Ep. 28 - Laura McGladrey, Responder Alliance, and Stress Injury: How to Get Back to Green and Save Living While Saving Lives. - Wilderness Medicine Updates

Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Patrick Fink MD (00:14):
Welcome back to Wilderness Medicine Updates.
I'm your host, Patrick Fink.
Today I'm very pleased towelcome Laura Mclare on the
show.
Laura Mclare is the founder ofthe Responder Alliance, an
organization that focuses onreducing stress injuries in
first line responders.

(00:35):
I first became aware of theResponder Alliance when I was
working at Snowbird.
I worked as a patrol physicianthere and unfortunately, in the
year prior to my joining theirteam, the Snowbird folks had
actually lost a me, alongstanding member of their
patrol to suicide.
And because of that, they becameclosely involved with the

(00:56):
Responder Alliance and startedto work to develop a system to
ensure that no one on theirteam.
Found themselves in that placeagain, that they lost no more
valuable members of their teamand their community to stress
injuries.
Whether you are a professionalski patroller, a volunteer
search and rescue member, amember of a healthcare

(01:17):
profession, or simply someonewho goes frequently into the
outdoors, if you frequentlymanage stressful situations,
particularly those in whichthere is danger to yourself or
others, you have the potentialto develop lifelong stress
injuries as a result of thoseexposures.
My hope is that thisconversation.
Tunes your awareness to the factthat we need to prevent these

(01:39):
kinds of injuries beginningearly in our career and learn
how to manage ourselves and thestress continuum so that we can
have a long, happy and healthycareer working on the front
line.
Without further ado, here is myconversation with Laura Mclare.

(02:00):
Hi Laura.

Laura (02:01):
Hi there.

Thank you for joining me.
I'm sorry for the snafu thefirst time that we tried to
connect.
That's okay.

Laura (02:08):
okay.
I think it worked out

So I know that you work as a clinician in
addition to your work in theResponder Alliance.
How do you explain to peoplewhat your day job is and, and
how do you balance the two?

Laura (02:22):
Thanks for assuming that I balance the two.
That's great.
Um, and so in my day job, I'm afamily and psychiatric nurse
practitioner.
I work at the Stress TraumaAdversity Research and Treatment
Center.
It's called the Start Center atUniversity of Colorado.
And my day job and background isin really at the interface of

(02:43):
occupational stress andtraumatic stress and first line
responders.
So we used to say firstresponders, but.
Really, we're using thatterminology now, first line
responders to also the people werely on to protect the things in
the places we care about themost.
So that's climate responders,forecasters, geo hazards, um, as

(03:04):
well as fire law enforcement,EMS, ski patrol, et cetera.

So how did you come to move from your work as a
psychiatric nurse practitionerinto your role in the Responder
alliance?
I know that you have abackground in the outdoors in
rafting and ski patrolling.
What brought you to where youare?

Laura (03:24):
Well, that's a long story.
Let me try and make it concise.
So I was, as you said, workingfor many years as an emergency
medicine versus a nurse and anurse practitioner in level one
trauma centers.
Um, I did that in part to fundand fuel my.

(03:45):
My habit of, um, working inremote places for Knowles
wilderness medicine and, um,teaching wilderness medicine,
which led to humanitarian aid.
And all the while, yes, I was,um, RAF guiding and guiding and
working with ski patrol as an aLS or advanced life support
provider and.

(04:05):
You know, it really was in someways sort of a fluke that when I
got back I was, I spent a yearon the north south border, um,
South Sudan, and when I got backand I decided to pursue, the
psych mental health postmas, soI'd have two certifications, um,
as I was graduating it.
So happened that the job thatfit with my schedule was

(04:26):
working, um, with lawenforcement and fire and EMS as
their prescriber for aprominent, um, uh, police
psychologist.
And so I, I had been doing thatwork for a while, and then
still, of course, every weekend.
I could say I was dirtbagging itwith my people and, and what I
realized is that as we startedto discover the language that

(04:48):
the military was using aroundstress injury and to detect it
and the stress continuum andcreating some, innovation and
scaffolding for folks to reallyearly mitigation and early
detection of stress injury, thenI would go and work on the
mountain on the weekends andrealize that this was not
getting out to my people.

(05:09):
And the time, this has been awhile now, but with wilderness
responders, I think there wasthis kind of understanding or
maybe a misunderstanding that aslong as we got to hang out in
cool places and do incrediblethings, we would never be
injured by

Mm-hmm.

Laura (05:25):
and particularly traumatic stress.
Um, I, you know.
People I cared about and spent alot of time with, you know, and
I was at a wilderness responderfor many years.
I'm like, A pediatric treestrike is a pediatric tree

Right.

Laura (05:39):
whether you're in an urban context or remote.
And I, I think thatmisunderstanding that.
our jobs are cool.
We couldn't get injured bystress was actually, I mean, I
was getting phone call afterphone call and people tugging on
my sleeve and saying, what isthis?
I was like, well, I'm treatingit my day job, but we don't have
any language for it in my, inmy, on my weekends.

Let's dive into the language a little bit'cause
I think some of our listenerswill be familiar with the idea
of stress injury, the stresscontinuum, but for those who
aren't, how do you define stressinjury?

Laura (06:13):
Well, thankfully it's not left up to me to define it.
I can, I can tell you.
Um, it was defined first by theUS Military Marine Corps, um,
and Navy Combat and OperationalStress First Aid.
They and to my knowledge, werethe first ones to.
To introduce the nomenclature.
When I discovered that around2018, I also learned that Canada

(06:34):
had been using the terminologyoccupational stress injury.
Um, but that the idea of stressinjury is really, um, the same
that we would use in physicalinjury.
It's the amount of exposure, um,over time will equal the
severity of the impact.
Um, but stress injury is really,uh, kind of a wider.

(06:55):
Acknowledgement that we could beinjured by stress, um, in our
careers.
And in fact, my understanding ofthe literature, it's the most
common injury to shorten or enda career, in, in any kind of,
um, response.
More common than needles takemore common than back injury.
More common than patientassaults is.

(07:17):
Is being injured physically bystress.
Um, and it, it is a fatal injurytype.
And I, unfortunately we've hadto come to reckon with that in
these last years.
But, um, but that's, that's howI would hold the stress, the
stress injury language and the.
Maybe I would say this too, thatafter teaching wilderness
medicine for so many years, youknow, there's a, there's an

(07:37):
algorithm or there's a, there'sa projection or a progression.
When you teach wildernessmedicine, it's, if it's a head
injury, there's early changingvital signs or late changing
vital signs.
If it's a sprained ankle, it's aankle fracture.
If it's, you know, diabetesearly and then diabetic
ketoacidosis, we were missing inmy, in my experience, early

(07:58):
changing language around.
impact.
And it wasn't until people wereliterally coming to see me in
what I would affectionately callthe psychological ICU, they were
finally asking for support.
And 20 years of emergencymedicine, I'm like, it's the
same if you come to me indiabetic ketoacidosis.
It's gonna be a lot harder treatthis than if we had had a name

(08:19):
for it and we could havedetected it with a hemoglobin
A1C hopefully.

