Thursday, March 16, 2017

Being of Service On The Front Line

Tough to know where to begin.
I'll start with stating this has been potentially the most intense week of my life. And those that know me understand the magnitude of that statement.
I can provide the synopsis here. It will take months to process and effectively document the experience and all that came with it.
As I commented at the beginning of the week, we moved up towards the front line as the Iraqi Special Forces continued to push ISIL back. We were told we would be as close as possible to the fighting but still have at least a 2km buffer. Although this is short of organizational policy of 5km, our team unanimously agreed to accept the implied danger. For reference, US military trauma units are mandated to be 15km from front line conflict.

We settled into our house and established our trauma bay across the street in a garage bay. The mortars and small arms fire were now over our heads and the house and ground would regularly shake with the larger explosions. Not 10 minutes would pass without gunfire or explosions. 24 hours a day.

We were surrounded by Iraqi special forces with humvees blocking each entrance to the road in front of our house/clinic. The neighborhood was mostly evacuated. The General of the ERB group posted up on our same block. We felt vulnerable but relatively safe.

The volume of critical patients was steady. We treated dozens. Most were salvageable. Occasionally we took cover in a subterranean reinforced basement as debris rained down on our tin roof.

Then yesterday happened.
The exodus of displaced locals began. Thousands of Iraqi civilians began filing down the street just 100 meters away from our clinic. Many of them needing care but all posing a security threat to us and our location. The security team did their best screening critical civilians and sending the rest down the road to some unknown location. The tension level went up as civilians were delivered to our trauma bay on wooden carts and broken wheelchairs. 

Right out of the gate we lost a civilian little girl... the absolute barbarism shook us all up.
Then we got a save on a civilian with extreme mortal injuries. Without providing details, he was hanging on... and out. But we stabilized him, packaged him and he will live.

Then it began.
The front line began to pulse back towards us. A mortar landed in the yard next to us which we would later come to find out was a locator.
We had been outed.
Someone, we are unable to confirm who... most likely a civilian passing by or glassing us from close by, passed our location on to ISIL and they began targeting us directly. The mortars started dropping in... each one closer. They had a bead on us and would have loved nothing more than to take out a group of Americans caring for their enemy.
The big one hit on the sidewalk just outside the gate to our house. One of our paramedics caught a piece of debris in the back of the leg. We took cover. 30 seconds later our security team carried in the soldier that was posted in front of our gate. He was lifeless.
Our team moved quickly on to him as heavy fire rained around. We decompressed his chest, threw lines in him and I placed a chest tube, which immediately improved his situation.
Two of our medics loaded him into the ambulance with blown out windows and screamed out of our location to a military OR. We all retreated to the basement and held tight as the mortars landed in our yard.

2 hours later we evacuated in the blown out ambulances and returned to our first location well out of mortar range. We built a little fire in the yard and sunk down as the adrenaline oozed away.

Prior to finally laying down around 11pm we set up 3 beds and our trauma rolls... thankfully.
We were awakened at 3:30 this morning. A massive IED had gone off a couple miles from our forward house. Eight ERB soldiers were killed. We began receiving ambulances in succession. Several amputations and shrapnel wounds. All will live.

I tried to go back to sleep a  couple hours ago but it's useless. Tough to slow down the mind at this point.

We will re establish our trauma bay at a new location tomorrow. Further back. The new team arrives Sunday. We will set them up for success. I go home on Monday. And I will rest.

I am honored to have served with this team. So talented and committed. An absolute privilege.

Hug your loved ones. Be compassionate. Be generous. The world needs more of that.

Addendum.... just got word they caught the local guy that was calling in the mortar strikes to ISIS. Dude lived 3 houses down from our house and was releasing pigeons to alert the ISIS mortars to our exact position.
He is in custody now in our former side yard. I saw a photo of him. He has a bag over his head. I am told he will be dealt with accordingly. That makes me happy.

Thursday, February 2, 2017

It's Always Coldest Before The Dawn

The current state of geopolitical affairs has me feeling a bit unsettled and apprehensive these days. And it appears that I'm not alone in my sentiments.

As I share conversations with friends and family and listen to the anger and frustration from essentially everyone I know, I find myself trying to find solace in one of the great lessons that alpine climbing teaches us...

It is always the darkest and coldest just before the dawn.

Summit nights/mornings are always a roller coaster of emotion and energy. As you climb through the night, the ebb and flow of momentum is noticeable. The internal struggle of strength fighting weakness. The dark and cold are persistent enemies that require vigilance and acknowledgement.

