One of the factors that I had to deal with during our Philmont expedition was paying attention to the health of the participants. One of the more challenging issues, and something many of us were not used to dealing with, was altitude sickness. In a general sense, altitude sickness is the effect on the body of a lack of oxygen at high elevations, and is usually felt by people who have not had a chance to acclimatize to a higher elevation environment. Simple symptoms had to do with exhaustion, hyperventilation, and an overall feeling of nausea. In this environment, we had to weigh how long it would take us to get from point A to point B, but at the same time, monitoring what could be developing health problems that, left untreated, could become serious.
One of the most disheartening things is to watch someone physically suffering through a hike. The smile leaves their faces, there's a grim look to them, similar to the "thousand yard stare" that was often used to describe soldiers, and on occasion, listening to boys coming into camp literally breaking down from exhaustion (in some cases rendering them to the point of tears). We had practiced backpacking scenarios for months, and we had gone through numerous terrain variations as well as carrying heavy loads on these practice runs. We felt sure we had met the rigors required, but when you live at sea level, and the highest elevation in the vicinity is just a little over 3,000 feet, there's just no way of preparing for days at 10,000 and 12,000 feet without going to those elevations and hanging out for a few weeks. We didn't have that luxury, and at certain times, we paid for that.
Be Alert and Attentive to Your Team
Each morning, I would do a simple ritual with all of the participants. While I would not dictate the activities of the trek itself, I did have authority over the safety and health of the expedition, so every morning I ensured that every participant was leaving camp with a liter of water for every hour we anticipated being on the trail (meaning we carried four to eight liters of water each day). Additionally, I made sure each participant had a separate Nalgene bottle that was topped off and mixed with an electrolyte drink mix (Gatorade, All Sport, Skratch, etc.) and made sure that they were drinking from it regularly. It may seem counter-intuitive, but you have to actively think about drinking water when you are engaged in long hikes. I found that, when I got into the zone of a hike, I would go for extended periods without drinking anything. At seal level, that may not be a big deal, but at higher elevations, the body goes through more water more quickly. If you feel thirsty, you are already in trouble (as in you are already dealing with moderate dehydration).
One thing we found helpful, especially on quick elevation rises, was to use a "procrastination dash" approach to the hike. We often struggled with trying to find a balance between keeping a good pace and allowing for adequate rest and recovery (because elevation sickness becomes more pronounced if you do not allow yourself adequate rest). To this end, we decided to do a cadence of ten minutes active hiking and two minutes of "standing rest". We would repeat this sequence ten times, which would give us 100 minutes of active hiking and 20 minutes of rest. At the end of the two hours, we could take off our packs and have a genuine rest for twenty minutes. The rest breaks were mainly so I could ensure everyone was drinking water and actually see them do it. Over time, we were able to shake of the headaches, nausea and other symptoms that were becoming a regular occurrence.
This may seem like an odd story to relate to from a testing perspective, but I see similar parallels when I am looking at skill levels and abilities on our respective teams. Some people are super resilient and can take on anything, while others struggle and suffer quietly. As I watched the participants deal with the challenges of the trek, I came to realize that some would complain easily. They wore their discomfort on their sleeves, and it was easy to tell where they were on a mood level and a health level. The real challenge were my "stoics". I had a few guys who were determined to not let me "see them sweat". They never complained, never gave me any reason to believe they could be in danger, and yet each and every member of the expedition at some point dealt with symptoms of altitude sickness.
For the stoics, their conditions were often more challenging, because I didn't see the signs until they were deep in the hole. Likewise, with our teams, we may have those same stoics among us, willing to shoulder their load and muscle through, but lacking in technique or additional understanding that could make them more effective. Too often, we don't learn about what the stoics need until they have actually cracked or gotten themselves into a situation where they can't hide any longer. From this trek, I realized that it was worth a moment's annoyance to confirm that everyone was doing what they needed to do, and was getting the food, water and rest that they needed. Our work teams have similar needs, if not so physically oriented.