Passing the Gift of Humanitarianism: The Next Generation

I have spent the better half of my life attempting to blend my passion for adventure with a desire to impact the world in a positive and lasting way. Two decades as an international mountain guide and emergency medicine physician assistant have provided countless opportunities to be in very compelling alpine and medical environments. From guiding a blind man to the top of the world to volunteering in Nepal after the earthquake as well as embedding with the Iraqi Special Operations Forces as they fought to eradicate ISIS from Mosul… I have found ways to discover the dynamic of exploration and humanitarianism. As with most solid adventures, a few of them were even fun.

And for all of my son’s 14 years, he has watched his dad head out on these obscure missions. Early on, Jace never questioned why I would pack my duffels and be gone for weeks at a time, but as he matured and developed a deeper understanding of the world around him, his line of questioning would be more inquisitive of the why and who I was engaging with. Some of the missions were easy to explain, some a little more nebulous. But what he was always took note of was my fundamental desire to help “make the world a smaller place” by showing compassion to other members of our global community.

It was only a matter of time before we reached a crescendo with the “Dad, can I come with you on this one?”

My relationship with the Himalayan Stove Project (HSP) goes all the way back to its inception. My good friend George Basch accompanied our Everest team to basecamp back in 2001 and just like all of us, Nepal and its people became planted in his consciousness in a profound way. On each of his subsequent journeys back to Nepal, he continued to encounter a reoccurring problem at every teahouse he ventured in. The open-air cooking fires produced an extraordinary amount of smoke that filled the rooms with heavy particulates that were inhaled by all of the residents both young and old. George intuitively knew that this issue was contributing to a whole host of environmental and physical detriments. It became his charge to interpret the problem, engineer options and execute a solution. What sprang from that is the Himalayan Stove Project. Clean burning stoves, economically fabricated and installed into Nepali homes would lower the incidence of lung disease, cataracts and fuel resource consumption. I watched George turn a dream into a reality, impacting thousands of homes all over the country that I loved so much. I was proud.

So a few months ago when Jace asked to join me on a humanitarian themed adventure, I knew a family trip to Nepal to do the work of HSP would capture the essence of the effort. We worked with HSP to identify a remote village that would greatly benefit from the stoves, booked our flights and headed east. My wife Merry Beth and I agreed that we would encourage Jace to take the lead on fund raising (he helped to raise over $12,000) as well as be out front with the stove distribution and installation once we arrived into the small village of Odanoku. I radiated with pride as he went from one small mud hut to another, bridging the language barrier with gesticulations and comical versions of charades, problem solving and doing the good work. The villagers didn’t know exactly where we were from, but they knew it was a long way away. They seemed to genuinely appreciate this family of foreigners traveling from afar to not just give them a stove unit, but more impactfully, show them compassion and love.

Undoubtedly, my son grew from this experience and will be a better man for it. I can only hope that this was the catalyst for the next generation to discover the wonders of blending adventure, exploration and compassion.

Jeff Evans

1/1/2020

I Know Where I'm Going... Just Don't Know Exactly How To Get There

“I know where I’m going... I just don’t know exactly how to get there”... said our Argentinian guide, Diego while reviewing maps with me the night before we kicked off our 4 day trek through a ridiculously remote zone in Patagonia.
•
Isn’t that just the case?
Poignant as hell.
•
At some point most of us figure out what it is we are shooting for in life with regards to work, play & love... the challenging aspect is determining how to arrive there.
•
I know one thing for sure... in order to find that place you’re looking for, you are guaranteed to get lost in the thick forest and have to machete your way through the density.
•
Then, after the struggle and work pay off and you arrive, you realize that it was in fact that arduous journey that you were seeking all along. The battle is what you were craving. Because it’s the battle that defines us... not the end result.

Everest By Air

“Trust is the glue of life. It's the most essential ingredient in effective communication. It's the foundational principle that holds all relationships.”

Steven Covey

As I peered out the front window of the helicopter, I could see the bank of clouds powering up the valley right towards us with the look of a massive oceanic wave. A wall of thick, white whip cream that contained enough energy to drop a helicopter out of the sky. The weather in the Himalaya was notoriously fickle. Within minutes I have seen it go from perfect blue bird, T-shirt weather to batten down the hatches, put on every stitch of clothing you have and hang on weather. What I saw coming towards us sure had the look of a game changer. 

