Surviving the Extremes: A Doctor's Journey to the Limits of Human Endurance (48 page)

BOOK: Surviving the Extremes: A Doctor's Journey to the Limits of Human Endurance
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The rewards of exploration are derived not just from where you go but in large measure from whom you go with. I have had the rare good fortune to endure harsh environments with some of the finest people on earth, and have been strengthened by their example. Expeditions are agglomerations of people from disparate backgrounds, and I am proud of the eclectic group of friends I have accumulated over the years.

In the jungle, I met Antonio, for whom survival was a daily event. I was brought to him by Sebastian, my native Ecuadoran guide, who bridged two worlds and so could help me better understand the people who were around us. The expedition was led by Bill Jahoda, Professor of Biology at Eastern Connecticut State University, and his son, John Jahoda, Professor of Biological Sciences at Bridgewater State College, Massachusetts. I am indebted to them, and to all the other zoologists and botanists who patiently explained their research to me and
made sure that I wasn’t just looking at the jungle, that I was actually seeing it.

I owe my French connection with the undersea world to my good friend Louis Potié, a hydrologist and former Deputy Mayor of Marseille, who introduced me to the pioneers of the deep. Of the hundreds of dives I have made, those that helped the most in the preparation of this book were done in the Mediterranean Sea, with the cooperation of Comex and its founder and chairman, Henri Delauze. Comex’s Chief Medical Officer, Bernard Gardette, is an extreme medicine researcher who brought me, academically, to the edge of the ocean frontier. I am especially grateful to Pierre Becker, President of NympheaWater, for making me part of his dive team exploring the resources of the seafloor. And a thank-you goes to marine architect Jacques Rougerie for his invitation, which I have accepted, to be part of the
SeaOrbiter
crew when it starts its around-the-world drift.

From the depths to the heights. My first climbing instructor, ex–Green Beret Rob Blathewick, saw fit to include an inexperienced doctor on what became my first expedition. Since then I have climbed all over the world and tested the limits of extreme medicine on six expeditions to Mount Everest. The first four were led by Todd Burleson of Alpine Ascents International, with Pete Athans as the climbing leader. They were sponsored in part by the National Geographic Society, under the direction of Brad Washburn, their former Chief Cartographer and President Emeritus of the Boston Museum of Science. I have worked closely with Brad for many years. He is a former world-class mountain climber and has come to represent for me and for many others the ultimate example of an explorer-scientist.

My latest two expeditions to Everest were undertaken at the request of the NASA Commercial Space Center under the direction of Dr. Ron Merrill at Yale University. The expeditions were led by Scott Hamilton, a director of the Explorers Club, and were specifically designed to test space-age equipment and communications at the limits of human survival. Via satellite, we were supported at Yale by Dr. Richard Satava, also a member of the Defense Advanced Research Projects Agency, and by Dr. Peter Angood. On Everest, where I was
the chief high-altitude physician, I worked with chief medical researchers Dr. Vincent Grasso, a fellow at Yale, and Dr. Chris Macedonia, a U.S. Army major on loan from the Defense Department. The engineering work was carried out by Mike Hawley and his group of techno-wizards from the Massachusetts Institute of Technology Media Lab.

Everest is a difficult and dangerous place to work. A large support team of American and Sherpa climbers successfully managed to expedite our research and keep us safe at the same time. I must especially recognize the conscientious and sometimes heroic efforts of Wally Berg and Jim Williams, two elite mountain guides who are able to maintain strength and clarity of thought even at the most extreme altitudes. Most especially, however, I want to thank my Sherpa climbing friend Nima Tashi, who with quiet loyalty and devoted support has looked after me for many years on the mountain.

To write a book on survival you have to leave extreme environments safely. Not everyone does. I wish to pay tribute to some friends who lost their lives in the course of their expeditions. New Zealand Everest climbers Gary Ball, who succumbed to pulmonary edema on Dhalighiri, and Rob Hall, who became hypothermic on Everest; American Muggs Stump with whom I climbed in Antarctica, who fell into a crevasse on Mount McKinley; my British pilot in Antarctica, Giles Kershaw, who crashed on the ice when his plane was caught in a downdraft; and Argentinian Explorers Club member Adrian Hutton, who crashed while flying low over a mountainous site in the Andes where he was reconnoitering his next exploration.

I have been lucky enough to come back from every expedition I have been on, lucky to have loyal friends eager to see me, and luckier still to have a devoted family waiting for me when I come home: my mother, Ethel; my brother, Jerry, and my sister-in-law, Marilyn; my two children, Jonathan and Jennifer; and my father, Willie, watching over us all. They are with me on every adventure, and they have sustained me through difficult times away and at home. They have endured my absences for weeks or months at a time as well as the countless hours I have spent writing. Those were hours my children and I shared in our study, I on the couch writing, they at their desks
doing homework—the three of us exchanging ideas, opinions, advice, and laughter. The memory of those days together I will keep as a timeless treasure. I hope that we will always share all our adventures and take pride in each other’s accomplishments. My family, and my many friends, give me the strength I need to explore extreme environments, and, especially, they give me that most valuable key to survival—the motivation to get back.