Then, just before the sun crests over the horizon, a cold sets in and challenges you. It does it's best to steal what remains. It's as if the dark takes one more valiant pull from you as it is vanquished by the sun. It's a palpable, corporeal feeling. I have seen it steal the gumption from many a climber in spite of being within a mere hour of the summit. It is at this point we must be the most hopeful. It is here that we must embrace our position that we have worked so hard to achieve. We can't concede. Right now is when we need to show our strength.

It is at this point that the dark is pleading with us to tap out and turn around. But it is now that we will dig down the deepest. We must embrace the effort we have put in to get this far. We must push through because the sun will rise again. And it will warm us all.
#lovetrumpshate #refugeesarenttheproblem

đź“·sunrise over Mustang, Nepal. May 2006.
đź“·credit- Steven Rubin

Monday, December 5, 2016

Saving Lives on Everest, Using a Reality TV Show

On April 18, 2014, ice shelves on the western spur of Mount Everest collapsed, creating an avalanche of ice, snow and debris that killed 16 people, all of them local Sherpa guides. It would be the deadliest disaster to strike the mountain until just over a year later when, on April 25, 2015, a magnitude 7.8 earthquake struck Nepal, wreaking havoc in Kathmandu and releasing a barrage of snow that tore through Base Camp and stranded climbers in precarious environments all over the mountain. The eventual death toll rose to 22. 

Despite these historic back-to-back disasters, the 2016 climbing season opened like many others before it. Hundreds of foreigners flocked to Nepal, like usual, for a chance at summiting the tallest mountain in the world. But there was also a notable new presence in the seasonal climbing community: a five-man team of Sherpas equipped with helmet and body cameras, working as the first-ever dedicated search-and-rescue team on Mount Everest.

Those five men, along with skilled helicopter pilots and lead medic Jeff Evans, make up Alpine Rescue Service, and their daring rescue experiment is the focus of a new Travel Channel show: Everest Air. Evans, the face and voice of the show, grew up in the Blue Ridge Mountains, graduated from the so-called “Colorado School of Climbing” and subsequently honed his abilities to a fine point whilst guiding a blind man named Erik Weihenmayer up Yosemite’s El Capitan and on to the tallest peaks of each continent, Everest included. Somewhere along the way Evans trained as a physician assistant training at the Medical College of Pennsylvania, worked in emergency settings as a PA for 17 years and was appointed as medical officer on dozens of expeditions.

As a show, Everest Air comes with all the hallmarks of reality TV: intense, pressure-building music; a deep-voiced narrator; talking-head segments; and commercial cutaways at vitally important moments. Danger and drama are so heavily underlined that the question immediately presents itself: is the motive here genuine, or has reality TV stepped into a realm where it doesn’t belong?

But take away the music and the exaggerated production elements and it becomes clear that peril exists despite the rolling cameras, and that Evans and his team are genuinely concerned with the prevention of further loss of life on a mountain that has already taken so many. On a recent phone call, he discussed how the team and the show came to be, how the mountain is changing, and what it takes to run rescue operations on Everest.

Q: How did Everest Air materialize for you?
A couple years ago an Aussie named Anthony Gordon, who ended up producing and appearing in the show as Base Camp Rescue Manager, was talking with Sherpas, and they said to him, “Hey, there is this void when it comes to a dedicated search-and-rescue team on Everest.” Up to now, a lot of these guys have been stepping away from their commercial expeditions in order to help people in need, and as a result there’s others on the mountain who are probably not being accommodated. These Sherpas wanted to do something but weren’t sure how, so Gordo gave them direction and came up with the idea of subsidizing it all by attaching cameras to them in order to tell their story.

What made you decide to accept the offer and join the team?
A:One of the things that really reinforced it all for me was that this was an opportunity to do something bigger than just rescue the rich folks off the side of Everest, and that’s kind of the way it was perceived — it’s called Everest Air, so it’s easy to think of it that way. There was a conversation when we were in the agreement stages, and I just said, “Listen, if I do this, I want a full commitment that we will open up our services to the locals and the Sherpas, too.” And they said yes. Of the 38 operations we did, over 60 to 70 percent were for the local population, which is a really big deal.

How did the team make the decision to involve those five specific Sherpas, and who are they?
These guys are the youngest generation of Sherpas up on the hill. They are pretty savvy and they realized that while they could just keep guiding and working for commercial outfitters this would be something even more impactful. They’re strong, they’re capable, clever and smart. They were hungry to learn more, too, which I think is another testament to how they wanted to help. I was honored and it was a privilege for me to be able to work for them, and I hope that we will be able to do it again.

