Division of Wilderness Medicine Faculty

N. Stuart Harris, MFA MD FACEP Chief, MGH Division of Wilderness Medicine Fellowship Director, MGH Wilderness Medicine Fellowship

Introduction: N. Stuart Harris M.D. M.FA, is an attending physician at the Massachusetts General Hospital Department of Emergency Medicine. He is the Chief of the Division of Wilderness Medicine and the Wilderness

Medicine Fellowship Director. He is an Associate Professor of Emergency Medicine at Harvard Medical School. Clinical Interests: Wilderness Medicine, Environmental and Human Health. Biography: Stuart is a former instructor with the National Outdoor Leadership School (NOLS) in the Lower 48 and Alaska. He has developed courses on wilderness medicine for Harvard Medical School students. His drive to increase physician awareness of the interaction between environmental degradation and individual and public health has led to the creation of the first Wilderness Medicine Fellowship at MGH. Dr. Harris is also both faculty and course director for NOLS Wilderness Medicine Institute. He has served as medical staff with a National Park Service climbing ranger patrol on Mt. McKinley (Denali National Park), pursued research with the Himalayan Rescue Association in the Khumbu Valley of Nepal (Mt. Everest region), and provided clinical care on Mt. Kilimanjaro on research expeditions. He was among the handful of non-Japanese physicians allowed to respond to the March 11, 2011 tsunami disaster.

He received his A.B. from the University of the South, and his MFA at the University of Iowa’s Writers; Workshop (Fiction). He received his MD from the Medical College of Virginia. He completed his residency in Emergency Medicine in the Harvard Affiliated Emergency Medicine Residency Program (HAEMR) at Brigham and Women’s Hospital and Massachusetts General Hospital – and has being

having so much fun, he has had a hard time leaving since. Former Jobs Held: Firefighter, commercial fisherman in Alaska (long-lining for black cod and halibut and seining for salmon), writer, whitewater and sea-kayak instructor (in Lower 48, Japan, Alaska), high school English teacher in Japan, grad student in English/ biochemistry; EMT/ ambulance driver, carpenter, NOLS Instructor (Rocky Mt and Alaska Branches).

Best Job Yet: The one I have now. Awards:

• Black Belt, Kodokan Judo, Iwaizumi, Iwate-ken, Japan. • Bronze Medalist, Slalom OC-2, U.S. Whitewater Open Canoe Nationals. • Povinelli Humanism Award, Harvard Affiliated Emergency Medicine

Residency. • Eleanor and Miles Shore Fellowship for Scholars in Medicine, Harvard

Medical School. • National Fellow, Explorer’s Club, New York City. • 2010 NOLS Alumni Service Award, National Outdoor Leadership School,

Wilderness Medicine Institute. • Symbols of Hope Award, Tsunami Relief, Pharmaceutical Research and

Manufacturers of America. Tokyo Imperial Hotel. • John E. Thayer III Award. The Japan Society of Boston. For distinguished

achievement in cultural exchange. • McGovern Award for Clinical Excellence Nominee, Massachusetts

General Hospital. March 2011. Japan Tsunami Response Research: Dr. Harris’ research focuses on investigating the pathogenesis and treatment of high altitude illness and on the interactions of human and global health. Dr. Harris’s research team continues to work closely with the U.S. Army’s Research Institute for Environmental Medicine (Natick, MA and Pikes Peak Summit Lab) on high altitude research funded by the U.S. Department of Defense. In collaboration with the Woods Hole Research Institute, his division is pursuing research in far eastern Siberia examining the interaction between human and environmental health on the Polaris Project. Research with multiple different departments at MGH and at BWH (Neurology, Cardiology, Surgery, Pulmonary and Critical Care, Radiology) is ongoing. In concert with leading international high altitude physiologists and physicians, he has created the International High Altitude Pulmonary Edema (HAPE) Registry. This Registry has been adopted as the global standard. He has been named Registry Master, Chair of the Registry Steering Committee, and Executive Committee

Member for the International Society for Mountain Medicine. The Registry is a fundamental tool in expanding the range of genetic, epidemiologic, and pharmacologic high altitude studies in the future. Dr. Harris’s work has been funded by the National Institutes of Health, the U.S. Department of Defense, the Center for the Integration of Medicine and Innovative Technology, MGH, and Harvard Medical School. In collaboration with others, Dr. Harris continues to actively research pathogenic changes in acute mountain sickness and HAPE. They continue to explore the critical basic pathophysiologic finding in the universal life threat of hypoxia.