Yeah.

Laura (08:25):
show, but some, there were ever even symptoms, we
could say, Hey, let's modifywith diet and exercise before
you develop these really relike, um, difficult and
difficult to modify impacts instress injury, which might
involve a loss of arelationship, a loss of a job,
loss of a life.

Yeah.
I like that language of thevital signs of stress injury
before you show up in the floridshock that is, you know,
relationship destroying,substance abuse and suicidal
ideation.
Maybe we could identify the.
The early derangement, the earderangement is the wrong word,
but the, the early tachycardia,the, the slight differences that

(09:07):
say, Hey, we're moving outsideof, of the realm of what should
be our, our normal and safeplace to be.

Laura (09:13):
Like that.
You just said derangement.
Um, it's funny, when I went fromemergency medicine to psych, I
had to really start watching mylanguage.
But you're talking aboutelectrolyte

Yeah.

Laura (09:21):
right?
Like the first we see yoursodium get low, we should be
addressing it.
And I, I do think that actuallywas where Responder Alliance was
born because the problem that Iwas trying to solve is that.
Like carbon monoxide, you know,in a high altitude tent, if you
don't know that exists, you'renot gonna watch for it.

(09:42):
if, if you don't know that whenyou start feeling sick, it means
you should get out of the tent.
You're gonna, you're gonna takea nap and go to sleep.
But without a common language,there is no way for people to
actually recognize, oh, what I'mfeeling are the early signs of
stress impact.
I should do something right now.
So it really mattered that wehad a name for it.

What now is the mission of Responder Alliance?

Laura (10:06):
The mission of Responder Alliance is to continue, and it
had been for many years toadvance the national
conversation, on stress, injuryand impact.
We also now have a foundation, Iwould say at the heart of the
mission is that we want everysingle.
vital responder, meaning anyonewho is gonna go put their heart

(10:27):
and their life on the line to dosomething important, have fair
warning that stress injuriesexist.
We want them to, to know aboutthem, what they face, and then
we want them to have cuttingedge skills to know what to do,
and not just for themselves, butfor each other.

How do you persuade the gruff pistachio
types who wanna spend all oftheir learning time on cool
things like skiing or learningtechnical rescue, that investing
in education, learning thislanguage, learning the tools
that you provide, how do youpersuade them that that is
worthwhile?

Laura (11:04):
It really depends on where they are in the arc of
their career.
And this is candidly why we'vereally put a focus on
FairWarning and a universalright for everyone to know about
stress, injury and impact.
I spend a lot of time in, saykind of jokingly, snow caves,
patrol huts and policedepartments, hall ski, um,

(11:25):
morning meetings.
way that I, I talk, I don'tthink that the, the crusty I'm,
I'm assuming we're talking aboutpistachio men and women.

Yes.
Sorry.

Laura (11:35):
the, is, um, the folks who are well into their careers,
if I start talking about stressinjuries, um, they surprisingly,
actually sometimes get quiteemotional and they're usually
the first ones to say, if we'dbeen having this conversation,
if we'd had this conversation atthe beginning of my career, I

(11:55):
would have my wife.
My ski partner, I would, I wouldhave these things back and
there's almost a sense of grieffor them.
It's funny, when I've trainedwith elite teams, they're always
like, oh, watch out for that oneCresty guy'cause he's not gonna
believe you.
And it helps me that, you know,I have the designation of junior

(12:17):
wood check forecaster, um, fromthe Avalanche folks.
Like all I do is pattern

Mm-hmm.

Laura (12:23):
So people kind of think I'm way far into their kitchen
when I'm not.
I've just seen it

Mm-hmm.

Laura (12:28):
again, you look at the stress continuum, that there's a
progression and it usually goesin a career that you won't feel
this or think it could everhappen to you to the, for the
first four to six or seven yearsof

Mm-hmm.

Laura (12:44):
It's really difficult about this particular injury.
Maybe like a not unlike carbonmonoxide is that when it does
finally hit you, it usuallyfrequently, you're already very
advanced.
Right.
If we go back to diabetes, youalready have microvascular
damage.
There's already things that arehard to reverse, and so it's
tricky.

(13:04):
a lot of people who come to meand say, I heard you talk about
it.
I never thought it would happento me.
I can't believe I'm here, but ithappened to me, and so I would
say.
I have actually never hadresistance from the crusty folks
because they've lived thisinjury.
Now, they may not feelcomfortable.
I've had people in a room of skipatrollers like, oh, here comes

(13:25):
Laura Mclare again.
We're feelers.
Uh, I try not to do that, but I,it's not that they were not
uncomfortable, but I don't thinkI've ever had anyone.
Deny to me because, I mean, I'min the trenches.
I have, like, I, I can see itfrom the door that it's not a
thing and it's not probably thebiggest challenge we face in

(13:46):
guiding and wilderness medicine,in climate, in, high angle
rescue and the guard, et cetera,et cetera.
So I, I don't know.
That might be a bit of a take,but I think we always think
don't believe it.
And I would say.
They can almost not afford tobelieve it.
I mean, I think what honestlyhappens, and this is a shout out
to you if you're a mustache C,how, what did you say?

(14:06):
A crusty

Christine Pistachio woman.
Yes.

Laura (14:09):
Yes.
But I wanna defend them maybe.
'cause I am one to say that wedidn't know any better.
Like no one ever said to us.
Hey, year 4, 5, 6, this is gonnahappen.
It's gonna impact yourrelationship.
You're gonna put down your kayakand never put it, pick it up
again.
You're gonna lose.
So I think the conversation forthem is more painful.

Mm-hmm.

Laura (14:32):
why didn't I have this?
Um, but.
I've never, also can sometimesfeel that, um, everyone's
looking at them like we talkabout the stress continuum,
which is that progressive acrossthe arc of the lifespan toward
more stress impact.
They feel very vulnerable.
Like, is everyone looking at mebecause I actually display these

(14:53):
attributes and to which I wouldbe very protective of and be
like, yeah, you show me how toget through a 25 year career.
You know, if you're in climbing,you've lost half of the people
that you started

Mm-hmm.

