The last thing I expected on my PCT climb: contracting MRSA

badvertisement. Things. Do. Happen. I said it there. I really enjoyed my time on the Pacific Crest Trail, but it is impossible to control everything and the risks along the way are more numerous than we can imagine beforehand.

Most are minor or can be easily mitigated through good decision making, but a small minority are far beyond our control. In statistics, this is known as “tail risk”: the low probability of an extreme outcome occurring. As humans, we are notoriously bad at assessing tail risk, often dismissing it, putting on rose-colored glasses and hoping for the best. The “tail” harbors “unknown unknowns,” those scenarios we could never think of in the first place, even if we tried. This is my story of my encounter with the «tail».

Unknown Unknown

I started my 2025 hiking season with confidence. I had successfully overcome countless challenges during my 2024 attempted hike of the Pacific Crest Trail, NOBO, and ended the year with more than 1,550 miles completed, including a stretch straddling the Bridge of the Gods and a couple segments in Washington, reaching the northern end and crossing into Manning Park. This was despite encountering bad weather that scared me off Mount San Jacinto early on, circling around to avoid numerous wildfire closures, and a couple of injuries that took me off the trail for a while.

My goal for 2025 was clear: connect my broken 2024 trail and leave only a couple of legs to tackle in 2026. I didn’t have a full season available due to other commitments, so I tackled the rest of Washington NOBO in August, then started Oregon SOBO from Timberline Lodge in September.

The several August weeks I spent in Washington were largely uneventful and it seemed like luck was on my side. I arrived early enough to get past Mount Adams before another wildfire closure and for the famous Section K to hold up a bit, leaving the trail for Mazama a day before the North Cascades were hit by wildfire smoke. My path through Washington successfully connected and I set my sights on the second part of the plan: Oregon.

No pain, no gain?

Heading south from Timberline Lodge, I immediately noticed a tight feeling in my right knee, likely related to a partially torn medial meniscus and aggravated by the long descent. I pulled out Advil and KT Tape and after a few days decided it was a sustainable walking condition. No pain, no gain, right?

I took advantage of the more moderate terrain to increase my daily mileage and progressed well, largely as planned. I was hit by two cold storms within a week of each other, each of which threatened hypothermia and both of which caused me to hunker down early for safety reasons. The second time, I woke up to the aftermath of a hard freeze, and the sodden trail had frozen over overnight. The storm had passed and I moved on.

Traversing the Rim Trail in Crater Lake National Park and taking advantage of good cell reception, I began to contemplate the end of the trip through Oregon passing through Mazama Village. My original plan had been to finish at Callahan’s and head home from Ashland, but the weather forecast was once again calling for a multi-day cold rain event in just a few days, and I wasn’t eager to try hypothermia for the third time in as many weeks.

I could wait for good weather until Highway 140, where I thought I could hitchhike to Medford. It would save me about 50 miles of travel and, more importantly, two and a half days. I briefly considered exiting at Mazama Village, but ultimately decided to continue toward Highway 140. That decision made, I lightened my resupply at Mazama Village and continued on.

«Something had clearly gone very wrong.»

During this last segment, I discovered that I had to increase my dose of Advil due to the increasing discomfort in my right knee. The last morning, I had to take a maximum dose to be able to move and it never completely let up. I made it to the highway without any significant difficulty and was lucky to get a quick disengagement to Medford.

At the bus stop, my knee started to get really stiff and I limped onto the bus towards Grant’s Pass, wondering what I had done to the poor knee. At Grant’s Pass, my knee was even stiffer and I had trouble walking. I managed to limp very hard to a grocery store and a park to pass the time until my next bus.

I had a very difficult time limping back to the bus stop and barely made it up the stairs to the bus. Advil was no longer helping. When I arrived in Portland, I could barely stand and couldn’t walk more than a few steps. Clearly something had gone very wrong.

Fast forward a few days to RICE (rest, ice, compression and elevation) and I finally went to seek medical attention as my symptoms were not improving. My doctor was quite concerned about the lack of an obvious explanation for the swelling in my knee and wisely sent me to the emergency room.