Renee N. Salas, MD, MS Assistant Fellowship Director, MGH Wilderness Medicine Fellowship Introduction: Renee N. Salas, MD, MS is an attending physician at the Massachusetts General Hospital Department of Emergency Medicine. She is a faculty member within the Division of Wilderness Medicine and is the Assistant Fellowship Director of the Wilderness Medicine Fellowship Program. She is a Clinical Instructor of Emergency Medicine at Harvard Medical

School. Clinical Interests: Wilderness Medicine, Climate Change and Human Health, Wilderness Medicine Education, High Altitude Biography: Renee is originally from Michigan and her soul has always been drawn to the mountains and outdoors. She earned a B.S. of Biology at Saint Mary’s College in Notre Dame, Indiana with minors in Chemistry and Psychology. Renee then went to medical school at the Cleveland Clinic Lerner College of Medicine at Case Western Reserve University in Cleveland, Ohio. She was a part of the first class in this innovative five year medical program with a class of 32 students and an integrated research curriculum with a goal of training the next generation of physician investigators. In addition to her MD, Renee also obtained a master degree in clinical research. Subsequently, she matched into her first choice for her emergency medicine residency at the four year University of Cincinnati program in Cincinnati, Ohio – the first emergency medicine training program in the country. Renee was first introduced to wilderness medicine during the Harvard-affiliated Emergency Medicine Residency/National Outdoor Leadership Program/Wilderness

Medicine Institute Medicine in the Wild course during her last year of medical school and was given the opportunity to return as a resident instructor. After exploring the intersecting sub-specialties of international health and disaster medicine, she returned to her true passion and completed a two year wilderness medicine fellowship at MGH. Renee worked for the Himalayan Rescue Association at the Pheriche post during the Spring 2015 season and was there during the horrific 7.8 magnitude earthquake which struck the region on April 25th. She wrote about her experiences in a New England Journal of Medicine Perspective article entitled “Humanity, Teamwork, and Art in Post-Earthquake Nepal.” She also worked with the International Medical Corp in the Gorkha region during the aftermath. Renee stepped into the role of Assistant Fellowship Director after joining faculty at Massachusetts General Hospital and Harvard Medical School. She is currently completing her Masters of Public Health (Concentration: Environmental Health) part time at the Harvard School of Public Health and is set to graduate in May of 2016. This will allow her to develop her planned niche in both the advocacy and synthesis of research in the realm of climate change and human health. She is also completing her Diploma in Mountain Medicine. In addition to regional and national speaking invitations, Renee is also active on the national level in ACEP and SAEM to further wilderness medicine. Her research is in the field of environmental health / climate change, high altitude, and wilderness medicine education. When not abroad, working clinically, or involved in her academic activities, Renee can be found rock and ice climbing, mountaineering, backpacking, battling whitewater, mountain biking, trail running, or enjoying the outdoors any way she can. She would much rather be there but feels blessed to be able to combine her personal passions with her professional.

Jon Adler, MD Introduction: Jonathan N. Adler, M.D. is an attending physician at the Massachusetts General Hospital Emergency Department, designated core faculty of the Harvard Affiliated Emergency Medicine Residency (HAEMR) and designated faculty within the MGH EM Division of Wilderness Medicine. He is also Clinical Strategy Editor for the New

England Journal of Medicine, and devoted to the progress of medical educational. Clinical Interests: Medical education, wilderness and environmental emergencies. Biography: Dr. Jonathan N. Adler is an attending physician at the Massachusetts General Hospital Emergency Department with a major commitment to all facets of medical education. He graduated from the University Of Colorado College Of Medicine in 1988 after obtaining a Masters of Science in Aerospace Engineering with emphasis in bioengineering from the University Of Colorado College of Engineering Sciences. Dr. Adler completed his residency in Emergency Medicine at Christ Hospital and Medical Center in Oak Lawn, IL. Dr. Adler has contributed to the mission of Harvard Medical School by leading in the creation, establishment and support of HAEMR, and by contributions to medical education. He served as Course Director for MGH’s emergency medicine clerkship from 1994 until 1998 and redesigned the course for medical students to include all aspects of the emergency medicine experience, including student contact with all types of emergency patients. Dr. Adler served as Assistant Program Director for HAEMR from 1994-1998. Dr. Adler was co-founder of Boston Medical Publishing and of eMedicine.com and served as Editor-in-Chief of eMedicine

: Emergency Medicine from 1995 until 2011. The text consists of 742 chapters written by 412 physician first authors with 90 physician editors. The book currently serves nearly one million online topic readings per year. He has been author or editor of 13 books as well as the Journal of Emergency Medicine.

