good individual stories out there that, that talk about individual challenges, but overall national parks, as Ken Burn said, America's greatest idea. It, it's, it's true. It's this amazing jewel that the rest of the world looks at and comes here to learn. It's, it's one of the greatest things about America is this commitment to preservation, long term of extraordinary places and stories. It isn't. The National Park Service doesn't just do a landscape. They're preserving stories around civil rights. They're, they're preserving stories about LGBT history. These are all valuable parts of America that need to be preserved, remembered, and recorded.

Patrick Fink:

And for better or for worse, the value of that needs to be remembered each generation in turn.

moose:

Dude. Well, that's, that's the thing about history. You keep relearning it. It's, it's, it has a, it has a tendency to repeat itself.

Patrick Fink:

Mm-hmm. heard it said that it history doesn't repeat itself, but it tends to rhyme.

moose:

Yes.

Patrick Fink:

So Moose, a lot of people are gonna be wondering right off the bat before we dive into some of the so nitty gritty, you're from the uk, are you not?

moose:

Yeah.

Patrick Fink:

To the best of my knowledge, there aren't any moose in the United Kingdom.

moose:

There aren't, and I, I got the nickname at a summer camp where I had made some poor career choices as far as the positions I was taking. And each week the management would discover that perhaps I wasn't best suited for group. Leader, right? The, their words were you inspired a riot on a Friday night, which I felt was a little harsh. And they would send me off to the local pub that had a deer head on the wall that was affectionately known as the moose. And I would find myself sitting beneath that moose most Friday nights looking a bit morose into my pint. And it, one, the people would come in and they would greet the moose, good evening to the moose and they would say hi to me. And eventually it became synonymous between the two. And Moose Marler has grace

Patrick Fink:

moose?

moose:

and, and working with young people, if young people can remember your name right off the get go, you instantly have a connection. You instantly can start working with them in a different way.'cause they're not afraid to ask you questions. So Moose is fairly memorable. So it's, it's been my name for 40 years.

Patrick Fink:

Okay. Well, we don't, we don't need to ruin your cover. I won't ask you what your given name is.

moose:

Oh my. Give her name's Jonathan, and my mom calls me Jonathan. That's, that's the only person. So there you go.

Patrick Fink:

refuses to call you Moose.

moose:

Uh, I wouldn't say refuse. She's very clear that I was named Jonathan.

Patrick Fink:

How did you come to leave the UK and, and in America through such a varied career? I.

moose:

Uh, Britain's a very small, small country. It's, you can only be about 70 odd miles away from the ocean at any time. And very early on, after a, a diet of watching outdoor type adventure shows very early David Attenborough and a show called World About Us that would be on Sunday nights, showing you what was out there. I had become smitten by what else could I see? What else, what else could I experience? And so at 18 and, and leaving high school, not necessarily on a track to university, I, I'd started to look at other places and the ability to be able to travel at that time and have opportunity with student and work visas was pretty good. And so I got out of that and I didn't really go back. It, it's, once you've experienced the Outback in Australia, the immensity of it and the emptiness of it, and you, you are lost in that landscape. It, it's harder to come back into Britain and, and feel at ease. I think the north of northwest of Scotland has this remoteness, it has this harsh, empty landscape that is, can fill the spirit. But I, I. I was always looking for something, a landscape ideally with big animals in it. That made me feel a little bit more humble that that's, that was my ultimate goal.

Patrick Fink:

How do you feel the US is compared to the Outback?

moose:

Uh, well there's lessons that bite you. Um,

Patrick Fink:

fair. It's

moose:

RA Australia, I love that thing. How can you tell an Australia and when they're gonna throw a stick for their dog? And the answer is, they always kick the stick.'cause you wanna make sure it's not a snake. And having gone there and guided, I, it's a pretty remarkable experience to be around that many things that can quietly kill you. Uh, so I, I don't miss that part of Australia. And I love, I love America because of its AC in the West, its access to. Wildness because I can go for a bike ride and I can see mountain lion tracks and I can maybe catch the back end of a bear taken off, maybe see a bobcat come across or have Golden Eagle. We watched Golden Eagles the other day, mating a couple of month or so ago, and it's all right there in the backyard. And it's not that Europe lacks that diversity. It it, it lacks the, uh, the emptiness,

Patrick Fink:

Right, right. The Swiss or the French Alps, there's little chalets every kilometer.

moose:

which are fantastic. My nephew lives in Austria and, and always things the praises of a stiff hike and then getting to a spring full a beer and a, and an on a box to like buy one. And he loves that. I mean, I mean that's, that's a fantastic thing,

Patrick Fink:

Yeah. No, I love it too, but it, it, there are no large tracks of undeveloped land or at least very few. It's hard to get to a place where you can't see a human structure.

moose:

As you drift into the Eastern Europe and you go along the, the vestige of what was the iron curtain? There are these amazing national parks that, that have rege have, have started, get the large wildlife back in on, on plants like European bison and wolves. But again, the access in America to this, this amazing thing of public lands is a, is remarkable,

Patrick Fink:

How did you go from working, doing outdoor education with Outward Bound into. The world of search and rescue.

moose:

well, every, every day without a bound is, is a potential search and rescue. And, and our bound schools around the world typically are a local resource. So you're, you're at, you can be categorized as an, as a. Search and rescue unit. Outward Bound, Abu Dhabi was the search and rescue unit and lifeboat operator, North Carolina Outward Bound had its search and rescue technically supporting Burke County. And, and because you're outdoorsy types and you have access to equipment and you can work as a team, there's always that overlap. And, and when you come to someone like Yosemite, which has a very active and busy search and rescue unit, once you get in, there's opportunity and that, that momentum builds on itself. So I started at, at the search and rescue catch cash, literally packing sleeping bags and putting gear away after missions. That's the way I got in. And then somebody one day recognizes you and says, but you on the river. And they start to look at your river resume and you end up in the swift water trainings. And that's another beautiful thing about America is my exp my experience has been. What can you do rather than what piece of paper do you have? There's a little bit more of an emphasis on the experience side and your potential,

Patrick Fink:

Yeah, certainly, certainly in some, some parts of the US and particularly in the, more so in the West than on the east coast perhaps. But it sounds like you, you were interested to enter the world of sar. You probably weren't there packing bags because that was the most fun thing you could be

moose:

No,

Patrick Fink:

time.

moose:

I, and the reason I love, uh, the, I love search and rescue is, I like working in a team. It's a bit, it's like emergency medicine and work in an ambulance. You have this task that it, that's packaged. You, you arrive on scene, you load somebody up. You treat them to the best of your ability. You get to the er, you offload them, you transfer care, all packages done, and it's, there's a beginning and an end for most of our assignments. And I loved, I loved working such and rescue because we're all, whatever, whatever we're doing, we're all focused on trying to get this good outcome and it, and it's bite size. And then working in project management on a big building project, it's a 20 year commitment to the, to getting to the end. Whereas I can go on a SAR and I can have a two hour resolution and that, that helps to feed my soul one of a better word,

Patrick Fink:

You get some, you get some positive feedback or

moose:

really, really,

Patrick Fink:

up some experiences.

moose:

really quickly and, and being around people. Where it's not a disparate response. You're all focused on this thing, and you all have a role, and when you don't have a role, you step back and let it play out until this opportunity opens up. It's, it's a good reminder of how you accomplish something. You don't have to be working at a hundred miles an hour all the time and be at the front. You just have to be ready to lend a hand when they need it.

