4
recreational activities has very little requirement for much medical examination. On the
other hand, a subject with demonstrated cardiovascular disease who wants to participate
in, for example, recreational or high performance activities, should have a very careful
examination, including, perhaps, physiological testing. Of course, physician judgment is
essential in any examination, and Table 8 is used simply as a guideline (Table 8).
Just as in any traditional medical examination, the history is the most critical
component. The physical examination and laboratory data may lend additional
information. Certain physiologic testing may be of value in resolving questions raised by
the history and the physical components. The interpretation of the results is based on the
physician's judgment and experience.
SUMMARY
A survey of selected physicians, organizations and venture leaders ranked relative
importance of components of a pre-venture medical examination for predicting success or
failure of various wilderness ventures (Tables 9A-D).
Over half (50%) of 60 respondents believed a history of success in a previous
similar venture was the most important predictor of success in the prospective venture
and a history of interpersonal or psycho-social problems was the most important predictor
of failure. Since each of these leading predictors can be determined by interview, this is
the most important part of the physical examination and the wilderness experience and
judgment of the examining medical person is of paramount importance. This was the
origin of our term "salty dog science." The "salty dog" physician, experienced in the
characteristics of the prospective venture is familiar with the physical, physiological, and
psychological demands of the venture, and the "salty dog" exam is crucial for predicting
the participant's venture outcomes.
Obscure or marginal observations found in the examination may be clarified by
use of precise technical components including laboratory studies and physiological
testing incorporated in the medical examination.