Dr. Adler joined NEJM Group in 2011 where he currently leads new strategic initiatives and serves as an editor. Research: Currently, Dr. Adler is PI on a study of therapeutic hypothermia at both MGH and Brigham and Women’s Hospital with Dr. Peter Hou (BWH) collaborating. He also is senior investigator on a retrospective evaluation of tachydysrhythmia in Wolff-Parkinson-White syndrome along with Dr. Keith Marill (MGH) and Dr. Jeff Siegelman (Emory). His last publication was a prospective, double blind study investigating the use of buccal fentanyl for emergency management of pain associated with orthopedic injury.

Mike Filbin, MD Introduction: Dr. Michael Filbin, is attending physician in the Department of Emergency Medicine at Massachusetts General Hospital, received his MD from Baylor College of Medicine. He completed a residency in the Harvard Affiliated Emergency Medicine Residency Program (HAEMR) at Brigham and Women's and Massachusetts General Hospitals. Biography: Mike Filbin is a veteran emergency physician who heralds from the great Northwest region of the US, where he built his roots in downhill skiing and backcountry touring. His first career was in aeronautics. Being a former NASA engineer and private pilot, he has an interest in aerospace medicine and manned space flight. Mike enjoys winter backcountry ski touring and dabbles in mountaineering and climbing, as much as academic life allows.

Associated Faculty: Bill Binder, MD Adjunct Faculty, MGH Wilderness Medicine Fellowship

Dr. William D. Binder, M.D. is an attending physician at the Brown University Emergency Department. He graduated from George Washington University School of Medicine after receiving masters in History of Science from Harvard University. He completed his residency in internal medicine followed by a residency in emergency medicine at the Rhode Island Hospital, Brown University.

Dr. Binder served with the Himalayan Rescue Association in Pheriche, Nepal. He has worked with emergency radiology to draft and implement policies regarding patient safety, including pregnancy guidelines, as well as the ordering of exams, thereby improving efficiency and safety in the emergency department. Additionally, alongside the infectious diseases department, Dr. Binder has worked to bring the Emergency Department up to and above national quality

measures for the treatment of community acquired pneumonia. Together with surgery and the Infectious Disease departments, Dr. Binder has helped to formulate policies and clinical guidelines for the diagnosis and treatment of soft tissue infections during initial stages of the CA-MRSA epidemic.

Dr. Binder has conducted research, both collaborative and individual, as well as performed administrative roles which have helped transform the emergency department into a highly functioning, efficient member of the MGH departmental community.

Dr. Stephen Muza, PhD Team Leader, Thermal and Mountain Medicine Division

Dr. Muza is only one of the world’s most experienced high altitude researchers. We have enjoyed a long and productive research collaboration with his team at USARIEM, from the chambers in Natick to the summits of Pikes Peak, Colorado and Mt. Kilimanjaro. Further field research collaborations are currently being planned.

U.S. Army Research Institute for Environmental Medicine (USARIEM -- Natick, MA and Pikes Peak Summit Lab)

USARIEM Location & Facilities: about USARIEM

USARIEM Hypobaric (Altitude) Chambers (9,000m,-15°Cto40°C) This facility simulates global atmospheric conditions by reducing ambient barometric pressure using vacuum pumps in combination with precise manipulation and control of temperature and relative humidity. The facility consists of a large (9.7 x 20.6 ft) and a small (9 x 12 ft) chamber, both connected to an airlock. It

also includes a shower, toilet, and running water for sustained multiday periods of operation. The chambers can be controlled for pressure (sea level to 9,000 meters), temperature (-32°C to 43°C), and relative humidity (20% to 80%).

