The Call of Everest Page 16

  There are more parallels between high-altitude exposure and heart failure. The overbreathing, or hyperventilation, that is key to adaptation at high altitudes negatively affects the brain’s blood flow, which causes constriction of the blood vessels to the brain and a decrease in carbon dioxide in the blood. Thus a battle emerges between the carotid body telling the brain to breathe and the brain trying to reduce breathing to improve its own blood flow. This tug-of-war occurs especially at night during periods of cluster breathing, causing episodes that resemble sleep apnea—that is, when a person stops breathing for more than ten seconds. Often the climber at high altitude awakens gasping for air, a condition called periodic breathing at high altitude. Heart-failure patients frequently develop a similar form of breathing called Cheyne-Stokes respiration, which is a period of panting followed by deep breaths. Associated with this condition is central sleep apnea (CSA)—common in heart failure. The periods of apnea at high altitudes not only cause more frequent awakenings and poorer sleep quality but also deeper dips in blood-oxygen levels at night. This likely increases the hypoxia stress response. One of the hypotheses of the Everest project was that these dips contribute to a greater stress response and higher risk for altitude-related illnesses. Both Cheyne-Stokes breathing and CSA in heart failure are also associated with higher risk of death.

  HIGH ALTITUDES AND HEART FAILURE

  High-altitude climbers can also face a problem if the blood vessels in their lungs constrict. This causes a high blood pressure condition in the lungs, known as pulmonary hypertension, that in turn causes increased shortness of breath at high altitude and can lead to water accumulating in the lungs, known as high altitude pulmonary edema (HAPE). HAPE can be a life-threatening condition, and climbers suffering from it may be evacuated from the mountain. HAPE occurs at reported rates that range from about 2 percent to as high as 70 percent, depending on how fast the ascent is made, the final altitude, the altitude at which the climber sleeps, and the method of lung-fluid detection. With relative rapid ascents to 4,500 meters, the rate at which HAPE occurs most likely approaches 12 to 15 percent.

  Similarly, heart-failure patients often have lung congestion, including fluid in the lungs. This usually occurs because of a backup of blood and pressure in the lungs from decreased function in the left ventricle.

  The way the body regulates fluids in the lungs is a complex subject, but recent studies in climbers may shed some light. Some studies have suggested that high-altitude exposure may cause a small rise in lung fluid in most climbers. However, in only a few does this actually degrade to the life-threatening condition of HAPE. Release of stress mediators, such as adrenaline and deeper breathing, may enhance fluid removal. Other, recent studies have suggested that a common inhaled medication for patients with chronic lung diseases such as asthma—called a beta agonist—may stimulate the clearance of fluid at high altitudes and reduce the incidence of lung edema. Use of this medication, long thought to have a negative impact on heart-failure patients, may actually stimulate the clearance of fluid for them as well.

  While the arterial blood in patients with chronic heart failure has relatively normal oxygen saturation values, the heart’s reduced pumping power causes a high loss of oxygen from the supply; and only a low amount feeds the tissues while the blood circulates. In addition, central sleep apnea may cause additional dips in oxygen at night. This can create a condition that resembles hypoxia (oxygen depravation) in sicker heart-failure patients.

  Both heart failure and high altitudes cause marked reductions in how much oxygen is delivered to the body’s organs and tissues. On the summit of Mount Everest, oxygen delivery to a healthy athlete climber’s tissues seems to be similar to that of a relatively sick heart-failure patient at sea level.

  UNSOLVED MYSTERIES

  During the recent expedition, as in the 1963 expedition, climbers suffered through the many days and nights of climbing Mount Everest. Most had to overcome illness, sleepless nights, weather delays, emotions, and poor conditions to reach the summit of the highest mountain in the world. As in 1963, the physiology and mental functions of the climbers were recorded, cataloged, and analyzed in light of these challenges. How and why do some make it to the top while others do not? Why do some adapt to lower air pressure while others do not? The answers remain unclear.