Patrick Fink:

It is, it is a joy to, a joy at times, a satisfaction most of the time to work in a competent team. think that there are a lot of folks who probably the best time in their life actually was like college or university because that was the last time that they were with similarly minded people working in a collective way towards a defined goal.

moose:

Well, yeah,

Patrick Fink:

I think.

moose:

it's, it's that loss of community. In a, in a disparate world where we've become connected at our community becomes virtual and on a computer, and we humans need to have that connection physically being in the space with other people, and we are, we are geared as much as to sort of fight for our own survival. It's to work with others to accomplish a common goal. We talk a lot about this idea of being the best or the alpha or what have you, and, and it doesn't mean anything without, without everybody working together, you don't achieve anything. You can be very lonely as in survival if you're simply focused on yourself.

Patrick Fink:

So can you bring us into the world of what Yosemite Swift Water Rescue looks like? What is your day-to-day operational life look like?

moose:

Well, it's pretty slow right now. We're just starting to get to the point where the, the spring flows are coming up incrementally. We've, we've had some low rain, so we've had some bigger days and the air temperatures have been pretty low, so that's a really good recipe for people staying away from the water edge. It looks cold, it is cold, and it's going fast. When the daytime temperature creeps up and you're starting to get a bit sweaty out on the trail, that's where our incidents start to creep up of people being hot and wanting to cool down. The water's still very cold and going very fast, and it's in this narrow window running April to June with high flow and high daytime temperatures where we'll start to get interactions with the water. And there aren't huge amounts. There's probably many more that are undocumented, which are just good stories. But we'll have a big, a big water year will be five drownings out of 12 to 20 to deaths in the park.

Patrick Fink:

Yeah. What is, what is that line between the rescue and the good story?

moose:

What's if, if the person telling the story is the person involved in the story? It's whether you've survived it. I like, I like to talk about the idea that, be able to tell your story, don't be the story. And most people are out there, they make a mistake next to the water and they get a wet foot and a bit, ooh, they're a bit scared. They might drop something in the water and they get away with it. Uh, it's a very, very fine line here. The margin on some of our trails and our exposure to some of these cascades is, is minute between. That is a great picture. And, oh, we're doing a three day body recovery.

Patrick Fink:

Right.

moose:

I.

Patrick Fink:

How, how would you, how do you steer people towards telling the story instead of being the story?

moose:

We do, we do some outreach. We do a media day in Yosemite

Patrick Fink:

I.

moose:

where we'll talk specifically about it, particularly around the big holiday weekends. And I, I'll tend to, we tend to train in the open, so you train in highly trafficked areas and, and I encourage all our participants, all the students, law enforcement rangers, resource rangers, that if somebody stops you during training, talk to'em because we've got all the gear on, we're demonstrating speed, and we're talking about how dynamic it is, and they can feel how cold the water is there. You touch a fraction of the people, but there isn't much if, if somebody actually is up the trail and they're just so excited about where they are and they're so out of touch with how powerful the natural world is, no amount of messaging can keep them back from the edge.'cause if it did, you wouldn't have people going off the top of the waterfalls every other year.

Patrick Fink:

Right.

moose:

And it, I think there's that, people have talked about the disneyfication of the outdoors, the idea that it's, that we're some sort of theme park and we can turn stuff off, and that's, that's a measure of society rather than the national parks. It's nobody, very few people come to the park to die. So it comes from a pace of ignorance. They don't quite get it.

Patrick Fink:

Right in us in Yosemite, that's probably 10 to 20 people per year who die. Right?

moose:

we have, it's 12 to 20, 10 to 20 or die of, of those four or five of those could just people who wake up dead, people who are come to a place they love. And then the hotel room, they had a really fun hike and they had dinner and they chatted to someone and, and then they just were late for breakfast and somebody went to their room and they passed away in the night in the sleep. I mean this beauty in that, uh, that sort of end.

Patrick Fink:

Yeah. We can all aspire to that

moose:

And then there's a few traumas and then falls, and then depending on, we've, we've got some pretty high risk activities that happen in the park. Climbing, uh, base jumping. There are, there are things that happen that come with a high degree of risk built into them, and so you would expect some disaster to play out.

Patrick Fink:

You've spoken about the need to allow people a learning curve or an apprenticeship in the outdoors. What would you say a, a good that allows you to take risks reaching that point where you're either the subject of rescue or, or not able to tell the story?

moose:

I think it's a really good mentor. I think it's somebody who, who takes you out and starts to build the fundamentals and, and give you a controlled environment. So whether it's the Girl Scouts is a really good example. They go out on trips and they have a leader and they have some corralling and they're working as a group and they do some prep. And very early on they get the fundamentals of how to stay dry in the outdoors. And then they, they might go to a summer camp and then you, you might do an overnight expedition and you get people helping you on, on really good ratios. The, the, the loss of mentorship. Now you do stuff online, you teach your staff stuff really quickly. You do, you used to go for a two or three day trip to REI to learn lightweight packing and somewhere in there you didn't learn anything about navigation apart from using your phone. That's the fundamentals. And you need somebody to, some people can be self-taught, you know, as kids we used to go off and do crazy stuff with maps and we'd figure it out. But then you remember, actually my dad was a navigator in the Air Force and taught me really good navigation skills when I was a really little kid. So it starts with mentorship and there's an accelerated level to practitioner. So you have people going from A to B faster. So they become, they go from being in a climbing gym to climbing really, really hard within the space of nine or 10 months.

Patrick Fink:

Mm-hmm.

moose:

But they've actually built no understanding of mountain weather and understanding what happens with thunderstorms because that comes over a season of watching those patterns. And so they get themselves into trouble'cause they start late and they just had, don't have that awareness.

Patrick Fink:

Right.

moose:

My.

Patrick Fink:

the, the few seasons that I worked for Knowles,

moose:

Yeah.

Patrick Fink:

which I'm, I'm few, I'm sure you're familiar

moose:

Yeah.

Patrick Fink:

it, it was really startlingly apparent that, you know, on first few days of a course, some folks just have no intuitive understanding of how to care for themselves, don't understand why want to keep their clothing dry or change their socks when they're soaping wet, soaking wet, and then it takes that full 30 to 40 days in the field before. You can have the confidence that they can spend two, three days traveling independently of you. It's a, it's a pretty substantial learning curve, even when it's undertaken full time. And that's just the beginning.

moose:

And that's an intent. That's an intensive experience. I. My nephew was climbing in Europe when he was younger, and he has a great story about who ends up taking him under his wing in the Austrian Alpine Club. And it was a 65 year, 65-year-old woman who climber, who would then go out free solo, everything, and he'd sort of tell him where to go, and then they would drink snaps and eat schnitzel and and sausages at the top of the cliff. But he had this person who was looking out for me, and she had this immense, she had decades of experience, so he really had true mentorship in his Alpine career.

Patrick Fink:

If you were 20, say, 20-year-old moose motlow, now arriving with big eyes and lots of ideas to Yosemite, where would you be looking for a mentor?

moose:

Well, I wouldn't be coming to Yosemite. I, I think I would go to a place that had less seen, and I would, I would go to Alaska. I would go to that space where they need a driver at a, at a raft company. And I would drive buses for a season and get out in the river three times and then discover that actually the, the guides leave and go to Costa Rica, uh, in the winter. And I would go to Costa Rica and learn Spanish, and I would learn to kayak. And that's how I would start to do it. And I would do it all on, in absolute dirt bag style. I would do it saving as much money as possible, not having a car. Everything fits in a backpack. You keep 30% of the space empty just in case you find something interesting. You don't buy any clothing. You bag like you find dirty t-shirts, you wash'em. Like I, I would, I would do the economy thing again, but I would, I would, I would be a bit more transnational.