R. Max Holmes, PhD.

Dr. Holmes is an earth system scientist with broad interests in the responses and feedbacks of coupled land-ocean systems to environmental and global change. Most of his current research focuses on large rivers and their watersheds and addresses how climate change and other disturbances are impacting the cycles of water and chemicals in the environment. Dr. Holmes has several ongoing projects in the Arctic (field sites in Russia, Canada, and Alaska) and has recently begun working in Africa and Asia (Congo, Ganges,

Brahmaputra, and Yangtze watersheds). He has also studied desert streams in the southwestern United States, stream/riparian ecosystems in France, and estuaries in Massachusetts. He is strongly committed to integrating education and outreach into his research projects, particularly by exposing K-12 and undergraduate students to the excitement of scientific research. (http://www.whrc.org/about/cvs/rmholmes.html) Tod Schimelpfennig Curriculum Director -Wilderness Medicine Institute of NOLS Fellow of the Academy of Wilderness Medicine

Tod Schimelpfenig has been a NOLS Instructor since 1973, has over 35 years field experience as an EMT, is a Fellow of the Academy of Wilderness Medicine and a two time winner of the Wilderness Medical Society's Warren Bowman award for contributions to the field of wilderness medicine by a non-physician. Tod has served as the NOLS Risk Management Director and Rocky Mountain School Director, and on the board of the Wilderness Medical Society. Tod has taught wilderness medicine since the late 1970's and has written numerous articles on educational program, risk management

and wilderness medicine topics. He is the author of NOLS Wilderness Medicine and co-author of Risk Management for Outdoor Leaders. In 2010 Tod received the Charles "Reb" Gregg award from the Wilderness Risk Managers Committee for Exceptional Leadership, Service, and Innovation in Wilderness Risk Management.

Shana Tarter Assistant Director, Wilderness Medicine Institute of NOLS FAWM, Wilderness EMT, EMT Intermediate 5 years as a wilderness medicine educator and instructor trainer 20 years EMS experience 25 years experience leading wilderness expeditions Former Chair Wilderness Risk Management Committee and

Conference.Former Associate Director Cornell Outdoor Education

Gates Richards, M.Ed., WEMT-I

Special Programs Manager - Wilderness Medicine Institute of NOLS Fellow of the Academy of Wilderness Medicine

20 years active EMS provider 20 years outdoor education 15 years wilderness medicine education 15 years search and rescue experience M.Ed. specialty in Adult Development, Learning and Training

David Weber WEMT-P, FAWM

Mountaineering Ranger & Lead Medic- Denali National Park Dave has worked as a rescue technician, mountain guide, and skills instructor for over a decade. He currently divides his year leading SAR operations during the climbing season on Denali, as a lead instructor for Remote Rescue Training, and as a lead instructor at the Khumbu Climbing Centre. In addition to these primary roles, Dave is employed as a senior field instructor for the National Outdoor Leadership School, a lead instructor for the Wilderness Medicine Institute and an instructor for the American Avalanche Institute. He has treated patients in remote settings as a paramedic, an urban and wildland firefighter, and as a ski patroller.

John Hovey

Senior Field Instructor, Wilderness Medicine Institute of NOLS Interests: I've lead expeditions and certified outdoor professionals in wilderness medicine since resigning my commission in the USMC in 2004. All adventures, especially those that benefit others--I'm in.

Peter J. Fagenholz, MD

Instructor in Surgery, Harvard Medical School Attending Surgeon, Division of Trauma, Emergency Surgery, and Critical Care, Massachusetts General Hospital

Dr. Fagenholz graduated from the New York University School of Medicine in 2002. While there he worked in the Laboratory of Developmental Biology and Repair under Dr. Michael Longaker performing studies on the molecular biology of wound healing and cranial suture fusion. From 2002-2005 he served as a resident in general surgery at the Massachusetts General Hospital. From 2005-2007 he was a research fellow in the Department of Surgery at MGH working with Dr. N. Stuart Harris studying the physiology of

hypoxia and high altitude illness as well as the epidemiology of surgical diseases such as pancreatitis and burn injury. His high altitude work led him to Nepal where he performed field work in the Khumbu Valley and met his wife Alice, an emergency medicine physician. Dr. Fagenholz then returned to the MGH, completing his residency in General Surgery in 2009. In 2009-20010 he moved to Edinburgh, Scotland where he worked as a Specialist Doctor in Cardiothoracic Surgery at the Edinburgh Royal Infirmary. In 2010 he returned to Boston to complete a fellowship in surgical critical care at the MGH before joining the staff in the Division of Trauma, Emergency Surgery, and Critical Care. In addition to his travel to Nepal, Dr. Fagenholz has also worked with Partners in Health performing and teaching surgery at Butaro Hospital in Rwanda and is currently involved in international surgical development through the Program in Global Surgery and Social Change at Harvard Medical School.

