A TRIBUTE| Volume 28, ISSUE 2, P64-71, June 2017

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Bruno Ernst Durrer, MD: January 14, 1953 to December 5, 2016

        Bruno Durrer, MD, of Switzerland, one of the world’s leading proponents and developers of mountain rescue medicine, passed away on December 5, 2016, at 63 years of age during a diving holiday in Suwalesi, Indonesia. Bruno has a special place not only in the history of mountain rescue, but also this journal and the Wilderness Medical Society (WMS). He served as an Editorial Board member for Wilderness & Environmental Medicine and was a staunch advocate for collegiality in research and publication. He received the Blair Erb W orld Congress Award from the WMS in 1999 Figure 1, Figure 2.
        Figure 2
        Figure 2Bruno Durrer, mountain/rescue doctor.
        Bruno was born in Goldau, in the central part of Switzerland, on January 14, 1953, the youngest of 4 children. Equipped with his mother’s clothesline, Bruno’s first climbing adventures took place on neighboring Mount Rigi. He spent his high school years in Sarnen, where he was taught by Benedictines (Catholic monks), who remained his lifelong role models. At the age of 17, he traveled to California as an exchange student. Living in Santa Cruz, Bruno became motivated to expand his academic horizons. When he returned home to Switzerland, he chose to become a medical doctor. During his years studying medicine at the University of Zurich, he fell in love with Susanne (Susi), who came to be his wife. After graduation from medical school, he trained in anesthesiology at the University Hospital Zurich, followed by orthopedic surgery in the city of Stans in the canton of Obwalden, internal medicine in the town and canton of Schwyz, and gynecology in the city and canton of Lucerne. He then completed 2 years of training in mountain rescue with Rega (Swiss Air Rescue) before he began his medical practice in Lauterbrunnen in 1987.
        While he studied, and throughout his life, Bruno never lost contact with the mountains. He became a mountain guide, wrote his thesis about accidental hypothermia, and worked as a prehospital emergency physician for Rega. Being a generalist appealed to him, so he opened the aforementioned general practice in Lauterbrunnen in the Bernese Oberland. As a family man (with Susi and children Thomas, Dina, and Tim), Bruno was a kind and understanding husband and father. But he was a very tireless worker as well. This was plainly evident in his efforts as a highly skilled and motivated general practitioner with almost endless availability to the people from the Lauterbrunnen valley, and while practicing as a busy mountain rescue physician for the air rescue service of Air Glaciers in Lauterbrunnen. He was known as the “family practitioner” of the 3880 m Jungfraujoch, a small railway station in the Bernese Alps that sits on a spectacular saddle that connects the two 4000 m peaks, Jungfrau and Mönch. Bruno also practiced in Mürren, a small village above Lauterbrunnen at 1500 m, during the winter season.
        As a helicopter emergency physician in the famous Jungfrau region, Bruno saved the lives of many tourists, climbers, and BASE jumpers. He always showed enormous sympathy to people who were victims of misfortune in the mountains. Bruno was an adventurer in act and at heart, and well understood the human need for adventure. Even though he rescued many BASE jumpers and also retrieved the mangled bodies of BASE jumping fatalities for decades, when interviewed, he always defended the sport and jumpers. Many jumpers have suggested that Bruno’s acceptance of the sport was the reason they still are permitted to BASE jump in Lauterbrunnen.
        Bruno took part in high-end mountain adventures. In one outstanding example in the autumn of 1984, he was a member of a Swiss Himalayan expedition to Annapurna I. Their objective was the unclimbed East Ridge of the mountain that involved, among other challenges, more than 7 km of technical climbing between 7000 and 8091 m altitude. Although Bruno was the expedition doctor, he also was a full climbing member. During the approach to the mountain as they passed through the foothills, the humanitarian Bruno treated porters and members of local villages. A fellow expedition member recalls Bruno on one occasion using a pair of pliers from the tool kit to extract the troublesome tooth of a villager. When Bruno was on the mountain, he contributed to the exacting and technical climbing at high altitude up to his personal high point at 7500 m.
        Because of Bruno’s interest in mountain rescue, he became a pioneer in mountain emergency medicine. Among other volunteer activities, he served as president of the International Climbing and Mountaineering Federation (UIAA) Medical Commission (MedCom), and member of the executive committees of the International Committee of Alpine Rescue (ICAR) and the International Society for Mountain Medicine (ISMM). Bruno was a founding member of the Swiss Society of Mountain Medicine and served as a board member of that organization for more than 20 years. He authored numerous publications, creating standards and guidelines for accidental hypothermia, avalanche rescue, and mountain emergency medicine.