Is the future of Alpine Rescue Service still up in the air?
A:We’ll do our best and hope that the network signs on again. We’ll do everything we can, but it really depends on them. It takes a huge budget to operate helicopters, especially in the Himalayas. We hope that they’ll see the value in it, because it’s a win for everybody, right? They get to make a TV show, we get to go save lives. That’s a pretty good gig.

Did it ever feel like there was any pressure of producing this TV show that resulted in changes in decision-making?
Definitely not. I would’ve backed out if that had happened. I have a wife and kid and in my mind; my whole commitment to this was about safety. I’ll risk my life to save someone else’s life, yes, but I will not do it for the sake of TV. And we didn’t. The production side stayed true to that. 
That being said, there were a couple of rescues that we did where the patient perhaps embellished their story, and when we got to them we were like, really? You have a headache? Everybody’s got a headache. A few of those situations took place, but it was no fault of our crew, and that’s just the nature of search and rescue.

Q: In backcountry rescue training one of the first things you learn to do is assess a scene and make sure that by performing a rescue you don’t put yourself at risk. How do you possibly navigate that in a place as inhospitable as Everest?
You have to go on the information you’re provided, which is often like the old telephone game — it’s third hand. You have to trust what you’re hearing and you can’t just sit and question the validity, you just have to go. There were definitely times when the information we got at the scene was absolutely what we had heard on the radio, and other times it wasn’t exactly what we heard or wasn’t totally factual. Once again, that’s what happens, and you go with it and understand that that’s the nature of it, especially in a place like Everest, which is a bit of a junk show at times. There’s a lot of people up there, and a lot more people means a lot more people getting in trouble. Generally nine times out of 10 we received a call and it was right and we went, scooped a person up and either impacted or saved their lives.

The TV show is a short, action-packed 30 minutes. What did a typical day really look like for Alpine Rescue Service?
In some cases we would have a call from the night before that we received too late, so we’d have to get up really early but we couldn’t get the helicopter rotors going until around 6 am. When we didn’t already have a call we’d get up and wait. We were there for two months and at least 40–45 out of the 60 days we were moving and shaking. We would get a call from up on the mountain or from one of our Sherpas who was connected to Nepalis down in the valley, see what helicopter pilot was available and if I needed to go I’d bring my jump bag and we’d roll out. I’d get there, evaluate, and make the call whether they needed to go to the medical facility in Lukla or in Kathmandu. Then I would triage and try to figure out what to do with them. 
That’s a typical day, but then there were some atypical days with no movement. Then there was an even more atypical day at the very end of the season where we did 11 rescues in one day. I was up at basecamp almost seven hours straight, just rotating through people, bringing people up and down and trying to figure out how to triage them.

What are the biggest changes you’ve seen since your first trip to Everest in 2001?
The Khumbu Valley has gotten a lot more tech-savvy. Back then there was no Internet at all, and now it’s connected to the world. The lodges in the valley and basecamp setups have gotten a lot nicer, plush and comfortable. Sherpas are a lot more media-savvy too — they’ve got a strong social media game. And big things like helicopter access are probably the number-one thing. The evolution of the B3 helicopter is a huge service to the whole valley — It’s this great combination of low weight and high power, so it gives it the nuts to be able to fly 25-26,000 feet and still function.

Have their been other positive or negative impacts on the local community due to climbing?
You’ve seen the negative side of it with the avalanches. 16 Sherpas and high-altitude workers were killed in one swoop, which is a huge loss for the community. A lot of these young men getting killed is so devastating because they’re the breadwinners of the family, the patriarchs or sons of the family. That was the biggest negative side. But then as a result there’s been a lot more accountability, and life insurance gets paid out now. These men are doing all the heavy lifting for these expeditions, and now here’s more of an effort to take care of the families.

What makes running a rescue operation on Everest different from any other mountain in the world?
The notoriety of Everest creates this status; it’s this thing that everybody wants a part of. There’s a lot of folks who want to touch it, and be on it, and experience it, and that just creates this aura. People will push themselves further on Everest than they would on other mountains. It’s a phenomenal mountain. It’s beautiful, it’s legendary and it’s mysterious, and it’s a huge piece of the economic puzzle for Nepal and the local people.

Tuesday, June 7, 2016

Flyboys Keeping Me Safe...

