Doctors in the mountains. The heroes of the background

“Doctors in the mountains. Heroes of the background” is an extraordinary story about the most spectacular rescue operations, mountain tragedies that were avoided only thanks to the dedication of doctors. It is also the story of the mysteries of the human body at altitude, exposed to the most extreme conditions.

The authors of the book introduce the role of doctors, describe the most dramatic accidents in the history of Polish Himalayan mountaineering, but also the everyday life at the base, often funny. They talk with climbers and with the doctors themselves, present the profiles of some of the most intensively working in the mountains. They reach back into history to show how rescue service and mountain medicine developed.

They write about medical issues, such as those related to Out of Body Experience, common at high altitude. They do not avoid painful stories when the rescue was already too late. With subtlety they describe the moments when the climber and the doctor were losing that most important duel, the battle for life.

Read excerpts from the book “Doctors in the Mountains. Heroes of the background”.

To some extent, frostbite is a problem of technology. In the past they happened more often, and above all, they were more severe, because the clothing was of lower quality. The equipment of the Polish expedition to Everest in 1980 in comparison with what some tourists now wear going through Zawrat to Pięciu Stawów is heaven and earth.

– Multi-layer boots, goretexes, fleeces, primalofts, chemical and battery operated cell phone heaters. Of course, winter on an eight-thousander is still hardcore, but even a bit lower it’s mainly a matter of spending money and basic knowledge,” says Mazik.

Wielicki climbed Everest in a flannel shirt, a woollen sweater and gloves, with ordinary welding goggles on his nose. And Andrzej Lapinski, while climbing Kanchendzonga, reached 8050 m in Odra jeans. The fact that he didn’t get a 99 percent discount for the rest of his life was only due to the fact that in communism marketing directors didn’t have sales targets, because everything went off in a flash.

There was romance in that climbing, and above all, the willpower of the first conquerors. Wielicki recalled many times how on Kala Pattar near Everest he met Sir Chris Bonington, who was sitting and looking down at the colourful camp of hundreds of tents. When he saw Christopher sitting down, he recognized him, greeted him and said:

– When I was here in 1975, we were alone.

– When I was here in 1980, we were also alone – added Wielicki.

– It’s worth being born at the right time,” concluded Bonington.

One must also admit, however, that despite growing knowledge, various myths about frostbite are still being spread. And sometimes some Himalayans can’t be convinced because they know their own. Example? Aspirin can sometimes cause frostbite, and it can also cool you down faster. When your arteries dilate, you lose more heat.

– Professor Korniszewski adds: “One more important thing. – There is no such thing as partial defrosting. We either defrost completely or not at all. Let’s say that we are coming down from the IV camp and we can’t feel our fingers. Not feeling them doesn’t mean you’ll lose them. If someone thinks to themselves that they have two hours, so they’re going to take off their boot, massage it a little bit, warm it up, and that’s going to take care of the problem, they’re wrong.

If you don’t have the ability to use hot water and stay at least overnight where you’re going to warm your foot, you’re better off going down during that time. Just talk to the cooks, who will tell you if it’s a good idea to take the chicken out of the freezer, and put it back in there after it’s partially thawed. A chicken after such an experiment sucks and so will our leg.

– I remember,” continues Korniszewski, “that the expedition to the south face of Annapurna in 1988 included two Ecuadorians: Ramiro Navarrete and Francesco Espinoza. At base camp they practiced for hours. One was a bullfighter, the other a bull. They showed us phrases. It was funny and a bit childish. Unfortunately, during one of the exits, Ramiro fell about 1500 meters.

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The mental shock that Francesco suffered made him feel so weak and sick that he refused to march in the caravan down the path. What was to be done, we had to put up with him. In Kathmandu the nibble came back to life. But the story is not about that. At the base camp it turned out that he had frostbitten his toes. He must have taken his gloves off somewhere or walked without feeling his fingers. Although it was severe frostbite, he managed to save them. I did not see the final result, but I got a thank you letter from him.

He wrote that the fingers are whole and there is no mark on them except for two scars on the thumbs.I want to emphasize that the treatment was successful because we watched the procedures. Francesco had confidence in me and followed instructions diligently. Despite the uncomfortable conditions during the descent, we often measured the temperature of the water in which he defrosted his hands – recalls the doctor.

You have to know and always take into account that a frozen foot or hand is like a piece of ice. Placed in a bowl it cools down quickly. So you need to check its temperature every few minutes. The optimal temperature is between 38 and 42 degrees.

– That’s how we fought frostbite on Maciek Berbek’s feet. He only half-successfully lost the tips of his toes and unfortunately one big toe fell off almost completely,” says Korniszewski. Fortunately, there was enough left for him to wear flip-flops, which he liked to wear when it was warm.

It was the mistakes of the doctor – as Alek Lwow writes and Jan Serafin indirectly confirms in the already quoted collective report – that made Tadeusz Łukajtys, who froze to death at Dhaulagiri in 1983, lose all his fingers.

A psychiatrist from West Berlin, Eva Demant, who was a doctor of the Wroclaw-Toruń-Gdańsk expedition to that peak, had absolutely no knowledge how to treat such cases. Another thing is that the leader Wojciech Szymański didn’t order a helicopter and the frostbitten man was coming down to civilization for over a week. First on foot, then on horseback. It certainly didn’t help his fingers.

To be fair – all the conquerors attacked the peak without proper acclimatization. This greatly slowed down the march from the last camp and caused the signs of altitude sickness (especially in case of Lukajtys) to take their toll. Łukajtys, the popular “Klaus”, a compulsive smoker, despite the cold, often took off his gloves to smoke, and eventually lost them. And just below the summit, after smoking another cigarette, according to his friends, he threw himself with his bare hands at the Soviet tanks that had appeared to attack Afghanistan.

He managed to calm down, but after a night’s sleep he was in such a bad condition that he had to use the help of a belayer to descend, which greatly delayed the march and contributed to his colleagues’ increased frostbite. As a consequence, apart from Lukajtys, Jacek Jezierski lost all his toes. Mirosław Gardzielewski also underwent a long treatment.

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Professor Lech Korniszewski recalls that he had the most serious frostbite at the airport in Pokhara.

– It was before the national expedition to Everest in 1980. I came across a team of climbers from Jelenia Góra in front of the building. They were waiting for a flight to Kathmandu and returning from the south face of Annapurna. A picture of misery and despair. They were sitting on their luggage almost motionless, very depressed.

As I approached, I saw for the first time what a foot looked like with all its toes frostbitten. They were black, wrinkled. And when I started looking at them, wondering what to do about it, the owner of the foot – I don’t remember his name, but his name was Marek – said: “You know what, I’ve already crushed two here, I’ll show you right now”. Before I could protest, he grabbed the end, something clicked and he put the piece of his finger under my eyes.

What impressed me the most was not the breaking of the finger itself, because as a doctor I had already seen a lot, but what happened next. A bunch of hens walking on the ruddy lawn in front of the building fought fiercely for a few minutes over that piece of Mark’s dead body. And we were all watching.

I was definitely more concerned than the owner,” says the doctor. As vividly as this veridical description, it comes close to Elizabeth Hawley’s recollection when she visited Willie Unsoeld treating frostbite at home in Kathmandu after a bivouac and her first traverse of Mount Everest.

“I remember, he was lying on his bed. He was playing with one of his toes – one of the smaller ones – like it was a moving tooth, like a child who plays with a tooth until it falls out.” The American paid for his success with the loss of nine toes.

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