Our position at Everest Basecamp (17,200ft) was precarious at best… but absolutely necessary. The young Sherpa climber in the back of the helicopter next to me was waxing in and out of consciousness. He would come to, clutch at his chest, flail about for a minute, and then collapse back into unconsciousness. I was fairly certain that he was suffering from a condition called Prinzmetal Angina. This condition is when the coronary arteries spasm from stress, exertion or other factors. It’s technically not a heart attack, but it sure feels like it to the patient and looks like it to the bystanders.

As I was crouching in the back of the helicopter caring for the young Sherpa, his friends, brothers and cousins all anxiously spectated from just outside the machine, each with deep looks of concern stretched across their sunburnt faces. I’m sure they were confused as to why their otherwise healthy colleague was apparently dying right in front of them. They also seemed to understand the urgent nature of the situation and the need to get him down to a lower altitude promptly and how challenging that seemed due to the imposing weather barreling down on us. 

The weather was shutting down quickly and the patient was deteriorating just as quickly. 

The chaos wheel was spinning pretty fast at this moment and I had a sense that things were going to get worse before they got better.  

*

Six months prior, I received one of those “friend of a friend” calls.  My buddy explained to me that an acquaintance of his was part of a consortium of folks trying to put together the first ever Search and Rescue team to operate on and around the flanks of Mt Everest. They had the budget. They had the Sherpas. They had the helicopters. Only thing they needed was a medic. This medic would have a fairly specific skill set of experiences… great familiarity with Everest and it’s flanks, well versed in altitude medicine and a strong relationship with Nepal and the Nepali people. Oh, and also, this medic would need to be OK with flying around in a helicopter in the largest and most daunting mountain range in the world in ever changing weather conditions all the while working on critically ill and injured patients. 

Check. Check. Check. Check.

What could go wrong?

I’m in.

It’s become a fairly typical routine for me over the years… get an invite for some random, daunting project… deeply consider the consequences for a total of perhaps 2 minutes and then sign up. I’m not sure whether that’s admirable or reckless. Either way, it’s this approach that regularly slaps me down right in the middle of some fairly sticky situations. Perhaps one of the strategies I have incidentally stumbled upon is that if I quickly sign on to a challenging objective, I will then be absolutely forced to immediately take the deep dive into the preparation phase prior to putting feet on the ground.  Agree to go… then worry about all the training and prep after the plane tickets are bought.

Now I had spent over a dozen seasons climbing and trekking in the Himalayas… and I had spent several seasons working Search and Rescue on Denali in Alaska… but flying around plucking sick and dying people from precarious positions throughout the biggest mountain range in the world… that makes for a spicy recipe.

I spent the better part of three months prior to departure honing the skills and knowledge base that I would have to pull from during the rescue season operating in the back of a helicopter. 

I went to my Emergency Department and practiced intubating and starting IVs on a mannequin straddled on a stretcher while a friend shook the stretcher back and forth to duplicate the feel of a bumpy helicopter ride. That scene garnered some laughs from colleagues as they passed by the training room. 

I poured over maps and reached out to many of the guide services that would be guiding clients on Everest that season, inquiring about their climbing schedules and guides. I established relationships with the hospitals in Lukla and Kathmandu where we would be transferring critical patients. I did as much on my end as I possibly could so that when the shit hit the fan, I would be the best version of me as possible. 

All of that being said… there would be plenty of elements that would be completely out of my control.

It’s fairly common knowledge that helicopters are an effective method of transportation, especially in the ‘runway limited’ Khumbu Valley of the Everest region. It’s also fairly common knowledge that helicopters occasionally fall out of the sky. Especially with the fickle and powerfully changing wind and weather patterns of the Valley. Storms come out of nowhere and when they hit, they are ferocious, slapping everything around with complete disregard.

Including hovering aircraft.

