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Cathleen Calkins | Longreads | January 23, 2024 | 17 minutes (4,667 words)
In my dream, I’m dressed in uniform—black ski pants and a red vest with a white cross—when I find a man lying in the snow. The late afternoon sun lights up the wispy blond hair that’s escaped his helmet. He looks at peace, like he’s sleeping, yet the angle his hips make with his thighs is cartoonish and grotesque.
I kneel at his side and work quickly, looking for clues. He’s breathing but not moving. I reach inside his jacket to apply a painful sternum rub—my attempt to rouse him—and the smell of weed envelops me. I key my radio, but my rapid-fire screams of I need help, backboard, oxygen, ambulance! don’t transmit. This is where I wake up: alone, sticky with anxiety, its grip firm in the back of my throat. And each time I remember the permanence of that day: the man lying in the snow never walked again.
I’d had this dream for almost a decade, and there are others—each an endless scroll of the anguish I’ve seen. Like the college kid who skied well beyond his ability. His epic fall left his pupils looking like two mismatched drops of motor oil. Smokey, dark, and unequal. Or the tiny girl who’d fallen from the chair lift at a span five times her height. Her offense? Playing pattycake with her friend without the protection of the comfort bar. Luckily, the fall only broke her femur.
As a seasoned ski patroller, I thrived in this rescue culture. Until I didn’t. And that’s when my dreams became nightmares.
Growing up in rural, central New York, I spent my free time outdoors. Summers on the network of rivers that crisscrossed the region and winters on Labrador Mountain, an hour’s drive from my family’s home. I preferred the cold. Between weekend trips to ski with my family, I jogged at night, making laps of my neighborhood after dinner. When I grew too warm, I’d sit in a snowbank and, in the cool stillness, enjoy the anonymity of the night. In this space, cold and snow became synonymous with joy and freedom.
As a seasoned ski patroller, I thrived in this rescue culture. Until I didn’t. And that’s when my dreams became nightmares.
At 33, I became a ski patroller. I had wanted this career since I was a child; I committed to the profession while other kids dreamed of being an astronaut, doctor, or scientist. My reverence for this work came from admiring the men who patrolled the nighttime slopes of Labrador Mountain. When I was a teenager, busloads of kids took over the resort every Thursday evening. The ski patrol was always ready to save us from ourselves.
My two friends and I liked to ski the treed glade that separated the designated night runs. Populated and thick with red bark willow and eastern white pine, only a narrow, winding trail sliced through the shadows. It was dark and off-limits, and we thought that was cool.
In the middle of the forest sat a small clearing with three knee-high tree stumps. It was our secret spot and, in the quiet of the night, we inhaled the cold. We also passed a joint and sipped from a flask filled with Southern Comfort stolen from my parent’s liquor cabinet. We were three adolescents caught in the reckless theater of our young lives. But someone always noticed our absence from the safety of the lighted slopes.
At the edge of the forest, a college-aged guy wearing a red vest with a white cross waited. Warm from the liquor and more than a little stoned, we’d come to a jumbled stop in front of him. He’d ask our names, our school, and what we were doing in the woods. “I’m showing my friends the trail I ski with my dad,” I’d say. It worked every time. He would admonish us to “stay out of the trees” and let us go. We were his usual Thursday night offenders.
My career as a ski patroller took shape after a conversation I had with a stranger on a pay phone in Reds Meadow, just outside California’s Yosemite National Park. I was on day five of a thru-hike on the John Muir Trail. Freshly showered and lubricated with a German-style pilsner, I confessed to Joe, my hiking partner, that I wanted to quit my corporate job and become a ski patroller. Joe, it turned out, was best friends with Cristof, who recruited patrollers at Mount Waterman, a small ski resort that sits close to downtown Los Angeles. We scraped together quarters from other hikers so Joe could call Cristof before handing the phone to me.
Two months later, I sat in the first aid course Cristof had recommended with 20 other enthusiastic want-to-be patrollers. The course was EMT-equivalent and designed for the professional rescuer. For five months we sat through biweekly training in lifesaving techniques, studying our ABCs—airway, breathing, and circulation. We also studied our D and Es. A deformity, like abnormal swelling or a bump on the skin caused by a broken bone, signaled us to expose the deformity to see the extent of the injury.
While there was no strict procedure for providing lifesaving first aid, the process for treating injuries is somewhat formulaic. As we became skilled at recognizing injuries based on their mechanism, or cause, we’d also become adept at the care to provide. Each mechanism had a lockstep response. For a skier hitting a tree, the mechanism was sudden deceleration. While the range of injuries was vast, the lifesaving action was simple: backboard and transport.
