N. Stuart Harris, associate professor of emergency medicine at Harvard Medical School and founder of the Division of Wilderness Medicine at Massachusetts General Hospital, described on Mar. 23 his experiences managing risk while providing medical care in challenging settings such as Mount McKinley.
Harris recounted a situation in 2011 when he was working for the National Park Service in Alaska and treated a veteran suffering from chest pains high on the mountain. With limited resources and evacuation impossible due to weather, Harris said he prioritized honest communication about risks with his patient: “I told him, ‘These are the things I’m concerned about; these are the risks if we run out of medications, or if we run out of oxygen, or if we’re not able to get you off the mountain in two or three days.’ I would like to think that we, whether it’s as physicians or patients, should be able to talk about risk in a little bit more of a realistic, humane way.”
The patient ultimately recovered after descending to Anchorage. Harris explained that such uncertainty is common in wilderness medicine: “It isn’t like if something bad happened, it was inevitably a bad decision — no. Given the confines, maybe you did what needed to be done. Sometimes what might seem a little bit more risky is exactly the right choice because it overall reduces risk.”
Harris’s background includes work as a firefighter and whitewater rafter during college and medical service following disasters such as Japan’s 2011 tsunami. He has also served as board chair for the National Outdoor Leadership School (NOLS) and co-created Medicine in the Wild with NOLS Wilderness Medicine.
Reflecting on broader cultural attitudes toward risk, Harris said: “We’ve become so risk-averse in some aspects of our civilization and culture, and with our children, that I think we’re creating tremendously larger risks and we’re just not recognizing them.” He emphasized that proper assessment involves balancing likelihood against potential downside consequences.
Harris attributes his approach to acceptance shaped by experience: “My fear level has really plummeted…I have an idea of what I can control…But I also have seen enough to know that I’m a wee little person…I’m not going to change some outcomes.” He added that personal setbacks help build character: “It’s not very interesting to hang out with people who haven’t seen the ugly downsides and experienced them personally. It makes us who we are.”