Laura (15:04):
They've doubt the idea that, that they wouldn't be
impacted is that I feel veryprotective of

So the,

Laura (15:11):
So you who are listening, um, you came by it honestly,

you, you mentioned the idea of fair
warning.
You're, you're saying thatthat's to bring this idea to
those first and second year teammembers and bring awareness to
that, that process, that this issomething that can sneak up
insidiously through theircareer.
Is that right?

Laura (15:32):
I use that terminology fair warning.
In the same way in publichealth, we would let people know
about crime and monoxide.
Like, hey, if you're in a, anenclosed cabin with a, a
wonderful chuggy stove, and youstart getting a headache and
feeling nauseous.
You should open the windows,right?
Like we do that in wildernessmedicine and that is what I'm

(15:53):
proposing.
And I think particularly, youknow, more recently as we've
been working on this year oneinitiative, actually predict
that people aren't gonna learnabout stress injuries and be
like, oh, thank you so much fortelling me.
Now I know I'll never get astress injury.
I think they'll be like, okay,yeah, got it.

Mm-hmm.

Laura (16:09):
to me, but.
They hit that year three or fourand they get off their, first
wild then season, or they getback from a call and they're
like, they sit down and they'relike, I used to love this, but I
don't wanna do it anymore.
And I actually have a reactionin my body every time I get on
that helicopter.
And I don't know what'shappening to me.
I hope, hope, hope that they'llgo, wait, I think I know what

(16:31):
this is.
I'm gonna take care of thisright now.
I'm gonna open some windows.

Let's talk about that.
What are, what are the earlysigns of cumulative stress
injury that listeners canrecognize in themselves or in
others?

Laura (16:44):
So I think one of the easier ways to think about this
and um, happy for you to putthis in your show notes.
You know, we took the combat andoperational Stress First aid, or
excuse me, the from combat andoperational Stress, first Aid,
the

Mm-hmm.
Yeah, I'll put that in the shownotes for sure.
Yeah.

Laura (16:59):
Yeah, we'll, we'll talk about that as a capacity
continuum too.
It's not just about like yourstress.
You could call it the resiliencecontinuum if you want, but the
idea is that.
Many of us start our careers orour seasons in this kind of
relative green, which I wouldsay is a lot of capacity for
complex things to happen.
We have maybe a little overagespiritually.
Um, we have strongrelationships, we have healthy

(17:22):
bodies.
We feel like we can handlethings and, and wem feel mission
satisfied.
Like, I can't believe I get topatrol all season.
I can't believe I get to be anER doc.
I can't believe I get to fly onthe helicopter.
And then in the yellow, there'susually like a, the earliest of
change from your baseline islike, I don't really wanna do
this today.
Or I'm more short fused than Iwant to, or I, I care less about

(17:46):
to pick up bamboo, or I'm count.
I'm starting to kind of countthe days till the season ends
'cause I'm kind of over it orI'm over my coworkers.
It's, it's very subtle, but ittends to be, I would say the
best way to look for it is tolook for a change from your
baseline.
Your baseline level of beingpsyched that you get to do this
job, maybe you would do it forfree, and then all of a sudden
you're like, Hmm.
So there's this change that kindof involves that.

(18:08):
And I would say energyconservation.
Like I don't wanna do this.
I'm starting to kind of clock inand clock out.
I'm not going out with myfriends as much.
I'm not engaging in training asmuch.
then there's this other kind ofprogression into orange, which
moves us closer to injury wherewe actually.
what we would, a lot of usdescribe is that true burnout
where you're like, I reacheddown.

(18:28):
I can't find a motivation forthis.
I'm counting the days till theend of the season or to the end
of my career.
I'm isolating myself'cause noone would understand.
And um, I am maybe using moresubstances or climbing higher
and farther to numb out.
it's all happening on theinside.
Usually people aren'tbroadcasting it.
They're like, man, I just, notmyself.

(18:50):
finally, there's thisprogression that we would put
more into the zone where Italked about psychological ICU,
which is more recognizable,which we traditionally call
like, oh, that's PTSD, or, oh,that's depression or anxiety or
substance use.
is.
feeling trapped and maybefeeling internal reaction every
time you go to work and notsleeping well and feeling very

(19:14):
isolated.
The challenge with getting thatfar from those early changing
the lates is that the fartheryou are into that state, the
less resources are available

In what sense?

Laura (19:25):
Right?
Well, you know, folks who livein that red zone or who touch
down in that red zone.
They don't ha feel like theyhave, um, the energy to get
themselves out it from an energymanagement status, um, kind of
standpoint.
If you took a battery, like yourcell phone battery and flipped
it.
It would be like that feeling ofred is like, I'm running out of
time, I'm running out ofresources.

(19:47):
I don't have that muchconnection.
I don't have enough energy.
I can't get myself out.
And even the military, when theyfirst defined it, said that
state of red, you're probablygonna need someone else to come
in and get you.
You can't often get yourselfout.
I think what's most dangerousabout that red state is um, most
rescuers, until we have thisconversation, feel like it's a

(20:08):
me problem.

I, if you're the hero, you're not supposed to
show that kind of thing.

Laura (20:12):
You're there.
We actually, we have thisresilience myth that heroes
don't get injured by stress, andif they do, it's probably a
moral failing.
so that's where people getreally trapped, where it gets
kind of dangerous because.
only do they feel isolated, theyfeel down on themselves.
They don't feel like themselvesis taking everything they have
just to go to work or dowhatever they're doing.
They profoundly feel likethey're letting other people

(20:34):
down.
And the worst part is it's a meproblem.
so that's why I think thisterminology is so important.
it gives us a greaterperspective to say, no, it is a
carbon monoxide problem.
It's an, it's an exposure issue.
You've been exposed to a lot ofstress over time without
mitigation, and this is anatural progression.

In my experience working in both the
emergency department andoutdoors prior to connecting
with the material from theResponder Alliance, I would say
that my, my experience has beenthat the focus on critical
incident stress management.
Is really for those like fouralarm fires where everyone can

(21:17):
recognize that something reallytraumatic happened.
Maybe a, a very traumaticepisode on the mountain or
something that involves acoworker, serious injury or
death of a coworker, maybe inthe emergency department.
A really traumatic patientexperience with a pediatric
trauma, for example.
And I'm interested to hear yourthoughts on those critical

(21:38):
incident stress debriefings andwhere that falls into things.
But I have always been a personwho would rather not participate
in that process, and it hasn'tbeen useful to me.
So I was very glad to encountersome of the other ideas about
how to manage those stressinjuries from you.
I'll, I'll seed the floor.
Let's start with, um, what areyour thoughts on those kind of

(22:02):
critical incident stressdebriefings and where do they
they fit into our world?

