Earlier this year, mountain guide, doctor and researcher Emmanuel “Manu” Cauchy was killed in an avalanche whilst skiing close to his home in Chamonix.
With the permission of author Penny Warren and the BMJ we are able to reproduce Manu's obituary in this post.
We asked Professor Chris Imray, a leading expert on frostbite management, to introduce the obituary. Here's what he wrote,
"When I was asked in 2016 by Adventure Medic, “Who do you look up to?” my immediate response was Manu Cauchy. He was a remarkable man of the mountains, being a fully qualified mountain guide, a remarkable and innovative wilderness doctor and one of the nicest guys you would ever wish to meet. He was based in Chamonix and came up with two really important advances in the treatment of frostbite. The first being the development of a predictive classification of frostbite so that on the second day after exposure it is possible to predict with a fair degree of accuracy what the subsequent outcome is likely to be. The second major advance he made was showing that giving iloprost within 24 hours of exposure reduces the number of digits that end up being amputated after a severe frostbite injury."
Emmanuel Cauchy: mountain rescue doctor and pioneer in altitude medicine
The eminent French mountain rescue doctor, Emmanuel (“Manu”) Cauchy, nicknamed “Docteur Vertical,” was passionate about climbing and mountain medicine: “I am drawn by a spirit of adventure and discovery in the savage arena of the mountains.” In 1991 Cauchy, a fully qualified mountain guide, climbed Everest without oxygen as part of his study of altitude sickness. He was involved in many rescue expeditions in the Mont Blanc massif and became close friends with some of his mountaineering patients. In 2001, for example, he climbed the Aiguille du Midi in the Mont Blanc massif with a former patient, the Scottish mountaineer and quadruple amputee Jamie Andrew. The feat was televised as Le Défi du Jamie (Jamie’s challenge).
A career in mountain medicine
Cauchy was born on 21 February 1960 in Petit-Quevilly in Normandy, an area of France that’s barely above sea level. Initially, his favourite sport was sailing, but when his parents took the family skiing in the Alps, his lifelong fascination with mountains began. Cauchy had wanted to be a vet, but he switched to medicine, training at the University of Rouen Medical School. In 1987 he moved south to Chamonix, becoming a medical intern and then an emergency medicine specialist at Les Hopitaux du Pays du Mont Blanc. Every year some 30 000 people attempt to scale Mont Blanc. The hospital, which sits in its shadow, has one of the highest
number of severe frostbite cases in the world. In 1996 Cauchy and his colleagues set up a department of mountain medicine at the hospital. He developed a new way to classify frostbite, using technetium-99m scintigraphy. By looking at the extent to which isotopes were taken up within bones, Cauchy and his colleagues could better assess whether a patient was likely to do well or if they might lose damaged digits. He also developed a protocol for giving patients with severe frostbite iloprost and thrombolytic drugs within 24 hours, to avoid amputations. Cauchy said their research had wide applications: helping to treat homeless people, for example. Speed is vital when treating frostbite and other injuries, and Cauchy and his colleagues were in the vanguard, sending medical teams in helicopters to give assistance to injured climbers. Cauchy went out with the Peloton de Gendarmerie de Haute Montagne (mountain police) in more than 1000 rescues, some of which he described in thrilling detail in his 2009 book, Hanging by a Thread—My Toughest Missions as a Helicopter Doctor. He also used his experiences in a series of thinly veiled fiction titles: Les Chroniques du Docteur Vertical.
IFREMMONT and Sport Altitude Center
In 2004 Cauchy founded L’Institut de Formation et de Recherche en Médecine de Montagne (IFREMMONT) in Chamonix. As well as training courses and research it offers the SOS MAM telemedicine service. Mountaineers and trekkers anywhere in the world can access advice from French and Swiss specialists in hypothermia and cold injuries. It was through this service that Cauchy treated the French climber Elizabeth Revol in January 2018, when she survived a severe storm that killed her climbing partner on Nanga Parbat in the Himalayas. Cauchy was able to treat her remotely for severe frostbite and altitude induced hallucinations. In March this year, Cauchy and his wife, Sandra Leal, saw the launch of another project dear to his heart: the Sport Altitude Center in Onex, Switzerland. It has two normobaric hypoxic chambers that simulate the effects of altitude. Cauchy himself spent a month in a similar chamber in Marseille in 1997, when eight people simulated reaching the top of Everest in 31 days in a hypobaric chamber. He hoped the new centre would help those researching vascular rehabilitation and obesity as well as altitude disorders.
Explorer, consultant, and writer
Cauchy travelled widely, joining sailing and mountaineering expeditions in Africa, the Antarctic, Bolivia, and Nepal, and conducting workshops in altitude medicine. It was in Nepal that he met his second wife, Sandra, whom he married in September 2017. Both he and Sandra each had two children from previous marriages, and he also adopted a girl whom he had come toknow in Nepal. Voluble, amusing, and energetic, Cauchy was informal and generous, described by a colleague as the “kind of person you’d invite to a dinner party to give the evening a boost.” His wideranging interests included playing the trumpet and the guitar, making pizza, and getting up early to bake bread every morning. He was a medical consultant for several films, including the thriller The Crimson River and the James Bond film Tomorrow Never Dies. A gifted communicator, he wrote regularly for the climbing magazine Vertical, as well as two books on mountain medicine, and over 30 research papers. On Easter Monday, 2 April 2018, Cauchy was guiding some skiiers when an avalanche in the Aiguilles Rouges massif overwhelmed the party. Sadly, he took a fatal blow to the head. Elizabeth Revol spoke for many when she said mountaineering had “lost its most brilliant doctor.”
Manu Cauchy leaves his wife, Sandra Leal, and their five children.
Emmanuel Cauchy died from a head injury on 2 April 2018.
Thanks to Penny Warren and the BMJ for providing their permission to reprint this article.
A tribute to Manu's work can be found here.