        Bruno was a member of the international group of mountain rescue physicians who developed the Diploma in Mountain Medicine (DiMM). Together with his medical friends Urs Wiget and Hans Jacomet (and many famous mountain guides), he initiated the Swiss courses in mountain medicine and was integrally involved with the DiMM for more than 10 years. Bruno was an excellent teacher who conveyed great enthusiasm and passion for the subjects he taught. Under Bruno’s attention and with his ability to bring experts together and motivate them, the Swiss DiMM course continued to evolve and became well known for maintaining a high teaching standard by combining knowledge transfer with mountaineering activities and fun.
        In 2010, Bruno received the prestigious King Albert Mountain Award for his contributions in avalanche rescue and mountain emergency medicine, having performed more than 3000 rescue operations of injured climbers and avalanche victims. Bruno had developed and influenced modern mountain rescue techniques, which in turn had improved rescue standards worldwide, and thereby saved the lives of many people who had come to difficult or desperate situations in the mountains.
        Bruno’s son Tom currently is the president of Lauterbrunnen Tourismus and continues to support the local mountain community in a manner in which his father would be very proud. After numerous expeditions to Nepal, Bruno extended his help to a young Sherpa boy Ang Tshering Sherpa from Namche Bazaar, who, with Bruno’s financial support, was able to study medicine and become an orthopedic surgeon. Bruno continued to give back to the mountain people of Nepal by persuading several Rotary clubs of the Bernese Oberland to support the Pasang Lhamu Nicole Niquille Hospital in Lukla. This hospital, which was built by the Swiss Nicole Niquille Foundation, recently was rebuilt after it had been completely destroyed during the 2015 earthquake.
        Bruno was a remarkable man who combined wonderful humility with bravery, enthusiasm, and love. He leaves a legacy of inspiration to those who seek to combine their profession with their passion. The remembrances that follow are reminders that we should all seek to help others, as Bruno always sought to assist those who needed him and support the many men and women he taught and trained.
        George W. Rodway PhD, APRN, DiMM, FAWMMonika Brodmann Maeder, MD, MMEdPaul S. Auerbach, MD, MS, FACEP, MFAWM, FAAEM

        Personal Reflections

        More than 20 years ago Bruno and I became good friends. Learning of his death was a blow to me, as well as to the wilderness medicine and mountaineering communities.
        Others will undoubtedly speak to Bruno’s considerable scientific contributions to our understanding of death from hypothermia and avalanche. I speak of him as a friend.
        Film star handsome and built like the trained mountain guide that he was, Bruno always was friendly and outgoing. As a mountain rescuer, he was courageous and self-sacrificing, and saved countless lives on the North Face of the Eiger and in the surrounding mountains. Once, when I was visiting his home in the magnificent town of Lauterbrunnen, we were sitting down to lunch and delicious wine when his phone rang. A short conversation followed. Then Bruno addressed me. “I am afraid that our trip in the helicopter will be delayed a little, as they are rescuing a cow. The slopes here are so steep that sometimes a cow gets stuck and has to be rescued. We use the same helicopter as we do for people, put a net under the cow’s belly, and haul it into the valley. One thing—if you see the helicopter coming with a cow, don’t look up!”
        Later that day we flew across the North Face, so close that I felt I could reach out and touch the rocks. At one point Bruno saw something blue on the face. Wanting to make sure it was not a body, we circled again and confirmed that it was just a duffle bag with climbing equipment. He always was ready to leap into action.
        Bruno will be sorely missed as a scientific leader, as the savior of many lives from dangerous situations, and above all, as a dear friend.
        Bruce Paton, MD
        On December 10, 2016, when I learned of the sudden demise of Bruno Durrer, my family and I were in Cape Town on holiday. I was tremendously saddened and immediately decided to dedicate that day to him. For Bruno, a man who so much loved the mountains, I thought a hike to the Lion’s Head Mountain would honor his memory. All along the hiking trail, I kept recalling some of the wonderful times we spent together.
        My first encounter with Bruno, his wife Susi, and 3 children, Tom, Tim, and Dina, was in 1998, when the Durrer family trekked to the Himalayas in Nepal. I was their guide. We trekked to Thyangboche and created wonderful memories. Their generosity extended our relationship and we became true family friends. We visited their beautiful home in Lauterbrunnen on many occasions, and it always was wonderful.
