From Great Outdoors Into the ER

Sandy Hogan never expected to see a bear, let alone slam into one, on her morning bicycle ride.

She was cruising down a hill early one morning in the mountain town of Mammoth Lakes when a bear wandered into the road. Hogan had nowhere to go.

“I got him right in the kidneys,” she recalled of the incident, which happened several years ago and left her and the dazed bear lying side by side on the road.

The frightened bear scurried back into the woods and Hogan -- a ranger with the Inyo National Forest -- eventually limped off to the local emergency room with a bruised ankle and a great story to tell.

With the long days of summer here, Californians are hitting the outdoors en masse this month and rural hospitals are bracing for the carnage that will inevitably follow.

“We see so many weird things, they tend to blur,” said Angela Moore, nursing supervisor at Barton Memorial Hospital in South Lake Tahoe. But, she added, “That’s exactly what keeps us going.”

In summers past, doctors have treated people with fishhooks dangling from their lips, people bruised by boxing mountain lions and people covered with rashes after exposing too much of themselves to the great outdoors.

That’s in addition to the usual cases of sunburn, blisters and food poisoning from consuming things that grow in the wild.

In the Inyo National Forest, a man using a knife to whittle a stick around a campfire slipped and severed a major artery in his leg. “We do see a lot of whittling injuries,” said Chris Hummel, director of the emergency room at Mammoth Hospital in Mammoth Lakes.

To hear the professionals tell it, someone is always finding a new and unusual way to get hurt.

Liz MacGard, of Trinity Hospital in Weaverville, said the emergency room is often visited by back-to-the-landers who try to feast on things they find in the woods -- and end up getting sick.

“We had this whole family come in because they got nauseous from eating white berries,” she recalled before cheerfully describing the revolting scene that followed in the hospital. “They spewed their toenails out,” she said.

Anglers, in particular, seem to be adept at finding trouble.

In May, a man was knocked to the ground by a mountain lion in southwestern Washington state. The man wasn’t injured and state wildlife officials still don’t know if the 25-pound Chinook salmon the man had strapped to his backpack was a factor in the attack.

“It’s hard to say what was on the cougar’s mind and what was the real motive,” said Capt. Murray Schlenker of the Washington Department of Fish and Wildlife.

Fishhooks have a nasty habit of landing in all the wrong places. It’s such a chronic problem that Tahoe Forest Hospital in Truckee, near Lake Tahoe, includes a clinic on fishhook removal at its annual men’s health fair. The men practice hook removal on chickens from the grocery.

“Chicken skin is the most similar to human skin,” said Janet Fletcher Brady, the hospital’s director of health promotions. “It’s better than getting a side of beef.”

Anglers are often urged on television shows and in books to “cast with emotion,” but sometimes too much emotion prevails.

Hooks get stuck in people “all over,” said Elizabeth Petrunak, a nurse at Bridgeport Medical Clinic in the Eastern Sierra.

The hospital has two cloth dolls it uses to display hooks and lures it has removed from patients. So many hooks were put on the first doll that it became a medical hazard -- leading to the addition of the second doll.

For the most part, doctors say, the idea of extracting a hook is worse than actually doing it. Many doctors use a simple technique in which they attach a piece of string to the hook and then use leverage and a quick pull. The hook slips from the flesh before most patients realize it’s gone.

“I yank on the string real hard with a big follow-through. You have to do it with a lot of confidence,” said Chris Hummel, an emergency room doctor in Mammoth Lakes, describing his technique. “I do it with a great deal of force, like a tennis swing.

“The first time you do it, it’s a little frightening,” he said. “The first time I did it, the nurse knew it was my first time. She had to leave the room. She didn’t want to watch.”

Hummel said he has had grateful patients offer him fly-fishing lessons in return. “There is some irony here,” he said.

People are so adept at getting themselves in trouble outdoors that many national parks in California and elsewhere in the West have their own sign-making shops to churn out warnings to tourists. At Sequoia National Park, there’s a sign advising campers not to pitch their tents in the middle of busy roads.

Carnage in the national parks is well chronicled in the “Morning Report,” which is found on the park service’s Web site. The report is a fascinating and often grim read, largely because of the seriousness of the accidents and the dry style in which it is written.

For example, a recent entry concerning a drunk-driving accident in Yellowstone National Park said that park rangers “determined that the driver had hit a bison weighing about 2,200 pounds, causing significant damage to the car.” The driver tried to drive to Old Faithful “but ended up driving into the river.” The driver survived; the bison did not.

That’s the reason Yellowstone has two videos on its Web site showing visitors being heaved about by bison. The animals often appear docile, said Marsha Karle, a parks spokeswoman, but they can be quite temperamental when someone shoves video cameras in their faces.

Another common problem, according to MacGard at Trinity Hospital, is people who are so happy to be released into the outdoors from their sterile offices that they promptly shed their clothes -- and come down with nasty rashes.

“People get away from other folks and want to strip down and make like bears,” she said. “People want to get back to the land. But they need to be careful about how far back to the land they want to get.”

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Outdoor perils

Summer means lots of vacationers in the outdoors. Hospitals are bracing for an onslaught of injuries and ailments ranging from sunburn and rashes to poisoning from eating things in the wild.

Fishhook injuries are so common that Tahoe Forest Hospital in Truckee sponsors a fishhook removal clinic at its annual men’s health fair.

Wild animals such as mountain lions and bears also are a common source of injuries. National Park Service officials say bison may appear docile, but they can be very temperamental.

The National Park Service chronicles injuries in its Morning Report, which can be found on the Web site www.nps.gov.

From Times Staff Reports