Newtonian physics has many mathematical truths. One goes like this: force equals mass over distance squared. And then it has its observational proofs: a body in motion tends to stay in motion. Unless that body belongs to a Vail skier catching an edge: then that body might tumble a while before coming to rest in a local emergency room.

When Vail pioneer Susan Milhoan broke her leg on Giant Steps on April 1, 1964, she was rushed—sort of—to the nascent resort’s makeshift ER, where she was tended by the sole doctor in town, a contract physician who worked only during the ski season.

“It was difficult to convince anyone that I had actually hurt myself, since it was April Fools’ Day,” Milhoan recounts in Women of Vail, an anthology of recollections from local grandes dames. “I was taken to the clinic, then located in the Red Lion kitchen, and put in a full-leg plaster cast.”

Fast-forward a half century. After Vail Resorts, Vail Valley Medical Center, the heir to that first ER, ranks as the area’s largest employer, with 350 physicians and 900 others working in hospitals and clinics from Frisco to Gypsum. As a Level III Trauma Center, VVMC treats an average of 12,000 patients a year in two state-of-the-art emergency departments (EDs): one in Vail, and one in Beaver Creek. (The hospital prefers the term ED to ER because ever since it vacated the Red Lion’s kitchen, there has always been more than one room for emergencies.)

Vail’s ED is located on the ground floor of the resort’s primary hospital on Meadow Drive, between Vail proper and Lionshead, a short hobble from the Eagle Bahn. But perhaps no emergency department anywhere is located as close to a ski run as VVMC’s ED in Beaver Creek (officially known as the Beaver Creek Medical Center, or BCMC), which sits below the blindingly white corduroy of President Ford and Stacker, adjacent to the Strawberry Park lift.

When a skier has a mishap on the mountain, ski patrollers arrive on the scene, assess the situation, and, if the injury is serious, load their patient onto a sled and ski down to a special snow ramp at the bottom of Stacker. There, they slide the sled onto a wooden box just outside BCMC’s door, at gurney height above a heated concrete walkway. Waiting at the box, EMTs and/or nurses who have been monitoring ski patrol’s radio traffic transfer the injured skier from sled to gurney and whisk the patient inside.

The waiting room has white leather chairs and a fireplace. Every afternoon, when Beaver Creek doles out its famous free chocolate chips, a cookie ambassador stops by. A long wait time for patients is more than five minutes—and that’s rare. The docs try to eat lunch early, when things are quieter: walk-ins seeking treatment for routine maladies like colds. Around 11 a.m., as skier legs start to get tired, the patrol starts bringing in the casualties. In a typical day during ski season, the BCMC, with 12 beds and a staff of three nurses and one physician, will see between 15 and 24 patients. (Vail’s ED, with 18 beds and a staff of seven nurses and three emergency physicians, averages 100.) During Christmas week, both EDs double their staff. April is quieter, as is summer—although summer is getting busier, especially during mountain biking season.

In a ski-town emergency department at the height of spring break, the injuries tend to be predictable: twisted knees, broken ribs, sprained necks, concussions. There aren’t many stabbings, unless you count the puncture wounds that result when a skier falls and lands on the business end of a ski pole. Gunshot wounds happen during hunting season. The worst lacerations occur not as a result of muggings but when a ski’s metal edge slices through someone’s calf. BCMC has storage lockers for the fallen’s skis, boots, and poles. And the crutches have crampons.

Year after year, says Vail ED doc Bernie Riberdy, the number of patients seeking emergency treatment in Vail and Beaver Creek has remained relatively constant over the past two decades, even as skier days have increased. “It’s just the pattern of injuries changes,” he says.

A ski-town emergency physician can intuit conditions on the hill based on the injuries that come through the door, without looking out the window or venturing outside. (Despite the proximity of lifts, and the fact that just about everybody skis or snowboards, on-duty medical personnel don’t take ski breaks.) In Vail, if ED doc Eman Podgorny sees snowboarders with broken wrists and concussions, and if VVMC emergency services director Mark Goldstein sees skiers with boot-top fractures, they know it’s probably not a powder day out there.

“In powder, you’re landing on a pillow,” Goldstein explains. “If you fall on hard-pack, there’s no fluffy stuff there to soften it.”

Conversely, in Beaver Creek, if physical therapist Rebecca White sees five ACL tears in a day, and ED doc Chip Woodland is diagnosing knee after twisted knee, there’s a good chance it is a powder day, when noobs catch their tips in the fluff and torque themselves straight into the ED.

Spend some time in a ski-town ED, and you might get the idea that skiing and snowboarding are dangerous. They are, but for perspective, consider the statistics. According to the National Ski Areas Association, the overall rate of reported ski injuries has declined by 50 percent since the early 1970s. Last ski season, 42 skiers and snowboarders nationwide suffered catastrophic injuries like broken backs or necks or severe head injuries, a significant drop from the 76 catastrophic injuries reported in the 2013–14 ski season. As for fatalities, 35 Americans died while skiing or snowboarding in 2014–15, slightly below the industry’s 10-year average, and roughly the same as the number of people who died from lightning strikes in the U.S. in 2015. Bottom line: on any day you go skiing, the NSAA reports, you stand about a one-in-a-million chance of dying. 

The most critical trauma cases treated at VVMC’s ED tend to be the result of crashes on I-70, not collisions on Born Free. And, it should be noted, in addition to mending bones broken on the hill, the VVMC is staffed and equipped to perform just about any medical procedure required; it’s rare for a patient to be transported to Denver for specialized care. 

Whatever the case or cause, patients seeking emergency medical treatment in Vail and Beaver Creek tend to be happier than the patients in big-city EDs, docs and nurses here agree. Their patients injured themselves doing something fun, and they are motivated to heal quickly so they can return to the slopes.

Which brings us back to physics. The force of gravity decreases ever so slightly the farther you travel from the Earth’s core. Given our formula (force equals mass over distance squared), an increase in altitude from sea level to the elevation of Eagle County means your weight drops by about 0.29 percent. So theoretically, falling in Vail or Beaver Creek should be slightly less painful than falling in Manhattan or L.A.

 Given that, and the quality of the medical pros staffing our valley’s slopeside EDs, if you’re going to take a beater, there’s no better place than here.