Laura (22:06):
Let me say that the critical incidents.
Stress debrief was one of thefirst great innovations of a
generation.
Think about the generation thatstarted 1973 EMS Act where the
the ER and paramedicine wasborn.
You follow that in the lateeighties or nineties?
I'll try not to be an academichere, but you follow that, and

(22:28):
there was a recognition thatsomething needed to be done.
Like, um, medics in a small townjust pull up on their own family
member and everyone was thereand they're like, that was bad.
We should do something.
So that first impulse of, um,debriefing was to bring people
together to help them kind of,to reorient and to get people

(22:50):
kind of set on a trajectory ofhealing.
a lot of times I work with,still use them frequently and.
I think what I would say ismaybe in your experience, those
aren't helpful for everyonebecause they're not helpful for
everyone.
And that came out at least, andI wanna be clear that, um, and
stress management are twodifferent

Mm-hmm.

Laura (23:11):
the early.
Things, um, and in part, youknow, early Lancet or articles
that, that detail like, Hey,everyone's using these, but some
people are actually, are havingmore difficult outcome work,
re-experiencing who go, thendon't go.
I would say that in myunderstanding of the literature
and kind of what happened nextwith psychological first aid and

(23:31):
some of these next innovations,the problems may be such that If
there are moments aftersomething major happens, you
definitely need connection.
But the thing you probably needthe very most, um, is to
reorient, like to what happened,to kind of get the ground
underneath you and it takes thentime to reorient.

(23:54):
So um, in my day job, I respondto a lot of officer involved
shootings and mass shootings.
I unfortunately just respondedto one yesterday and.
Again, all I did for the firstday is said it's okay to be
disoriented.
leverage those innate, um, thoseinnate capacities of connecting
with each other, creatingessentially psychological first

(24:16):
aid, creating a sense ofstructure, having you involved
in your own rescue, and thenlet's watch how you do over
time.
So the challenge for me withdebriefing in the old days in
ski patrol, for instance, Imentioned that tree strike back
in, you know, in the nineties, Ihate to say that word, but, um,
it, the answer was like, let'sgo to the

Mm-hmm.

Laura (24:38):
And it, we weren't wrong, right?
It was like connection.
It was trying to reorient beforewe went home to our families.
There was some very good thingsin there.
I think the newer technologysays it is not a one size fit
all technology.
Some of us need to be withothers, some of us need to be
alone.
Some of us, I'm gonna be kind ofsilly here, but this challenge
with occupational health that Ilearned all through the pandemic

(25:00):
was all mitigate stress and.
Advance her own resiliency andnourishment in different ways.
So where someone, one rescue, Iliterally work with an elite
rescue team where one personneeds to go home and pet their
cat.
The other person needs to betogether, the other person needs
to wear play Norwegian blackmetal in their basement.
And if you just say, we're allgonna get together and we're.

(25:21):
All gonna do this and you allhave to be there.
Some people are following avery, um, intelligent impulse to
go spend some time by themselvesand kind of let the state of
arousal come down.
And the minute you make'em comeback in the room and talk about
everything again, gets all firedup and they know it.
And that might have been yourexperience.
Some people are like, love,debriefing.

(25:42):
'cause they're like, I need thatconnection.
I need that reorientation.
So what we've done in the lastfew years is to try and identify
what components.
be or helpful to kind ofeveryone structurally, right?
3, 3, 3 protocol that we'veworked together to develop says
at the three day mark, you'regonna still feel disoriented.

(26:02):
By the three week mark, yourstate of arousal should be
coming down.
It's a great place fordetection.
And by three months probablyshould have really found
reorientation.
And if you haven't, then thoseare the points where we wanna
stop and intervene.
if we went after everyone in thefirst three days and said,
you're displaying signs ofP-T-S-D-A, we'd be treating.

(26:23):
but B, we would be short cuttingpeople's innate survival
responses to come together.
So we're more likely to giveinformation and, and inject the
skills.
Of quote unquote debriefing intothe patrol, into the rescue
team, into the hospital, and tryand get folks a little bit more,

(26:44):
um, attuned to what to watch forin each other and who's at the
highest risk.
So that was a very long answer,but I, I don't wanna criticize
debriefing outright becausethere's a lot of really
incredible resources there.
And the teams who are using themare using them to great effect.
It was not working for everyone.
So I think what's, what we'reseeing more of now is the need

(27:05):
for a wider toolkit so that somepeople have the skills to, to
self deploy on their own stress.
And we're seeing that in themilitary.
They want every single operatorto have the skills to self
deploy on their own stress.
then there's kind of a corporateplan for how to, to catch
people.

Let's talk about that self deploying
against your own stress.
I think, um, the language I'veheard before is, is like your
green choices.
What, what keeps you in the, inthe green?
How can people identify thattoolkit to treat their own
stress and.
Make it effective.
I'm thinking that the, theopposite of effective here to my

(27:48):
mind are sometimes the safetyplans that I see for some of my
psychiatric patients, where it'slike when I start to feel
suicidal again, I'm going towatch YouTube videos and eat
junk food, right?
Things that are, that are notnecessarily healthy and also
don't, um, are hard to deploy intimes of, of stress states.

(28:08):
So how do people identifyeffective green choices for
them?

Laura (28:12):
Well, if you don't mind, I would take you back to the why
of green Choices, because Ithink if you're in healthcare,
if you're in rescue, if you'vebeen in fire, you've been, if
you lived through the pandemic,was a lot of conversation about
just.
sure you're self-care.
Self-care.
Take time for yourselfself-care, I think we might miss
the why, which I think is whatactually motivates us to do it.

(28:35):
told you about that stresscontinuum, one of the things I
didn't mention is that it'ssomewhat of a predictive tool
for tma traumatic stress.
Um, what that means is that, um,when I, as a stress responder
show up on scene, I actually ammore interested in where people
are on the stress continuum whatthey saw.

Mm-hmm.

Laura (28:58):
And the reason for that is that the farther you get in
toward the red, remember I saidit was kind of a battery.
It's like how much can youhandle and respond to?
So the people who tend moretoward green have more capacity.
To have hard things happen andnot get injured.
And this somewhat kind ofanswers the questions of how you
could line up 10 people at thescene of something or in your ER

(29:21):
and they could all see the samething.
And some of them are profoundlyinjured.
I've seen this many times at atmass violence events profoundly
injured, where some people arelike, that was really hard, but
I'm okay.
Why?
And in part it has to do with,you know.
the way that stress becomestraumatic stress is essentially
when we, whatever's in front ofus is more than we can handle.

(29:43):
So what might be missing fromthe conversation isn't just that
we make green choices so that weget to be, you know, like go
around, like, look at me, I'mglowing in green.
It's literally making micronizedinvestments toward your own
capacity every single day.
And auto correcting.

