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East 17th Place
Aurora, CO,

(303) 386-2251


Way Out There...

Happiest Place on Earth

Ryan Paterson



Wilderness, Altitude, Tropical and Mountain medicine combined. A 200km race thru the mountains of Bhutan. This is a perfect race for my training to shine. A few participants with dog bites, a fall leading to a broken humerus and a short evacuation and much diarrhea and vomiting, but yet people remained happy. 

The Bhutanese along the trails were nearly skipping with delight and the shop keepers, hotel staff, Buddhist Monks as well as our local partners exemplified the national moto. It is easy to understand why they were so happy in a country that maintains more than 50% of its territory as unadulterated forest, rivers, lakes and streams. What beauty. 

This is why we practice expedition medicine. When we travel and are outside of the halls of medicine with its experts we are privileged to interact with people who understand that health and its relationship to pure environment and a life of happiness is enlightening. 

Bhutan truly is a beacon of life and happiness in our world. 


Ryan Paterson

Standing at the edge ready to drop. I hear a voice calling me into the deep sea of white. The powder ethereal as cirrus; the taste of ice cold as gravity has its way?  Know one knows how deep it goes. Untouched...

They call this place the snowiest on earth. “JaPow!” they say as the light powder floats over my head. Whoohoo. How far will we go for adventure? Hakkaido? There is more snow here than I have seen in my life. The "worst snow in 20 years," if that is true, more please...Everyone on this island is so pleasant, kind and content appearing while we search for more, deeper, faster.

Wake, eat, climb, ski, climb, ski, climb ski, eat, Onsen, sleep as we travel Japan by Van. From “secret powder zone A” to “secret powder zone B” we were led by Yuki (meaning snow in Japanese). Fitting. Yoi Yuki (good snow).

How about a meal of Sushi, Ramen, King Crab, Curry Soup, or more Sushi? or just a sandwich or rice ball from 7-11?

Rice and salad for breakfast? (arbitrary that we eat these things only at lunch and dinner). So, why not?

More please!

Way Out There...

Ryan Paterson

Traveling across Cambodia by foot, sleeping, hanging from a tree in a hammock and swimming in jungle rivers with massive waterfalls all while providing medical direction and support to the 40 runners running 220KM. This is Expedition Medicine. 

Global-Limits runs some of the worlds most amazing, staged ultra-marathons in locations such as Albania, Sri Lanka, Bhutan and Cambodia and I was privileged to work with this organization to keep the runners healthy during this race. 

We prepared with race medicine topics in mind. Dehydration, hyperthermia and hyponatremia were the major initial considerations for which we were well prepared and continually vigilant. However, blisters, sprains, strains and over-use injuries were the most common. Yet, when race medicine collides with tropical and travel medicine, then you have some fun. 

Nausea, vomiting and diarrhea? Is it due to the hyperosmolar race supplements, bad water/food or some virus being spread thru the close living quarters of the camp. When the runners and staff share tents, toilets and hot water containers - for the dehydrated meals - and no-one has showered in 6 days, aside from beautiful jungle rivers and waterfalls; sanitation is a challenge. The logistics abound. 

Fever, chills and myalgias? Is it a bite, sting, vector borne disease, hyperthermia, dehydrations, flu or a UTI? All while carrying all of your medical equipment on your back or in the support vehicle and hours away from definitive medical care. This is the grand intersection of my training in Wilderness, Tropical/Travel, Expedition and Emergency Medicine and the perfect spot for me to practice my kind of medicine!