Patrick Fink:

Let, let's take that up to your role now as a Swift water trainer. When you're looking at bringing people into an essentially hazardous and dynamic environment and conducting trainings in high flows in Yosemite, how do you help team members learn the boundary what is acceptable risk in the context of rescue or recovery and, and without crossing the line into the unacceptable?

moose:

You are really careful where you pick your training sites. You, you wanna make sure that people can have success early on and success isn't necessarily, oh, I can do it. Success is learning how I'm not powerful within water. There are things I can do to get from A to B, but sometimes I can't get to B. I've gotta go another route. And so I talk a lot with people in search and rescue in training is how can you do the swift water rescue without getting wet? The idea that it's really alluring to be in the water. It's like there's a, it's very easy to slip into the hero complex of, of sort of swimming out and getting someone and actually throwing a rope and pendulum mint is actually a better option. So I talk a lot about people finding their limit and then backing off a little bit from that so that you make good decisions. It's a bit like an alpine route. You might be able to climb really hard, but you can't climb really hard for a day and a half on this big alpine route. So you have to come down a couple of grades'cause it's a sustained challenge. And then the water, it becomes a sustained challenge 25 meters after you enter, because it's snow melt and it's going at 20 miles an hour. So I, I get people to start to look and draw hard lines about what they're comfortable with and where they're competent.

Patrick Fink:

You've said that there's a great deal of myth around SAR unit capacity and performance. How do you think the, the public imagines what you do?

moose:

Well, I, I think they're guided by media and they have this idea that you can just take an aircraft up in the air and it can do these remarkable things regardless of the weather and visibility. Uh, I think dramas sort of show this superhuman quality to rescuers, that there are times that people do extraordinary stuff like working big wall rescue in Yosemite. Yosemite has it down, it's there. We have a helicopter pilot who can fly with him. A couple of meters of the face and hold a pattern there and basically get a line out to people stranded on the wall. It's a remarkable technical accomplishment, and we have a really good team that understands how to do, lowers over two and a half thousand, 3000 feet like Denali has, can do massive raises on Denali, but these are little sections of, of, of what the response is. And on a really bad day with really low visibility and really remote settings, it's gonna take us two days to mobilize and get people out there. We can't, we can't fly a Blackhawk in that, uh, those conditions and drop a bunch of National Guard out there and magically fix it. It's, it's complex. I, I thi

Patrick Fink:

a

moose:

I think about the idea. Most, uh, teams are very ordinary people in the United States. Most search and rescue groups are volunteers. They aren't paid. They, they, they're a posse that works under the sheriff and they go out there on their own time with their own gear. And I think about ordinary people doing extraordinary things. Um, every so often. Most of the time it's pretty standard. You just run out there and package somebody and bring'em down with a busted ankle. But every so often it's, there's a remarkable series of lucky things that add up and you use your training and you accomplish something extraordinary.

Patrick Fink:

Do you have an experience that you can relate where the public conception of what was possible with SAR was misaligned with the reality on the ground.

moose:

Yeah. Any water rescue in your san, any water rescue in which you, you, you have a recovery component. So somebody's gone in the water, they've gone off a 400 foot waterfall, it's unsurvivable, and families in their desperation want to. Get the loved one back. They wanna find the body and the water hasn't gone down and it's still raging and you can't even get to the edge of the waterfall because the water is, the misting iss so intense. You can't, you got no calms there. People think that some people feel you can just turn the waterfall off and it will just stop like a ride at an amusement park and it doesn't. And that part of that struggle in this sort of this trauma, this, this crisis that they're going through, you have to figure out a way to put people in a position to be able to hear that or, or not. If, and then if they can't hear it, that's okay. You, you have to listen to them though. They need to feel like they've been listened to. But it happens over and over again. Somebody gets lost and you're in a park that's, you know, a million acres. It's. That's a lot of area you have to search if you're gonna go onto every rock. I, I remember being in a helicopter with a family flying over a search area and looking down and they could, they could start to see the search party in the tower slope. And there were these tiny little figures with neon colors moving through these giant rocks. And the family member looked at me and just went, you aren't gonna find her, are you? And, and they'd had that realization of the immensity of the task

Patrick Fink:

Did the mismatch between realities and and these family expectations lead you into your role as a family liaison officer? How did you, how did you come into that space?

moose:

I'd, I'd, I'd worked in social work and in personal development and wildness therapy. So I'd done a lot of processing and facilitation. So when the chance came along to be in family liaison. It, it kind of made sense with some of the skillset I've got around communication and, and around understand the technicalities of what's out there. If you've got this blend of, of knowing how to communicate, listen and talk to people and put people in a position to hear what you have to say, and you don't have to keep referencing somebody else as an expert. That's, that helps in building that trusting relationship to work under this very charged, in this very charged atmosphere. And so it, it became pretty clear that I could be successful in that and help people, uh, which is the ultimate goal. You, you, you, you fulfill the goal where you can make the most difference. And so I can make a lot of difference in that role.

Patrick Fink:

Can you explain for our audience what is the role of the FA

moose:

I.

Patrick Fink:

Liaison officer?

moose:

So the family liaison officer is the Instant Commander's representative to the family. So you're actually what's called the command staff. You have a very, you have a direct line to the instant commander. You're, you're really in their pocket and you are providing the insulation for the instant commander from the family so they can focus on completing the assignment, and you're making sure the family has somebody that they can talk to who's got some level of H in the hierarchy and empowerment to answer their questions and make them and look after them. So it's a, i, I talk about it as a empathetic administrator. You're not there as a therapist or counselor. You're there to provide information and choreograph interactions. So the family get the information as quickly as they can, and then we can also get information if it's gonna be helpful for us with an investigation.

Patrick Fink:

Why have you described yourself as a reluctant family liaison officer?

moose:

Well, I think sometimes, I think sometimes uh, you end up in the, in the EMS world, working with the family and effective people as well as the patient. So you want to focus on, okay, I gotta, I gotta treat this person here. This is my primary. And their spouse, or their brother or their sister or their kid is coming in and, and they're kind of a victim too. They've, they've got an injury too, cause they're being traumatized. And so you end up in this position where you have to switch on your, your interpersonal skills, somewhat reluctant, reluctantly.'cause you got into EMT to do all the really fun stuff with the bone drills. And you have to figure out how to zone in on them and give them the sport they need so they feel listened to. They have a role and they're also insulated from what you're doing on the gurney.

Patrick Fink:

Yeah. You've said that part of the role of the family liaison officer is to manage incidents within incidents. Can you give us an understanding of what you mean by that?

moose:

If you think about a rock being thrown into a pool of water and you have these concentric circles rippling out, and where the rock touches, where it touches that, bam, that's the trauma. That's, that's where your focus is at. And then there are these concentric circles that go out that have different levels of impact. So you, the first circle might be the witnesses, which the other family members. And the next circle might be somebody who's distant, a parent who's on the phone. And so the idea at that point is how, how do you meet their needs?'cause they have needs too. They've, they've got an injury, it's not obvious, but it's trauma. They've had something that's interrupted the flow, and they need to have some level of treatment to help. And once you start looking at it as a treatment cycle as opposed to, I can't be bothered, or I feel really uncomfortable talking to family, it, it, it actually can help, it helps the patient, it helps you and it helps those people. I.