(30:05):
you find that you're getting outof alignment, right?
Where green just turned toyellow, you're like, whew, I
gotta stop and fix.
Because of us who deployed toanything, that could be a
wildland deployment, it could bea very busy shift.
You know?
I know after all those years inthe er, I didn't know if I went
in the ER if I was gonna bethere for three days'cause
something happened or I was justworking a SZ 12.
so that idea that we make greenchoices as an investment in our

(30:30):
own capacity, that's, I thinkwhat we need to hold onto
because we have really no, nomagic wands, and I don't, as a
traumatologist particularlyright now in this moment, to
make the sad things untrue.
I can't, there's only two thingsI can do to prevent PTSD.
I can either make all the sadthings untrue.
Or what we're trying to do, Ithink, is to try and empower.

(30:54):
Everybody, as many, everybody'sas we have our hands on or
everybody's happen to be firstresponders and medics and but
empower them to live in a spacewhere they have as much capacity
as possible to integrate thehard things respond to the hard
things when they happen.
'cause your brain, somethinghappens.
You go, I can't handle this.
It's already gonna put you inthe trauma pathway.

(31:15):
But if something sad happens,you go, this is really hard, but
I can handle this at capacityfor it, usually you're gonna be
okay.
So those green choices, a littleworried and we're like, you
know, people are like, is yourwhole, is the whole mission just
to get people to like, you know,eat more green leafy vegetables
and move their bodies and sleep?

(31:35):
And I'm like, well, yes, but notfor the reasons you think.
It's really because we're tryingto, essentially my patrol
director used to collect carboloading for the soul.
We're trying to preload thatpeople have everything they
need.
When the hard things come and ifthe hard things come, like I
just said in that first threedays, you don't have everything,

(31:56):
everything you need, then we'regonna do everything we can in
that moment to increase thosegreen choices and decrease
stressors to get them to a placeof capacity where they can use
their innate healing me andry,get themselves through this
without getting injured.

To make this a little bit more concrete, would
you be comfortable sharing withus what your investment on a
daily basis looks like?

Laura (32:21):
My investment in.

Yeah, exactly.
You talked about making acontinual investment in your
capacity to handle thesesituations.
I think it's easy to identify.
Severe stress injury.
You know, I, I think you'vecome, you've met Moose Motlow.
He was on the podcast and hetalked about realizing that he
was in the far orange or the redbecause he was standing in front

(32:46):
of his refrigerator door andcould not make a very simple
decision about what to eat.
And it was his wife whorecognized in him that he needed
to go make that investment andthat investment for him was to
get back in the water, get backin the river, and, and paddle on
the whitewater.
What are the smaller things thatyou do that keep you in, in

(33:07):
touch with the, the sources ofyour resilience?
I.

Laura (33:10):
Well, I feel like full disclosure, just like Moose,
who's my dear friend?
Um.
I think that I don't have amagic wand for this.
You would think like, I mean, itfeels incredibly important for
me to, to stay as close to greenas I can because I'm telling
other people to do it.
But what I've learned comingthrough a pandemic,

(33:31):
administrative changes, somevery.
stressors.
My own cancer journey, like allof these things is that, um,
it's not so important that Ialways in my glowing orb of
green, that would be wonderful,but that I have a roadmap.
Like moose, that when I getthere, I don't think, I don't
know what's wrong with me, I'mgonna keep paddling harder.

(33:51):
Or like the carbon monoxideexample, I'm gonna go to sleep
and hope this goes awaytomorrow, which we know that
will end.
So I have a real gentleness withmyself, um, that even though
this is what I do for a living.
Most of us are gonna get to thered in our careers.
I have in, you know, afterAfrica and, and I may again.

(34:11):
Um, but what I love is that Iknow that'cause I, pattern
recognition have watched a lotof people who never thought they
could get from red to green, getback to green.
Um, I think a lot of peopleright now kind of circle between
green and yellow.

Mm-hmm.

Laura (34:26):
yellow, yellow, orange.
Strange.
But, um, so that's important forme.
So to me there's this kind of,um, that's sort of the what,
what contains my efforts to staygreen.
I try to, to go with what's inthe literature for myself.
Um, I know that movement, andparticularly running fast and

(34:47):
lifting heavy things, stimulatesmy nervous system.
To feel like I can actuallydischarge my stress and complete
the stress cycle.
So, so I lift heavy and I am aNordic racer.
I ski as hard as I can.
I mountain bike in the summer.
Um, I can tell, my friends cantell too, where I am on the
stress continuum based on whatmy lunch looks like, right?

(35:09):
And it's like the green with allthe, like, you know, you work
the shift and people look atyour lunch and like pumpkin
seeds and like what you likereally

I can relate to that completely.
It's the end of the difficultshift when I get garbage food
out of the cafeteria.

Laura (35:24):
Yeah, right.
When people are coming to dothree days into a shift and
they're like, you're eatingTrader Joe's Res, like you just.
Tore open the lentils and you'rejust eating it out of the, I
mean, all have those metrics andso I often try and pay attention
and I want my people to knowtoo, and they're like, Hey,
trader Joe's, Emory's.

(35:45):
Like I, I just had one of mystress buddies call me this
morning, is like, Hey, really?
For real?
I haven't heard from you.
I see some markers, you know,what green choices are you
making?
And so again, there those,there's exercise, there's
nutrition.
I mean, sleep is a hugeharbinger.
Like we, we actually mitigatetraumatic stress in our sleep.

(36:06):
We clean our, you know, glialcleansing, like we clean our
brains when we sleep.
We consolidate learning.
Uh, it's the first thing I workon with my patients and.
You know, I have sort of astress continuum from my sleep.
Like having an eight hour sleepopportunity, I'm gonna sleep or
not, is a sign of green for me.
So that's kind of how I thinkabout those things.
If folks are listening andthinking about green I would

(36:27):
also say that because we'reliving in such a condensed dense
time where we've lost so much ofthe margin we had even before.
COVID.
We wanna make things count.
So you might take that greenchoice space from the freedom of
other minds or space forintegration, combine that with
movement, combine it with natureor creativity.

(36:50):
And to me that's, you know, whenI go on a Nordic skier, I'm
racing with a friend, I'm like,well, I just hit four green
choices in the Venn diagram whenI'm, when I'm playing my fiddle.
With other people and we're likein creativity and laughter, I'm
like, oh, I've got connection.
That's a green choice.
I've got creativity, I've gotjoy and kind of learned my own
to start checking those thingsoff.

(37:11):
And I think you'll know too whatit feels like, the version of
the Trader Joe's MREs, whenyou're like, I'm just working.
I'm not doing anything that Ilove.
I'm not getting outside.
is not sustainable.