        I have been blessed to meet many marvelous people in my life who played major roles in my becoming a medical doctor. Bruno was one of the most important. I was born in a remote Himalayan village called Namche Bazaar. With financial support from clients whom my father guided, I was able to go to a private school and medical school in Nepal. By the time I entered medical school I already knew Bruno. Frank Tshirky and Bruno helped me find financial support for my studies.
        I always will remember a particular incident when I was visiting the Durrer home in Lauterbrunnen. Bruno was summoned for an emergency situation. An American couple was getting married in the hotel in the neighborhood, and suddenly the groom’s elderly father suffered a cardiac arrest. Cardiopulmonary resuscitation was being performed by the bride wearing her full wedding gown. She was a nurse. Bruno and I jumped in to assist, but it was too late. That was the sort of life led by Bruno. He would regularly receive patients at his clinic 24/7 and was very dedicated to them and his practice. During my early days in medical school, he took me to visit old sick people at their homes, where I watched him treat and comfort them. He was such an amazing role model. I could sense that the people of Lauterbrunnen considered him to be a kind, loving, and caring doctor. When he was home, he was always available. When Bruno and I hiked the mountains, he carried his walkie-talkie in case he was needed for an emergency rescue. Because he was one of only a few medical doctors in the area, he remained alert and ready. We spoke of many things, and he impressed upon me his opinion that most medical doctors focused their establishments in the cities, leaving rural areas short of medical personnel. We often talked about his interest in hypothermia.
        I attended a mountain medicine diploma course in Switzerland. At that time, Bruno was recognized as one of the pioneers in this field. His demonstration at the end of the course was the highlight. Who better than Bruno to simulate the rescue of a patient trapped on a cliff needing to be airlifted to safety?
        I am lucky that in April of 2016 I brought my daughter Zia and wife Anne to visit Bruno and Susi. Although the stay was short, we had a wonderful time together. I know that anyone who visited Bruno and Susi in Lauterbrunnen always felt the same way. His time with all of us was too short, and we shall fondly remember him and miss his wisdom, spirit, and kindness.
        Ang Tshering Sherpa, MBBS
        In the late 1990s, at a WMS World Congress meeting in Whistler, Dr Franz Berghold from Austria suggested that I consider becoming the next UIAA (International Mountaineering and Climbing Federation) MedCom (medical commission) president. It came to pass that I became the next president, but my unforgettable predecessor was Dr Bruno Durrer. Tall, handsome, and easy-mannered—it was impossible to not like Bruno. For me personally, he also was a special mentor in the approaches and methods of European mountain medicine. What I very early on truly admired him for was how he could cut (with the precision of a Swiss army knife) through any kind of nonsense and reach a logical conclusion. Bruno was uniquely a problem solver, and he taught us to be the same. For instance, he told me that some of the UIAA General Assembly meetings in different parts of world might at times not really be very relevant for the MedCom representative, but advised that it was important to go and enjoy the “bonfires,” which is what I did. In 2007, when the Germans and Austrians left the UIAA, he as a self-described “MedCom addict” was very disappointed and recognized that this was not a decision based on what was good for worldwide trekking and mountaineering, but rather a political stunt.
        I came to know Bruno not only from the UIAA MedCom days (2001−2008), but also when I became the president of the International Society of Mountain Medicine (2012−2016), where he was our initial treasurer. At mountain medicine meetings around the globe and for many years, Bruno was someone to whom I always looked for his views and news of our mountain medicine community, and for his amazing ability to socialize across many diverse groups. Like many others, I will feel the void left by his passing. We will all need to get used to not having him present and will frequently be reminded of how much we enjoyed his company.
        The last time he and his wife Susi came to our home in Kathmandu was 2 years ago. They had just finished trekking in the Himalayas. He was, as usual, impressed by the Nepali warmth and hospitality. Such was one of the wonderful things about Bruno—how he saw the good in people and was eager to share that opinion with others. He had us feel at home in our home. We did not know then that this would be the last time we would see each other. It is a lesson for each of us—to cherish the moments with our true friends.