Sara W. Nelson, MD Department of Emergency Medicine, Maine Medical Center Assistant Professor of Emergency Medicine, Tufts University School of Medicine Vice President, Board Member Global Emergency Care Collaborative

Dr. Nelson graduated from Dartmouth College and Harvard Medical School, and completed her emergency medicine residency at the Brigham and Women’s Hospital and the Massachusetts General Hospital, where she served as chief resident. Sara is currently an emergency attending at Maine Medical Center and an Assistant Professor at Tufts. She co-directs the University of Massachusetts/Maine Medical Center Wilderness Medicine Elective and also oversees the wilderness medicine curriculum for the MMC residency. In addition to her work at MMC, Sara teaches

wilderness medicine courses at the NOLS Wilderness Medicine Institute. Sara also works internationally to develop emergency medicine, and is a board member and the curriculum director of the Global Emergency Care Collaborative (GECC), a non-profit organization that does work in Uganda. When not working or teaching, Sara can often be found in her kayak in Casco Bay.

Mark Bisanzo, MD, DTM&H, FACEP

President, Global Emergency Care Collaborative Assistant Professor, University of Massachusetts

John Semple, M.D.

Dr. John Semple is Surgeon-in-Chief at Women’s College Hospital, and is a senior scientist at Women’s College Research Institute and Professor in the Department of Surgery at the University of Toronto. He received his MD degree at McMaster University and his surgical training at the University of Toronto. He received a Medical Research Council of Canada Research Fellowship during his surgical training and completed a M.Sc. in Experimental Pathology. Upon completion of his surgical training he was clinical Fellow in Microsurgery at the Toronto

General Hospital.

Role as a Researcher and Educator Dr. Semple has a special interest the converging disciplines of surgery, tissue engineering and basic science and their potential to act as a novel research platform in regenerative medicine and in solving surgical challenges. His clinical practice is in soft tissue reconstruction following cancer surgery. Current research projects include the use of micro fat grafting in mitigating the effects of radiation in soft tissue reconstruction, lymphedema following breast cancer treatment. He recently completed a pilot study to evaluate smart phone technology in the post operative monitoring of the quality of recovery of patients at home.

Credentials & Accomplishments Currently, Dr. Semple is Surgeon in Chief at Women's College Hospital and a Professor in the Department of Surgery at the University of Toronto. He is past Director of Research at the University of Toronto's Division of Plastic Surgery and Past President of the Canadian Society of Plastic Surgeons.

As Chief of Surgery at Women’s College Hospital, Dr. John Semple has been instrumental in establishing the hospital as one of the country’s top centres for breast restoration. Previously, as Co Founder and Director of the Advanced Regenerative Tissue Engineering Centre (ARTEC) at the University of Toronto and Sunnybrook Health Sciences Centre, Dr. Semple led a group of scientists, engineers, private corporations and surgeons in producing new technologies for soft tissue regeneration and reconstruction following cancer surgery. To fund this initiative he was successful in receiving an Ontario Challenge Fund (OCF) grant for over 12 million dollars, which in 2001, was the largest surgical grant ever awarded in Canada.

In March 2010, Dr. Semple was named Chair in Surgical Breast Cancer Research by the Canadian Breast Cancer Foundation (CBCF) – Ontario Region. The Chair is based at Women’s College and was the first endowed chair in the hospital’s Department of Surgery and the first Surgical Research Chair awarded by the CBCF in Canada. Dr. Semple is a Senior Scientist at Women’s College Research Institute (WCRI) and is a Member of the Institute of Medical Science in the School of Graduate Studies at the University of Toronto. He recently was awarded the Cause Leadership Award for 2014 from the Canadian Breast Cancer Foundation for his work and leadership in Breast Reconstruction.

Personal Information Outside of medicine, Dr. Semple plays in a jazz/blues band. Dr. Semple is a keen mountaineer having climbed on mountains in many parts of the world. He was team physician for a British climbing team on the North side of Mount Everest in 2005 and has climbed in the Himalaya and on Mount Everest numerous times in regards to his research. He has published over 14 different research papers on the increasing air pollution, climate change and severe weather patterns on Mount Everest and the Himalaya. In 2012 he was elected as a Fellow of the Canadian Geographic Society in recognition of this research.

