Most of us have jobs where daily activities follow a relatively standard pattern and constant alert for the unexpected is not the norm. On expeditions we have a heightened sense of the potential for an unexpected occurrence but upon completion of the trip, we revert to our routines. But what if your job entailed always being ready to deal with unusual and often bizarre medical events? One such person is Karen Barry, the registered nurse who runs the medical office dispensing medical care and advice for the National Geographic Society explorers. These are just some of her tales…..
MJM: Can you give us an example of a special request in your office?
KB: I am lucky to share my life with some amazing scientist and explorers. The engineers who developed the “critter cam”, the small camera attached to animals to see their perspective, came in to request condoms. It is always my intention to keep an open mind as the employees that I care for are scientists. When I delicately asked what they needed condoms for, they replied that they were looking for material to keep the camera dry when tied to the arm of a giant Humboldt squid. Sadly, I had to tell them that I did not stock condoms. They were successful though and the spectacular photography collected showed the squid attacking the camera’s blinking red light. Scientists are only beginning to understand how they communicate with one another.
MJM: I remember when you called me to find out where to get antivenin for poisonous African adders. What was that story?
KB: That was a terrifying ordeal involving a group of explorers studying elephant behavior in a remote location in Niger. At dusk one day an unknown event startled the elephant herd and they began to stampede, shaking the ground violently with completely unexpected consequences. The vibration of the ground stirred up the poisonous adder snakes and suddenly our explorers were surrounded. Panicked calls came in and, staying as calm as possible, they were instructed to flee to base camp and zip up their tents. No one slept a wink that night. At dawn, reports confirmed no one had sustained a snake bite. The lesson learned is to expect the unexpected with an elephant stampede.
MJM: What is the strangest case you have been involved with?
KB: The strangest medical circumstance involved an explorer working in remote Indonesia with Komodo dragons. He had to approach the dragon very closely to provide an ideal view. Unfortunately, the dragon disagreed and spit into his eye. The call came and I knew the bite alone could cause prey to die from infection. This could not be a good thing for the human eye, but copious flushing and an eye exam revealed no infection after a tense delay. I learned subsequently that not only do Komodo dragons have 60-80 different kinds of oral bacteria, but they eat chickens…chickens collected from the bird markets at the height of the Avian Flu outbreak.
MJM: Aside from the guys chasing pythons into caves where unusual respiratory diseases lurk, give us an instance of a recent medical challenge.
KB: This spring I had an unusual request for leptospirosis vaccine for a team headed to the sewers of Paris. Leptospirosis is transmitted in rat urine and the vaccine was required for entry into the contaminated sewers. The vaccine is unavailable in the US and after consulting with the CDC we were able to have the team vaccinated in a local Parisian hospital before photographing the amazing artwork on the walls, deep beneath the city. Our travelers wore protective clothing and footwear and carried the right antibiotics in case of infection.
MJM: How do you prepare the NGS travelers and do they listen to your advice?
KB: Preparation and prevention is of utmost importance in travel medicine. Our initial consultation establishes the exact travel itinerary with assignment details, potential contact with the local populace, and planned activities. After research on endemic diseases and hospital resources in the travel area, I meet with the traveler and provide the necessary vaccinations as guided by the CDC and discuss the inherent risks. We obtain a thorough health history and provide a first aid kit customized for the traveler and locale. I highly recommend that travelers carry medical insurance and the Society provides medical management and evacuation through Medex and Global Rescue. Fortunately, the explorers listen to my advice even when we have had to cancel an assignment for medical reasons.
MJM: What resources do you use to keep abreast of such diverse and exotic issues?
KB: My day begins with coffee and reading Promed Mail, a valuable resource from the International Society of Travel Medicine (ISTM) with news and updates on disease outbreaks. I regularly consult the American Society of Tropical Medicine and Hygiene and attend several conferences to keep current on all travel medicine topics. And I keep the CDC on speed dial! I think they actually know me on a first name basis now.
This article was published in The Explorers Journal
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