  But we can take the lessons from Everest and apply them to the larger arena of human adaptation and health. Extreme altitudes provide an important model for studying the acute and chronic effects of oxygen deprivation on the human body. Scientists gain small but important increments in knowledge with each expedition, and these contributions get integrated into the body of medical knowledge and improve patient care. The 2012 Everest expedition involved a new generation of researchers who will carry forward this exciting endeavor to expand the realms of medical care.

  CONRAD ANKER ORGANIZES bags at Base Camp, where climbers spend time getting acclimated before making a push for the summit. As the group’s leader, he was faced not only with the logistics but also with making tough calls, such as when to try for the summit and when to wait.

  Big Jim Whittaker, 83 but unstooped, still believes in the magic of Mount Everest.

  “The day after I stood on the summit, we got a telegram from President Kennedy,” says Whittaker, then recites it by heart: “For pushing human endurance and experience to their farthest frontiers … I know all Americans will join me in saluting our gallant countrymen.”

  On May 1, 1963, Big Jim, accompanied by Nepali Sherpa Nawang Gombu, became the first American to summit Everest. They climbed the South Col route, pioneered by New Zealander Edmund Hillary and Sherpa Tenzing Norgay on the first ascent of Everest ten years earlier. Three weeks later, in an unprecedented act of boldness, Whittaker’s fellow teammates Tom Hornbein and Willi Unsoeld clawed their way up a completely unknown route, the West Ridge. On that same day Barry Bishop and Lute Jerstad made the second American ascent of the South Col. The two teams managed to meet up, but it was late in the day and they were forced to bivouac at 28,000 feet. Without tents, sleeping bags, stoves, oxygen, water, or food, no one believed they would survive.

  “God, they were lucky,” says Whittaker. “If there had been any wind, they would have all perished. It would have been horrible!”

  All four men survived—although Unsoeld and Bishop would lose 19 toes and two fingers between them—and the ’63 expedition became a tale of heroic American success.

  EVEREST 50 YEARS BACK

  Fifty years later, Jim Whittaker, a mountain of a man, is walking to the world’s highest mountain to commemorate the expedition’s accomplishments. We meet on the trail in the wind and later sit down together in Pheriche, a dusty tourist village along the trek to Base Camp.

  “Even though Hillary had climbed the South Col, there was nothing there,” reminisces Whittaker. “We had to climb with our eyes wide open. We knew we had to get through the icefall. I hated it. That’s where Jake was killed. But we had to put a route through it and we did. Up higher, I worked on the Lhotse Face for three weeks to get the route in. We led the route and then fixed our own ropes.” When I respond that Everest is not what it was then, that today Sherpas fix lines from Base Camp to the summit and that 95 percent of climbers are clients, he nods, his good cheer undiminished.

  “I still admire the people who reach the summit of Everest. It’s hard work and there are still hazards,” says Whittaker. “In a way, I think they’re getting out of it what we got out of it back then. They’re learning about the limits of their bodies. Nature is teaching them. They’re learning about the beauty of our planet, and maybe this will get the bastards to protect it.”

  TROPHY CLIMB

  Commercial guiding on Everest, which began in earnest in the early 1990s, is little different from climbing assistance in the Alps over a hundred years ago. Ninety-nine percent of all ascents of the Matterhorn have been guided climbs. (Today most ascents of well-known mountains—Mont Blanc, Rainier, Denali, Kilimanjar
o—are guided.) Namche Bazar has become the Zermatt of the Himalaya, and the Sherpas, like the Swiss before them, have profited handsomely from the influx of tourists, trekkers, and climbers. So too has the Nepali government, which charges every Everest climber a $10,000 peak fee. Surprisingly, the precipitous increase in client climbers on Everest has caused an equally precipitous decline in the statistical dangers of ascending the mountain. Back in 1986, when I first attempted Everest with a team of accomplished alpinists (we reached 8,000 meters on the North Face before being turned back by avalanches), if you were a summiter, you had about a 10 percent chance of dying—worse odds than going to war. Now it’s under 2 percent.