The violence of injury is remarkable. The class scared me. I remembered the evening I drank too much on a Thursday night foray into the forest with my friends. I was skiing too fast for the icy conditions. The tracks had frozen in the trail that zigzagged through the trees, making it nearly impossible to check my speed. I hit a tree. Hard. The impact gave me a lump on my temple the size of a silver dollar and left the right side of my rib cage feeling spongy. I didn’t sleep that night, and my head pounded for days.
I had come close to sustaining permanent injury, but a future lost to my youth was never my intention. Skiing equaled freedom, autonomy, and power. It represented unchecked permission to glide through each moment and make my own decisions. Perhaps it was this early negligence that compelled adult me to want to help others who found themselves in situations they had never intended.
Six months after my phone conversation with Cristof, we met in person on my first day as a ski patrol rookie at Mount Waterman. By then, I’d passed my first aid test and was ready to work on real injuries and put my new skills to use.
The first time I witnessed respiratory arrest, I was six years into my career as a ski patroller.
There is nothing more fundamental to life than breathing, and the college kid who lay below me had stopped. The dull, leaden blue of his lips was creeping to his cheeks. It was as if a watercolorist had swiped the soaked tip of her brush across his jaw and the pigment had begun to bleed and then dry.
As my coworker methodically looked for clues to his injury, I knelt in the spring-soft snow and held C-spine, a life-sustaining measure for suspected spinal trauma. An uncomfortable position to hold for long, I was leaning over the boy’s face—my nose hovering above his—as my knees lightly touched his shoulders and I cupped my gloved hands on either side of his head. “He’s not breathing,” I whispered, as if I were afraid the boy would hear me. Feeling helpless, I mumbled, “We need to move quicker,” in judgment only of myself.
The boy lay motionless on the snow as other skiers and snowboarders slid past. Snippets of their conversations filled the air above us. Let’s hit that again, the snow is really good today. Ready for lunch? Trivial. Unimportant. Memorable. While time stood as still as the boy on the snow, the movement around us continued to swell.
A moment later, we repositioned his jaw and the boy took a breath. He also opened his eyes. Relief swept through me as oxygen returned color to his skin, and I no longer worried that mine was the last face this boy would ever see.
The alchemy between rescuer and rescued is strange: like a romantic relationship, only faster moving. The euphoria of starting simply at hello, I’m here to help before moving on and culminating at what feels like deep attachment. We say my patient, as in they transported my patient to the hospital, or my patient opted to return to the slopes, or my patient is in the bar. I felt possessive of those I spent so little time with because our paths crossed at a moment they needed my help. Perhaps I cared too much.
A moment later, we repositioned his jaw and the boy took a breath. He also opened his eyes. Relief swept through me as oxygen returned color to his skin, and I no longer worried that mine was the last face this boy would ever see.
I used to wonder how the people I’d assisted were doing. Like the college student who snagged first chair to get on the snow early so he could make it home before his afternoon class. He didn’t look like a skier. His cheap snow pants were too big, his cotton hoodie soaked. I remember how crumpled he looked when I skied up to him and how his inaudible moans grew louder when we secured him to the backboard. Had his injury prevented him from leading the life he wanted?
During my third year, I assisted an older woman who was sitting at the edge of a wide run on the mountain’s upper slopes. She couldn’t stand and seemed resigned to the fact that she would never ski again. Between long draws on a cigarette, she explained in detail the pop she heard and felt in the back of her left knee. The snow was new and wet and heavy; it had prevented her uphill ski from turning in tandem with her downhill ski. A sport-ending injury, she couldn’t move without excruciating pain. As I skied her down the mountain in the toboggan, I listened as she softly cried into the blanket I’d wrapped her in. For years after, I’d occasionally see her at the grocery store, where I would watch from a distance and convince myself her gait was better than the last time I’d seen her.
As I experienced both trivial and traumatic moments day after day, an emotional narrative emerged, and I began to confront the falsehood that I too would be okay. My thinning confidence overshadowed my passion to rescue others, and seven years into my career, I became terrified to do my job.
I was anxious that I’d be tasked to do something I couldn’t do, like misinterpret a patient’s rapid pulse and shallow respirations for something else when their distended jugular vein (signaling a collapsed lung) was buried beneath layers of clothing. I worried that I’d cause more injury to the injured; or that I’d fail, and failure had repercussions I couldn’t entertain.
Even on my days off, it was an endless loop of pointless dialogue that rarely paused, causing sleepless nights and nightmares. The cracks in my readiness already visible.