Erik R. Swenson, M.D.

Dr. Swenson is Professor of Medicine and Physiology at the University of Washington, Seattle, attending physician and director of the Pulmonary Function and Exercise Laboratory at the Veterans Affairs Puget Sound Health Care System, and adjunct faculty within the MGH EM Division of Wilderness Medicine. He is currently the editor-in-chief of High Altitude Medicine and Biology and serves on the editorial boards of the Journal of Applied Physiology and the American Journal of Respiratory and Critical Care Medicine.

Clinical Interests: Pulmonary and critical care medicine, general internal medicine, high altitude and wilderness medicine, medical education, exercise medicine and pharmacology. He is a regular consultant with the US Food and Drug Administration on the safety and efficacy of drugs and devices in pulmonary, cardiovascular and renal medicine. Biography: Dr. Swenson graduated from Princeton University in 1974 with an AB in biochemistry and then received his MD from the University of California, San Diego in 1979. He undertook 2 years fellowship study in pharmacology at the University of Florida and then completed his residency in internal medicine at the Hospital of the University of Pennsylvania in 1983. Thereafter he completed 4 years of fellowship training in pulmonary and critical care medicine at the University of Washington and at the Hammersmith Hospital, Royal Postgraduate Medical School in London, England. He was then appointed to the faculty in the Department of Medicine at the University of Washington. He was invited to be a visiting professor from 1996 to 1997 in the Division of Sports and Performance Medicine of the University of Heidelberg, Germany. For over 35 years he has been a principal investigator at the Mt Desert Island Biological Laboratory, a marine station on the coast of Maine. Research: Dr. Swenson has had a long interest in integrative physiology of humans and animals living in different and extreme environments. This has taken him from studying fish and amphibians in hypoxic and acidic waters to mammals in simulated high altitude and acid-base disturbances in the laboratory to humans at high altitude, in the laboratory and in the intensive care unit. Over his career he has had an abiding interest in high altitude medicine with studies focusing on the pathogenesis, prevention and treatment of acute mountain sickness and high altitude pulmonary edema, including performing bronchoscopy, echocardiography, exercise testing, cellular studies and drug trials on Mt Denali, in Alaska, the Peruvian Andes, the Alps and the Himalayas and in the Rocky and Cascade mountains. Another major area of interest considerably overlapping with his high altitude studies has been the investigation of carbonic anhydrase and its inhibitors, such as acetazolamide, in a variety of organ systems in many creatures, and in the many ways that acetazolamide is useful in prevention and treatment of high altitude illnesses.

Current Fellows:

Isabel Algaze is currently completing a fellowship in Wilderness Medicine at Massachusetts General Hospital. She was born in Carolina, Puerto Rico, at the same hospital where she completed her Emergency Medicine residency training. She attended a visual arts vocational high school where she graduated from

painting and has been a team player for multiple sports during her life including a regional swimming team for 12 years, the high school basketball team and the track and field team in college. Isabel earned her BA in Biology from the University of Puerto Rico Rio Piedras Campus and her MD from the University of Puerto Rico Medical Sciences Campus School of Medicine. During medical training, Isabel was part of Haiti earthquake relief efforts. While in residency, she had the privilege to take care of one of the two first diagnosed Irukandji-like syndromes on the island and wrote a case report which she has orally presented locally and nationally to raise awareness of the presence of this syndrome in the Caribbean, thus preventing misdiagnosis, underreporting, and improper treatment strategies. Isabel was also medical staff at a three day cycling event in which we were responsible for planning and delivering medical care to a group of 600 riders covering a 375-mile course that encircles the entire island of Puerto Rico. While EM senior, she was the residency’s Journal Club Coordinator. As a natural adventurer, Isabel acquired a taste for adventure and a passion for nature. Her key interests lie in expedition medicine, dive medicine, search and rescue and wilderness trauma, and animal envenomation. During her wilderness medicine fellowship, Isabel is working to become a Fellow of the Academy of Wilderness Medicine. In addition to diving lessons, she will

receive Hyperbaric Training at MEEI's Knight Hyperbaric facility through the National Baromedical Services to accommodate her Maine medicine interests. She is very excited to make her first trip to Nepal where she will work for three months at the Health Aid Post in Manang through the Himalayan Rescue Association. Isabel wishes to pursue an academic career by combining patient care and teaching in traditional and non-traditional emergency medicine settings and plans to contribute to the specialty by expanding it to the Caribbean. In her free time, Isabel enjoys drawing, painting, renovating old objects/furniture, running with her dog, hiking, camping, water activities, and traveling.