Patrick Fink:

Yeah. How do you pitch this role to an organization with limited resources that's full of people who feel like they came, came to the park to do the bone drill stuff?

moose:

Uh, I talk about making their lives easier. I quite often you'll say to people, what's the most challenging thing? And they'll, they say, well, actually it was the spouse screaming in my ear. And they say, well, if I've got, if I've got a formula that can help mitigate that, reduce that scream, or Would you be interested? Then they'll say, potentially, um, is there an acronym? And I'll be like, there is an acronym you can learn, a new acronym. And they get really excited about that. I, I did this talk to a bunch of, I know, second or third year medical students and there was silent and I thought it wasn't going down very well. Then you have this idea of, oh, what am I saying? They're just like, they're doctors. They know everything. And, and when I finished talking and doing that first little introduction, one of them said, I wish I had this in my first year of medical school. Because that, that interpersonal piece, which we hear over and over again is something that isn't taught particularly well or hasn't been, is so critical in treatment of everybody and, and for the person doing the treatment because you are putting yourself in a healthier position.

Patrick Fink:

So you, you're saying that you offer it up to them as way to create space between activities of the rescue and, and the family needs so that both can proceed separately.

moose:

It's a way of insul, uh, basically insulating and compartmentalizing. If you think about it as two overlapping circles with you in the middle of it with treatment to the right and the family to the left, and you inhabit that little strip in the middle, if that becomes a really big space, you're not being able to focus on, you're not focusing on the treatment, which is your, with your primary part in the triage. So it's, it's figuring out how do I respectfully answer their questions, succinctly, tell them why I need space, and then give them a role. Like their role could be. I want you to sit over here and I want you to hold this space. I want you to start writing down like the Kenny's birthday, his telephone number, whose spouse is what his home address is. Write down your re reflections of what happened. Are there any medical incidents that are going on that that's 10 seconds and you've given them a job to do and you've bought yourself at a minute and a half before they ask another question. That's, it's the on scene, the disempowerment that family members feel is so profound that all they're looking for is a job to do to help distract them and be useful. When I say distract, it's with purpose.

Patrick Fink:

Yeah, what are those needs? Do you have a way of categorizing or understanding the needs that family members have?

moose:

Well, if, if I have the, if I have the capacity, if I, if I have enough people, I'll have somebody go over and say, what do you need to know? Like, here I am. This is my introduction. I'm here to help you. You're safe right now. So you're giving them the opportunity and the keys to actually go from that flight fight to sort of come down the cortisol response, which is just, they're freaking out and you're starting to actually get into a point where they're into an easier functioning state, state. And then you ask them, Hey, what do you wanna know? I got some, I got some facts here. I can deliver them to you, but you might have some questions. How do you wanna do, do you want me to tell you, tell you stuff, or do you wanna ask me stuff? And you're instantly giving them options. A binary choice that says, oh, I want to ask questions. And they go for 15 minutes if you, and you let'em, because that's the best way to, to manage them at that moment. Or they say, just quickly tell me what's going on you like. Well, right now we're, we've got with CPR in progress, we're 12 minutes in, we've got a life flight booked. I, I really want to get back there, but I wanna make sure you've got the information. And they go, well, can I fly with them? You're like, there isn't gonna be opportunity to do that. But I'll walk you up when we're loading Kenny onto the air, onto the aircraft. Oh, thank you. Can you hold here? I'm gonna come back to this spot in five minutes. So you've given them a place to be, you've got'em bought in and they're gonna drift. But you know the point person to talk to that point to go back and manage them away.

Patrick Fink:

It sounds like you keep things really, I, I think you've put it binary. So simple decisions.

moose:

Yeah, it's like the idea that if you walk in and you say, what do you wanna know? That's kind of the worst question out there.'cause they're like, oh no, it's a test. Um, whereas if you say, I have something to say that I can give you some facts, or you may have some questions and they go, well, I haven't got any questions, or Let's listen to what the person says. You give them a very simple choice, but I don't give'em four or five things. And then a group is trying to figure out which one's the priority.

Patrick Fink:

Do you ever find yourself in a position where your role starts reflecting back in the opposite direction and you're becoming more of a, know, an advocate for the family to the ic?

moose:

So that's, that's one thing I teach a lot in family liaisons, difference in advocacy and liaison. And if, if you are a family liaison officer, you are working in that role. You are, you are representing the, the agency, the response. And so in truth, you have a little bit of advocacy'cause your, your primary response is to the ic, but you aren't making deals. You're just reporting back information. Allowing the incident commander to figure out maybe the best play to make and the best way forward. When you drift into advocacy, you, you, you have no role left in the, in the response because it becomes combative and it works against what the position's trying to do, which is the free flow of information and installation. You start?

Patrick Fink:

in, you ever been involved in an incident where you were tempted to move into that

moose:

Yeah. Inadvertently I ended up in a situation where I complicated something'cause I just got worn down and the family really wanted something to happen and I ended up just being three days in exhausted and agreeing to this thing and then ending up, taking on board a vast amount of what was actually scenting items. It was for dogs to track with, you only need one, one sock in a Ziploc. And I ended up with a garbage, garbage bag full of all these clothes. And so we had to enter them as evidence and so it, it made the investigator's job harder because they suddenly had 36 pieces of clothing that individually needed to be entered into evidence. And that was my lesson. Don't, don't, don't make it more complicated. And a lot of what you do in the Family Liaison is I'll talk about, I'll give them a, a, a single uh, truth. Like it's something that's absolutely true. I've tested it three times. I'll give them the facts. An undeniable truth. And you don't over commit without talking to the ic and every commitment you make, you honor. So it's, it, this is important because in the intensity of the relationship of the family liaison, you have this accelerated knowing of the family. The family will share intimate details with you an hour in because they are, they want to talk about their family member and they want to talk about who, how valued they were as a human being. So you've become privy to all this inside information. And sometimes family get a bit confused'cause you can become a family member. And that's dangerous. And so at the same time that you listen, you have this objectivity to be able to keep a step back because it's a transitional role. It has a beginning and an end. And that's part of that needs to happen for the family because you can't keep reoccurring in their thoughts and interactions.'cause it goes back to how you were brought together, which was this tragedy. So you're this, this kindhearted administrator, this empathetic, compassionate administrator who, who steps back. And I couldn't have done a hundred missions and fatalities if I had not had that very clear boundary. It's not that I don't care, I just have a very good regulating, uh, approach that I know it will finish and I'll, I'll hold some memories of that family and that intensity. But it is, that incident was not mine, it was theirs. It's not possessional.

Patrick Fink:

Do you have recollection of a specific incident that illustrates the value of the FLO role?

moose:

I, I had a very early interaction where, uh, there was a death of a young person and when the family arrived to support the, the cousins and his brother, uh, his family members said, thank you for being here and supporting them and not, not letting them be alone. And I, I think that's a really good guiding point. And I, I look back on that incident continually when I go on assignments is that death in, in our Western culture, for the most part, it's a very uncomfortable thing to deal with traumatic death in particular, and. Uh, communities struggle at times, not always struggle at times to figure out how to support families. And we tend to withdraw and give people space. And actually what people need is companionship and witness. They need people just sitting there looking uncomfortable. And people say to me, well, what should I say? I say, maybe you don't say anything. You just sit in the room and you're uncomfortable. You're not on your phone. You can read a book. You can like write down. And as soon as they ask you a question, you put everything down, you look'em straight in the face or you like, share that space. And if you're uncomfortable, it's okay.'cause it's just, what can you say? So you, when people are faced with this, they shouldn't be feel like they're alone. They, they should feel, they have, not necessarily somebody providing the answers, but somebody just to listen and to hold space. I.