I was quite aware of these topics when I boarded my international flight for Kathmandu. I squeezed my wife and kid tightly before I left, all of us acutely aware that the unthinkable was a stark reality. One of the helicopter pilots I had flown with in Nepal during the earthquake medical mission had just recently crashed into the side of a mountain killing everyone in the aircraft. My military friends had lost plenty of brothers in helicopter crashes. Turns out, helicopters crash. 

I promised them that I would do my job the best I could. I promised them I would be very situationally aware and not take any unmanageable risks. I promised them I would assess every situation and limit the amount of exposure to danger… as best I could.

And therein lies the tricky part. 

What might seem like a risk for one person might be a lot more manageable for someone else. My wife and I have slightlydifferent levels of acceptable risk. I made my promise to those I love the most with my optic of risk management as my measure. My wife and I were quite aware that flying in the helicopter would be an integral part of this mission and that this element would be 100% out of my control. We feel better when we are in control, that much is certain. But in order for a team to run at its optimum and most efficient gear, there needs to be a level of trust in the process. An understanding that each of has a particular job and if our rope team is constructed, developed and nurtured with compassion and attention to detail, the ability to give our teammates the breadth to operate objectively will be part of the successful executed process.

*

The young Sherpa sat up straight in the back of the helicopter, clasped at his chest and let out an agonal cry. The benzodiazepine syringe that I was holding in my hand dropped onto the cockpit floor as his arm swung around wildly. I located the syringe and with the help of my Sherpa team, got his jacket sleeve pulled back to expose his deltoid. Only a couple minutes after the jab, the Valium appeared to start to lessen the frequency of his painful attacks. All the while, my pilot Andrew was providing me up to the minute weather reports from the front seat, most of which were bleak as the cloudbank surrounding the bird showed no indication of abating. Our flight path from Basecamp would require us to lift off from the 17,200ft landing pad and make our way down valley in between the gargantuan walls of Nuptse, Pumori, Lobuche and Cholatse. The flying is precise and being able to visually identify the flanks of these beasts was critical. I could hear the slight concern in Andrews voice as he communicated back to me over our headsets. He knew the kid was in grave condition and needed to get down to lower elevations and he knew that our jet-A fuel was dwindling. He was also acutely aware of the ‘rule of the rescuer’… do not put the aircraft or its occupants in undue danger.

Suddenly Andrew called over to me on the headset, “Doc, I see a hole and am going to see if I can get us out of here.”

“We are packaged up back here ready to fly when you are”, I replied.

Ten seconds later I could hear the rotors start to spin with a more furious pace and the turbo began to whine in anticipation of lift off. I reached over and clipped the patient and myself into a couple of the cockpit eyebolts… the only option for security since we always remove the backseat when flying at extreme altitudes to cut down on weight. I felt the helicopter strain to lift up in the thin air and the nose start to point down valley. Although I was facing backwards toward the patient, I took a glance over my shoulder out the front of the helo and saw nothing but dense white. Andrew had made the judgment call and although I could not make sense of how we were going to find our way through the clouds, I was confident in my teammate and his decision making and piloting skills.

After a couple minutes of slow, tense creeping down the valley, Andrew spotted a patch of clear sky and shot right towards it. That clear air took us down to another spot of clear air and another and another until we were down somewhere around the 14,000ft mark with nothing but clear skies out the front window. We made our way to the Lukla hospital and within a few minutes after landing, we had the patient on a bed, hooked up to a monitor with a team of Docs and Nurses working to get him stabilized. He would live to climb another day.

*

When a distress call would statically come over our radios, several dozen variants would come into play immediately. Current weather, forecasted weather, current helicopter position, position of patient, condition of patient, potential landing zone and on and on and on. Although I would contribute to each mission discussion with the pilots, the director of operations and the Sherpas on the ground, my job was to be the medic. Not the pilot (he had his job). Not the Sherpa (he had his job). My job was very specific and had enough of its own critical decision making moments that I could not spend critical bandwidth contemplating the nuances of my colleague’s responsibilities. An effective team relies on the profound trust each member bestows on the others to do their job. Working on high-level teams with many moving parts requires each individual to empower those around you to optimize their performance so that you can effectively focus on your own objective.