Prior Fellows: Peter Fagenholz, MD Instructor in Surgery, Harvard Medical School Attending Surgeon, Division of Trauma, Emergency Surgery, and Critical Care, Massachusetts General Hospital Highlights: • 4 months spent at the Himalayan Rescue

Association Clinic in Pheriche, Nepal. Feb-May 2006

• Trip to International Hypoxia Symposium, Lake Louise, Alberta, Canada, Feb 2007. Won Best Post-Doctoral Research Presentation Prize for "Chest ultrasonography for the diagnosis and monitoring of high-altitude pulmonary edema" and got in 4 days of backcountry skiing afterwards.

• Denali Expedition, May-June 2007 • Galapagos Islands SCUBA trip, 2 weeks, May 2006

Tracy A Cushing, MD, MPH, FACEP, FAWM Attending Physician, Denver Health Medical Center Dept. of Emergency Medicine Assistant Professor, Dept. of Emergency Medicine, University of Colorado School of Medicine Co-Director, Wilderness Medicine Fellowship at Denver Health/U. of Colorado

Ongoing WM Interests: Wilderness Medical Society Board of Directors; Wilderness and Environmental Medicine (journal) - Associate Editor; AWLS, Instructor; High altitude physiology research at the Altitude Research Center (ARC) of U of Colorado SOM.

Highlights of my fellowship: Working with Dr. Harris! Going to Pheriche, Nepal. Learning to SCUBA dive. Email: tracycushing@gmail.com

Doug Gregorie, MD Central Maine Medical Center in Lewiston, MA

“In 2010, after completing residency training at Maine Medical Center, I entered fellowship at Massachusetts General Hospital. During my time there I was able to get my feet wet as a clinical instructor while greatly expanding my knowledge base of wilderness medicine, particularly the area of altitude illness. The program gave me the freedom to combine my career with my love for the mountains, which led me to Pheriche, Nepal for the spring of my fellowship year. There I worked as one of two physician volunteers with the Himalayan Rescue Association treating local Nepali patients as well as trekkers and climbers high in the Solu Khumbu district of the country. Experiences

such as this are invaluable for developing skills in mountain medicine and also present ample research opportunities. Since completing fellowship I have entered private practice at Central Maine Medical Center in Lewiston, Maine and have continue to explore the mountains of New England, although on a slightly more limited basis since my wife, Charlotte, and I had our first child this past March. After a year of family building I am looking forward to putting my skills to use again later in the year as a ski patroller and field instructor for wilderness medicine education courses.”

John Tanner, MD Attending Physician, Yakima, WA. Highlights of my fellowship: Working with Stuart. Learning to multi-pitch rock climb on Cathedral Ledge. Teaching AWLS. Nepal.

Justin Pitman, MD Attending Physician, Mount Auburn Hospital, Cambridge, MA Adjunct Faculty, MGH Wilderness Medicine Fellowship

Justin grew up in western Washington, on the immediate northern edge of the Olympic National Park. It was this proximity to one of the most beautiful places of our country that sparked his interest in the outdoors. He has lived in New England for the past 10 years. Justin attended the University of Washington (Evolutionary Genetics), then relocated to Boston

immediately after graduation in 2003 to take a job in a nuclear medicine research lab, then attended the University of Vermont College of Medicine (’09). During the months and years spent in Vermont and Maine, he extensively explored the Green (VT) and White (NH) mountains, as well as the Adirondack Mountains of New York. After falling in love with New England and making the decision to pursue a career in emergency medicine, he moved to Boston for residency where I have been for the past four years.