        Being a very practical man who had spent most of his life rescuing sick people, often with life-threatening injuries in the mountains, Bruno clearly was very aware of death and dying. For this remembrance, I searched my earlier emails from Bruno. I found he had sent me in 2011 an email regarding the death of his old friend and mountain guide Erhard Loretan, who was the third summiteer of all 14 of the 8000 m peaks. Erhard often has been described as one of the greatest mountaineers of all time. Bruno had gone out to try to rescue him, but it was an arduous attempt in inclement weather. Unfortunately, Erhard had succumbed to his injuries, but the person whom Erhard was guiding was able to be rescued, although she was severely injured. Bruno’s philosophical comment in his email had struck me at that time. He had written, “In the mountains, happiness and sadness can be very close.”
        Bruno was a man who understood the fragility of life, but never let that keep him from fully participating in the adventures he loved. He died as he was enjoying a dive vacation in Indonesia, where he was on holiday doing what he loved—being outdoors with his family. We will all dearly miss him. He left us with indelible memories, and one final most important lesson, to affirm life and whatever it has to offer us by joyfully participating in it.
        Buddha Basnyat, MD
        I met Bruno Durrer in Aspen, CO, in August 1995 at the Second World Congress on Wilderness Medicine. Bruno was president of the UIAA MedCom and also on the board of the ISMM, which was one of the 2 organizations that joined the WMS for the meeting. Bruno was, in fact, a founder of the ISMM and a member of the Medical Commission of CISA/IKAR (International Commission for Alpine Rescue), ICAR MedCom for short, which I joined later in 1995 as the representative of the United States.
        Bruno was an energetic leader of the mountain medicine and mountain rescue communities. He was extremely active in mountain rescue. From his home in Lauterbrunnen, in which he also had his medical practice, he could interrupt consultations with patients to drive a few minutes up the valley where a helicopter would take off and fly him to rescues in the Bernese Oberland. Often these were technical rescues on the Eiger or adjacent steep glaciated mountains. After the rescue was concluded, he would return to the valley, drive back to his office, and resume seeing patients.
        I soon got to know Bruno not only as a prolific rescuer, but also as a driving force for advances in mountain medicine. He was the lead author of the Swiss System for staging hypothermia and a principal author of articles on resuscitation of avalanche victims. His last published article was a re-evaluation of the Swiss staging system with a group of young French-speaking authors. Bruno always had new ideas and novel ways of looking at problems.
        In addition to being a doctor and rescuer, Bruno also was a mountain guide and a devoted husband and father. He was easygoing, warm, and gracious in a gemütlich (pleasant and cheerful) Swiss style. Soon after I met him, Bruno began referring to me as an “Old Elephant,” a term of respect in German.
        While working with Bruno, I noticed that his written English was a cut above that of other German-speaking colleagues. The explanation was that Bruno had been a high school exchange student in Santa Cruz, CA. This fit Bruno’s surfer dude personality perfectly.
        Bruno invited me to be a speaker at the 1997 World Congress of Mountain Medicine in Interlaken, Switzerland. The date grew near, but I didn’t know to which hotel I had been assigned. When I asked Bruno, the answer was that I wouldn’t be in a hotel but would be staying with him. Actually, I slept in a centuries-old chalet at the end of the valley owned by friends of Bruno’s family. As always, Bruno showed great consideration and transported me to and fro each day.
        After the meeting, I went on a climb of the Jungfrau with Bruno and other friends. Bruno had told me not to bring an ice ax, crampons, and climbing harness. He would provide them. The ice ax was an ancient ax with a wooden shaft that could have been Edward Whymper’s for the first ascent of the Matterhorn. I didn’t say anything because Bruno’s own ice ax was identical. We had a spectacular climb.
        At 63 years, Bruno showed no sign of slowing down. His death was sudden and unexpected. Now, especially when I am in the mountains, I will remember Bruno’s energy and enthusiasm as an example of how to live life to the fullest extent possible.
        Ken Zafren, MD
        Years ago, at a distant first glance, Bruno cast a formidable impression—strong, assured, dashing. Although he was all those things, his first handshake and inviting smile unveiled the warmth and surety of an Alpine sunrise—the arena he so dearly loved. I did not have the opportunity to venture into the mountains with Bruno. My encounters entailed mostly engaging him at mountain medicine meetings, but I always looked forward to seeing him. There was something about him that was endearing. He was in part a strong role model for those he mentored, but mostly a warm, smart, and adventuresome soul who inspired by being who he was. I will miss his spirit.
