Thursday, August 27, 2015

Summit Night… The Microcosm of Life

It’s 1:30 in the morning and you’re wide-awake. And it’s not because you’ve been partying balls and have the munchies. In fact, you’re lying in your sleeping bag, in a tent at 16,000 ft with a slight headache that just won’t seem to go away no matter how many grams of Tylenol you ingest. The guy in the tent next to you is crushing logs so deeply you are convinced he is wrestling a wookie…. which makes your lingering insomnia even more frustrating.
On top of the tossing and turning in your stinky sleeping bag, you are racked with a cocktail of feelings and emotions.
Excitement, Fear, Uncertainty, Nervousness, Self doubt.
All percolating in your sleepy head.

This is a typical scenario for most folks as they prepare for a summit attempt on a mountain with any substance to it. I have seen it play out for over 20 years…including last weeks Kilimanjaro expedition.

This was another good one…

As I typically do, I had planned out the staggered times of departure our team based on observed pace over the previous week. Alpha team would depart at 3am and I would depart with Bravo team at 4am. I downloaded expectations for the clients, established contingency plans for potential evacs, arranged my African guide team in the order that seemed most effective… and so on. Dot all the “I”s; cross all the “T”s.

Then we step off…and it all changes. As usual.

Within 10 minutes from camp I noticed that one of my strongest returning vets from last year’s Whitney expedition was dropping off the “peloton”. I spent 30 minutes with him, trying to get him fired up and coax him into lock stepping with me as I watched the rest of the 24 clients slowly pull away up the hill by the light of their headlamps. His legs just felt heavy and his motor wasn’t firing. We’ve all been there. It just wasn’t his day. We both knew it.
But this wasn’t the guy I expected to drop off early.
Alas… strange things happen up high.
As I left my guy in the competent hands of my assistant African guide, I charged up the hill to join the rest of the team. And all was back to normal. The cacophony of folks pressure breathing. The shuffle of the dirt and rocks. The chant of Swahili song. All sounds that are so familiar to my ears on Kili summit nights.
And then…

“Shit!!! Shit!!! It’s out again!!!”

From 10 meters up above, I knew immediately whose voice it was and exactly what he was referring to.
It was Rick and he was reacting to the fact that his wife, Tina, had her shoulder dislocate. Again. This time at 17,500 ft.

A week before, in the midst of the pre departure excitement of arriving at the gate and preparing to step off on this grand adventure, Tina had lowered herself down from the Landcruiser using her left arm in a stressed angle and suddenly…
It was out. First time ever.

Now I've put a lot of shoulders and hips back in place over my 20-year medical career but never on Day 1 of an expedition at the entry gate, literally minutes before we were to step off on a 7 day expedition.
With about 2 to 3 minutes of manipulation, I was able to reduce the shoulder back in place. She showed her grit and strength during the procedure and once she was slinged up and and her pack was handed off…she acted as if nothing had even happened.
The women are stronger. No doubt.

Back at 17,500 ft the sun had just crested over the horizon, Venus was glowing red in the low sky and the coldest hours were behind us. The backdrop couldn’t have been more magnificent… but the levity of the dislocated shoulder was significant.

We all breathed together. Calmed down as best we could. Situated our bodies to get good position on the shoulder and arm. And I got to work. There are several approaches and techniques for reducing shoulders and sometimes they are all needed to finally get it back in. This was one of those cases. I attempted the approach I was successful with 7 days prior. Nope. No matter how hard I yarded on Tina’s shoulder and how much pain I subjected her to… still out.

She went to a deep place. A deep meditative place that takes skill and experience to reach. A place that most of us won’t know. I watched my wife go there during her 18 hours of natural childbirth.  I’ve seen a handful of climbers go there during rescue operations off of Alaskan peaks back in the day when I was working SAR in the Range.
But a weaker person would have crumbled into a sloppy pile of blubbering shit. Tina did not. She stuck with me as I changed my approach. Again and again.
Thirty minutes went by and it was still out. I had run through my bag of tricks.
Forty-five minutes now and I was getting scared. Every minute that went by meant that the musculature and tissue around the shoulder joint were clamping down and making it progressively harder to reduce. If we would have been in the safe confines of an emergency department, we would have sedated Tina and administered some muscle relaxants to drop the head of humerus back into it’s joint space.
But instead, we were leaned up against a rock in the dirt at sunrise close to the summit of one of the “7 Summits”.

In somewhat of a last ditch effort, I positioned Tina head to head with me, standing, facing me. I held her forearm with one of my hands and with the other I slowly continued to manipulate her shoulder. I closed my eyes. I prayed. And the Great Spirit, she listened.


It was back in.
Slowly I applied a sling and swath and started into the conversation with Rick and Tina about the next steps.
Clearly Tina was headed down. But what about Rick?
Rick is a tough dude. He is like me in the sense that his character is to summit. When he attempts something, it will get done. This is who he is. He was born to summit.
I offered to take Tina down and let him go up with the team on stand on top.
After a quick consult with Tina, he told me there was no question… he would accompany his wife down.
I was more than impressed with this decision. He chose commitment to his wife over his own aspirations. He chose to be a servant leader.
Bad ass.

OK…get them packaged up and set up with an African guide for the descent and get back to work with the team… who were now an hour above me on the mountain.

As the adrenaline of the shoulder incident ebbed from my body, I kicked it into a high gear and caught the team within 20 minutes.
And it was then that I realized I was smoked. My heart pounding out of my chest. My energy levels clearly effected. Not something I wanted my clients to take note of.

I shelved it as best I could and methodically walked the remaining steps to the summit of Africa.

The joy and satisfaction was palpable. Within our coalition we had a blind vet, a vet with 1 foot, several other injured vets, a 66 year old woman that had never camped before and over another dozen folks that represent straight up Americana.

I was proud.

But then came the descent. Often times the hardest part. Physically and metaphorically. We must return home and share the story of the journey with those who weren’t with us. This is not easy. How do you capture the feelings and emotions that are only gleaned from battle with yourself and the elements?

Summit night captures the spectrum of the human condition.
That’s why we keep searching for it. We need to feel alive. And when the landscape changes in spite of our best efforts, we feel the most alive.