*

A week after the Basecamp rescue of the young Sherpa, the morning of May 6^th dawned. The heart of the Spring Himalayan climbing season was starting to kick off. Teams were all moving and shaking up their respective mountains in order to be in position for a summit attempt when the jet stream lifted around the end of the month. Knowing this would be a busy time window, our SAR team remained vigilant for the pending distress calls from Everest as well as the proximal climbing peaks in the region. Sometime in the late afternoon we received a call that a Spanish climber was close to death at Camp 2 on an 8,000-meter mountain called Makalu. This beautiful but daunting mountain was a solid hour flight from our HQ over a very high mountain pass. Due to the limited daylight remaining, our options were limited to monitoring the situation and check back in the next morning with the hope that the weather was adequate to fly and make an attempt at retrieving the climber.

I woke on the morning of the 7^thand with all of the tension surrounding the pending rescue, forgot that it was my birthday. Our SAR headquarters in Lukla (9,600ft) was socked in with a thick layer of cloud cover and a threat of rain. Our inquiries up the valley where our flight path would take us towards Makalu also came back with patchy clouds and variable wind gusts. Not exactly optimum bird flying weather. The status report we received that morning on the Spaniard was that he was in and out of consciousness and only moderately coherent when he was awake. The folks taking care of him relayed to us that basically he would be dead by days end if not evacuated.

Anyone that has ever worked Search and Rescue would tell you that the first order of business is to never put the rescuer in a compromised position, by doing so, potentially adding to the casualty count. But this is the conundrum of working to save our fellow human beings… by pulling people out of deadly and tenuous situations; the rescuer is by default placing him or herself in potentially harrowing scenarios. What does that risk vs. reward equation look like? 

I stood on the heliport in Lukla discussing weather and options with Captain Nischal KC, the helicopter pilot I was working with that week. He was a seasoned and gifted Nepali pilot that had logged thousands of hours flying all over the Himalaya as well as Europe and North America. The week before, in a display of skill and absolute megaballs, he landed his helicopter in the middle of the Everest icefall in order to rescue an injured climber. No pilot had ever even imagined landing a helicopter in one of the most volatile pieces of terrain on the planet. So clearly I trusted Nischal’s decision making with regards to “go” or “no go”.

Our discussion was based on available collected data. Then all of the data was weighted accordingly. We considered all of the pressing variables: the clock was ticking on this guy… another few hours and he’d be dead. The clouds were thick up valley and behind those clouds were very large, immovable mountains. Unlike an airplane that can operate on instruments alone, visibility is paramount with a helicopter.

Our decision to go or not go was very collaborative. We both asked questions of the other. We were transparent and honest in the assessments we provided from a medical and aeronautical perspective. We had to both be all in to make it a go.

After much deliberation, it was decided that we would, at the least, take off and head up valley with the caveat that if we encountered a situation where the soup got too thick, we would bail and return home. 

Out of Lukla, the going wasn’t too bad… with the cloud bank hanging high in the valley there was a fairly clear path down deep between the cavernous mountain walls.  It was when we crested over the hill into the small village of Chukhung that things got a little spicy. The wind gusts began hitting the aircraft like a rattling Mike Tyson punch, lifting and rolling us back and forth. I could feel my stomach lurch up into my chest like similar to that feeling you get on a super turbulent airplane flight… only by an order of magnitude. The cloud cover thickened to the point where Captain Nischal had to move along at a very pedestrian pace, connecting the dots of clear air.

“It’s just a game of connect the dots” I said.

Nischal replied with a spry, “Yep, connect the sucker holes… with consequences.”

As we continued to fly up the valley gaining altitude, the intermittent flashes of brown terrain below us gave way to snow and then, with a full dramatic entrance, the massive glaciated face of Imja Tse filled the entire window of the cockpit. Fluted ridges dropping thousands of feet from the summit, cresting over massive hanging glaciers… all just a few hundred feet from our helicopter. It almost felt like we could reach out and touch the wall.

Nischal made a deft turn to the left to steer us away from the wall as the sky opened up before us. Just as the bird tilted to the left, Nischal’s GPS iPad that was attached to the front window via suction cup, popped off and clattered onto the cockpit floor and to make matters worse, slid up under his seat.