  Whittaker, a former guide himself, concludes our conversation with a positive perspective toward the commercialization of Everest: “It’s just fine if people are paying $10,000 to climb Everest. More power to them. They could be killing endangered species in Africa, going for some disgusting Boone and Crockett trophy.”

  Trophy. The word will be lodged in me like a sliver for the rest of the expedition.

  VOICES

  LIVING UP TO THE LEGACY

  Everest was a part of me before I was born. My father, Barry Bishop, first went to Nepal in 1961 to join the Silver Hut expedition on Ama Dablam, led by Sir Edmund Hillary. This was five years before my birth. The team wintered at 18,000 feet on the Mingbo Glacier collecting what would be seminal research on high-altitude physiology. My mother, Lila, led her first trek from Kathmandu to Everest Base Camp in support of the 1963 American Everest expedition and has been leading treks to the high mountains ever since. Mount Everest became an unknowing cornerstone in so many ways for our family: The mountain would define Barry’s climbing career with his ascent in 1963, lifelong friendships were formed around the mountain, and countless adventures were launched with people Everest brought together. Our family would live in the mountains of Nepal in a tent for two years when I was a boy, and we have now worked, trekked, and climbed in the Himalaya for over 50 years. I simply can’t remember a time when the Himalaya were not woven into the fabric of our family’s life in one sense or another.

  My father was a member of the American Mount Everest Expedition (AMEE) team, and I have been lucky enough to follow in his footsteps, reaching the summit of Everest in both 1994 and 2002 and attempting to summit the mountain via the West Ridge in the spring of 2012. This May marks the 50th anniversary of the first American ascent of Mount Everest, which was achieved by the AMEE. My own three expeditions to the mountain over the course of nearly two decades have given me a unique vantage point from which to reflect on the significance of the 1963 American team.

  GROWING UP EVEREST

  As much as I picked Everest, the mountain picked me. My father was a photographer and scientist for the National Geographic Society and a renowned climber—and he was my hero. Growing up in his household left an indelible imprint on me. I remember watching Americans on Everest as a child, the first National Geographic television show ever produced. It documented that first American ascent of the mountain and was narrated by Orson Welles. I was captivated by the grand adventure of scaling the world’s highest peak. This trip epitomized what exploration means to a young boy.

  The men of the expedition were giants to me, larger-than-life climbers, and it was my great privilege to know them firsthand. I vividly recall scenes from our kitchen where my father and his cohorts would be telling stories about climbing and travel to far-off places. Unbeknownst to me, these men were all elite climbers, explorers, and scientists; I simply viewed them as my father’s friends. Such moments filled a young boy with wonder and amazement for what awaited him in the world. As early as I can remember, following in my father’s footsteps and climbing Everest was a dream of mine, and this quest seemed normal and simply part of the legacy that I was lucky enough to be born into.

  Growing up with a father with a larger-than-life persona whose curriculum vitae fills page after page can be a tricky business. Pride and admiration for my dad were balanced by trepidation that his boots were so large it seemed a daunting task to fill them. I remember early climbing trips to the Tetons with my father when fear gripped me while on an exposed precipice or ridgeline. As I grew older, the fear of exposure gave way to a thirst for adventure and the unknown. Looking back, the greatest gift bestowed on me by my father was not technical instruction but an attitude that any adventure was possible and within your grasp as long as you took the first step and had commitment to the process. My first expedition to the Himalaya had lofty goals: to climb Mount Everest. And when asked about what I learned most from my father about climbing, the answer is not technique or skill but the unwavering belief in myself that I would be successful. Failure and triumph have marked subsequent expeditions, but it was the attitude my father bestowed on me from an early age that has been his greatest gift in the mountains.