Patrick Fink:

That sounds like a role that could potentially bring a fairly significant emo emotional burden onto the person who is acting as the liaison officer. How do you manage that, that burden? How do you monitor and manage that in a healthy way?

moose:

Well, I didn't actually, I, I did seven or eight deaths really quickly one year and turned up at a board meeting for a nonprofit I worked with and had a beer. And a friend looked at me and went, are you okay? And I just burst into tears and went, apparently not. And I had just come from a, being a family liaison, uh, for a particularly traumatic loss. And I kind of went to pieces and I, and I struggled a couple of times in my career with that, where. You end up in this, essentially, if you're looking at it as an injury with trauma where I'm act, where I'm injured, and the most telling point with that is the inability to deal with complexity. The story I like to tell is at the height of all this stress in and around working with these, these families in crisis, I decided I needed a sandwich and I went to the refrigerator and I opened it and I had the most fantastic selection to make a wonderful sandwich. Like it was unbelievable that I had a great tomatoes or this really happened and I opened it and it was so overwhelming that I couldn't make a choice because I, I couldn't deal with the complexity of the decision, which sort of indicates in trauma you're pretty, you've got a pretty high level of injury. And I shut the refrigerator and I went to bed. And what saved me is, is the work on the stress continuum, particularly work that Laura Mclare has done, which is a. Sliding scale that looks at whether you're performing or you, you have an injury and it allows you to self recognize and diagnose. My wife actually said, you, you're in red. You're on that sort of really injured end. And the beauty of the stress continuum is because you figured out when you're performing, when you're healthy, you know how to be healthy again. And my wife knows if I get on the river in a boat, the troubles of the world fall away and she, you have to go to the river. And I went to the river for a week and I boated a bunch and I just zenned out in my canoe. And it started to fix and re reroute some of that, that injury. But it, it, it, now we do a lot more work in the squad of checking in with people not to be therapists or counselors or necessarily to process. It's to say, give us clues about how you're doing. So if people aren't doing the thing they love, why is that? And it's, it's a trauma response. Um, and so you, you recognizing them and helping them maybe to go out on the river or to go climbing or to go fishing to do the thing that gets you back in what we call green

Patrick Fink:

Mm-hmm. It sounds like recognizing that you're in a similar space to the families that you were speaking about earlier who need simple, binary decisions, who can't handle complexity.

moose:

and often caregivers get in that position where, where we act in denial.

Patrick Fink:

Oh yeah, we're, uh, we're not allowed We're not allowed to show any vulnerability and we're not supposed to be affected by these things.

moose:

Yeah. Which actually are like, but it's a really traumatic, ugly thing that just happened. We're human emotions are really important thing. Like if you. Uh, cry if you get a bit angry, if you, if you have these natural reactions, it's actually quite healthy. What's unhealthy is saying it's had no effect on me. And then drinking a bottle of whiskey and not doing anything for three days and smoking a lot of cigarettes, that isn't, that's, that's an unhealthy response. You

Patrick Fink:

Really?

moose:

Yeah. It's, it's, and it's this idea that you can torture yourself and that's legitimate. Yeah. That's like supported and that's okay. Whereas actually if you say it in 15 minutes, I've had a really bad day. I just want, just want somebody to give a hug. That's incredibly healing.

Patrick Fink:

It is, but it, it is a, a, a slow changing cultural norm. Moose, we, we sort of pedestal those who would self-sacrifice and then go home and, terrible family life. But at work, they're a hero.

moose:

Which,

Patrick Fink:

it's

moose:

yeah, which is kind of messed up. I, I, I had a fan very early in my career within Search and Rescue. I was in a, a debrief at the time in which one of the participants is a guy who's like, he's kind of completely unreadable, like there's no emotion. And he turned up for the debrief and he said, the reason we are here is not for the ones who are doing fine with this. We are here to, for, for, we are here to support our colleagues who may be. They're a little unsettled. And he stood there and he said that, and at the time he sort of acknowledged that, you know, some people were uncomfortable and he was okay, but he was like, I'm here to support you. And that was incredibly powerful to have one of these really upper level rescuers who do all the real hero stuff under the, the helicopter sort of say, I'm here in a support role. You're not alone. Which is the other key in all of this is the cost of not treating it healthily is these failed marriages, it's unsatisfied lives, it's substance abuse, and, and it's very worse. It's ending your life. The, the, the sort of, the, the, the. The buildup of all that trauma and all the gifts that you have as a, as someone trying to, trying to serve other people is the only option that you face is to end your life. It's an absolute tragedy, and we should fight against that every single day with our peers so that we say to peers, not How was your weekend? You say, what did you do this weekend? And if they say, I just sort of sat around and you're like, didn't you have anybody to go out with? And they go, no. Hey, next time you go, maybe we could pop out. I, I don't drink, but we can have a coffee on Saturday morning. You start to show interest in each other beyond just talking shop.

Patrick Fink:

Yeah. Creating room to express and process those emotions in a healthy way.

moose:

Yeah. And you've, I mean, I, I, I've lost people that I know who've chosen to end their lives, who've who, who've worked on exposure within emergency service in law enforcement and the. The disconnect that allows'em to get to that decision. All of us bear responsibility to, uh, dig a little deeper, be a little friendlier, be kinder and more forgiving, uh, to our peers to fight against that loss.

Patrick Fink:

Yeah. It's, it's a, it's a tragedy when one of your peers has to die for that to be the up call for the organization to start giving attention to this, start working with Responder Alliance and creating stress resiliency structures that previously weren't there.

moose:

And I, another good place to look is the Quail Foundation, which is looked targeting specifically the mental health issues in and around responders and the, and the challenge of, of. Of suicide within that group is another place I recommend people to look, uh, because it's, it's a fantastic resource. It'cause you're in a position where you're talking with like-minded people trying to figure out how to support your community. I.

Patrick Fink:

Yeah. I'll tell you, it's five years out now from. and recently on some emergency medicine podcasts, they've started doing kind of retrospectives and only now are we starting to kind of process that whole period I think a lot of us, I was in training too, so it was like kind of different layers of stress, but to deal with those high intensity situations with lots of unknowns, with risk to yourself, risk to other people, and a sense of lot that is, that is beyond your control and that you can't affect sometimes. The only way to deal with that, that in the moment, and maybe you can relate to this in, in a rescue context, is you need to yourself from it and you compartmentalize, right? You,

moose:

Yeah.

Patrick Fink:

you, you do what you can operationalize. But if there's no time later where you turn back and address that other part of yourself. That stuff starts to come out and man, it has taken me probably all 36 of my years to figure out, I have to feel my feelings like

moose:

and, and it ultimately, it comes down to leadership and peer leadership. It's having the relationships where you can show what is perceived as weakness. And actually I perceive it as honesty. It's this, this idea that we, I wanna say rebrand it in a way that in the same way that we expect, um, a level of professionalism is, is clearness in our communication. And to really say when we're not doing well. It's this long, that five years you talk about where it's, it's been, it's been compressed and it's been the pressured and it's taken it, and it's this little sharp diamond that knows away inside your soul. And it's there and it's, and it has to be unearthed. It has to be brought to the light, and it has to be either looked at as, oh, this is ultimately enriched and strengthened me. Which it can, and it can also be something that's really pulling you down and it needs to be sort professionally processed and, and not cast out, but, but put to the side. I, I think it's interesting you talk about time and how long it takes. Five years is a long time in a profession.

Patrick Fink:

Right. Yeah.

moose:

I.

