Sunday, February 18, 2001

ER doctor teaches real survival skills

By Jim Knippenberg
The Cincinnati Enquirer

Dr. Ed Otten's freeze-dried rattlesnake was given to him by snake-bite expert Willis Wingert.
(Steven M. Herppich photo)
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        The problem with Survivor, Dr. Ed Otten says, is it has nothing to do with surviving.“A true survival situation requires a physical, emotional, spiritual and psychological threat.

        “Of these, by far the most devastating is the psychological side. Not missing food or water, but the fear of no rescue. The fear that this could be your last day on earth.

        “They eat rats 'n' roots and use survival techniques, but it's all for entertainment. There's never a doubt that they're getting out.”

        Dr. Otten, Mel to his friends, knows about this stuff. He's been teaching survival skills for the Army, Navy and Marine Corps for more than 20 years. Not to mention the Boy Scouts, Red Cross, Wilderness Medical Society, police cadets, the National Disaster Medical Assistance Team, UC's air care units and heaven only knows how many others. All on a volunteer basis.

        That's on top of his 80-hour a week day job as emergency room physician, professor of emergency medicine and pediatrics at the University of Cincinnati Medical School and director of Children's Hospital Medical Center's division of toxicology.

        So here he is sitting in the shadow of his freeze-dried snake in a cramped, book-lined office at 3:30 on a Thursday afternoon: “I came to work last night at 11:30 for an 8-hour shift in the emergency room. Then I worked on lectures, research, administration, class preparation. I'll be here till it's over.”

        Problem is, it's never over for this 52-year-old west sider. His ER sees 84,000 people a year (up from 65,000 just a few years ago) for everything from toothaches to gunshot wounds. Some days, “8-hour shift” is a joke.

        But survival is never a joke. “Don't use the word "survivalist.' That brings up images of people running around the woods with machine guns. That's not me.

        “My message is that too many people tend to think of survival as a wilderness thing. It's not, it's an everyday thing. Just last week, a guy drove off a cliff into icy water. That's a survival situation. Stuck in the snow on some lonely country road? That's a survival situation.

        “Even on city streets. I'm with the Hamilton County SWAT team as medical team leader. Like all police, they need survival skills — spotting frostbite or hypothermia, how to avoid them, recognizing dehydration, how to dress in the worst weather imaginable, first aid skills if the unthinkable happens.

        “You don't think it will happen to you, but it happens to people every day. Normal working people who left home in the morning and now they don't know if they're ever getting back.”

        They'll have a better chance of getting back, Dr. Otten says, if they remember that preparation is the key.

        “You keep yourself in good physical shape. You prepare mentally by knowing how to build a fire, find water, erect a shelter. You prepare spiritually by asking "What would I do? How would I cope?' then answering the questions.

        “You call on your religious background and you keep your sense of humor because the ability to laugh is what keeps us from giving up. Give up and you're gone.

        “Humor can be a wellspring of strength.”

        Hmmm. Maybe we need to tap into that well with a few questions ...

        The most important rule in survival ...

Be prepared. Ask "what if?' Flat tire in the desert? Sprained ankle alone on a hike in the woods? Be ready for them.

        The easiest one to remember ...

The rule of 3s. You can last three minutes without oxygen; three hours without warmth; three days without water; three weeks without food. You prioritize your response to a threat based on them. If you're in a fire, for example, oxygen is your problem. In a boating accident, it may be cold, or oxygen if you can't swim.

        One falsehood Survivor spreads ...

That the show's about survival. It's about entertainment.

        One thing I'd like to tell contestants ...

Stop laying in the sun. You're going to dehydrate. You're going to get a sunburn. You're going to get skin cancer. The less exposed skin, the better off you are.

        The biggest misconception about survival training ...

Is that one solution covers all situations. None does.

        For most people, the most common survival situation ...

Probably car breakdowns. It's dangerous on the interstate, but at least you can flag someone down. In the desert, on mountain roads, you're in a survival situation. In more general terms, technology fails you, now what?

        Emergency medicine has taught me ...

After 27 years, it has taught me that there are no surprises left. Also, that many, many people need direction as far as health care is concerned. They simply don't take responsibility for their own health.

        In a survival situation, never underestimate ...

The weather. You don't think you can die of hypothermia in the summer in Colorado, but it kills a lot of people. You go out hiking in shorts and T-shirt, get up to 12,000 feet and the weather changes. You're dead if you aren't prepared.

        The reason I do these training sessions as a volunteer ...

To whom much is given, much is expected.


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