As one of the most well known figures in expedition medicine, Jon Dallimore has had a long and inspiring career as a doctor, teacher and International Mountain Leader. He is one of the senior instructors on the Diploma in Mountain Medicine, Editor of the Oxford Handbook of Expedition and Wilderness Medicine and has recently founded Phoenix Expedition Medicine. Adventure Medic’s Hannah Evans spoke to him about the highs, the scares, and balancing career with family life.
What attracted you to this field of medicine?
My parents always took us on adventurous holidays driving through Europe in the 60’s and 70’s as a small child and I’ve loved travelling for as long as I can remember. I spent a lot of time in the outdoors and the mountains in my teens and later as a medical student. I absolutely loved Africa on my undergraduate elective, so, at the end of my GP training, I seized the chance to go back to Africa as a doctor with Operation Raleigh. It all started from there.
I’ve had some amazing opportunities to travel with different groups to lots of different environments. I’ve totted up more than 35 forays to the developing world – from week-long trips to Morocco to five-week treks to Nepal, up to four and a half months when I was working in Kenya with Operation Raleigh back in 1988.
Any highlights or particularly proud moments?
In 1992, I managed to fit four expeditions into one year – twice to Kenya, once to Nepal, and a trip to Ecuador – a total of sixteen weeks. At the end of that time I managed to persuade my future GP partners that I would settle down and take on a partnership.
My main highlights are the high places. I was delighted to summit a couple of 6,000m Himalayan trekking peaks in the 1990s, but going on to ascend unclimbed peaks in remote parts of Greenland was very special. There’s nothing quite like being on top of a high mountain with stunning views across the Greenland Icecap knowing that no-one has stood where you are standing.
I am most proud of my alternative potential career as an International Mountain Leader. I completed the qualification in 2007 and it means I’m qualified and insured to take groups trekking in the mountains anywhere in the world (except France!).
Any tips on integrating expeditions with a ‘day job’ and family life?
At first, I earned money as a locum GP or Paediatric Registrar and then took any expedition opportunities that came along. After three years I became a Rural GP. However, it proved very difficult to go off on expeditions as a GP partner so that’s why I didn’t stay in rural practice for long.
After that, I was able to return to expedition leading and doctoring until Karen became pregnant with Sam, our first son. I was still leading expeditions when Karen was 32 weeks pregnant. I’m very glad that I was with her when he was born: I don’t think I’d have forgiven myself if I’d been in Sulawesi, Indonesia while Karen was giving birth in Bristol.
I deserted Karen and Sam to fit in four trips before Tom was born (Greenland, Belize, Sinai and Kilimanjaro). Selfishly, I’ve been on many trips while the boys have been growing up but I’ve tried to choose only shorter opportunities – up to three weeks long. It’s difficult, but I manage to balance family holidays with annual leave from work so that I can head off on expeditions. I’ve been very fortunate that the Emergency Department in Bristol has always been very flexible, allowing me to swap my shifts or to take unpaid leave to accommodate some of my excursions.
Also, I have tried to make family life expedition life! Both Sam and Tom have spent time in the European Alps since before they were a year old. They started skiing and climbing when they were three. Now, they have caught the adventure travel bug and have burgeoning expedition CVs of their own. Apart from annual camping and climbing trips to the Alps we’ve shared ‘family expeditions’ to the Canadian Rockies, a self-drive safari to Tanzania and a couple of trips to Everest Base Camp. We’re off to explore the Pyrenees this year. Sam says, ‘I love road trips!’
Finally, I should point out that Karen (Forbes) is a saint and still lets me spend a lot of time away teaching and travelling. But these days, I must say I prefer looking after my own children to someone else’s.
Any moments out on expedition that have given you a scare?
I’ve had a few scary encounters with elephants while camping in the bush, a close call with a black mamba snake and a brief episode of unpleasantness at the wrong end of an AK47 rifle in northern Uganda. There was a horrid flight in a Cessna Caravan plane during an electrical storm over northern Kenya, a couple of vehicle-related incidents and, most frightening of all, losing a 17 year old in the Sinai desert at dusk.
Only once did I think someone might die on me. It was Pakistan in 1989. A 21 year old with Campylobacter enteritis suffering severe epigastric pain looked as if he had a perforated peptic ulcer. He looked terrible but it was probably the Temgesic (buprenorphine) that I’d given him for the pain.
In the Namibian desert one of the team managed to drop the bucket into the well. There was no other way to get water. Luckily I had 30 metres of walking rope and got the team to lower me into the well to retrieve the bucket. Not a lot in all really, considering I’ve spent well over two years in the field.