Now, it’s dangerous enough when this happens while you’re driving down the road in your car; but dropping your handheld device under the seat while you are flying a helicopter at 19,000ft surrounded by Himalayan giants is fairly unsettling. With the collected calm of a seasoned pilot, Nischal worked the yaw peddles and the cyclic stick gently while fishing around under his seat with his right hand… a smile across his face.

“Ah ha!” he blurted as his right arm came up from below with the wayward iPad in hand.

I gave out a weak and ever so slightly concerned, “Oh good.”

“Doc, can you hold this for me so I can see where to go?”

As I held the GPS for the Captain to peer over at intermittently, I could see that up ahead another cloudbank blocked what looked to be our intended path. Nischal clearly took note as well as I felt the bird tilt to the left again. We began climbing even higher now, attempting to find a clear route over the pass and over to the Makalu valley. I could see on the GPS that we had just crested over 21,000ft, tinkering close to the high altitude range of this powerful Astar B3 machine. The thwap of the rotors took on that familiar deep sound as they tried hard to dig into the anemic air.

Then Everest came into view, commanding the skyline… her beauty and majesty belying her ferocity and deadliness. Nischal leaned the copter in her direction and then it appeared; a low cut in the ridgeline with clear air. The Captain aimed the bird over in that direction and I felt myself take in a breath and hold it as we crested over the 21,200ft ridge and quickly dropped down into the clear valley below. 

The flanks of Makalu came into view as we rounded a corner and then, up in the foreground, what I assumed was Camp 2. As we approached we could see dozens of individuals on the ground frantically waving their arms in our direction. Looks like we found our guy.

Nischal gently set the helicopter down on the rocky landing zone and I quickly hopped out to assess the patient. His name was Jesus… yep, Jesus… and he was, as advertised, barely conscious. With the help of a dozen Sherpas, we loaded Jesus into the back of the seatless helicopter cabin and I buckled us both in for what I anticipated to be a fun reverse of the trip in.

Jesus perked up a bit when I started speaking to him in Spanish. He was coherent enough to understand me as I detailed what was about to happen. The flight path, the medicines I was about to administer, the hospital that we would reach in Lukla. He voiced understanding as we continued to gain elevation towards the daunting ridge ahead.

Nischal again repeated the flight path and dropped us down the other side, connecting the dots along the way eventually dropping us down at the Lukla hospital landing zone. Jesus perked up quickly with the sudden drop in elevation and began conversing with me in Spanish, telling me about his family and how this near death event would surely be the end of his climbing career. He was effusive with his gratitude for us and the effort we made to come retrieve him. He was keenly aware of the precarious nature of his condition and subsequent rescue.

I still hear from Jesus on a regular basis as he sends me seasonal photos of him back in Spain with his parents and siblings. 

*

Over the course of my two-month search and rescue stint, every single day was filled with dozens of fluctuating variables, any one of which could be the singular reason a life was lost. It seemed that every day provided a new rescue scenario that carried with it a myriad of mind numbing, mutating factors. Current weather, forecasted weather, current position of ground team, current position of helicopter, current position of the patient, jet A refuel options… and those were just the basics. Then the nuanced dynamics came into play… operational altitude, potential weight of helicopter with pilot/patient/medic, air density changes, snow conditions at landing zone, communications, etc, etc., in addition to patient diagnosis and treatment. Enough to make your head spin.

It’s easy for any of us to become overwhelmed with how so many variables can coalesce and conspire against our best intentions. At times it appears as if each speed bump on our path builds on the previous one until you have what feels like an insurmountable hill of dirt problems. 

In each of our rescue maneuvers that season, I had to calmly but efficiently work through an operational algorithm in my own head… focusing on the decisions that I was directly responsible for, communicating efficiently and effectively with my teammates, and then trusting them to manage their responsibilities; all the while understanding that some of the factors where simply out of our direct control. It was and always will be a matter of applying my bandwidth into the issues that are mine to manage and believing in my teammates that they will perform their tasks effectively.

