David Cifaldi and his two hiking companions were crossing Montana’s ominous Froze-to-Death Plateau and approaching the top of the state’s highest peak when their adventure took a bizarre and dangerous turn: Cifaldi slipped and impaled himself on his trekking pole as he fell. The 112cm steel-tipped pole passed through the flesh beneath Cifaldi’s left arm, missing any vital organs, and protruded from his back. After conferring with his friends — and considering the high cost of a helicopter rescue — Cifaldi knew who would save him: himself. “I was like: ‘We’ve got to get off this mountain.’ And they’re both like: ‘I don’t know about that,’” Cifaldi said of his friends’ initial reaction. “I’m pretty confident this is outside my chest wall. ’Tis but a flesh wound.”

David Cifaldi sits on a bed with a trekking pole through his side while being treated at St Vincent Regional Hospital in Billings, Montana, on Monday last week.

The 32-year-old nurse, who works in wound care at a Billings, Montana, hospital, did a self-assessment. He was alert. There was little pain or blood, and the pole was not moving. The group used a satellite-based communication device, a Garmin inReach, to contact local authorities and inform them of their plan to self-rescue. Then they started hiking out, carefully descending from the plateau along an unmarked route, navigating through boulders and snowfields before bushwacking their way to an established trail.