Helping you live your best life

Skip main navigation
Group Created with Sketch.

Need help

What can we help you find?

Related Search Terms

Related Search Results


Taking patient care from the clinic to the wilderness

Emergency physicians combine their love of the outdoors with the skills to care for patients in unpredictable environments

two men practicing emergency medicine on a dummy and a person. Left to right: Rand Michael, D.O., Russell Dowell, D.O. and Riley North, M.D., competed together in the 2022 Blue Ridge MedWar. (Left to right: Rand Michael and Riley North) (Contributed photo)

By Laura Ingles

Jesse Spangler, M.D., is the guy you want around if you happen to get injured in the wilderness. During a recent trail run in George Washington National Forest, without batting an eye he straightened and splinted several broken bones in a friend’s hand using the medical supplies he had alongside the water and fruit-flavored electrolyte gels in his pack. He always carries a 2-pound first aid kid with enough supplies “to keep a person alive for a while.” At any given time, he’s prepared to immobilize a joint, prevent hypothermia, start a fire, treat a wound and contact emergency services with his satellite phone.

An avid trail runner, mountain biker and endurance athlete, Spangler is also an assistant professor in the Department of Emergency Medicine at Virginia Commonwealth University’s School of Medicine, director of the wilderness medicine track of the residency program and 2024 president of the Virginia College of Emergency Physicians.

When he’s not at VCU Medical Center or teaching, Spangler is often training for and competing in multisport adventure races, sometimes for two or three long, sleepless days at a time. His career and his hobbies complement and balance one another, he says, noting the teamwork, flexibility and perseverance that they each require.

Playing to his strengths

Spangler, who grew up in the Midwest, has been a runner since high school. When he visited Richmond for the first time in 2011, he squeezed in a run along the James River Park System’s North Bank Trail to shake out some nerves before heading to the MCV Campus for a residency interview. Impressed by both the emergency medicine training program and the area’s extensive trails and parks, he and his wife moved to Richmond in 2012 and have been here ever since.

And he’s not alone in his chosen hobbies — the running joke at work, Spangler says, is that everybody shows up for their shifts wearing bike helmets or regaling their colleagues with recent tales of rock climbing or white-water rafting. While obviously not comprehensive, Spangler said he sees some truth in the stereotype of emergency physicians as thrill-seekers. The emergency department (ED) is inherently unpredictable and fast-paced, and his time spent in nature is a form of self-care.

“At least for me, the stress of our work environment is balanced out by going outside for a run beforehand,” Spangler said.

Man kayaking

Jesse Spangler, M.D., kayaked down the James River during the 2023 King of the James Adventure Triathlon. (Contributed photo)

Harinder Dhindsa, M.D., chair of the Department of Emergency Medicine and chief of Emergency Medicine at VCU Medical Center, noted other connections between the ED and the outdoors. Emergency physicians usually don’t have to take calls while they’re off work, he said, making it easy to get lost in the woods for a while.

“Emergency physicians also seem to be interested in exploring, learning and the unknown,” Dhindsa said. “We take care of anyone, anytime, regardless of their background, station in life and the circumstances that led them to present through the doors of our department. This attitude to learn and explore can extend beyond the ED and out into the rest of the world.”

While Spangler logs many training hours on his own, much like being an emergency doctor, adventure racing is not a solo sport. He and his fellow athletes take care of one another, he said, like the time he gently guided a teammate behind a boulder to shelter her from the wind and rain during an overnight race. While Spangler warmed her near-hypothermic hands, other teammates dug dry clothes out of her pack and helped her layer up and get moving again.

“There were other times when I needed help, and they got me through those tough times,” Spangler said. “You learn how to rely on your teammates, because you have to.”

Adventure races also help fine-tune the interpersonal skills that are essential in the workplace. In competitions that require participants to be awake for 48 hours straight — a type of sleep deprivation familiar to any emergency physicians — maintaining team dynamics can be a challenge.

I’ve learned how to communicate with people and get through those problems while we’re trying to accomplish a goal, which has definitely helped me at work,” Spangler said. “And a lot of the skills I’ve learned at work, like anticipating and preparing for problems so I’m already in that mindset when it happens, have helped us win races.”

Man walking with bike in the woods

When Jesse Spangler, M.D., isn't in the emergency department, he is often competing in multi-sport adventure races. (Contributed photo)

These experiences have also helped him connect with colleagues, like Rand Michael, D.O., a third-year emergency medicine resident on the program’s wilderness medicine track. Alongside other colleagues in 2022, Spangler and Michael both competed in the Blue Ridge MedWar, a springtime race outside of Roanoke, Va., that includes orienteering, trail running, mountain biking and canoeing, plus a series of wilderness medicine questions and hands-on medical simulations.

Michael described Spangler as not only a mentor in medicine, but someone he can always talk to. Both are fathers to young girls — Spangler has two, Michael has three — and they can relate on both the challenges of parenthood and the joys of sharing their outdoor hobbies with their kids.

“He’s very hands-on when it comes to procedures, which gives me a lot of confidence,” Michael said. “I also feel confident bringing any personal struggles to him, since he’s kind of been there, done that with his young family as well. He gives me peace of mind, because he’s full of compassion and empathy for the things residents are going through.”

In the spirit of adventure

As an active-duty member of the U.S. Air Force, and as the father of two kids who also love outdoor adventures, Michael noted that wilderness training will serve him well both personally and professionally.

So far, he has only had to draw on his medical training outside of the hospital twice — both times for his daughters when they split their chins and needed stitches. But as he completes the longitudinal track under Spangler’s guidance, while simultaneously participating in the Academy of Wilderness Medicine’s virtual fellowship program, Michael looks forward to expanding his tool belt and his confidence as a physician.

“It’s uniquely beneficial, having the experience and qualifications in wilderness medicine, because of the nature of practicing medicine in austere environments, with limited resources,” Michael said. “I like being able to be the provider and supporter of the people I’m with. If I’m on a group hike or ski trip or some other expedition, I want to be qualified to help someone through an illness or injury.”

After finishing his residency this summer, Michael and his family will move to rural New Mexico, where he will practice emergency medicine at a military hospital and serve in the Air Force as dictated by the Health Professions Scholarship Program. He’ll miss VCU and the trails around Richmond, he says, but Michael views his next chapter with the same clarity and open-mindedness that has gotten him this far.

“I definitely feel qualified to be able to provide care appropriately in that setting,” Michael said, noting that he’s never visited New Mexico before. “Whatever comes next, I’ll take it on as any new adventure.”