How To Be A Better Mountain Medic ... High Altitude Psychosis (Part 2)



Posted by Jeremy Windsor on Jun 19, 2019

Following on from our recent post on High Altitude Psychosis, Jim Duff got in touch to share his experiences...

"Aye aye Jeremy, a fascinating subject, here are my personal experiences, I'm  not quite sure if they all fit in as psychosis so please exercise your judgement if and how you use them...

1975 Sagarmatha South West Face (8850m) - The first British ascent of Everest, new route, classic (assault) style expedition. My first expedition, no climbing for two years (house jobs, work in Nepali Terrai).


The 1975 British Mount Everest South West Face Expedition were the first to climb a face route on the mountain. Unlike earlier routes, a high standard of technical rock and ice climbing was required. Five members of the expedition reached the summit, however Mick Burke disappeared on the descent. Jim Duff and Charlie Clarke were the expedition doctors.


As base camp doc I'd carried several loads thru the icefall, and was delighted to swap places with Charlie Clarke at Camp 2 whence I carried loads to Camp 4. I stayed at Camp 4 (7220m) for two nights without a sleeping bag (idiot) and then, using oxygen, made an almost successful carry to Camp 5 (7720m). Chris Bonington descended a couple of hundred feet to take my load asking 'Are you alright?'. 'Yes', I lied, as I was exhausted and out of oxygen. On the long fixed rope traverse above Camp 4 I 'passed out'. I can't say I went unconscious as I became stunningly aware of my body hanging on the ropes as seen from 30 feet above and out from the face. This lasted an eternity, at least an hour, until Tut Braithwaite and Nick Estcourt rudely 'woke me up' and I recommenced the descent.


South West Face of Mt Everest. The line followed by the 1975 team is marked in red. Rope was fixed from Camp 2 to the upper snow field above Camp 6. Jim's carry from Camp 4 to just below Camp 5 took him through the Great Central Gully, an area that was regularly swept by avalanches.


1984 Chomolungma North Face (8850m) - This was a new route on Everest, "White Limbo" North Face, no Sherps, no oxygen, minimal fixed rope, first Australian ascent of Everest, total tour de force. I had two oxygen cylinders at ABC for medical purposes (one used for HACE, one severe frostbite) it never went above above Camp 1. 


White Limbo - The route climbed by Tim Macartney Snape and Greg Mortimer on the north face of Mt Everest in 1984. It was described by mountaineering historian Walt Unsworth as, "one of the greatest climbs ever done on the mountain". This is the first of 7 short films made about the climb. All of "Everest - The Australian Challenge" can be viewed on Youtube.


Between doctoring and guiding our camera man I managed to get up to the snow cave at the White Limbo (7000m). I set off far too late and found myself struggling on the fixed ropes 200 feet below the cave well after dark. This was technically the steepest and most difficult part of the route and I felt that I was losing the plot. I started talking to myself to keep focused and started to get encouragement from a companion. It seemed totally natural, very real and felt like a close mate. He wandered off when I crawled into the cave.


Kedarnath Dome (6831m) - The north west flank was first climbed by a Swiss team in 1947 and remains the most popular route on the mountain today.


1988 Kedarnath Dome (6831m) - A warm up ascent before an attempt on the Spanish route on Shivling. It was a big team of my mates, a dozen had summited when Andy Henderson and I set off ourselves. As we set off from Camp 2 on summit day it started to snow ever so gently but persistently. Andy was leading the last steep section before the summit dome and, with tiny avalanches starting to slough off around us, he turned to me and asked what I thought about continuing. I was knackered (My excuse: doctor, leader, sixteen climbers and responsibility for several supernumerarys including my daughter etc) and there was a considerable pause as I weighed up the situation. Then a voice, completely alien to me, appearing to be 'outside' clearly and loudly said 'TURN BACK!'. So we did. That was the biggest storm in living memory and lasted ten days wreaking havoc all the way to Ladakh.

I'm not sure if this last one is a description of psychosis but toss it in as an interesting experience! 

What is the cause of High Altitude Psychosis? 

I've come to the conclusion that any ailment at high altitude will commonly be a mixture of the following causes - a high altitude quintet!

Hypoxia 
Hypothermia
Dehydration 
Hypoglycaemia
Exhaustion

I've put exhaustion last but to me it's an entity that stands alone as a cause of many deaths at high altitude as climbers slow down, take less care and succumb to the other factors.

Hope this is of interest!"


Jim is right. Illnesses and injuries at high altitude are often triggered by a number of different physiological insults. In the next post we'll see if we can add to Jim's "High Altitude Quintet" and identify other factors that might contribute to High Altitude Psychosis.


Thanks to Jim Duff for taking the time to write to STDZ and sharing his invaluable experience.


1 thought on “How To Be A Better Mountain Medic ... High Altitude Psychosis (Part 2)

Mike Whiteside commented 3 months ago
Jim, as ever, telling it like it really is. A fictional ghost story on the mountains with similar signs of another person on the mountain is a good read by Michelle Paver. ‘Thin Air’

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