Contracting MRSA on the PCT: How could this happen?

After an initial series of tests, I was sent home, but was called back to urgent care the next day. The test results indicated that he had acquired an MRSA infection in his knee, a very serious and life-threatening infection that required urgent treatment. This strain of staph is highly resistant to antibiotics, making it difficult to eradicate.

How could this happen? I kept wondering how, in the wilderness of the PCT, I had managed to acquire an MRSA infection that is most commonly acquired in hospital settings. While we were never able to definitively answer this question, one compelling suggestion is that it was the result of an undetected tick bite.

I walk in long pants, long sleeves, and leggings, so there isn’t much space for ticks to take advantage of. However, I had noticed a single tick at one point in this section, crawling into my tent. That is proof that there had been ticks in the area, and that there may have been a bite that I never detected.

There is a general belief that in this region of the country ticks are not of particular concern, as they do not transmit Lyme disease or Rocky Mountain spotted fever like they do in the AT or CDT. I had no idea PCT ticks could transmit an equally concerning infection.

Ed. note: resistant to methicillin staphylococcus aureus (MRSA) is not a vector-borne disease and there are no documented cases of ticks transmitting MRSA. However, MRSA often enters the body through cuts and abrasions, so it is possible for a tick bite to lead to a secondary infection. We are hikers, not doctors; Consult a medical professional if you are concerned about the risk of contracting MRSA.

I was hospitalized for ten days, given regular doses of specialist antibiotics and had two operations to remove bacteria from my knee. After discharge, I had to self-administer more intravenous antibiotics for over a month. When I started physical therapy, my knee’s range of motion was only 40 degrees, not even enough to walk properly.

After four months of physical therapy and another arthroscopic knee surgery, I am now close to being able to resume normal activity without crutches or a cane. Fortunately, my prognosis is good, subject to much more physical therapy.

Key Takeaways for Hikers

Given how unexpected my experience has been, there are two key takeaways I want to share with the hiking community. First, make sure you have good health insurance coverage when hiking. Second, don’t cut corners on emergency connectivity, such as satellite messaging devices.

When it comes to health insurance, many hikers have quit their jobs to take time off to hike the trail, and that comes with the loss of employer-subsidized health insurance. It may be tempting to bet that you won’t need coverage during your walk and that you’ll be able to resume it when you get another job.

Making that decision can prove financially ruinous if the unexpected happens. I highly recommend all hikers to ensure they have quality insurance coverage for the duration of their hikes. My medical bills would have been in multiples of six figures if I hadn’t been insured.

Even with coverage, I had to cover the maximum out-of-pocket amount, something some hikers might struggle to cover. Better insurance could have reduced that burden, so think about what the worst-case scenario would be like financially when comparing policies.

While it didn’t directly influence my situation, having some type of satellite messaging service is extremely important. The timing of my departure turned out to be fortuitous. Had I been a day behind, or continued past Highway 140, I might have found myself unable to walk, 20 miles from the nearest road, and with minimal foot traffic at the end of the hiking season.

I had a satellite messenger and could have pressed the SOS button in this scenario, but I shudder to imagine what would have happened if I couldn’t walk and couldn’t contact emergency services, with inclement weather approaching for several days.

Risk management

I am sharing this experience not to generate sympathy, but as evidence that the unexpected can happen, and does happen to some hikers. I wish all aspiring hikers a satisfying and uneventful trip, but I also hope that everyone practices prudent risk management by planning ahead for low-probability «tail risk» events.

I now have two sections left totaling a little over 400 miles of the PCT, all in NorCal and the southern tip of Oregon, and I hope to complete those sections in the not-too-distant future after completing my recovery.

– Pinion

About the author

I’m Pine Nut, a long-distance hiker and avid world traveler living in Vancouver, Washington. I completed the Colorado Trail and am working on completing my PCT trip. I started NOBO in 2024.

Cover image: Graphic design by Chris Helm.