Leading up to my departure for Nepal a couple months ago, I spent many waking AND sleeping hours considering the safety of the mission I was signing up for. I would be flying within the most magnificent and daunting mountain range in the world, conducting the highest and some of the most complex alpine rescue operations in history and doing it all in a helicopter with complete strangers. 
What could go wrong?
Well, I have to admit I lost a little sleep and probably sprouted a few more gray whiskers dwelling on an issue that was out of my hands. Just another affirmation that it is an absolute waste of time and energy to fret over issues that are beyond your control. 
I quickly eased into the helicopter lifestyle over the first couple weeks. The first ten flights or so I would grit down on the bumpier rides as the headwind would throw the bird around and up and down. Two months later it wouldn't even occur to me we were in the middle of bumpy ride as I was chatting and laughing with the pilot... until I took a look over at the passenger who would be fully gripped, clinging to a handle. 
The skills these men possess are extraordinary. To them it's like driving a sports car on the Audubon. Precision and skill... balanced with a centered calm. 
They handle themselves with the utmost professionalism and take courage and bravery to the next level. Their mission is to be of service and I have been honored to work with each one of them.
I flew 84 flights in 5 different helicopters with 6 pilots. Landed on just about every helipad in the Khumbu Valley. Landed at Everest Basecamp maybe 30 times... lost track. Landed at Everest Camp 1, three times and Camp 2, four times. Landed in bluebird weather as well as 30mph winds and sideways snow.
My life was in their hands everyday and they are sending me home intact. 
Thank you and Namaste gentlemen. Let's do it again next year. 
Thanks to Capt Andrew, Capt Chris, Capt Nischal, Capt Deepak, Capt Kiran and Capt Dave. 

Everybody Goes Home...