        Brownie Schoene, MD
        I was deeply impressed by the personality of Bruno when I first met him 30 years ago in a study group dealing with accidental hypothermia in Switzerland. Bruno was an open-minded enthusiastic doctor who had been one of the pioneers in the field of prehospital mountain medicine in Switzerland. His quiet and calm appearance when speaking about audacious rescue operations in the early days of helicopter rescue flying in that country made a great impression on me, especially because I was dealing mostly with in-hospital treatment of hypothermia victims. He was not only a good doctor, but also had a reassuring attitude for the rescue teams and victims during such extreme situations. In addition, he had an open scientific mind, typified by being the father of the Swiss Hypothermia Grading System. Last, but not least, he remained a marvelous true friend.
        My former mentor, Professor Ulrich Althaus, head of Cardiac Surgery at the Inselspital, Bern, performed the first successful rewarming of 2 patients with cardiac arrest and deep hypothermia using a heart-lung machine more than 30 years ago. Since then, Switzerland has played a leading role in accidental hypothermia treatment and research. All the Swiss rescue teams were informed of the aforementioned new resuscitation modality and asked to transport deeply hypothermic victims in cardiac arrest to cardiac centres at university hospitals. Bruno Durrer was most influential in propagating this new rewarming method in our rescue community. I remember he once asked me what he could do during patient transport to increase the chances of sequelae-free neurologic survival. I told him to pack the head in snow in order to prevent rewarming during transportation, and so he did! Our team was quite amazed to see the victims arriving with their heads packed in snow.
        Bruno always showed enthusiasm and did his best to transmit his knowledge and share his experiences with young doctors at meetings. He played a major role at the International Symposiums on Accidental Hypothermia in Zermatt in 2009 and Interlaken in 2016, the latter which he co-organized in conjunction with the Swiss Mountain Rescue Medical meeting that he founded and organized 9 times. It was an honor to have him on the committee and as a major speaker, but even more wonderful to see him happy with all his friends and wife Susi 6 weeks before he passed away. Losing Bruno is certainly a big loss for mountain medicine, especially because to so many of us he was such a good friend.
        Beat H. Walpoth, MD
        I first met Bruno in 2001 at a UIAA MedCom meeting in Kathmandu. I had been sent there by the British Mountaineering Council to get more information on the UIAA/ICAR/ISMM diploma of mountain medicine. Prior to my attendance, I was keen to ensure that we did not end up with one more “paper qualification” within the UK mountaineering community. It was Bruno’s infectious enthusiasm for the qualification that totally reversed my opinion and led to hard work and much personal fun for me throughout the past 17 years.
        I was at our national mountaineering center, Plas y Brenin, in December when I got the news of Bruno’s tragic, untimely death. We had just welcomed 30 new candidates, and I had tears in my eyes when I stood on the stage the next morning to announce the news to these young doctors. Of course, many had no knowledge of Bruno’s influence on the mountain medicine world. I explained that if it were not for him they may well not have been there. I pointed out that I was standing at the very place where Bruno had stood on several occasions and that one of the great “Elephants” (his words, not mine) of our community had left us. His legacy is that very group of young enthusiasts in the room and many similar groups around the globe.
        Bruno was an Elephant. He was big and gentle, but could fight for what he believed in. He had vision and quietly drove projects with wisdom and insight. He could unite groups across cultural and political barriers. He was a mountaineer. He had a big smile.
        I clearly remember our Swiss friend leading the “presidential rope” on some sea cliff climbs in southern Sweden after the 2003 UIAA MedCom meeting. Bruno leading with ease and style, Buddha explaining that as a Nepali he never performed well below 5000 m, and my feet getting wet as the tide came in.
        Bruno, we will miss you.
        David Hillebrandt, MBBS
        Along with everyone else, I was shocked and saddened to learn of the loss of a good friend, Bruno Durrer. I know that elsewhere in this tribute, we learn of the many contributions Bruno made to wilderness and prehospital medicine and why he was a giant in this field. I would like to offer a few personal anecdotes.