Justin graduated from the Harvard Affiliated Emergency Medicine Residency in 2013 and started his fellowship immediately following. He writes, “In terms of my outdoor interest, my main love is hiking and backpacking, and over the past 5-6 years, have grown quite fond of winter mountaineering. Emergency Medicine is unique in that I have chosen a career that allows me to both combine both my work and play life in one. As my residency draws to a close, I am eager to begin my fellowship, with the eventual goal to incorporate outdoor experiential education in my career as an emergency medicine physician.” "The Mountains are calling, and I must go." -John Muir

Hillary Irons, MD, PhD Attending Physician, University of Massachusetts Memorial Medical Center Assistant Professor, University of Massachusetts Medical School

Hillary Irons attended undergraduate at Georgia Tech majoring in Molecular biology. She completed her MD at the Medical College of Georgia and Ph.D. in Biomedical Engineering from Georgia Institute of Technology / Emory University where she focused on tissue engineering for traumatic brain injury. Hillary completed her residency in Emergency Medicine at Michigan State University in Lansing, during which she served as chief resident, established a Wilderness

Committee, began fulfilling requirements for FAWM certification (Fellow of the Academy of Wilderness Medicine) , and taught AWLS (Advanced Wilderness Life Support). Hillary Irons is currently a Wilderness Medicine Fellow in the Department of Emergency Medicine at Massachusetts General Hospital. For the past 12 years she has been planning MedWAR (Medical Wilderness Adventure Race) events which are team-based adventure races with various physical challenges and simulated wilderness medical scenarios designed to teach and test wilderness medicine knowledge and skills. During medical school, she spent 5 weeks near Mt. Everest in Nepal on a research project investigating the use of ibuprofen for prevention of acute altitude illness. During her fellowship, she will

return to Nepal to work at the Himalayan Rescue Association and conduct further research. Her current areas of research interest include management of states of increased intracranial pressure, particularly those associated with high altitude illness and acute head trauma. In addition to adventure racing and cycling, Hillary enjoys snowboarding, scuba diving, yoga, and collecting stamps on her passport. Renee Salas, MS, M.D. Assistant Fellowship Director, MGH Wilderness Medicine Fellowship Clinical Instructor of Emergency Medicine, Harvard Medical School

Renee is originally from Michigan and went to medical school at the Cleveland Clinic Lerner College where she also obtained a master degree in clinical research. Subsequently, she matched into an emergency medicine residency at the University of Cincinnati. She was first introduced to wilderness medicine during the HAEMR/NOLS/WMI Medicine in the Wild course

during her last year of medical school and was given the opportunity to return as a resident instructor. After exploring other possible sub-specialty niches, she returned to her true passion and will complete a two-year fellowship. She plans to have an academic emergency medicine career in wilderness medicine. Her current specific interests are in the effect of climate change on human health, cold injuries, high altitude medicine, and wilderness medicine education. In her spare time she can be found ascending a mountain with a backpack, battling whitewater, mountain biking, trail running, traveling, or enjoying the outdoors any way she can.

Lara L. Phillips, M.D. Attending Physician, Thomas Jefferson University Hospitals Clinical Professor and Director of Wilderness Medicine, Thomas Jefferson University

Lara completed a fellowship in Wilderness Medicine at Massachusetts General Hospital. She received her BA from Massachusetts Institute of Technology where she studied Brain and Cognitive Science. While attending MIT, Lara worked and volunteered as an EMT. In 2007, she moved south where she received her MD from Vanderbilt School of Medicine and completed residency through Vanderbilt’s Department of Emergency Medicine. During her residency training, Lara worked in rural Dillingham, Alaska through the Indian Health Service and in Guyana at Georgetown Public Hospital Corporation. She was involved in organizing the wilderness medicine portion of the 3rd year medical student elective. Lara has a passion for teaching and service to the underserved in

rural areas. During her wilderness medicine fellowship, Lara is working to become a Fellow of the Academy of Wilderness Medicine. She is interested in investigating the detection of cognitive changes at high altitudes. She is very excited to make her first trip to Nepal where she will work for three months at the Health Aid Post in Manang through the Himalayan Rescue Association at the end of her fellowship. Lara continues to pursue an academic career by combining patient care and teaching in traditional and non-traditional emergency medicine settings. In her free time, Lara enjoys running, mud races, water activities, and traveling.

MGH Wilderness Medicine Poet Laureate We are deeply honored to have Gary Snyder as the MGH Wilderness Medicine Poet Laureate. Gary is a leading poet and intellectual who has spent his life examining and writing about wilderness, wilderness ethics, the ‘practice of the wild’, and American, Chinese, and Japanese Poetry. He won the 1975 Pulitzer Prize (Poetry) for this collection, Turtle Island.