I don't even know where to begin. The last four days have been a blur. Multiple 4:30am wake ups for all day missions. Guess I'll start at the last calm evening. 
The final week of the Everest season typically provides a fair bit of high mountain drama and this year has been no different. 
Hundreds of people all move up into position to summit around the same time. This is due to the weather window being fairly narrow and if you miss it, you're either stuck in screaming winds and cold or you call it and come home with no summit. Many teams feel this pressure and all line up at the same time to hit that precious week of low winds. 
A number of folks get in trouble and many of them don't have the moxie or the assistance of a world class guide to get down alive. Crowding, wind, cold and inexperience all play a big part in creating a total shitshow. This what we encountered the last few days. 
The weather forecast for the night of the 17th showed very high winds so we assumed that all the teams would see the same thing we did and delay arriving on the exposed South Col (Camp 4 @ 26,000ft) till the next day. Turns out, several teams went anyway. 
And this is when the wheels started falling off. 
The next day we began receiving reports of 24+ hr summit attempts, frostbite, exposure and severe altitude illness. We were hearing that clients and a few Sherpa guides were scattered and stranded above high camp and in big trouble. Many of those that did get down to the relative safety of Camp 4 began tearing through other teams' supplemental oxygen cylinders. Obviously this is a shitty thing to do and in my opinion, is not only worthy of an ass whooping, it's grounds for criminal charges. Stealing supplemental oxygen from climbers that are expecting it to be in place for their upcoming ascent or for use in emergencies is about as low as one can go in the world of mountain karma. It has happened before and sadly will happen again. 
We were hearing that Chinese, Indian and UAE teams were reporting several of their members were either broke off completely and requiring assistance or, in a few cases, unaccounted for. Anticipating such a setting, we had arranged for our stud Sherpa team to be in place at Camp 4 the next day to help clean up the mess and help evac climbers in need. Once the rescue request was made, our guys activated quickly. We got confirmation that an Indian woman and her Sherpa guide were "stuck" just below the south summit (28,500ft). At the same time that call came in, Lakpa and Nima Dorje were tending to a sick American climber that was the client of a fairly large operator on the mountain. They worked alongside the guide to nurse this fellow back to health and ultimately helped in lowering him all the way down to Camp 2. 
So that left Mingma and Nima Ninja to head up from Camp 4 to locate the Indian woman and her guide. For all intents and purposes they were essentially on the moon... and our guys would be their only chance of survival. 
It was 8pm and -20F. 
The next morning we woke to hear that our guys had found the 2 stranded climbers at just above 28,000ft. They were out of oxygen and water. Our guys provided them hot drinks and then, because of the disparity of extra oxygen cylinders, provided them their own personal oxygen masks. 
Talk about selfless. 
The woman was barely able to bear weight and required over five hours of labor intensive "short roping" down to Camp 4. Essentially they lowered her 2,000 ft down a snow slope with the occasional rock feature. 
At the same time these events were unfolding, we were getting word that a young Dutch male had died at Camp 4 after returning from the summit. There are plenty of news outlets reporting extensively on his plight so I'll just add that his sudden deterioration was another source of confusion and tension in the flow of communication between the players at Camp 4, Basecamp and Lukla. 
That morning I hopped in Andrews stripped down Dynasty bird and we headed to EBC knowing that we were about to have a massive day of evacs and full blown rescues. One by one, Andrew landed at Camp 2, loaded up a single patient and dropped them with me at EBC. Twelve round trips later we had evac'd a ruptured Achilles' tendon, 4 deep tissue frostbite cases, 2 altitude illnesses and our 4 bad ass Sherpas. 
At that point it was noon and the weather was starting to deteriorate so we flew back down the valley to Lukla with the most critical of our lot. The remaining evacs were ferried down by other helos and the most in need of acute frostbite care were ultimately flown down to Kathmandu.
That evening as we are eating supper, discussing the day's events as well as what the next day might look like, we begin hearing the storyline of an Australian female climber who was in the middle of a full blown epic above Camp 4 with multiple Sherpas attempting to bring her down. I received a call from Gordo at Basecamp around 8pm requesting medical advice to pass along to the team that was trying to stabilize this woman. It sounded like she was quite ill but had a solid support staff tending to her. We discussed a plan that was to be passed on to Camp 4 and agreed to communicate throughout the night should her condition worsen. 
Around 5am the next morning I got an update that she had made it through the night, was speaking and the rescue team was very shortly going to begin assisting her down the mountain. 
We had several more evacs to clear from EBC that day so Chris and I stripped the seats from Kilo Bravo and headed up towards EBC. As we turned up above Pheriche, we ran into a wall of wind and snow that bounced us around enough to where Chris called it and we headed back to Lukla to wait it out. The weather in this valley is unquestionably the most fickle and unpredictable as anywhere in the world. We hoped to wait out the weather and go rescue this woman either later that day or perhaps the next morning once the Sherpa team delivered her to Camp 2. 
As we sat in the teahouse waiting for the clouds to clear, we got word that the female climber had died during the descent to Camp 3. The effort to get her down that terrain was superhuman. I'm confident that everyone involved did everything they could to save her life.
I had never met this woman, but her survival meant a great deal to me. I wanted so badly to help load her on the chopper and take her down to Kathmandu. I visualized it the night before. But it just wouldn't be the case. Once again, countless media sources have provided commentary about the death of this young woman. I've got nothing more to add. 
The next day we heard that our Sherpa team had just arrived into Camp 2 with the Indian woman they had rescued from just below the south summit. It was time to go pick her up. An hour later, Chris and I had Kilo Bravo stripped down and ready for the trip to Camp 2. As this was Chris' first landing at C2, we decided to drop me at EBC so he could navigate the tricky terrain with the absolute lightest helo possible. I watched as he crested over the icefall out of sight into the western cwm in very shitty conditions. Five minutes later he came over the radio telling me he was on his way down with a fairly critical patient.
I hopped in the bird with Chris and finally laid eyes on the Indian woman. She was not well. Shallow respirations, thready pulse, sluggish pupils and lower extremity cold injuries. Sick.
We lifted off from EBC weighted down and booked it straight to the Lukla hospital. We stabilized her and ultimately shipped her down to KTM to address her frostbite therapy. She'll live to fight another day. 
I didn't know it at the time, but that would be the final rescue of the season for us. The few remaining climbers descended without issue and we went straight into beer drinking mode. 
It's gonna take me awhile to process this two month experience. I'll have to reflect on it and I'm sure I'll write a bit more. 
For now... I turn my attention to putting a bow on it. It's time to go home. To my family.

I Work With Some VERY Bad Dudes...

