More than a decade ago, I had the good fortune to be searching for new species of flowering lianas in the remote jungles of central Suriname. A tropical downpour had just ended, and we wandered through a forest still dripping from the rain shower. The air had become cool and buoyant, perfumed with a panoply of enticing floral scents.

Within a few hours of collecting, however, the heat had once again set into the equatorial lowland forest. Members of our small expedition sat down underneath the shade of a large bergibita tree on granitic stones covered with a fine green moss to take a rest in the torpid jungle atmosphere. As I struggled to fish granola out of my waterproof daypack, the botanist accompanying me cursed and jumped to his feet. “Something bit me!” he exclaimed.

We searched the site but never found the offending creature. Only two small pinpoints on the skin of his ankle, separated by no more than a couple of millimeters, could scarcely be discerned, nothing remotely commensurate to the pain experienced by my friend. I asked our Indian guide—a shaman of the Trio tribe and a man of few words—what had happened. He replied, “Mwe,” the Trio word for spider.

In short order, the botanist became very ill. He became dizzy and dropped to his knees. Delirium set in as he begged for water and crawled into a nearby shallow stream. Nausea set in, accompanied by dry heaves. This famously stoic scientist was reduced to sobbing from the excruciating pain, which seemed to wrack every joint of his body.

My first aid kit offered no remedy with which we could be hopeful of improvement. My colleague’s condition steadily deteriorated. Fighting the urge to panic, I tried to determine the best course of action. Should I attempt to move him? Leave him and seek help? We were dozens of miles of trackless jungle away from any Western-trained health care professional or even the most rudimentary pharmaceuticals or supportive care. I was terrified and powerless to help my friend.

I felt a presence and looked up from my incapacitated colleague onto the stream bank. There sat the medicine man, serenely surveying the scene with calm, knowing eyes. I had hired him to teach us the indigenous names of the plants we were collecting, never anticipating that we might need his healing services as well. Working in the Amazon as an ethnobotanist for 20 years, I have developed an immense respect for the traditional knowledge of these ancient healers. I asked the shaman if my ailing colleague would die.

The Indian grunted as he pointed his chin at the botanist. “Not going to die,” he said, in his language. “Going to suffer, but not die.”

His words began to lift my weight of concern, but were soon contradicted by the pitiful cries and moans of my colleague. “Well,” I urgently asked, “do you know of any therapies that can help him?”

“Yes,” he nodded, standing up from his resting place on the ground and brushing coarse sand off his red breechcloth. “Give me your machete.”

He took the knife and disappeared into the bush. About three minutes later, he returned with two meters of a dull brown liana stem from the Philodendron family. The medicine man walked into the stream, turned the botanist onto his back, sliced the liana into four pieces and carefully let the liana sap drip onto the bite marks on the victim’s ankles.

In less than 10 minutes, our patient felt well enough to sit up. His dizziness and nausea had diminished substantially. Within a half-hour, we were able to help him back to camp, where he spent the rest of the day recuperating in his hammock. He dozed fitfully for most of the afternoon, awoke in time to eat a hearty dinner by the campfire, and then slept through the night. By the next morning, he seemed back to normal.

This episode is likely how most of wilderness medicine was originally practiced and how, in more than a few remote corners of the world, it is still practiced today. For most of human history and prehistory, there was not a significant presence of doctors, validated drugs, or hospitals. There were, of course, healers (e.g., shamans, herbalists, bonesetters) and remedies (usually plants, but also other substances ranging from molds to insects to honey to soils); these evolved from trial and error to our current scientific approach. So it was a supreme irony when Paul Auerbach and his colleagues coalesced the field of Wilderness Medicine two and a half decades ago—clearly a case of back to the future!

In my world of ethnobotany, work and adventure carry me far from medical security. I have the good fortune to work in remote places where much of Western medicine has never been available. This is not thrill seeking—it is my professional calling. For large portions of my life, I live in the wilderness. Thus, I regularly witness the practice of wilderness medicine. It is at once remarkable and frightening—remarkable in the sense that indigenous healers know so many things from which we could derive enormous benefit and frightening because their medicine is laden with empiricism, mysticism, and lack of what we would consider detailed scientific substantiation. Some would call it “primitive,” but that shouldn’t be taken to mean it is incorrect. In fact, time and time again, as in the case of the spider bite, I have seen it heal.

In an age in which medicine becomes increasingly specialized and enhanced by technology, I like to think of practitioners of wilderness medicine as masters of “Renaissance medicine.” They must be willing to abandon urban trappings and tools to get “down and dirty.” Furthermore, they must know much more than they learned in medical school. If you are in a mountaineering accident, do you want the first healer on the scene to be a doctor whose expertise is confined to cancer? If you fall out of a tree and break your bones, do you want the first responder to be someone who has never attended a fracture?

When my wife was bitten by a copperhead snake in Virginia several years ago, she was taken by ambulance to a major, well-equipped suburban hospital. The good news was that she had no end of doctors eager to examine her. The bad news was that none of them had ever treated or even seen a snakebite, hence their interest in having a look! I was able to track down Paul Auerbach, who talked the treating physician through the necessary treatment. I had known enough to turn to my friend from the Wilderness Medical Society. Where else in the medical world can you consistently find people adept at treating victims of snakebite, frostbite, lightning strikes, volcanic eruptions, and scorpion envenomation?

This is not to argue that wilderness medicine is restricted solely to treating obscure afflictions or problems of the past. The marriage of traditional wisdom with cutting edge science offers new and important potential for better treatment of everything from high-altitude pulmonary and cerebral edema to heat stroke. These new approaches may incorporate everything from wisdom of local peoples to biodesign of novel medical devices. Remember that doctors now place leeches on healing wounds, which is more effective than drugs designed by modeling proteins with computers.

We live in an interesting epoch in which our societies are increasingly urban and technology oriented. Yet, something in our souls yearns for regular and sustained contact with the wonders of Mother Nature. The demand for ecotourism is expanding at an astounding rate. Doctors, nurses, and other health care providers simply must know what to do when confronted by the inevitable afflictions that result from our species’ collisions with the natural world.

© 2007  Mosby, Inc. Tous droits réservés.

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L’accès au texte intégral de cet article nécessite un abonnement.