Patrick Fink:

I mean, it's the better part of my professional career, and I think the, the main, the main problem, at least in, in medicine, is that we, everyone suffers from. Imposter syndrome. We all think that at some point we're gonna be discovered to not be as amazing as, as everyone else thinks we are. a, it is a terrible problem in training, but it, it never really gets better. One day your peers will discover that you're not as smart as, as they are, and you're not as capable as you make yourself out to be. And so it feels like there's a risk if you show that you are emotionally affected by things that you're, you're sort of tipping your cards and, and showing, oh, actually he, he isn't that, you know, superhero. But as you said, I think that that invites peers to show that part of themselves as well and creates opportunity for all of you to become more open, well-rounded humans who are capable of, of sustaining a career. In a, in a field that is extremely challenging. Right? It's, it's the same in emergency medicine as in search and rescue, where you I'm sure have had colleagues that you've seen come in great characters, lots of energy, incredible technical expertise, and within years kind of fizzle out and have to go do something else.

moose:

Oh yeah, the implosion and I, and I, I mean, it starts with us individually believing the myth. It's, it's, we're fallible. We're, we're, we're not as great as we think we are. That's okay. It's who. Living the lie. Like if you, if you, if you could come out and, and, and say professionally, Hey, this is where I'm at, and people dump on you. It's not pleasant, but it's a better place to be than, than pretending it isn't existing. It, it's,

Patrick Fink:

But I think a, a lot of times it's, I. it till you make it is, is a real strategy that gets people into really interesting places and in into great roles. It's how you, it's how medical school works. to a certain extent, I think, you know, putting yourself out there and taking professional risk is probably what has brought you into a number of interesting roles in your life. But then there comes a point where the strategies that have gotten us to where we are now are no longer serving us. Those, those kind of like, I'm just gonna put my head down, grin and bear. It no longer a sustainable strategy and it, it requires a, a

moose:

yeah.

Patrick Fink:

and a and a change of understanding.

moose:

And we lose a lot of good people. It's like if you're at that point where you've got that degree of reflection and you've had that volume or that level of experience, that's where mentorship is born out because you've been to that difficult place. And if you don't articulate it to somebody who's just getting in, there's a really powerful lesson there. I, I think that one of the things that within emergency services that stands out for me, the really good mentors are able to articulate intuitive action. So the things that they do naturally organize in the back of the ambulance or, or this is how I put a line in and how line stuff up. You don't even think about it. If you can talk through it with a new EMT,

Patrick Fink:

Mm-hmm.

moose:

this benefit of your distilled knowledge from the last eight to 10 years and they learn it on the, in their first four months. Wow. Where are they gonna be in 10 years time? And so our professional legacy. Isn't just in treatment of patients in front of us, it's how do we set up the next generation of EMTs, paramedics to, to go on this and exceed where I'm at? How do we share that distilled knowledge? And it, there's, there's such power in that'cause you start to see your own self-worth as well. You're like, oh, I actually know what I'm doing. Wow. That's a really good trick. Um, so I, I think that that's almost a great place to, to start as a group is to all sit around as a team and go, I want you to count with your top three tricks of the trade. And you put'em all up and there'll be some overlap. You are like, wow, look at all that distilled knowledge and let's add up how many years we've got. How are we gonna give this as a sort of handout to next group? And it's a really easy place to start sharing'cause it's professional. You drift into that personal place when you've built that, that understanding of trust and sharing of information.

Patrick Fink:

Do you think that that's given you career longevity as you, you have to be looking at to some degree and saying there's a, there's a day where jumping in a river isn't for rescue purposes, isn't gonna make a lot of sense anymore.

moose:

Oh, it already doesn't make sense. Like I have this, the most amazing, uh, colleague that I work with, Zach, who's a former, uh, surf lifeguard, and he's like a fish, he's a torpedo. And if I didn't have Zach when I was teaching, I probably wouldn't be teaching because I need this, this guy who's basically a jet ski to go out there and demonstrate everything. And it, so part of, part of knowing, you have to recognize what your limitations are. And it comes pretty quick. When you get through your forties, you're like, I'm still a badass. And then your fifties, every so often, you're a badass. And like, I'm gonna be 60 next month. And, and I was a badass. Like it's, it's, it's okay. It's, I carry a bit more weight. I, I can't swim quite like I used to, but I'm a really good, I still float great with a PFD on so I can, that's 90% of the job. And, and you just go into something else. You, you, you, you allow yourself to keep evolving and, and life, life is not static. We, we, you, you have it visited to you. Every time you take a gurney out, put a patient on there is you, you are faced with mortality.

Patrick Fink:

mm-hmm.

moose:

And so we have to continue to grow. And it's hard'cause we go into the unknown, but it's, I mean, one of the greatest things that any medical practitioner could do is become a better communicator and teacher. Because you're in a command position where you kind of need to know what you're happening and, and what happens with that is you can kind of be a really crap teacher because you're kinda like, I know the answers. And you have to sort of take a step back and go, well, maybe the first thing I'm gonna do when I teach somebody is ask a question and have them evolve the answer. So it's rediscovering that communication skill to allow somebody to grow with your encouragement.

Patrick Fink:

Do you think that there are, are roles within, this is a leading question.

moose:

Yes.

Patrick Fink:

Is, is the, is the family liaison role one that you think is, is better by someone who has been, been through the ringer and is more experienced within the organization?

moose:

I, I think 80, 80 or 90% would, being a good family liaison is being a certain type of human being who is very, very comfortable with death. You know, and sort of the, you know, the forces that are out there and they have good communication skills, and the other 10% is learning the system. So I, I think it's people come into the role already equipped. They just need to learn the system. Did that answer,

Patrick Fink:

of, yeah,

moose:

that answer the question?

Patrick Fink:

Mm-hmm. Are those sorts of people born or can they be made.

moose:

But, um, they're both, they're like, there's intuitive people who are, like, the person who trained me was a great hugger. Like she, she, she is like an, she was like an Italian grandma. Like her, her entire persona in that moment is, I'm gonna have the most amazing spaghetti dinner'cause I need to be fed. You know, I need to be looked after. And she just radiates love and connection. And that's her style. Like she, that is, that is who that person is. And I have other people, there's, there's somebody I work with who's basically a standup comedian and they're incredibly gifted because they find humor in everything. And they're very fast thinking and they're incredibly organized, but they're intuitive. They look at situations and they, they make good calculated decisions. And I would, and they are younger and I think they're absolutely amazing. So it's, and they learned the system, they learned, you know, oh, this is how I do it within the system.

Patrick Fink:

Mm-hmm.

moose:

But it's,

Patrick Fink:

you would need a very strong intuition to use humor consistently in that context.'cause that could go awry.

moose:

yeah, I mean, like, but, but that's that idea of, of where are the family at and you are figuring out and reading the situation

Patrick Fink:

Mm-hmm.

moose:

and it's, this person is particularly gifted. They, the, the way they can read their audience is exceptional, which is what a good comedian is. They look at the crowd and they go, okay, where can I go with this? What's my boundary? And they're, they read it consistently. They're an interpreter. So they, they've got that background of, of working with disparate groups.

Patrick Fink:

If, if someone listening wanted to bring an awareness of the need for this kind of communication skill into their organization, into their search and rescue group or ski patrol, and wanted to to that line, SAR member or or ski patrol are the value of this, how can you imagine like designing some kind of training scenario that would just make it blatantly apparent to them the need for this within the organization.

moose:

I think you can sit there particularly in ski patrol and say, when was the last fatality you dealt with? And you can tabletop it as an exercise. And what will emerge for the pretty clearly is a, a underwhelming response to the family because liability at, at ski areas says, don't say anything.

Patrick Fink:

Right.

moose:

And actually I advocate say a lot because they, if you're gonna be sued, you're gonna be sued. And if a family says, actually, they're really nice to me on the stand. That can really affect your judgment'cause you didn't treat them with contempt.

Patrick Fink:

Yeah.

moose:

I think that's a good place to look is, is what have we done in the past and how has, how has it been a problem? So if you doing a water recovery and you hear the family sort of rushed the beach as the body was being pulled out and you analyze it, you realize that nobody was on point

Patrick Fink:

Mm-hmm.

moose:

the family in a location and explain to'em what's gonna happen and how you, they were gonna be able to be with the body in the back of the ambulance and have some privacy before it, before the ambulance leaves. So you've set up what's gonna happen. You, you, you basically identify where the gaps are and if you, and on a level of staffing, if you have a good family liaison program, you reduce the trauma that the rest of the team goes through.