You have a number of different roles at the moment. What are your favourite aspects of working life?
It seems glamorous to have lots of different jobs but in reality it’s very difficult to balance family, expedition medicine teaching, advisory work, hospital, GP and university commitments.
I enjoy keeping my skills up to date with sick and injured patients in the Emergency Department. I try to enthuse students from Bristol University about the opportunities that they have during their elective period. I spend a lot of time sharing my experience of expedition medical problems with expedition leaders and young doctors.
Sometimes I get exciting opportunities to teach abroad – I’ve just returned from Kathmandu where I was teaching Nepalese group leaders about altitude-related illness. I guess teaching is my favourite overall.
Do you have any advice for those who are just starting out in expedition/wilderness medicine hoping to pursue a similar path?
I often get asked this question and I always say the same sort of thing: get out and get experience of travel in your chosen adventure discipline, whether it’s mountaineering, sailing, canoeing or parapenting. Once you know you can look after yourself in challenging environments then you can volunteer your services to Raleigh International, or look here on Adventure Medic for other opportunities.
Some medical confidence and skills are useful too, so get some experience in emergency medicine. Remember you won’t have a registrar or consultant available to come look at the patient. Most importantly take and use a good sense of humour when you go off on your expeditions.
How about for elective students?
Go to Africa… but then I am biased!
Is there anywhere you haven’t been, or anything that you are still itching to do?
I very much want to go back to South America – particularly to Chile and Peru. And there are so many other places that I’d like to visit – Malawi, Papua New Guinea, Arctic Norway and New Zealand. I’ve been able to take up most of the opportunities that have come my way.
Two chances that I had to turn down (with deep regret) were working as a helicopter doctor for the Camel Trophy in Tierra del Fuego and a short trip to Antarctica to cover one of the bases.
I should have done the Diploma in Tropical Medicine and Hygiene, not just the MSc in Travel Medicine.
It would also have been good to work with Merlin or MSF. Maybe one day…?
The next big challenge is to start teaching expedition medicine combined with global health and I’ve recently set up Phoenix Expedition Medicine with a few friends to do this. I’m really looking forward to teaching with them in Nepal in 2015.
The Oxford Handbook of Expedition and Wilderness Medicine is something we would never be without on an expedition. How did it come about?
I’m a member of the Royal Geographical Society Medical Cell and was involved in writing chapters for two previous books on expedition medicine. Both were published by Profile and involved many people who were experienced in expedition work in the 1990s.
In 2008, we had the opportunity to publish with the very prestigious Oxford University Press. The first edition of the OUP Handbook brought together many more contributors and is a much more comprehensive work. The second edition is a great improvement on the first and will be published in the autumn. Please buy one – I get about 25p in royalties for every copy sold!
Favourite book?
A Prayer for Owen Meany by John Irving. I read it during one of my early climbing trips to Nepal.
Any recommendations for courses or postgraduate qualifications that have been useful to you?
The Diploma in Tropical Medicine and Hygiene is very useful for tropical environments and the developing world in general. I wish I’d done it.
I’ve been teaching on the UK Diploma in Mountain Medicine for the last ten years and think it is a great chance to learn from all sorts of experts on altitude, expedition and travel medicine. There are plenty of practical skills to learn too in Snowdonia, Scotland and Arolla, Switzerland.
Finally, while courses and postgraduate qualifications can be useful, I feel that experience of the expedition environment and a good grounding in medicine are far more important.
Five favourite expeditions?
Honeymoon to climb Mera Peak (6,400m) / Just with Karen and our small group of porters and Sherpas.
Greenland climbing trip 2005 / As a team we climbed 24 un-climbed peaks.
AMREF Flying Doctors / Not really an expedition but I loved working as a volunteer flight physician in Kenya for 5 weeks.
Trekking to Everest Basecamp / With the whole family at Easter this year
Jungle trekking / In the remote Indonesian jungle.
Five things you would never travel without?
D&V Treatment / Ciprofloxacin and Stemetil (prochlorperazine)
GPS / Garmin GPS (but I can navigate with a map and compass too!)
Camera / My Pentax digital SLR camera
Thermarest / I’ve used one since my first trip to Kenya in ‘88.
Rope / 30 metres of walking rope (see above) – in any environment.
Thanks Jon. The second edition of the Oxford Handbook of Wilderness Medicine will be published in Autumn 2014.
