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Assault on the Summit
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Altitude and the Brain: Cerebral Edema
The brain uses over 20% of the oxygen we breathe. Not surprisingly, therefore, hypoxia affects the highest functions first—such as judgment. This fact alone might be a contributory factor in some, if not nearly all, of the "accidental deaths" at altitude. Climbers on the highest mountains, especially in the Himalayas, have made mistakes they would never make on smaller peaks. In severe cases, the brain becomes waterlogged and literally swells. Coordination fails, and hallucinations become vivid. This is called High Altitude Cerebral Edema, or HACE, and a climber can die from it unless treatment is immediate.

climber on a slope

Hallucinations nonetheless are a regularly experienced phenomenon at high altitudes. Frank Smythe in 1933 saw strange 'flying objects' above the North Ridge which his friends jocularly called "Frank's pulsating teapots". Reinhold Messner, when he climbed the mountain without oxygen, felt he was reduced to a single gasping lung: "I am nothing more than a single narrow gasping lung, floating over the mists and the summits." His companion Peter Habler also had an "out of body" experience, floating above his own shoulder as he watched himself climbing the upper slopes. The illusion of an extra partner is common under the physical stresses of high altitude climbing. Brummie Stokes and Bronco Lane, coming down from the summit, each felt there was a third person on their rope, and when they brewed tea or shared food they offered some to their unseen companion. Chris Bonington in 1985 was helped to the summit by the sense that his father-in-law was steering one arm and his friend Dough Scott the other. Stephen Venables was encouraged to find himself in a comfortable country pub with a long-haired girl beside him.

mountain scenic

Yves Malartic, author of Tenzing on Everest, wrote of the severity of cerebral edema and what happens to a victim before death: "Finally, the euphoria, hallucinations, and over-excitement give way to lassitude. At first it becomes impossible for a man to... think and to draw conclusions. His ideas float away, vanish like clouds, and the man is unable to fix his attention on anything. He struggles against the fogginess of his mind, as he struggles against the wind from Everest; he makes every effort to cling to the guide lines, which, however, elude his grasp....The lassitude gets worse...he continues to perceive, but he can no longer reason, or if he does, then only to a slight degree. The impressions that he receives no longer enter his mind. That is why those who undertake such extraordinary exploits, such superhuman efforts in the mountains, can for the most part give only uncertain, vague, extremely terse reports of what they have done. "

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Photos: (1-3) courtesy Robert Schauer.

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