Patrick Fink:

Hmm.

moose:

You.

Patrick Fink:

everyone is, is facing that emotional energy from the family.

moose:

Yeah, when a family, uh, when a family wants to have that connection with the team and say, thank you for bringing their loved one home who's died, it's coming from a really good place. They want to, they wanna share. But, but I know and I see those and the team know, it's kind of hard when you've got a mom coming up to you and just crying.

Patrick Fink:

Mm-hmm.

moose:

I dunno if I've got 34 of those experiences in me.'cause I just really like moving the litter. My skill is moving the litter. It isn't hugging a, a distraught mom. So I think I would say work through your incidents and you'll see where the gaps are. And at that point you can look at something like the Responder Alliance and say, Hey, there's a really good program there that trains up how to, how to work specifically along the stress continuum with families affected by it. Or you can look within the instant command such and look at the family liaison set up for these bigger incidents. There's really good work. Nicole, Dr. Nicole Lester in Britain did a whole bunch of interviews with families affected by loss and how they interacted with their family, uh, liaison officer. It's a great hour, uh, YouTube video where she took, comes out with really good information. That's science, it's facts, and it shows why that role has value.

Patrick Fink:

I will chase that down and, and put that along with Responder Alliance and the other resources you've

moose:

I'll send you the, I'll send you the, I'll send you the link.

Patrick Fink:

Okay. Very good. Yeah. I, one, one passage that struck me from your book that seems pertinent, um, is there is a clock ticking inside of every responder that records every second of traumatic exposure and banks it for a future breakdown. People discount it and say, not me. some on the surface it appears true, but examine the road they're on and patterns emerge. Unhealthy choices, binging, bickering, insignificant disagreements fester up and metastasize misdirected rage. a reckoning at some point. I think that that fully illustrates the need to really come back to the, the stress continuum and, and have structures to both minimize trauma for the team, but also address the trauma that that does arise.

moose:

Yeah. And, and what you wanna do is have a long career. So if you manage that trauma and you surface it and you, and you treat it, you'll have decades more in the thing you love doing and you won't be angry and you won't make bad decisions and you won't have this unsatisfied life outside the job. I like that definition of trauma, which says trauma is what stops us living the life we wanna live. And, and that's such a powerful sentence.'cause what it says is everybody's trauma is different. Nobody owns exclusivity to, to the worst trauma.'cause we, it's whatever stops us living the life we wanna live and we have a resp, we, we, when we're faced with the mortality every day of other people, I. It shouldn't put us in a position. Understand why. We get, we get drawn down and we get worn down by that. But it's also a reminder what, how precious life is and to live every moment.

Patrick Fink:

So I, I wanna bring us back to something lighthearted to end our conversation, but before we do, I, I would ask you if, if, if you are speaking to someone who's at the beginning of their career in wilderness medicine, search and rescue, where they're bringing their, you know, their passion for a sport and their technical competence into line with maybe medical expertise or, or, um, volunteering within an organization, and they're, and they're starting on their career, they feel like possibly the most important thing that they can do is become competent in these technical domains. What else would you have them do now to most, not insulate them, but make them resilient to. challenges that grind people down in the middle of their career to the trauma, to the stress, what? What can they do early? What are the skills they can take on?

moose:

Learn how to build a community that isn't around the job. Learn, learn to build friends that are able to listen to you without passing judgment. And a community that offers you more than just more work speak.'cause that gives you the insulation and within that have hobbies that extend beyond really, really good, uh, management of airways. It's, it's having these things that are different but complimentary.

Patrick Fink:

Mm-hmm.

moose:

So the idea that if you work in the, you are working in wounds, medicine, make sure you go out and hike a bunch and camp a bunch and go with people who are really clean bird watchers and, and really have no idea about what you do. And maybe talk about a bit, but learn more about birds. And so the idea of a generalist is, is, is a way to be healthy. I'm a generalist. I have competency in different areas. I'm not an expert in anything. It's, and it's, it's, and it's also really great to realize that you are, for the most part, we're incredibly ordinary. We're not exceptional. It takes a lot of pressure off is the idea that I don't have to be exceptional. Oh, I could just be Audrey awesome. And every so often I'll do something that's kind of reasonably competent and good. But be fair to yourself. Like I was a, I wasn't a great student. I, I was the, I think I was the only kid in my high school that didn't go to college at the start. I went and I got a minimum wage job working on a fish farm, and I, I left my sort of school life and I went straight into a 60 hour week for, for$35 a week. It's, it's, we are very ordinary and at moments we do things that are extraordinary that, that are really exciting and they, that you save a life, but you do it with it isn't you. It's all the knowledge that you've got. It's so in, in saying all of this is be fair on yourself and be humble. It's,

Patrick Fink:

it's putting down that, uh, syndrome that I was talking about earlier. That character that you put on to go to work.

moose:

yeah. It's, it, it's, it's, it's okay to be valuable. I mean, it's not, it's not okay to go out there and, and give the wrong drug combination and fail to, to follow procedure, but that's just me. It's like you kind of got these equations you have to follow and these procedures, which is kind of a framework and it's easy to lose your way and lose who you are and then suddenly discover at 40, you have to rediscover that and it, it, I I've always had a very lighthearted outlook on life, even with all the tragedy and stuff that's going on. I, and I put that down to my dad was a, was a real comedian about everything. And that lightness is really important to remember in life, even when we're consumed by all this heaviness is don't lose that'cause at the at, at the, at the soul of everything that we do. It should, we should get satisfaction and enjoyment out of it. And if we aren't, it's, it is probably time to do something else.

Patrick Fink:

Right. I would really recommend to the audience your book searching, because I think it, one, it's just really fascinating to get inside your world and and hear some of these experiences from Yosemite. also you can, I can see, I feel like I can see in real time. that you use humor and other positive means to process, you know, these difficult situations. I mean, you're dealing with people who are dying left and right, and, and families who are traumatized, but there's, uh, something in moose motlow that can make light of it

moose:

Make it lighter and it, all we're trying to do is put things in a digestible form. It's, there's a, the chameleon's the most amazing animal, you know, the chameleon where it changes its color to match the background. And I, I'm fascinated by that.'cause not only that, but it's also got these sort of independent eyes that can look all over the place. It's kind of cool. And I think a chameleon adapts to the situation and tries to stay hidden. And it does that'cause it doesn't wanna be at risk or it's hunting. Right. That's what it's trying to do. And I think the richness. That we bring as individuals shouldn't be hidden. So a team is made up of, of, of people who shouldn't be hiding. You kind of that out in the foreground, you know who each other are, and at that point, you know your strengths and weaknesses and you play to your strengths and you work on your weaknesses. And that's being human. It's, it's okay. Don't hide.

