The “far afield” fishing stories that I chase now fall into two categories: There are trips for which I pack duct tape and super glue in my fishing kit, expecting to use those things to repair the rods and gear I’ll break along the way, and there are trips where I shift the super glue and duct tape to the first aid kit I pack, expecting to use them on myself. Scary as it sounds, I like the latter stories better.

My wife and my mother don’t like to hear me talk about those trips, but I must tell you, if there isn’t a legitimate danger element involving fish that “bite back,” and if I’m not expecting harsh conditions that are a legitimate physical threat, I feel like I’m just driving the bus. I get into chasing fish and stories in places that few others have thought about, or dared to go. It’s a habit I cannot break.

As such, I live for fishing in the backcountry, anywhere in the world. I’m on my way to a place right now that, for security reasons, I can’t say where I’m going or how long I’ll be there. (For all you know, I may be there already.) But it’s going to be hard-core, and I promise a good tale when I get back.

I’ve made a good connection with Dr. Roger Matthews, who specializes in family medicine, with extra attention on backcountry situations. Put it this way: I’ve learned, through my travels, that it’s a really good idea to check in with Roger before you go into the “stuff,” because if you run into the likes of Roger after you’re in the “stuff,” well, that’s usually a very bad sign. And in terms of fishing (and hunting) in the backcountry, an ounce of prevention is worth many, many pounds of cure. Even so, a little bit of preparedness and insight can also help you deal with the worst better, in spots when you may have to be your own best help.

Dr. Matthews is a legitimate backcountry enthusiast himself. He grew up exploring the mountains, and by the tender age of 12 (back when parents let kids do those things) was a solo hiker and camper in the high country. He’s been to different countries and environments, treated many who have returned with various maladies, and has dropped in to treat and rescue many others.

After a brief check-up the other day, I put him “On the Spot” with five questions any backcountry angler or hunter should consider.

_Fly Talk: There’s obviously a difference, for a doctor, when it comes to treating people in the backcountry, and treating people who walk into a clinic off the street. As a doctor, what’s you’re backcountry mindset?
Dr. Matthews: You need to be cognizant of the fact that treatments are different in the backcountry than they are in an urban setting. You need to think out of the box. I always like to think of treatments that can effect multiple cures. For example, Cipro can help treat travelers’ diarrhea, but it can also treat skin infections. In a preventive sense, or at the onset of symptoms, you’re looking for two-for-one cures.

Fly Talk: What are the “atypical” pieces of equipment that are in your bag, when you’re in the backcountry?

Dr. Matthews: I carry super glue (for closing cuts); I carry duct tape (for holding things together); and I carry a SAM splint (for splinting broken bones). The SAM splint costs $12 or so, and I’ve used it a lot on bones, to make a collar, etc. Those are the three things.

Fly Talk (and this is a long, leading question, by design): Along those “ounce of prevention being worth a pound of cure” lines, there are things that backcountry hunters and anglers should be dialed into–avoid sun and heat exposure, stay hydrated, understand that bugs kill more people than all the lions, tigers, sharks, snakes, and crocodiles in the world, combined–but what’s the one “self-help” tip that you think is most important?
Dr. Matthews: Don’t travel if you’re sick. Don’t travel into the backcountry if you are not ready. Sure, that involves seeing a doctor, and getting checked out. But you don’t want to be in a jungle and find yourself with a 105-degree fever that you picked up the week before you left. I’d rather be on the space station and come down with something than be in the backcountry and feel sick. They have ways of communicating with and treating people in space. In the backcountry, you’re on your own.
Fly Talk: If you find yourself in the backcountry, and you encounter someone who obviously needs medical help, given all the liability issues and other things that might prevent someone from stepping in, what is the key factor?

Dr. Matthews: Communication. You need to ask for permission. “I’m here to help you, are you okay with that? Is there something I can do. Is there someone I/we can contact? What are you feeling? What is the problem?” And beyond that, you need to understand that no means no.

Fly Talk: What is the number one goal for someone delivering care to another in the backcountry?

Dr. Matthews: It’s all about giving them comfort, and keeping them calm. If they’re injured or sick, their heart rate is going to be elevated. That’s going to worsen factors like dehydration, and hypothermia. They’re scared. You need to make them feel better, and the more effectively you can do that, the better you help them.