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.

Perfect.

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.
‪#‎beofservice‬