To date, this was the most high profile rescue of the season and showcased to the world exactly what I've known for months... our Sherpa rescue team is the most bad ass, highly trained, hard charging collection of alpine rescuers the Himalaya has ever seen. 
Yesterday we received a report that 2 Slovakian climbers had been hit by an avalanche around 23,000 ft while climbing the extremely difficult southwest face of Everest. They were stuck, one was injured and they were requesting a rescue. Based on sat phone reports from the climbers, they were perched some 2,000 ft above the valley floor, holing up on a ledge known as Bonningtons Plateau. They could neither ascend nor descend. A long line helicopter rescue was out of the question based on the steepness of the slope and surrounding rock and ice. In order to rescue these guys, a team would have to climb up the technical face, secure the Slovaks and descend with them to standard Everest Camp 2. 
Our 5 man Sherpa team have essentially been training their entire careers for this operation and knew this was the type of mission for which they were in place on Everest for the season. Once they heard about this and what it would require of them to accomplish the task, they were like caged animals at basecamp... they couldn't get their harnesses on fast enough. 
The southwest face of Everest is unquestionably one of the most technical and challenging routes on the highest mountain in the world. Sir Chris Bonnington lead a team of Brits with the first successful summit of the route in 1975 and it has only successfully been repeated by two other teams since then. Several other teams have attempted it... all have failed, several have died.
It's steep, sustained and has an abundance of objective dangers at every turn. 
At the moment, our Sherpa team was positioned at Everest Basecamp (EBC) preparing to ascend to Camp 2 tomorrow and rotate around the mountain for the next 2 weeks as the heart of the summit season is in full swing. So, first things first, we had to get them up to Camp 2. I hopped in the Dynasty helicopter with Andrew again and flew up to EBC to help coordinate and discuss the next 24 hr operation with our EBC team. In order to move 4 of our guys and all of their gear, it would require 4 helo shuttles from EBC up to Camp 2. They would then begin climbing from there up to the Plateau around noon with the hope of reaching the Slovaks by dark. Then it would be up to them based on time, terrain, condition of the climbers and group fatigue whether they would continue to descend or wait till morning. I gave them each a big hug and wished them safety and strength as they boarded the stripped down bird in succession. Close to an hour later, Andrew had them all in position at Camp 2 and I flew with him back down to Lukla where we would monitor comms all afternoon into the evening. 
We settled in to our Lukla headquarters and patiently waited for each of the team's transmissions. They were climbing fast. And I mean really fast. Within 2 hours they were half way up to the Plateau. Another hour later they relayed back to us that they had made visible contact with the Slovaks. Then, 4 hours and close to 2,000 vertical feet of technical terrain from stepping off, they reached the stranded party. 
They found one of the climbers to be able bodied and ambulatory on his own power. The other guy was essentially blind from taking the brunt of the spindrift avalanche in his face which left him with painful corneal abrasions. He could walk but would need guidance with his new found blindness. 
A blind dude descending Everest... I've heard that story before 
The team made a quick decision to start the descent in deteriorating conditions at 6pm. Ballsy for sure. We expected to be sitting by the radio till the wee hours, so we were a bit surprised to get a transmission 2 hrs later that the entire team and Slovaks had safely made it back to Camp 2. An absolute Herculean effort. 
The next morning Andrew and I headed back to EBC in a stripped down bird. A quick stop at the EBC landing pad to drop extra fuel and the two of us began the circling flight up to Camp 2 at 21,000 ft. The conditions were perfect as we crested over the icefall and entered the Cwm. The walls of Everest, Lhotse and Nuptse were glistening with fresh snow. We got a visual on the lower landing zone and Andrew deftly landed us on top of the glacier. 
I exited the helo and walked directly to our Sherpa team and bear hugged each of them. They looked remarkably fresh. 
Then I got a good look at my blind Slovakian. He had a patch over his right eye, sunglasses on and was sitting on his pack in the snow. I had him hold onto my shoulder as I led him into the spooled up helicopter. Andrew lifted us off, swung the bird down the valley and over the icefall. We landed at EBC a couple minutes later and got out so Andrew could return for the second Slovak.
The mid 40s, temporarily blind Slovakian climber was all smiles upon landing. I applied some ocular drops in each eye which quickly relieved his pain and I watched him fully relax now that his pain was gone.
He knew how close they had come to the edge and what an effort our Sherpa team had gone to in order to safely get them down. He was effusively grateful. Yesterday afternoon they were precariously perched high up on a technical face unable to escape... today, they were headed down to Kathmandu for more pain meds, a hot shower and a hotel bed. 
There is no doubt that what our Sherpa team did yesterday was of epic proportion. Their job this season was to conduct rescue operations on the biggest mountain in the world. They transcended that yesterday and took it to legendary status. 
They are my heroes. 
One self-appointed spokesman of the Khumbu newsfeed claimed from his home in the U.S. that we "aggressively inserted" ourselves into the scene to perform the rescue. It should be clear that without an aggressive approach these Slovakian men would have met a much different fate. 
The summit window is wide open for the next 10 days. I'm guessing our guys will have more work up high.
And we will be aggressive.

Go Save Jesus On Your Birthday...

