Dr. Paul Auerbach, an emergency care physician who pioneered the field of wilderness medicine in the 1980s and then taught ways to heal people injured by the unpredictable, died on June 23 at his home in Los Altos, Calif. He was 70.
His wife, Sherry Auerbach, said the cause was brain cancer.
Out in the wild, knowing how to treat a venomous snake bite or a gangrenous infection can mean the difference between life and death. In the 1970s, however, the specialized field of health care known as wilderness medicine was still in its infancy. Then Dr. Auerbach showed up.
A medical student at Duke University at the time, he went to work in 1975 with the Indian Health Service on a Native American reservation in Montana, and the experience was revelatory.
“We saw all kinds of cases that I would have never seen at Duke or frankly anywhere else except on the reservation,” Dr. Auerbach said in a recent interview given to Stanford University, where he taught for many years. “Snakebites. Drowning. Lightning strike.”
“And I just thoroughly enjoyed it,” he continued. “Taking care of people with very limited resources.”
Back at Duke he tried to learn more about outdoor medicine, but he struggled to find resource material.
“I kept going back to literature to read, but there was no literature,” he said. “If I wanted to read about snake bites, I was all over the place. If I wanted to read about heat illness, I was all over the place. So I thought, ‘Huh, maybe I’ll do a book on wilderness medicine.’”
Dr. Auerbach started researching material for the book in 1978, when he began his medical residency at U.C.L.A., finding the time to do so despite grueling 12-hour hospital shifts. He collected information about how to treat burn wounds, hypothermia, frostbite and lighting injuries. He interviewed hikers, skiers and divers. And he assigned chapters to doctors who were passionate about the outdoors.
The resulting book, “Management of Wilderness and Environmental Emergencies,” which he edited with a colleague, Edward Geehr, was published in 1983 and is widely considered the definitive textbook in the field, with sections like “Protection From Blood-Feeding Arthropods” and “Aerospace Medicine: The Vertical Frontier.” Updated by Dr. Auerbach over 30 years, it is in its seventh edition and now titled “Auerbach’s Wilderness Medicine.”
“Paul literally conceived of this subspecialty of medicine,” said Dr. Andra Blomkalns, chair of emergency medicine at Stanford. “At the time, there wasn’t a recognition that things happen when you’re out doing things. He developed this notion of, ‘Things happen to people all the time.’ Which is now a big part of our identity in emergency medicine.”
In the early 1980s, hearing from doctors and nurses with similar interests in outdoor medicine, Dr. Auerbach founded the Wilderness Medical Society with Dr. Geehr and Dr. Ken Kizer. The group is now the largest membership organization in its field and has hosted events like a trek to a Mount Everest base camp and a trip to a station in the Utah desert that simulates life on Mars.
Dr. Auerbach joined Stanford as chief of its emergency medicine division in 1991. He left the university four years later to work in the private health care sector before returning to the university in 2005 and remaining there until his retirement earlier this year.
He became an elder statesman in his field. He spoke at conferences around the world, in one case describing how the erectile-dysfunction pill Viagra can be used to treat high altitude pulmonary edema because it reduces artery pressure.
At Stanford, Dr. Auerbach encouraged his students, foremost, to respect the outdoors.
“When house staff and residents and young doctors say, ‘How do I learn wilderness medicine?’ My very first answer to them always is, ‘Learn the wilderness first,” he said in the Stanford interview. “Because you can’t help anybody if you’re just scrambling to keep yourself alive.”
In 2010, when an earthquake devastated Haiti, Dr. Auerbach traveled to the country with a team of emergency medical workers, and despite his years of experience, he found the trip harrowing. A few years later, when an earthquake hit Nepal, he went there to assist with emergency care and later helped establish a hospital there.
Dr. Auerbach said it was imperative never to get too comfortable when dealing with the whims of nature. “You have to be afraid when you go into work,” he said. “You have to stay humble.”
Paul Stuart Auerbach was born on Jan. 4, 1951, in Plainfield, N.J. His father, Victor, was a patents manager for Union Carbide. His mother, Leona (Fishkin) Auerbach, was a teacher. Paul was a wrestling star in high school and grew up spending summers on the Jersey Shore.
He graduated from Duke in 1973 with a bachelor’s degree in religion and then enrolled in Duke’s medical school. He met Sherry Steindorf at U.C.L.A., and they were married in 1982. (In the 1980s he worked part-time as a swimsuit model for a swimwear company.) Dr. Auerbach studied at Stanford’s business school shortly before joining the university’s medical faculty in 1991.
In addition to his wife, he is survived by two sons, Brian and Daniel; a daughter, Lauren Auerbach Dixon; his mother; a brother, Burt; and a sister, Jan Sherman.
As he grew older, Dr. Auerbach became increasingly devoted to expanding the field of wilderness medicine. In revising his textbook, he added sections about handling environmental disasters, and, with Jay Lemery, he wrote “Enviromedics: The Impact of Climate Change on Human Health,” published in 2017.
Last year, shortly before he received his cancer diagnosis, the coronavirus pandemic began to take hold, and Dr. Auerbach decided to act.
“The minute it all first happened, he started working on disaster response,” his wife said. “Hospitals were running out of PPE. He was calling this person and that person to learn as much as he could. He wanted to find out how to design better masks and better ventilators. He never stopped.”
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