On most shifts, I felt transcendence, especially with the care I gave: an ice pack to a 5-year-old whose knee had an invisible ache. A splint to a dad whose wrist resembled a fork. A wheelchair ride to a teenager who’d ascended the mountains too quickly, only to collapse on the slopes from altitude sickness. More than a string of kind words to a woman whose ankle was likely fractured beyond repair.
I was confident because those injuries felt routine. I’d experienced each one enough times to grow comfortable with what I needed to do. I wasn’t flawed and someone else’s experience—their fear, their pain, their reaction—was theirs. And I didn’t take my work home with me when we parted ways.
Except, I was mistaken. Even those experiences eventually became too much.
As a patroller, I have a front row seat to someone in pain, and pain causes people to behave and react erratically. Screaming is distracting and, at work, I wanted it to stop. That’s when my patience wore thin. To someone shrieking at the top of their lungs, I’d demand they calm down. To someone I couldn’t understand because their sobbing made it hard to hear their words, I told them I couldn’t help if they didn’t stop crying. It wasn’t that I didn’t care, it was that I didn’t want to feel—prioritizing my pain over theirs. Those interactions only added to my mounting guilt and shame.
My empathy waning, I was constantly on edge and amped. My burnout singed other areas of my life too. I picked fights with my husband about the most innocuous things. I’d yell and argue about the coats he’d allow to pile up on the hook by the front door until I couldn’t breathe. I’d berate him for leaving an empty coffee mug in my car, never satisfied with his reaction or apology. I was negative and moody and unhinged. I normalized my behavior—it was who I was. But it wasn’t who I wanted to be.
A cowboy-esque, I’m-as-tough-as-they-come attitude has shaped the culture of ski patrol. As professionals, we bring calm to a chaotic rescue scene. The end goal: to ensure the injured remain resilient. But that resiliency is one-sided. Until recent years, caring for a ski patroller who works one gruesome incident after another has not been on anyone’s agenda.
Talking about the toll working grim scenes and witnessing life-ending injuries takes on us is seen as weak. In fact, the trauma ski patrollers face is cumulative and can cause a stress injury, a specific ache invisible to everyone, including ourselves. There’s never been a consistent approach, or even acceptance, to say “I’m not feeling it today.” Instead, we are expected to forget yesterday’s gory details and show up for our shift unaffected by the past. But that exposure to nonstop trauma catches you.
Holly Christensen, an Idaho-based master clinician in Accelerated Resolution Therapy, a form of psychotherapy used to treat traumatic stress, explains cumulative trauma like this: “We think we have a reservoir to hold and to tolerate every traumatic experience, and that our reservoir is limitless. But if you don’t pay attention to what’s happening—to the warning signs—we risk hitting a threshold we didn’t even know was approaching.” This is when stress injury forms and, Christensen says, we often don’t know what the trigger will be.
Understandably, we think that spark will be the next big incident we see. But when our reservoir is close to full, the brain doesn’t differentiate between death or a twisted knee. In practice, the thing likely to tip the balance is more benign; it’s less shocking and more ordinary, and as insignificant as a drop in the already full bucket. This is why we, as rescuers, don’t recognize when we need help.
The brain’s amygdala, hippocampus, and prefrontal cortex help us respond to stressful situations. When our brain is healthy, the amygdala, our most primitive region, categorizes our experiences into sensory fragments, while the hippocampus acts as the brain’s camcorder: recording an event so we can remember it accurately to make sense of it later. But Christensen emphasizes, when we hit our trauma threshold, that sensory record—sounds, smells, colors—gets coded incorrectly.
When these sensory experiences overload, they lock up our logical brain, or prefrontal cortex, which is the most sophisticated region Christiansen says. Often the incident that pushes a rescuer over the threshold is something mundane, a situation we’ve handled countless times before. Or the trigger is a color—like a guest’s red jacket, or a blue hat. “Logically, our brain questions why this situation bothers us, why these seemingly insignificant things are what sideline us as rescuers.” It doesn’t take much, Christiansen adds. “While the prefrontal cortex tells us we can handle it, we actually can’t without clearing stuff out, which requires a way to process and release the cumulation of our trauma.” In essence, our brain tricks us into thinking we’re okay, when really, we’re not.
The signs were there long before I noticed them; I was better at burying the trauma than dealing with it. One Saturday, at the end of a particularly long shift, I remember feeling like I had the bottled-up energy of a storm. There was an intensity I knew I needed to dissipate. Vivid, violent, and untamable. Drinking did the trick. So did sitting alongside my coworkers and sharing our gore stories.