I like, I like all of those.
The reaction that I have to, letme, let me start over and
rephrase this by saying I likethat there are individual tools.
I think it's also important forthe organizations that we belong
to, to help support theindividuals that are accruing

(37:47):
stress there.
Right?
Like I, I totally agree withyou.
Ski patrol is a great example ofa setting where people really
can accrue.
Stress injury.
And it can be really written offwith that.
You know, you get the, the bestyour, your compensation is to go
ski, right?
You're, you're poorly paid andpoorly supported'cause you get

(38:07):
to ski and because

Laura (38:08):
Two And lunch is what

Yeah.

Laura (38:11):
That's you getting paid and two Es and lunch.
Yeah.

So how, how can organizations best support their
members?
When I think about what I haveseen in the past, it's kind of
painful.
Like when I was in residency,loved my residency, but burnout
became a big subject inemergency medicine.
And so the, the main response tothat was we're gonna have some

(38:37):
talks about burnout and thenwe're gonna have some mandatory
fun where we're gonna scheduleyou and you have to do a fun
thing.
'cause that's how we preventburnout.

Laura (38:47):
It's really

Oh, I hate mandatory fun.
I got in trouble for skippingout on mandatory fun to have
real fun and.
I know you have a betterstructure that you can offer.
What does, what does that looklike for a ski patrol that
hasn't worked with your groupbefore to implement a program to
help support their members andhelp prevent severe stress

(39:09):
injury?

Laura (39:10):
So programmatically you're asking or.

Yes.
I think it's great that we givepeople the tools, but we could
fall into that same hero trap,right?
If I'm, if I'm not managing mystress effectively myself, I
should know all my greens, Ishould be able to take care of
myself.
If I'm not, then I'm justfailing at one other thing in my
life, and that's my personalproblem.
I think it's important to have astructure also that creates

(39:36):
resiliency within theorganization so that if, if
someone is not able to getthemselves back into the green,
there's a way to help them backinto it.

Laura (39:44):
Yes.
I think there's a few thingsthat I can point to that have
been really effective.
Um, we also pilot them inhealthcare during the pandemic
and in ERs of the VA and otherset with residents.
the first is recognition.
Always.
I said that before, you have toknow what you face before you
know what to do about it.
we were not working with thestress continuum.

(40:05):
I was not for very long before Irealized that that teams and
organizations.
units could be injured bystress, just like individuals.
So if you haven't seen it, weactually created the stress
continuum for cultural, um,application and organization.
So the attributes would be likein, in the organizational green,

(40:26):
you would have, um, more ofmission cohesion.
Um, problems would be facedcollectively.
There would be a sense ofcohesion.
And support.
And then that would start tofray in yellow where people
would start kind of doing theirown thing and blaming.
And then an orange, maybe we'dsee more silos.
I'm not gonna call mandatory fungaslighting, but it is, it's

(40:48):
troubling.
Um, and then I get the spirit ofit though.
And then red would be like,don't trust the leadership.
Don't trust each other, every

Mm-hmm.

Laura (40:57):
themselves and, and drift.
And what we learned pretty earlyon is that.
Individual humans like you and Imight say, I'm gonna bring my
green leafy salads, I'm gonna goto the desert and my time off,
I'm gonna do everything I can toleverage my own green.
But then they were working inenvironments.
As soon as you got back from thedesert, two days in, it's

(41:17):
already pulling you into orangebecause the environment
collectively was quite orange.
And so we actually created a, acourse for the stress stress and
your awareness for teams.
And what's interesting is thatthe, that the treatment is in
some ways the same if you have acollective understanding.
Um, the green choices for teamsand rescue, for instance, are,

(41:39):
what are you doing?
For cohesion and connection.
What's your mandatory funversion like when you're at the
rescue, you know, you finish arescue and someone's got chili
in the crockpot.
Are you gonna stay a kind of atradition?
Are you in the Christmas paradefor rescue together?
Are you, are there things thatyou're doing that feel missional
to you?

(41:59):
Um, how do you relate to eachother?
And so we actually built and.
about programs like the Denaliprogram after the pandemic, like
reinstating some of those thingsthat have been lost in the
pandemic.
Like, Hey, when are we gonna gettogether?
I remember that first year ofthe pandemic, they went out, um,
out on one of the rivers andthey're at, at this big, at the

(42:20):
end of the season, like a bigsoftball game.
And the same happened in JennyLake.
Um.
They used to have a Thursdaynight softball game, like, where
are we playing together?
How are we keeping thistogether?
So very tangibly asking teamsoften, and I just worked with a,
an elite team this week and Isay that like their high,

(42:40):
reliability operators in themilitary.
you know, I asked'em to kind ofmap that out, like, what does
green look like in thisenvironment for you?
What does it feel like to be ona team that screen and what are
the choices that you could back?
And it was really fun.
They're like, why are we eatingour lunch in front of the
computers?
Like on Wednesdays we're gonnago outside and here's this

(43:01):
amazing humans in uniform, menand women mustache, um, who were
like, it's skinny Jean Friday,where wear civvies and let's,
we're gonna do this runtogether.
Let's bring play back in.
Let's bring, and so those arethe green choices of the
organization.
And what I'll say has beenworking, you know, responder
Alliance actually has supportedthe formation of resilience

(43:24):
teams, embedded teams on apatrol and a rescue team, and an
ER whose sole job is to look atfrom one another and bring those
green choices into culture.
what I think has been veryuseful, um, so there's a course
on it.
There are resilience teams whereteams can get memberships and
work on these skills.
It's been really fun to watch itover time.

(43:45):
But what I, I think that's meantover time is that I've started
to see leadership actually hireor interview.
Like imagine if they'd said inyour er, um, Hey, during your
interview process, we value,quote unquote green people.
Who make our green, our teammore green?
What do you bring into thetable?
How do you take care ofyourself?
How do you take care of yourteammates?

(44:07):
when you recruit for that, youimmediately say, this is what we
value.
And in the first year, all yourresidents are like, I better
demonstrate my green.
I'm gonna say, Hey, I'm making agreen choice.
Or, Hey, let's make a greenchoice together.
Because you know, that's whatleadership values.
If you think as I do, when Istarted, I won't tell you where,

(44:27):
but level two trauma center inmy twenties, those nurses who
could like start IVs on babiesin the dark, they were so
incredible.
They're incredible.
They, they were also teaching mehow to go out drinking at 9:00
AM in the morning and twomarriages in, you know what I
mean?
Like the culture was.
you're gonna be good at this,you're also going to have all

(44:50):
these attributes of

Mm-hmm.

Laura (44:52):
what we need is to change that cultural relationship to
say no.
What we actually value isprofessionalism, cultural
competence, and how much youbring green to our team.
'cause that's our best shot atsurviving.
something terrible walks in thedoor.