Due to spotty (read... none) interweb, this is a post from last Saturday.
Today we completed a 24 hr rescue of 2 Slovakians that were trapped on the Southwest face of Everest. More on that later.
For now... May 7. 
The older you get, the less important birthdays are... right?
Well, this one was pretty important. 
I woke this morning only to remember that it was my birthday after seeing the date on my watch as I quickly pulled myself from bed to get dressed. We had work to do and birthdays were an afterthought. 
We received a call last night that there was an extremely critical climber circling the drain at Makalu Basecamp (19,100 ft). The report was that he was very close to death and everyone there was concerned he would not make it through the night. All the other important facts like age, gender, nationality, history or chief complaint were not filtered down to me so this would be flying in to the darkness towards an unknown situation. Pretty much par for the course over here. 
We spooled up the helicopter and were just about to lift off as a massive cloudbank enveloped the heliport in Lukla. The pilot turned down the engine and we watched in awe as the helicopter was instantly swallowed by white. Couldn't see 10 feet beyond the bird. 
And just as with most important things in life... the timing was quite auspicious. Moments later the bottom dropped out of the sky as a monsoonal rain pounded down for a solid 2 hours. If we had lifted off two minutes earlier, we absolutely would have never made it up to rescue this fellow some 10,000ft higher up and surely would have been shut down from returning to Lukla... and potentially a lot worse. We were grounded and would have to delay till the next morning. 
I went to sleep last night not knowing anything about this sick person that was surely having the shittiest night of their life. Perhaps he/she wouldn't even make it through the night. Maybe this person felt like we had abandon them. I tossed and turned wondering how alone and scared this person must feel. 
So this morning dawns with patchy clouds and no wind. I was fired up to get going and hopefully save this persons life. We spooled up again to go see what we would find some thirty nautical miles and a lifetime away from Lukla. 
Makalu is a stunning mountain a couple dozen miles east, southeast from Everest. It sits very close to the Tibetan border as a stand-alone sentinel almost to distance itself from the crowds on Everest. To fly there requires crossing one of several high passes. On marginal weather days it's advisable to start evaluating the succession of passes from lowest to highest... obviously using the the lowest one possible, only using the highest one as a last resort. 
As we crept up the valley, my pilot Nischal and I kept gazing out the right side of the bird to see if the lower, standard pass was open. Not a chance. Completely socked in. OK, higher up the the valley we eval the next option. Nope. Massive wall of clouds. Higher and higher up the valley we go. Past the last, highest village of Chukung. Then over Island Peak Basecamp and into a sea of clouds. Captain Nischal and I started referring to our strategy as "connecting the dots". He would fly a hundred yards and then find a little "sucker hole" and take it, each time gaining some altitude. We continued to climb... now over 20,000ft. I would occasionally catch a glimpse of some Himalayan giant out of the glass in front of me... just popping through a veil of clouds. We were heading for what I thought was the absolute highest pass over to the Makalu region and it looked fairly clear on our side. As we drew closer we both let out an audible "shit" as we saw the impassable cloudbank resting just on the other side of the pass. 
I thought that would be the end of it and we would turn back, but Nischal in his 18 years of Himalayan piloting said... "Let's try the very highest one. Our last shot." 
OK. Let's do it. 
We climbed another couple hundred feet and followed a massive, corniced wall as it hooked around to the north until a small nook appeared. The captain deftly crested about fifty feet over the ridge down the other side. The helo altimeter read 21,000ft. I could feel that the helicopter was straining at its max, cutting through the thin air with every rotor spin. 
Five minutes later we came in hot on top of Makalu Basecamp. Our patient was a mid 30s, Spaniard named Jesus that could not walk. With the help of the ground crew of Sherpa, I loaded him into the helo till he flopped into the back floor. I turned his oxygen mask up and told the captain that we were locked and loaded. He powered up the bird and I listened again as the rotors thwapped through the thin air. 
Jesus was a very experienced climber with five, 8,000-meter peaks on his resume. He had never had any physical problems in his 10-year career. Throughout the flight he continued to describe to me in Spanish how he was convinced he would have died within two hours of our arrival. He had been suffering from a very elevated heart rate and chest pain for 2 days and told me he was losing his will to fight. 
We flew him straight to the Lukla hospital where his tears flowed freely. I told that him that today was my birthday and he had given me the best present ever. He gave me the opportunity to be a part of a renewal of life. I was a part of a team that gave him the chance to celebrate another birthday of his own. 
I can't imagine a more profound gift.
Well... that, and we got to rescue Jesus on my birthday.
Pretty dope.

Be Of Service To Your Own...