Patrick Fink:

All right, moose. Let's turn it around and, and talk about something lighthearted so that everyone can relax their shoulders. After this conversation, can you share with the audience the story from your book, searching about the discovery of the finger?

moose:

Oh, that's just, well, I like this story, uh, because it has so many, it says so much about rescue. So a, I think it was a, a dad and his son were out. Fishing on the Masad and they were just walking along the bank and they looked down and there in the water is a human finger right on the edge of the water. And the dad takes out and looks and goes, that's a human finger. And this is, I think the height of summer or something. It's quite busy and it gets called out to 9 1 1 and very quickly we muster up and we start looking for the rest of the body. And we've got people on the river. The south side is a completely pumped'cause they've got, like, they're out there on boogie boards, just swimming along with fins and they're looking everywhere. And if we've got a a finger, there's a lot more, there's 99% of our body is out there that we've gotta look for. And they look and look and look and the finger ends up in a bag of ice in the ic and the instant commands are sitting there dealing with this scaling up. Summertime, uh, response. And somebody happens to wander in and says, what's happening? And, and you very quick, oh, it's kind of exciting. We found a finger. You know, and there's lots of guessing about how the finger got there. And,

Patrick Fink:

stories. Yeah.

moose:

and then at some point the person goes, oh, can I have a look? And, you know, oh yeah, I'll have a look. And they open it up and they look in there, and at that point there's this realization, actually, it's not a finger. The person looks at it and goes, that's a chicken gizzard, which is used for bait for fish. So we had, we had, we had absolutely scaled this enormous response looking for a, a human body. We, it turned out we were looking, we should've been looking for a chicken body all right. Out there. So the great gizzard search was called off. We never, we never resolved where that chicken was, unfortunately. Yeah.

Patrick Fink:

A number of heroes.

moose:

Yeah. Not least the person who walked in and went, that's a chicken gizzard. I love that fact because it's so ridiculous that we, nobody at the time looked at it. If you look at the chicken gizzard, it kind of, it does look like a human finger, but then when you know it's a chicken gizzard, you're like, that's a chicken gizzard. There's no doubt about it. It's not a finger. The suggestibility of emergency. Yeah.

Patrick Fink:

Yeah. The, the early closure, that's a finger. Therefore, everything else

moose:

It's, but there, there's lunacy out there, all over the place. Like there was a group, one of my favorite things ever was I was working an incident in which two men have gone out at the start of a major winter storm, and it's kind of odd, right? The, the wife has rung up and said they haven't come back. And we find their car up at Badger Pass and. The wife is a little bit evasive about why they were out there under these conditions and what they end up eventually investigating. And she cracks. She goes, listen, they're looking for buried tre treasure. And it was like that, uh, there was a guy, remember this

Patrick Fink:

there's some book, right?

moose:

fern something or other, and he, he'd written this book about buried treasure and there's, there's like a budget version, there's like a cheap version of this story. And these two men, it was a father and son, had decided that they'd found exactly where this treasure was buried in Yosemite, despite it saying in the book, it's not in a national park. And what had given it away to them was they had discovered two trees that have fallen across each other in the woods in a Big X. And it was visible on Google Earth. And they headed out to look for these big trees in the middle of winter as a big winter storm was starting

Patrick Fink:

Have to get there before everyone

moose:

Everybody else. So they go out there and they're woefully inadequately, like, uh, prepared really early on. One of them falls through, uh, like an ice bridge and drops in the creek and they're soaking wet and they're trying to make a fire and it just becomes a total epic. And they had videoed their departure and sent a video. So they were really upbeat and you could see they were totally ill-equipped to be out there. And we are, we are walking around looking for them, and we find the sun, the sun sort of stumbles up onto a snowshoe trail, and his dad has actually given up. His dad has been like, I can't go on, just leave me behind to die here. And he's like a hundred feet away.

Patrick Fink:

yourself.

moose:

And so it's this ludicrous nest of like, they were, they were, they were focused on the prize. They were totally inadequate. They were totally pumped for an adventure, and it all went terribly wrong. We laugh about it now because it's like, oh, they came through it, they actually survived. But it could have been so tragically wrong. And that is, that's on a lot of sars. Like there are stories of that all over the place of people coming this close to disaster, but having a great story going on. And just to tell you that treasure was not there. All right. It wasn't in the park. And trees fall across each other the whole time.

Patrick Fink:

I think I've seen that before.

moose:

Yeah.

Patrick Fink:

Alright. Moose. Um, are, are you familiar with any other, I, so I mentioned that I really enjoyed your book. Are you familiar with any other books, other memoirs, other texts with, uh, experience from rescue that, that you enjoy?

moose:

Uh uh, it's kind of, it's a thin, it's a thin, uh, genre, uh, that is out there. Um, there's a Ranger Noir, which is, which is a good, good read, which is an, which is a law enforcement ranger who's based down the Sequoia Kings, which is a, which I would recommend. It's an easy, it's an easy read and it's a good storyteller. And there is, there's another story, and I can't remember the name of it, which is a ranger that disappears. Randy Mortenson, I think disappears down in Sequoia. And it's about a long search to resolve his disappearance. And that is a great read in the national parks. Um, and then there's a book called The Cold Vanish, which is, um, cold vanishing. Cold vanish, which is about a disappearance in Olympic National Park. And about the dynamics of looking, the family, looking for, um,

Patrick Fink:

someone Gray

moose:

yeah. Yeah, and it's definitely one sided. It's, it's the da it's essentially the dad's story, but it, it gives you an idea the complexity of response

Patrick Fink:

Mm-hmm.

moose:

and jurisdiction.

Patrick Fink:

Fantastic. All right. I'll put, I'll, I'll chase those down and throw those in the show notes as well. Finally, if um, folks want more Moose Motlow, they want to connect with you, want to look at your trainings or, or learn more about you, where, where is Moose Motlow on the

moose:

Uh, I'm in a few places now. Um, I've got a website, ww dot moose motlow.com, and that talks about trainings and some resources and some links. I'm on Blue Sky at Moose Motlow. I'm on Substack at Moose Motlow. I'm on Instagram at Moose Motlow, and yeah, I'm, I'm happy to, to chat with people and to talk through what they're trying to do or how they're trying to scale their own programs.

Patrick Fink:

Fantastic. Well, moose, I've really enjoyed this conversation. It went a little, little further, a little deeper, a little more emotional than I was expecting, uh, which I probably not surprising given the subject. But I'd love to have you on again in the future and everything, all the wisdom that you bring to the table from years and years doing the thing.

moose:

And good luck, Patrick. Good, good luck on your rehabbing. Um, aggressively rest and aggressively rehab. Um, yeah, I've enjoyed the opportunity to have a chat and yeah, good luck.

Patrick Fink:

That's it for this episode of Wilderness Medicine Updates. Thanks for listening, man. What an episode. Definitely the longest wilderness medicine updates discussion to date, but I think Moose Motlow deserves it, and you deserve all the moose Motlow that we can bring to you. So I hope that that was a useful discussion, kinda wide ranging, you know, really started with the family liaison officer idea and then moved from there into thinking about. Managing trauma and how to do that so you can have a long career in search and rescue and wilderness medicine. Do take a look at the resources in the show notes. I hope that if anyone out there is experiencing burnout, isn't loving what they used to love, that you reach out, get help. If as an organization, this is something you struggle with, reach out to the Responder Alliance. They do trainings for groups. They have online trainings, and they're really invested. In helping the people who are doing the job, they understand what you do and they want to help. So with that, don't hesitate to reach out Wilderness medicine updates@gmail.com. I want to hear from you, your feedback, your questions, your requests for future shows or ideas for podcast guests. Or hey, if you are like moose and you listened and you want to be on the show, you think you have something to bring, don't hesitate to reach out. No promises, but I wanna meet you. And the best way that you can support this show is on Apple Podcasts on Spotify. Give me that five star review. It helps us game the algorithm and get these podcasts in front of more people. And I'm here on my own time bringing things of value to you, I hope, and I just wanna spread that to more people. So give us a shout out, give us a five star rating, and then share this show with someone that you think would appreciate it or someone who needs to hear it. And that's the best way that you can bring another ski patroller, another SAR R member, another EMT, another medical student into the fold and expand the reach of this show. I appreciate your time. I appreciate you guys listening. Until next time, stay fit, stay focused, and have fun.

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Patrick Fink MD, FAWM

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