That's interesting.
The admirable nurses in yourearly career who are also
modeling bad behavior, that'sprobably tied back into that
generational nature you werejust discussing, where that
first generation of emergencyresponders, at least in the US
from the seventies to say thenineties, were all figuring it

(45:27):
out and figuring out tools thatwere maybe less effective in the
long run.
Natural, but less effective.
Right.
Um.

Laura (45:36):
I would call them adaptive behaviors rather than
bad.

Sure.
Uh,

Laura (45:40):
they had no guidance and they were and they were coping
with their injuries as best theycould while trying to teach
their young how to get by.
And I look back on them and I'mlike, I really, I, I could see
how they were trying to be like.
kid, don't get emotionallyinvolved.
If this is getting to you, youshould go somewhere else.
It sounds really harsh, but theywere really trying to say like,

(46:02):
this is the best I figured out

right.

Laura (46:04):
injured and still take care of other

Yeah.
Those adaptive behaviors thatlater become maladaptive or no
longer serve you.
Um, so now we have a, a chance,I guess, to set a, a different
culture and have the people thatwe admire in our organizations
model a different form ofresiliency.
Some of the people that I thinkof who I admire the most in that

(46:30):
respect are, are the most openabout their experiences and how
they were emotionally impactedby them.
And I think 10, let's call it15, 20 years ago, that might
have been seen as a sign ofweakness.
But someone I'm thinking of offthe top of my head is a, a
friend of mine, drew Hardesty,who you've, you probably know,

(46:50):
who is very open about his, hismind, his experiences and his
wisdom, and that vulnerabilityseems to feed into his
resiliency in a stressfulprofession as an avalanche
forecaster who has weatheredquite a few accidents in, in
Utah and, and his life as aJenny Lake Ranger.

(47:10):
Before that.

Laura (47:11):
We could spend quite a lot of time on, on talking about
what's going right with DrewHardesty.
Um, he's me, my junior woodcheck forecasting designation.
Um.
And I will say that he, you'reright, the leaders of the
industry who've had the courageto say, I mean, I think one of
the most helpful things thatDrew's ever said to the

(47:33):
avalanche forecasters that Isupport, um, down the line I
fucked up that forecast and thisis how it felt.
And to bring that intoavalanche.
about the role of shame inforecasting and you know, I
think after the Wilson's gradeevent, we hosted an event
together.
We're like, you guys, let's talkabout the 3, 3, 3 in avalanche.

(47:55):
Like he, he's a great exampleand he, you know, I've been out
skiing with him, with his kid onhis back.
Like we try and play togethermore than we talk about work.
Um, he practices what hepreaches and.
That's, I think where like wetalked about those resilience
teams, those teams, we alwaystry and get a few reference

(48:15):
leaders who are kind of theones, the evergreens I'll say,
who've somehow managed to stay.
They, they either got to thereand back again, or they've
stayed green in their careers.
And I don't mean that they don'tleave skin on the pavement, but
they still love the job.
They have a passion for it.
They have a passion for teachingnew folks.
Um.
That's the resilience team idea,right?

(48:36):
Like, let's put the city, cityon a hill, those bright lights
in front of folks and say, thisis actually who we want you to
grow up to be.
And so, um, I think if folks arelistening and they, they know
those people, first of all let'em know that they're
influencing and second of all,you know, follow them home.
This sounds like I'm gonna saysomething creepy, but know.

(48:59):
Researcher, like them abouttheir s like ask them what they
eat for breakfast.
Ask them what you'll find inthose people.
And I went throughout my dearfriend Drew and Moose is another
one.
Go listen to his podcast.
Like what's kept him engaged forall these years.
You find out that they actuallyhave very, um, they have a

(49:21):
strong commitment to their greenchoices.
off work.
Like, I remember Drew going toJapan in the middle of an
avalanche season.
I was like, can forecasters evendo that?
And he is like, well, I'm doingit right.
They, they go to the woods, theyshut off their phones, they
spend time with their families.
And I can, I can, you know, I'dlove to start calling out my
friends.
I think about, you know, NickArmitage and the Tetons and the

(49:43):
people who we look up to patroldirectors who are like, sorry,
it's five o'clock.
I'm with my band, I'm with myfamily.
I have a life outside of theuniform.
I have rituals that I do everyyear or every day that keep me
this way, and I do not falter.
And so that's why I wouldencourage people, and I can
think of a lot of them, of thegreat fortune to work with, some

(50:04):
of them who've been out it 30years and can stay green.
It's because of these rituals.
So ask them if you're like, howare you staying so green?
They're gonna tell you that theymade a commitment a long time
ago.
To take care of themselves andthey've stuck with it.
And that's when I, when you saygreen choices, I get a little
worried that we're like, get, goto your yoga class and drink

(50:27):
your smoothies.
It's much grittier than that tome.
They're making green choiceswhen they're hard.
They're making green choicesthat work for them, and they're
making green choices out of adeep commitment for their family
and for themselves.

I don't have anything to add to that.
That's, I love that.
Um,

Laura (50:45):
You ask them, don't say, Laura, I'm glad you asking me
and ask you of what you eat forbreakfast.
You gotta be a little bit

maybe I'll have him on and I'll just ask him
what he eats for breakfast.

Laura (50:55):
Do it.
Yeah, do it.
You have him on, have him on andask him about his green choices.
And he wasn't a we, you know,he'll tell you like, I've been
there and back again, but thisis how I got here.
And I think we need more ofthose conversations and, and
more inspiration that you canget all the way red.
'cause a lot of us will.

(51:16):
And the, the problem withgetting to red when you're in
others before self person is youcan keep operating for a long
time

Mm-hmm.

Laura (51:24):
red people keep.
I kept secrets, like, I'm cool,I'm fine, and all the Y, like
I'm not fine, but I don't knowwhat's wrong and.
What's happening is they'restill serving everyone else, but
it's coming at great personalcosts.
I no longer think of like highreliability responders as like,
you get to the red, we shouldtake your badge and a gun.

(51:45):
You shouldn't be hoisting, youshouldn't be injecting
medication.
I just say, this is, you'resmoking under the hood.
This is gonna have tremendousimpact for you or your family
and your life.
I know you can do it, but pleasedon't.

Yeah.
For me, I find that even whenI'm burned out, I can still be
very highly functional at workand at least would probably be
perceived by the people aroundme as being highly functional.
But where the, the fallouthappens and where the warning
signs show up is in the rest ofmy life where I don't have the
same energy and capacity tobring home to my family.

