The first few teams at Transition Area 5 arrived within minutes of each other, 32 hours after starting Primal Quest (PQ) Utah, the world's toughest expedition adventure race. The four-person teams had completed 29 miles of horseback riding, 21 miles of desert trekking, 65 miles of mountain biking, 8 miles of whitewater swimming and 35 miles of tandem kayaking on the Green River. Daytime temperatures had soared above 100ºF, and the racers were hot, tired, hungry and thirsty. In a flurry of action, they unpacked from kayaking, repacked for the next leg-26 miles of canyoneering-and pillaged their food boxes for the 5,000+ calories they would need for the next 24 hours.

     I was a medic stationed at Transition Area 5 and 6 at the Ruby Ranch on the Green River for the first three days of PQ. Teams arrived at the transition area to check in with race directors, exchange gear for a new discipline, replace food and fluids, and receive medical care.

     Just after midnight on Day 3, Chris shuffled up to the medical tent and asked for help with a "few blisters." He grimaced in pain as he gingerly removed his shoes from his swollen and blistered feet. On his right foot was a quarter-size, fluid-filled blister at the base of his big toe, popped blisters between most of his toes, and the skin was circumferentially degloving around his left pinky toe. Eventually, he would lose the skin and nail from that toe. He asked, "Can you help me tape these blisters before I start the canyoneering section?"

     Twenty-two hours later, Chris shuffled back to the medical tent after completing the 26-mile canyoneering section, during which he and his teammates walked on hot sand and rocks, swam across rivers, rappelled from cliffs and ran out of water six hours earlier. Chris asked, "Can you look at my feet again? I have some new blisters. Also, can you listen to my lungs? I have been coughing up blood for the last six hours." Chris was just one of the many patients I saw as a medical team volunteer at PQ.

Primal Quest 2006
     Eighty-nine four-person teams from 20 countries registered for a 7-10-day test of physical endurance, mental strength, teamwork and logistical cunning. The 2006 race was contested in the blast furnace heat, sandy desert, red rock cliffs, slick rock trails, mountain slopes and cool rivers in and around Moab, UT. Transition Area 5 and 6 is a 1½-hour drive from Moab (location of nearest hospital).