Rarely a day passes that I don’t reflect on our rescue season in the Himalayas. I think of the patients we rescued: the matriarch grandmother of a small village that broke her back falling 20ft out of a tree. The young Tamang boy that we air lifted from a small village that had an undiagnosed bowel obstruction. The Indian woman that our Sherpas evacuated by sled down from 26,000ft. And of course, Jesus. But mostly I think fondly about my team of Sherpas and pilots who all were dedicated to their jobs and specific skill sets. Two months filled with close to forty rescues, filled with quick decisions, collaborative teamwork, complete with plenty of tense and awe inspiring adventures.

Risk/Consequence Relationship

In the month since I sat with wet palms through a pre screening of @jimmy_chin & his team capturing @alexhonnold climbing off the rocket ship and on to the moon... not a day has gone by that I don't reflect on the layers and optics it took to accomplish that mind bending feat.

•

For the one fella that is somehow unaware... #FreeSolo documents the journey that Alex took in considering, planning, training and ultimately executing the monumental effort of climbing El Capitan without a rope.

•

Among other heady topics, the film asks us to consider the risk/consequence relationship. Risk being the chance that something negative will happen and consequence being that negative result itself. Alex showed us that with absolute dedication to a challenging objective, it's possible to mitigate risk, all the while understanding that the consequence will still be profound. The subjective optic we all carry with us provides us each with an opportunity to accept the ratio of risk/consequence. I've done my share of what the world would call 'crazy ass shit'... although it all seemed fairly reasonable to me simply because I was prepared and ready for the task. Although the consequences have been high, I have been able to manage the risk through planning & preparation. Alex takes this strategy to the next level. Dream, plan, train, execute. Repeat. It's a solid learning opportunity for all of us that with enough dedication, we can aim high and manage the risk.

•

All that being said... I've climbed El Cap and there is no way in hell I'd go more than 10ft off the ground without a rope. So here's to shootin for the moon.

•

I believe the film is now being shown in theaters around the country and will soon make its way to Europe and beyond. Goes without saying, you should see it... climber or not, you will be required to evaluate what it means to step out into space and consider taking that extra move that scares you.

•

📸—> @erikweihenmayer and I mitigating risk on the North Face of Mt Athabasca in BC.

Teamwork Carry To The Top

Last Sunday was a gift and a privilege. The kind of day that underscores the beauty of a group of individuals coming together to help their fellow human being achieve something big.

.

@nerissa_cannon joined a @nobarriersusa event this summer, came away fired up and decided she wanted to climb a Colorado 14er. She was keenly aware that as a high functioning para, she would need to put out a rally cry for a team of folks to help her.

.

The community answered her request in full force.

.

21 of us showed up predawn last Sunday at the Mt Beirstadt trailhead and over the next 9 hours we assisted Nerissa as she worked her modified off-road chair by pushing, pulling and carrying her and her chair all the way to the summit and back down to cold beers.

.

There was laughter, frustration, joy, tears, fatigue, pride, resiliency... all the good ingredients of a solid adventure.

.

The most beautiful things take place when we embark on a mission that is uniquely directed at helping someone else achieve their dream.

.

Thank you @nerissa_cannon for the opportunity to spend the day with you. What’s next?

.

Also proud of @sheepdog_05 who put every bit of his 95lb frame into this mission.

.

#beofservice #servantleadership #mountains #mountain #ability #leanintoit #dream #teamwork #teamworkmakesthedreamwork #getoutside #coloRADo #colorado14ers #travel #climbing #climber

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.

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

📷sunrise over Mustang, Nepal. May 2006.
📷credit- Steven Rubin

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:

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.

Q:

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.

Q:

How did the team make the decision to involve those five specific Sherpas, and who are they?

   A:

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.

Q:

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.

Q:

Did it ever feel like there was any pressure of producing this TV show that resulted in changes in decision-making?

   A:

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?

  A:

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.

Q:

The TV show is a short, action-packed 30 minutes. What did a typical day really look like for Alpine Rescue Service?

   A:

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.

Q:

What are the biggest changes you’ve seen since your first trip to Everest in 2001?

A:

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.

Q:

Have their been other positive or negative impacts on the local community due to climbing?

   A:

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.

Q:

What makes running a rescue operation on Everest different from any other mountain in the world?

   A:

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.