(52:23):
And so it would be easy enoughfor some of those around me at
work to think, oh, this is goingokay.
Unless maybe they're picking upon the, the Trader Joe's res or
the,

Laura (52:33):
That's

the, the chocolate cake.
Uh, to be fair, I eat that whenI'm green.
Um,

Laura (52:39):
I think chocolate cake's a pretty green

yeah.
Well, I'd like to wrap this upby saying I think there's
probably folks out there who arelistening to this and they say,
I want to be able to work a fulland fulfilled career doing the
stressful thing that I do.
Where should they look to inResponder Alliance to learn
more?

(53:01):
I.

Laura (53:01):
So on the Responder Alliance website, there's an
opportunity for folks to taketheir own individual classes.
You talked about self deployingyour own stress, so maybe you
work at an organization thatdoesn't yet have this kind of a
stress mitigation.
Program.
Um, skill sets there arepsychological first response,
incident support, and thenstress injury awareness for the

(53:23):
individual and the team.
we'll see, this is kind ofexciting, but we'll see a
desktop, um, app that willsupport, um, teams reporting on
their own stress levels guidingthem through that incident
pathway.
Um, coming out in the fall,which is pretty exciting.
there is an opportunity withresponder lines too.

(53:44):
You can reach out for teammembership, like, Hey, an
avalanche center, we're an er,we're a larger organization and
we wanna take more steps.
To really get my, get thosefirst line, um, change agents
trained on this so we can getthis into our culture.
So would say those are all,those are all great
possibilities and all availablethrough responder alliance.com.

(54:06):
if you'll let me put in

Please.

Laura (54:08):
um.
If you just happen to be thatperson.
Uh, well, there's two things.
If, if, um, finances are anissue for you, we do have, there
is, um, a new 5 0 1 C3, theResponder Alliance Foundation
that supports folks goingthrough that process, um, to get
funding.
Or to enroll in what I sharedwith you at the year one

(54:29):
campaign.
So for folks who may be on theirown or maybe as a cohort, say,
Hey, we wanna train on this fromthe beginning.
And that's a guided, um,skills-based habit science.
And program to try and get folksin their first year.
But I would say the plug is too,if you also happen to, to have
that rich uncle who loves heliski guiding and really wants to

(54:52):
invest in the future of guides,please tell them to donate to
the foundation.
Because the problem we've beentrying to solve there for me for
many years is I go to theseincredible ski towns and
beautiful places all over NorthAmerica and now in the world,
Uh, the folks that I'msupporting who are on the front
lines don't have enough money or

Mm-hmm.

Laura (55:12):
line in their program, stress mitigation.
but yet I'm staying in someone's$4 million house.
So we're trying to bridge thepeople who deeply care the first
responders and the ones whoactually need that training
because unfortunately.
You know, unlike some cool, youknow, New Zealand, Scottish
Mountain Rescue, we don't have afederally funded or a hospital

(55:35):
funded program to tell us aboutthis injury type.
So we're kind of, doing it fromthe ground up.

Uh, thanks for the work you do.
I think you guys are really,you, you truly are saving lives,
not just those who would be lostto suicide, but.
People who otherwise would betorn up by their careers and,
and finish wondering why theyhad spent all that time doing
the thing that they used tolove.
And instead now hopefully are,are learning the tools to stay

(56:05):
in that place where theyappreciate everything in their
lives, including, includingtheir work.
And so I, I thank you for that.

Laura (56:11):
Thanks I, that distinction is really important
to me that, um, you know, Iremember many years ago, one of
the, he was a law enforcementofficer.
I used to teach wildernessmedicine with who I really cared
about, who wrote and said.
I have everything in my worldthat I want and love, but I
can't find a reason to live.
despite going on and being verybrave in that and still doing

(56:31):
that, I think what we're workingon here with this particular
problem is saving living.

Hmm.

Laura (56:37):
Like really living, not just going through the motions,
um, as we unfortunately dosometimes as first responders
and healthcare responders.
So that distinction may, I dothink lives will be saved, but I
it's, it's so meaningful that wesave living because those of you
who are out there doing thiswork are the climate responders.
And the ones protecting theresources and protecting the

(56:59):
people and protecting scienceand protecting our world and our
people and our communities.
So what is also deeplymeaningful is that we could do
that with vital vitality andcreativity.
So thanks.
Thanks for your time.
And what a great conversation.

Thank you for coming on.
When I'm in the green, I feelgrateful to be part of the
network of folks who are kind ofhelping to be the net under
society and you are and yourorganization are the net who are
under us, and I appreciate youfor that.
I.

Laura (57:30):
Well, thanks so much and, um, make sure to make Drew Hardy
tell you all his green choicesand, um, think of me the next
time you're eating a TraderJoe's Emory at the er.
Hope to

Oh, thank you Laura.
I appreciate you taking thetime.
So that's it for this episode ofWilderness Medicine Updates.
I hope that that was valuable toyou.
I feel like no matter whatcapacity you are in, whether

(58:04):
you're a recreationalists or aprofessional operator, a rescue
team member, or working inhealthcare, this is super
important information andsomething that we can all apply
to our own lives.
Something that became.
All the more important after weall learned our maladaptive
coping mechanisms during theCOVID Pandemic.
Please take a look at theresources that are down in the

(58:25):
show notes that let you connectwith Laura Mc gladly and the
Responder Alliance and learnmore about this.
Learn more about the process toadminister psychological first
aid to yourself and others.
And the steps that yourorganizations or your teams can
take to build a peer supportculture that prevents cumulative
stress injury.
This does, as Laura said, bothsave lives and save living, and

(58:49):
helps support us in long,healthy, enjoyable careers doing
the things that we have lovedfrom the very beginning.
If you know someone who wouldbenefit from this podcast.
Please share it with them.
I think that there are a lot offolks out there who would
benefit from hearing thismaterial, both the the new folks
on your team, as well as theGrizzly Mustachioed ladies out

(59:11):
there.
And if you have any thoughts onthe subject or have any
questions, as always, pleasereach out at Wilderness medicine
updates@gmail.com.
And until next time, stay fit,stay focused, and have fun.

All Episodes

Ep. 28 - Laura McGladrey, Responder Alliance, and Stress Injury: How to Get Back to Green and Save Living While Saving Lives.

Episode Transcript

Popular Podcasts

Stuff You Should Know

Las Culturistas with Matt Rogers and Bowen Yang

Crime Junkie

.css-15opob5{left:0;position:absolute;top:0.8rem;} All Episodes

.css-14f5ked{margin:0;word-break:break-word;display:-webkit-box;-webkit-box-orient:vertical;box-orient:vertical;-webkit-line-clamp:2;overflow:hidden;}Ep. 28 - Laura McGladrey, Responder Alliance, and Stress Injury: How to Get Back to Green and Save Living While Saving Lives.