        A number of years back I stayed at Bruno and Susi’s home for a few days before Bruno and I were to drive to a medical meeting in Bruneck, Italy. Bruno was obviously very busy tying up loose ends in preparation to leave his practice for a few days. Midway through my first morning in Lauterbrunnen, Bruno came to my room and with his usual impeccable good manners sighed and said, “Gordon, I’m sorry—I just have too many things to do to be a good host and take care of you the way I should. Would it be OK if I just gave you my Harley (Davidson motorcycle) and you could drive around for the next couple of days until we leave for Bruneck?” I thought I had died and gone to heaven, but there was just one problem. I had not driven a motorcycle for many years and my lifetime mileage was about 3 miles. I had just one goal, “I’ve got to get off the parking lot before Bruno figures out that I don’t know how to drive this thing!” I managed to get to a back road where I drove back and forth until I figured it out and then spent 2 glorious days driving through the Swiss Alps. I thought Bruno was a perfect host.
        On another day, Bruno, a certified Swiss Mountain Guide, and I climbed the Mönch, a sister mountain to the Eiger. The route has a permanent cable running to the top, which climbers can clip into for safety. Bruno suggested (read, insisted) that I clip in. The route seemed easy and I protested a bit that I did not need to clip in. Finally, when I again suggested I would be okay without the unnecessary safety measure, Bruno slowly turned to me and said in his usual calm, unassuming, and respectful voice, “Gordon, I am a guide in this country, if something happens to you, it will look very bad for me.” I clipped in … and enjoyed the rest of the climb with one of Switzerland’s most accomplished physician-guides.
        Gordon Giesbrecht, PhD
        We are all sad that Bruno Durrer has left us, but for me, remembering him brings a smile with the tears. Bruno was family to many of us. The hospitality of the Durrer family in Lauterbrunnen is legendary. Bruno and Susi always opened their home to visitors, even while their lives were extraordinarily busy and they had so much to do. Bruno’s accomplishments are more than what 10 of us could ever achieve, but it is his warm smile, big Swiss hug, and hearty laugh that I recall when I think of him. His sense of humor was relentless, and when he was enthusiastic, there were no limits to what we could dream and hope to accomplish.
        When we were young and the WMS was barely an idea, people like Bruno sustained it. I came to wilderness medicine from a vantage point in warm waters beneath the sea, and Bruno came from the cold and windy high peaks. He shared freely of his experience and growing wisdom and was able to use his intensity and work ethic to keep us moving forward. Bruno knew how to collaborate as well as anyone I have ever met and to make people with different skills and diverse ideas feel welcome. He was inspirational to me because I wanted to be a better person, and he showed me how to do that. He was brave, but not foolish. He was strong, but not a bully. And he talked slower with a greater sense of mischief than anyone I had ever met.
        Being with Bruno was always an adventure. Everyone has a Bruno story, and many of them originate from his workplace home, which happens to be in one of the most idyllic places on Earth. We sat at the coffee table at 5:30 am while everyone else slept, talking about what the day might have in store for us. Ever on call, he answered the phone. He listened carefully and then hung up. “Well, Paul, do you wanna go on a rescue?” he asked in his trademark Swiss drawl. A climber had been injured by icefall while rappelling. His partner had called for help, and it was Bruno’s duty to respond. Without waiting for my answer, he handed me a helmet and pulled me onto the back of his motorcycle. A few minutes later he invited me to fly reconnaissance with him, but it was more appropriate for me to make room for the real professionals. I wished Bruno good luck as a helicopter carried him to the scene of the accident. Bruno flew over the site, lowered himself by rope from the aircraft to be next to the victim, who was decapitated, and then tied on to the climber’s rope so that he could cut the man free and allow him to be hauled off the mountain. The helicopter left Bruno swinging under more potential icefall while it delivered the body and refueled before it returned to pick him up. I asked Bruno later if he was worried hanging out there, and he told me that he had hoped that I was OK waiting for him. When we got back to the helipad, Bruno realized that he had not swept the mountainside clear of the accident remains. In order to fulfill his duties to local authorities, who did not want tourists riding the train up to the Jungfraujoch to see blood in the snow, Bruno flew back and tidied things up. All of this happened swiftly, so that we were back at the coffee table eating jelly donuts before our young children were out of bed.
        We saw each other at WMS and ISMM meetings, and a couple of times when my wife and I visited Bruno and Susi. It was always the same—Bruno working hard but making time to visit and talk, to walk, to eat and drink great food and wine, and to plan the dive trip we would one day make together. The last time we were together in Switzerland, we laughed a lot and schemed great plans. I will always regret that we did not get to be together in our retirement, but at least we were together when we were young. The world is better for having had Bruno Durrer as its friend.