INDEX

abdomen,
150

acceleration (G),
242–46

acclimatization,
194–96
,
254

acetone,
112

achiote,
38
,
54
,
65

acupressure,
93

acute mountain sickness,
191–92

adaptation

to heat,
149–51

to high altitude,
210–13

adrenaline,
140

African peoples,
150–51

African plains, temperature of,
128

aggression,
216

air, compressed,
169
,
237–38

airline attendants, radiation exposure of,
262

air pressure

low, in mountains,
183–84
,
192–93

and lung action,
205

sudden drop in,
210
,
251–53

Albatross
,
85
,
89–91

alcohol (medicinal),
50

Algeria,
138

alkalinity,
194

alkaloids,
69

altitude.
See
high altitude

altruism,
60
,
227
,
280

alveoli,
175
,
193
,
205–6
,
244

Amazon Basin,
17–83
,
276

complexity of life in,
83

Amazon Indians,
18–19
,
80
,
82–83

amino acids,
104

ampiwaska vine,
67–68

amputation,
48
,
110
,
274
,
278

amygdala,
70
,
118
,
281
,
285

anaconda,
53–54

anaerobic respiration,
211–12

anatomy, study of,
114

Anderson, Clay,
238–41

anesthesia,
27–28
,
90
,
169

animals

brain of,
71

predator and prey,
59
,
145

anopheles mosquito,
35–36

Antarctica,
202–3
,
264–65

antelope,
140

antibiotics,
33
,
192

antibody response,
47

anti-G suit,
244

antivenin,
47

Antonio (Amazon Indian),
19–24
,
28–29
,
36
,
80
,
275

ants,
57

navigation of,
146

as surgical tools,
58–59
,
79–80

anxiety,
131

aorta,
218–19
,
243

Apollo
13
,
257–59

Aquarius undersea habitat,
237–41

Arctic explorers,
203

armpits,
225

arms,
93
,
225
,
266
,
278

army ants,
57

arteries,
129
,
193
,
243

arterioles,
129

astronauts and cosmonauts,
245–46
,
249
,
251

training of,
237–41

Athans, Pete,
222–25
,
228

Atlantic Ocean,
125

Atlas Mountains,
125

atmosphere

composition of,
192

protection from radiation by,
261

See also
air pressure

Australian Aborigines,
202

Australian Outback,
149

autonomic nervous system,
287

auto-recovery system,
245–46

axon,
289

ayahuasca vine,
69–70

Ayamara Indians,
212–13

 

bacteria, heat-tolerant,
142

Bailey, Maurice and Marilyn,
101
,
102
,
105
,
118
,
119
,
120
,
122
,
279–80

Baker, Norman,
109–11

balance, loss of,
217

barnacles,
96

basal metabolic rate,
112
,
128

basic training, military,
141

bat,
136

bathing,
39–41
,
203
,
257

beauty, sense of,
97

Becker, Pierre,
167
,
176

bedsores,
100

beetles,
144

bends, the,
14
,
171–75
,
238
,
252–53

Bernabe, Pascal,
166

Berullio (Amazon Indian),
18–19
,
28–29
,
52

bicarbonate,
194

biofeedback,
287

bioluminescence,
180

black caiman,
20–21

bleeding,
45–46
,
68

blisters,
49

blood

circulation of,
87
,
132
,
141–42
,
225

as cooling mechanism,
129–30
,
150

decreased volume of,
266

flow, cut off by tourniquet,
30

fuel transport in,
112

nitrogen in,
13–14

oxygen in,
193–94

pressure drop,
230

red blood cells in,
163
,
195
,
211–12
,
218–19
,
266

salt concentration of,
108
,
109
,
131
,
132
,
145

thickened,
120
,
132
,
134
,
218–19

blood vessels,
45
,
87
,
199
,
214–15
,
230

dilation of,
216–18

blowgun,
60
,
66
,
68–69

blubber,
163–64

blushing,
287

Bombard, Alain,
111

bone marrow,
195

bones,
32

deterioration of,
265
,
270

boots,
77
,
185

borderline environments,
4–5
,
13

boredom,
263–64
,
267

botfly,
276

Boukreev, Anatoli,
224
,
226–27
,
275

brachial artery,
225

brain

animal,
71

bleeding in,
3

blood supply to,
193

complexity of,
51
,
281

cooling of, in desert mammals,
140

human, as survival asset,
146–47
,
148
,
151
,
204
,
281

mapping the, with MR I and PET,
282

metabolic rate of,
200

need for oxygen,
86
,
90
,
243

need for stimulation,
110–11
,
264

overheating of,
135

pressure in,
3–4
,
216–18

structures of, higher and lower,
70–72
,
118–19
,
281–84

trauma to,
3–4

brain stem,
281

Breashears, Dave,
228

breath, holding the,
89
,
163

breathing,
131
,
193

rate of,
3
,
211

of thin air,
184

breathing device, positive-pressure,
245

buoyancy-compensation vest,
180

Burleson, Todd,
200–201
,
222–25
,
228

bus, overturned on a mountain road,
8–9

bushmaster,
47–48

Bushmen,
148
,
202

buttocks,
49–50
,
150

 

caffeine,
191

caisson’s disease,
171

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