It wasn’t unusual for us to talk about our work experiences to get over them. We discussed how a guest had pulled their OPA, a device used to maintain an airway in an unconscious patient, out of their mouth mid-transport to the first-aid room. We reenacted the foul language a teen with a bad concussion had used when responding to our questions. We made fun of how the injured were dressed and judged them by the equipment they used.
To laugh in the face of calamity is cathartic. But to anyone else, our playful banter about the injured would have seemed callous, monstrous even. But for us, it was meaningless and our way to release the day’s intense stress and anxiety. Along with drinking, our discourse became routine.
To laugh in the face of calamity is cathartic. But to anyone else, our playful banter about the injured would have seemed callous, monstrous even.
However, alcohol was a crutch and I didn’t stop once the tab was paid. It continued at home and my strategy was to hold onto the buzz to cope. But drinking to excess gave me a false sense of hope, akin to using a Band-Aid to hold a gaping wound closed. Booze merely masked my symptoms and did nothing to curb the fervor of my rising anxiety. The next morning, hungover and rough from a poor night’s sleep, I’d return to work to face and feel the same stresses as the day before.
It was only during the off season that I prioritized self-care. Then I had the time to catch up and tend to both the visible and invisible injuries of ski patrolling. From April through November, I traded plastic ski boots for flip-flops to heal my mangled feet, practiced yoga to calm my central nervous system, chased endurance adventures to retain my physical strength, and tried to drink less frequently. All to reset my resilience so I could be capable and clear-minded when winter rolled around.
But taking care of myself felt more like something else I needed to overcome. And by the end of fall, there were still deep-seated issues that I simply could not mend without expressing the angst I felt, and that was years away.
As ski patrollers, we are trained to anticipate something bad happening during our shift. We’re taught to be ready, quick, and calm, which in a classroom is easy. But in reality, it’s harder than expected.
But taking care of myself felt more like something else I needed to overcome. And by the end of fall, there were still deep-seated issues that I simply could not mend without expressing the angst I felt, and that was years away.
It’s imperative we show up physically ready and emotionally whole. Luckily, the majority of the first aid we deliver is easy to provide—a sling for a dislocated shoulder or a ride down the mountain in a rescue toboggan. We walk away from those incidents as saviors; the ones who confidently told them they would be okay. But for the bigger, more tragic events that require every synapse firing at a level hard to sustain, we, as rescuers, are impacted, and there is no one to tell us we’ll be okay.
I wasn’t warned that working traumatic scenes came with a separate set of risks. I wasn’t taught to recognize my own emotional trauma. I was trained to save others, tend to their injuries, and develop the muscle memory to react quickly. I was prepared to ensure a scene was safe to enter, to mitigate the possibility that I’d sustain a season-ending injury. And that is easy to do—it relies on my senses and intuition and experience, something I am attuned to. I didn’t know flashbacks and nightmares, anxiety and avoidance, negative thoughts and a change in my mood were also part of what I’d signed up for.
There’s a paradox to ski patrol—you’re essential but forgotten. Vital then invisible. Moved aside when an ambulance arrives, left to silently heal as your patient is wheeled away. Even worse, we are replaced as the rescuer so we can deal with the physical and emotional mess the injured have left behind, like capturing every detail in a written report, delivering the bad news to a family member, comforting a grieving friend, tagging the equipment and clothing left behind, removing the bloodied bandages from the floor, and completing your shift so you can sit at the bar and drink your day away.
We think we’re good after talking about our shift’s events over a beer. We feel seen and heard. Alcohol heals our wounds temporarily and, in a group context, that’s okay. But often, the self-destruction escalates and continues when we’re alone. The cumulative trauma ski patrollers face is considered a stress injury, and it alters the way we move through life, the way we respond, think, and feel.
For me, anger became a problem, and I was angry at the injured. Their careless horseplay, their determined recklessness, and their simple ignorance—everything that led up to a full-blown rescue reflected a series of poor decisions and a certain self-centeredness I couldn’t forgive.
By the time I arrived on scene for the guy in my dream, my colleague had discovered he didn’t have any feeling below his waist. Her sleuthing was a gift. Now it was simple: get him on a backboard and off the mountain. Between bouts of brief consciousness, he landed a few heavy punches as we worked to secure him for transport, and when we lifted him off the snow, an empty fifth of gin fell from an interior coat pocket. At least he had movement of his upper limbs, I told myself. Thirty minutes later we loaded him into a waiting ambulance.
When the door of the ambulance closed, I didn’t feel the relief that delivering a person to a higher level of care could provide. Him heading to a hospital should have left me feeling certain. Certain in the care we’d provided, certain he’d be okay, certain he’d overcome the lasting effects of his injury. Instead, I asked myself: is this all there is to it, to never walk again? Severing your spinal cord seemed so simple; swift yet incomprehensible. And it took no more time than it takes to hit send on an email.