Yesterday’s morning radio comm began with a rather impassioned call from our team up at Everest Basecamp imploring us to get a bird up to Camp 1 as promptly as possible. A close friend of one of our 5 super-stud climbing Sherpas was at Camp 1 in dire straights. The evening before, while carrying a load through the icefall, this mid 20’s, highly experienced climbing Sherpa had an acute onset of left sided chest pain. The story we were receiving was that Ongchu Sherpa was writhing in pain, clutching his chest and gasping for air. And this dude was a stud… not some middle-aged, guided, western climber. This lead climbing Sherpa had multiple 8,000-meter summits under his belt including standing on top of Everest twice. His Sherpa brethren surrounding him were extremely concerned for him as he was clearly in overwhelming pain and from their perspective, close to death.
We absolutely needed to go get him.
And here’s where things get a little complicated… both of our helicopters were grounded down in Kathmandu getting their regularly scheduled maintenance. So of course during our mandated 4 hours of down daylight time, we have a “do or die” mission requiring a helo evac from 20,000ft.
Luckily for us there is another helo operation basing out of Lukla with a badass B3 bird and an even badder ass Kiwi pilot named Andrew. I had been intermittently chatting it up and swapping stories with Andrew during the month the two of us have spent flying on separate operations in and out of the Lukla heliport.
Good dude.
Sick pilot.
So let’s get to work.
Once all the operations guys made their deals and we were confirmed a go, Andrew and I high fived and started planning. We would strip all the seats out of the bird here in Lukla, clip me in via my climbing harness into a fixed cabin bolt and fire up to Camp 1 to scoop up this fella.
I have to admit that I was just a twinge skeptical that a healthy, mid 20s, super fit climbing Sherpa was having a heart attack… but the approach to medicine is always to assume the worse and work backwards from there.
The weather was manageable with gentle winds as the patient was loaded into the bird.
Then I got my first look at this guy.
He was sick and this was no bullshit.
The report from up high was bang on… true to the tale, as he collapsed into the helo he clutched at his chest and squirmed violently in pain. As I went in to move his sunglasses aside so I could more clearly see his face, he took a wild, scared swing at me. He was in pain, frightened and delirious.
The last thing you want in a helicopter is to have a passenger goin all UFC in the back of the cabin. I managed to get a quick exam in with some basic vitals and promptly loaded up a dose of Haldol. This would shut him down for the length of the flight and allow us to safely return down valley.
The 10-minute flight felt like an hour. Every minute or two Ongchu would appear to pass out for a couple seconds, requiring me to press him with a solid sternal rub after which he would pop up in another confused thrashing session. The Haldol helped to sedate him but he clearly still had some fight left hiding inside his pain and delirium. Each time he dropped out I prepared to begin CPR on him…but each time he would spring back to life.
I alerted Andrew of Ongchu's tenuous condition and how great it would be to get down valley as quick as possible. Then Andrew gave me a choice… fly at a higher elevation and arrive a minute quicker or stay lower in the valley and take that extra minute in flight time. I chose to get lower as quickly as possible as my likely diagnosis was starting to take shape in my mind and the higher altitude was not helping his case. I began to get a sense that this was in fact not a heart attack but an episode of coronary artery spasm, which is not all that uncommon with exertion at altitude. The process is just like it sounds… the coronary artery goes into spasm, which intermittently occludes blood and nutrients into the heart. It hurts and robs a heart of the thing it needs the most… blood. Typically these episodes don’t last a very long time but my guess was that the excessive altitude exacerbated this whole process.
It felt like we were in a rocket ship. Faster than I’ve ever been in a helicopter. Andrew very nonchalantly radios back that he has the helo pinned. 
No shit.
We are absolutely nuking down the valley.
We make the call to bypass the helo pad in Lukla and head straight to the Lukla hospital landing pad. I knew the local hospital had all the staffing and equipment to handle a potential cardiac patient and was an hour closer than traveling all the way down to Kathmandu.
Andrew requested the tower hold all other aircraft as we blew over Lukla and dropped down onto the hospital LZ.
We carried Ongchu into the ER bay, got him settled into a bed, hooked up to monitors and I officially handed over care.
Yesterday afternoon I ventured back over to the hospital to get the final diagnosis. Dr K.C. confirmed my suspicion… no signs of a heart attack but we both agreed that his heart was indeed sick and he was in need of further cardiology follow up in KTM today. That quick 10,000ft descent relaxed that coronary artery and his heart began to normalize.
Our Sherpa crew felt this one. They were scared for their friend.
It’s another clear illustration… altitude is no joke. It’s the invisible assassin. Can take a strong man or woman and drive them to their knees.
I’m very satisfied looking back on this one. Our team showed how well it could perform at a high level with absolute situational awareness.
No down days in the Khumbu.