        Paul Auerbach, MD
        His spirit made it happen. It was in 1992 in Windisch-Garsten, Austria, where the annual conference of the ICAR took place. Excited to get feedback from the avalanche rescue services, I was preparing for the first time to present the freshly calculated survival curve for completely buried avalanche victims. The auditorium was packed. I saw Urs Wiget, president of the International Commission of Mountain Emergency Medicine ICAR MedCom sitting in one of the front rows. Next to him was Bruno Durrer, president of the Medical Commission of the International Mountaineering and Climbing Federation UIAA MedCom. After my speech, Bruno invited me for a drink in the bar, “to briefly talk about avalanche and hypothermia.” We conversed for 6 hours until the early morning, not aware that this was to be the beginning of a friendship and collaboration that would last for decades.
        Bruno was a mountain guide and general practitioner in Lauterbrunnen, a small village at the bases of the Eiger, Mönch, and Jungfrau. Often practicing medicine during mountain rescue operations by helicopter, Bruno also was an enthusiastic mountaineer. Similarly, I was a simple family and rescue doctor in Bruneck, South Tyrol. Like Bruno, I was regularly involved in mountain rescue operations in the Alpine mountain range or Dolomites. I also was in charge of training and educating local mountain rescuers. We were cut from the same cloth, about the same age, and had many things in common. During our aforementioned first meeting, after just a few minutes we came to the conclusion that we had to render our work more efficient. “We need practical guidance for rescue folks,” Bruno said, and asked the waiter for pen and paper. We started to sketch dozens of flowcharts and potential algorithms for the on-site management of hypothermic and avalanche victims. The work continued after we left the bar. We were aware that our personal opinions and collective experience were not sufficient to reach our goal, so we tried to merge personal experience with the results of our statistical avalanche research. We modified and fine-tuned the graphs innumerable times until we had a scientific, evidence-based, plausible, simple and practical model. Both algorithms were endorsed by ICAR MedCom and published.
        Today, the treatment recommendations for hypothermic patients and avalanche victims have been adapted and revised by international societies and their committees. We always should remember how much of a motivator Bruno was. After all these years, the basic structure and pathways used to provide solutions to the leading concerns in our field have remained the same. Bruno helped guide us to understanding who should be transported to a center for extracorporeal rewarming. We will continue to work from the foundations he helped create. Our nocturnal brainstorm in Windisch-Garsten was based upon our strong feeling that rescue teams needed more assistance and a commitment from medical experts that their advice should be grounded in peer-reviewed, scientific evidence.
        Bruno always found understandable answers to difficult questions and helped make mountain rescue more practical. Furthermore, he uniquely combined a humane approach with a great love and respect for nature. The mountaineering community and rescue world will miss Bruno for as long as he is remembered, which will hopefully be forever.
        Hermann Brugger, MD
        Forty-five years ago when I was travelling in my car to the mountains, I picked up a young man from the side of the road—the beginning of a very close lifelong friendship.
        Bruno Durrer was the most important mountain rescue physician in Switzerland, and he was also a certified mountain guide. While he chaired the UIAA medical commission, I led the medical commission of IKAR. There is no doubt that this coincidence provided the seeds for a fruitful collaboration.
        What a gift Bruno had to spread his professional pearls all over the place. He was one of the founders of the ISMM some 30 years ago. He was many times an important member of the organization committees of conferences in mountain medicine and mountain rescue all over the world. Together, we tried to spread the spirit and skills of mountain medicine in our country by organizing the first courses in mountain medicine for doctors and running medical courses for future mountain guides. There is no doubt that Bruno also was one of the most important actors in avalanche and cold environment medicine.
        Even more important were his accomplishments as a family physician in the remote mountain valley of Lauterbrunnen. Bruno and Susi Durrer took care of the local population for at least 30 years. Bruno was the only medical doctor in the valley, and nothing was too much for him. His energy seemed endless. He also taught many medical students in family and mountain medicine, and ran all manner of education courses for schoolchildren, avalanche dog handlers, and rescue squads. Whenever he was needed, Bruno was there to take part in the many mountain rescue actions each year.
        His superior empathic personality allowed him to be a very successful mediator between the different actors of the Swiss emergency and rescue medicine establishments. At times, this was not easy, but Bruno handled it as well as anyone.
        I can still not believe that we never ever again will see our monumental Bruno explaining mountain medicine in talks, charmingly answer questions, smiling at everybody, and drinking beer with us after a successful rescue or satisfying rock climb. Bruno, we all miss you.
        Urs Wiget, MD