  And while these climbers were already heroes to me as a boy, it was not until I embarked on my own Everest climb at age 27 that I came to fully understand the significance of these men, and in particular their 1963 Everest expedition. Climbing through terrain that I knew from pictures embedded in my memory from my youth, I was flooded with admiration and emotion. These early climbers hadn’t only accumulated knowledge of the mountain after hundreds of ascents over decades of climbing. They earned their knowledge of the route one foot at a time. I remember struggling with the weight of my own oxygen equipment as I labored up the Geneva Spur to Camp IV at 26,000 feet. There on the South Col I picked up a discarded bottle from the AMEE’s era of rudimentary equipment. It weighed three times as much as my modern apparatus. Even with the psychological barriers of the unknown removed and the benefit of more than 30 years of technological advancement, the climb pushed me beyond what I thought was possible both psychologically and physically.

  CONNECTING

  The first time I approached Everest’s summit in ’94, tears ran down my face as a deep sense of connection to my father welled up inside of me—a connection as a climber I had finally earned a right to call my own. I now had a true glimpse of how strong and bold those climbers were in 1963, a time when there was no simple formula for success and every step on the mountain was gained through sheer will and fortitude. Their lives hung on every decision they made, with no preordained template to guide them to the summit. Tragically, my father was killed in a car accident only four months later, robbing me of the opportunity to share and reflect with him as the first American legacy to reach the summit.

  Nearly a decade later, I returned to the mountain with the opportunity to partake in a film for the National Geographic Society, Everest: 50 Years on the Mountain. The film celebrates the 50th anniversary of Sir Edmund Hillary and Tenzing Norgay’s first ascent and is told through the eyes of the sons of these pioneer climbers. When asked to join the project, I jumped at the invitation to partake in a film that would continue the legacy of my father and his peers. And just as the original film influenced me as a young boy, partaking in a film that might influence my own two sons made me proud to be part of the American Everest legacy.

  Our climbing goal was to repeat Willi Unsoeld and Tom Hornbein’s epic first ascent of the West Ridge, but poor weather and high winds hastened our retreat from the West Shoulder. We were able to redirect our efforts and summit via the South Col route, and once again, I literally and figuratively followed in my father’s footsteps to the summit of the mountain, carrying both the American and National Geographic flags that my father had taken with him nearly 40 years earlier. The memory of that summit day is bittersweet for me; I remember Peter Hillary making an emotional call to his father from the summit, and while elated from standing on the top of the world, Peter’s connection with his father made me acutely aware of my own father’s absence at such a significant moment for me.

  The allure of Everest is quite strong, and after failing on the West Ridge in ’02 I felt I still had unfinished business on the route. The aesthetics, commitment, and climbing style embodied by t
he line appeal to me on every level as a climber, so I was glad for the opportunity, in 2012, to join a 50th anniversary commemorative climb of the West Ridge. This team was quite experienced, with 11 summits of the mountain between the four principal climbers. But once again the conditions on the route were unfavorable and forced our retreat after relatively little progress above Camp II. Each day that our veteran team labored to gain ground on the route and found itself bogged down, I kept wondering with amazement how the original American climbers were able to push the route successfully into the unknown so effectively. Nearly 50 years after first ascent of the West Ridge, the route’s significance has withstood the test of time. The technical nature of the climb and the commitment it demanded were unparalleled in 1963, and it still remains a coveted achievement in the Himalaya, as evidenced by the mere handful of successful ascents in the 50 years since.

  THE MEANING OF AMEE

  Not only has the first American ascent withstood the test of time, but within the context of the era, the AMEE is even more significant: 1963 was the age of Camelot, when Kennedy championed the merits of the “vigorous life.” At this point, America had lost the first step in the space race to the Soviet Union’s successful launch of the first man into space. A wave of patriotism swept through America, and it was clear that no one—not mountaineers, politicians, nor the general public—wanted to see America lose another race to the Soviets. The AMEE team was assembled, and the national support it received was not only unparalleled at the time but has not been witnessed since.