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That day, I returned to the scene where it had happened. I was there to document the depth of his error. I recorded the marks in the snow, measured the width of the run, triangulated the tree’s location so we could find the exact spot he lost movement in his legs should we need to. After, to clear my head, I took a lap. I hoped the act of skiing, the thing that gave me the most joy in life, would take my mind off what had happened.
Instead, caught in a cloud of my thoughts, I hooked my ski on something in the snow and fell face forward with a thud so hard I expected the pain to never end. That day, my patrol director sent me home. The mild concussion I sustained only added to my anger and difficulty to emotionally heal. It was the first time I’d had an injury at work acknowledged by someone else. I’d been so careful about my physical health and so negligent about my psychological well-being.
Our body and mind provide the absolute representation of ourselves. To lose life or mobility or the capacity to think well is unimaginable and challenges everything familiar. Sustaining permanent injury is not the intent of the millions of skiers and snowboarders who flock to America’s winter resorts looking only for a day of fun. Yet the unthinkable happens at a frequency that terrifies me.
During the 2021–22 season, 57 people lost their lives and 54 people sustained catastrophic trauma, like permanent head, spine, or neurological injury. A high percentage of those who died were young men who had collided with a tree. Even when you consider that 61 million skiers and riders visited US ski areas during that same period, I find these statistics staggering. Staggering because for every lost life or catastrophic injury, I know there were countless ski patrollers who bore witness to that pain and suffering.
For a ski patroller, performing consequential rescues is a bit like playing roulette. Christensen says it is only a matter of time before we, too, become injured beyond repair. Pain is tricky and affects us all differently. Relieving the pain of cumulative trauma is exhausting if you don’t know its signs and symptoms. But this is changing as more resorts address the challenges ski patrollers face. While psychological first aid, PFA for short, is not new—it came into prominence after 9/11—ski resorts are only starting to adopt it. But to do PFA well, to address your stress injury, you must share your truth, and being vulnerable is complicated and hard.
It means admitting you are flawed to the people who rely on you. Signaling failure and conceding to your coworkers that you may not have their back, and that trust is vital. In my 17th year, I took a two-year sabbatical, choosing to be a skier only. I became part of the masses who go to the mountains to shred the powder, enjoy the vibe, and find joy in the groomed corduroy runs, never exposed to the sadness when someone else gets hurt. I also moved to a resort where the terrain—natural, soft, and forgiving, with open pitches and less people and snowpack—was less likely to contribute to injury, and I joined a patrol that made an effort to safeguard my emotional well-being.
The first time I experienced PFA, I wasn’t invested in the outcome. We were asked to assign ourselves a color that matched our mood, and our choices were green, yellow, orange, and red. The colors held meaning: choosing green meant I was emotionally and physically ready for whatever happens, that my team could count on me no matter what. Choosing yellow, orange, or red signaled something was amiss: I was less than capable of stepping up to whatever the day threw my way.
I was entrenched in the old ways, and I blurted “green,” even though I was clearly yellow—tired, dehydrated, and slightly hungover from the party the night before. In my mind, I was paid to show up ready, and giving voice to vulnerability of my own making wasn’t an option. By not taking care of myself, I let everyone else down, including me.
But something happened in the persistence and practice of honestly describing how I was feeling. As I watched others open up, I did too. That alone was cathartic—creating a safe space to share our feelings of helplessness, anger, and depression. Admitting I was yellow helped me see I was wounded and begin to address my own stress injury. In those moments, I finally realized there was a lockstep approach to rescuing the rescuer and it started with becoming mindful and trusting and willing to heal.
Now my dreams are formulaic. When a situation I’ve experienced shows up, I calm myself by floating above the chaos. I recognize the sad narrative and skip to the end. In one, I’m in the locker room, changing from my uniform into my street clothes. I twist the radio in my chest pocket to off, as if it has significance beyond silencing the chatter. In another, I close my eyes and exhale. My breath looks heavy, and it holds the activity of my day. I watch as familiar shapes—a skier, an ambulance, a rescue toboggan—become less recognizable. In each, the lightness returns. I smile and leave. And then it goes dark, and I wake up rested and relieved and ready.
Cathleen Calkins is a freelance writer and ski patroller and sits on the Board of Women of Patrol. She lives outside Bend, Oregon, with her husband and temperamental dog, Betty.
Editor: Krista Stevens
Copyeditor: Cheri Lucas Rowlands
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