Jim Milledge Is 90!
This month Jim Milledge celebrates his 90th birthday!
Jim has been involved in high altitude medicine and physiology since serving as a member of Sir Edmund Hillary's "Silver Hut" Expedition in 1960-61.
He started hill walking as a boy in North Wales and began rock climbing as a medical student. A 3-year commission in the RAF gave him a taste of aviation medicine. Training in respiratory medicine subsequently followed and experience in lung function testing led to a life long interest in respiratory physiology. After the Silver Hut, Jim spent 10 years as physician and physiologist at Christian Medical College in Vellore during which time he had further expeditions to Nepal and a year spent as a research fellow in San Francisco with John Severinghaus.
Professor Jim Milledge
On returning to the UK in 1972 he was appointed to Northwick Park Hospital's Clinical Research Centre as a Consultant Physician and a Medical Research Centre (MRC) Scientific Member. He was able to continue altitude research at intervals, mainly on expeditions to the great ranges of Nepal, China, Kenya and throughout South America. In 1981 he was a member of the American Medical Research Expedition to Everest (AMREE) led by John West. For the last 4 years of his time at Northwick Park Hospital he served as Medical Director.
He retired in 1995 and has been able to continue to pursue his interest in mountain medicine, almost full time, ever since! With two friends from the Silver Hut he published the definitive textbook on the subject, High Altitude Medicine and Physiology, now in it's 5th edition. He has written and lectured widely and is involved with many altitude research groups in the UK. He was a founder member of Medical Expeditions (MEDEX) and a faculty member of the Diploma in Mountain Medicine (DiMM). In 2005 he was made an Honorary Professor at University College London. In 2007 he was the "Honoree" at the Lake Louise Hypoxia Symposium and was President of the International Society of Mountain Medicine between 2004 and 2008.
In 2020 Jim was awarded Honorary Membership of the British Mountain Medicine Society (BMMS). The Professor James Milledge Bursary will be launched later this year. Details will follow shortly.
To celebrate Jim's 90th we have asked his friends and colleagues to share their memories. Here’s Dr David Hillebrandt, GP and Honorary Medical Advisor to the British Mountaineering Council (BMC), to get us started...
“An Open Birthday Letter to Professor Jim Milledge
It is an honour to have been asked to write a few words for your 90th birthday celebration. It is a chance to thank you for the inspiration you have given and continue to give the world of mountain medicine. I know many of the young doctors who attended our last Plas y Brenin course in December 2019 who say that sharing a drink with you at the bar was a highlight of their DiMM course. Your working and mountaineering life is an inspiration to many. Although you hold the title of Honorary Professor at University College London, throughout the world of mountain medicine you are simply known as Jim.
A birthday is a great chance to express our thanks to you Jim for the many lives you have enriched!
I spent some time pondering what you have given to the mountain medicine world and could start with your Silver Hut work and then go through many research projects, expeditions and papers. It would be an impressive, but rather dry list, so then I started to think about what linked all these projects together. It is far more than the projects themselves but it is your attitude to life. It is your enquiring mind driven by the determination to embrace as many opportunities as possible and follow them wherever they may lead. Examples would not only include the 1960-61 Silver Hut Expedition but also your side trips to the Himalayas when on RAF service or during your 10 years at the Christian Medical College in Velore, India. You have always been one to seize the moment with an open mind. UIAA MedCom trips were always an excuse to incorporate a quick climb such as Damavand in Iran, a rock route in Germany or a cycle trip around Copenhagen, incorporating the independent state of Christiania. In theory you “retired” in 1995 but we all know this was just a time for a slight change in direction.
Jim about to climb one of the sandstone towers at Effels
It would be wrong to pay tribute to you without acknowledging the important women who stood beside you. Your first wife Betty was with you on many of your travels before sadly dying in 1991. You remarried in 1993 to Pat who has also had to put up with many of your schemes. I remember when she spotted you slipping your rock boots and harness into my camper van as we departed to a UIAA MedCom meeting in Europe. She made me promise that I would not let you lead any routes.
Many of us, myself included, have valued your support and guidance over the years. Many research projects have benefited from your encouraging words early in their gestation.
Thank you, Jim!"
Here’s Dr Jeremy Windsor with an example of one of those many opportunities that David highlighted...
"Back in the late 2000’s an enthusiastic skier called Edwin Hamilton approached Jim with an invention that he wanted to test. Knowing that avalanche-related deaths were often due to asphyxiation, Edwin had invented the “Snow Snorkel”, a simple device consisting of a length of stiff plastic and mouthpiece that was stitched into the lining of a ski jacket. On burial, the victim was instructed to breathe air normally and exhale waste gases through the “Snow Snorkel”. This, it was hoped, would prevent carbon dioxide from accumulating and allow victims to survive snow burial for much longer periods of time. Yes, it sounded like a good idea but it just needed testing!
Jim with the Snow Snorkel
Jim knew that I had access to monitoring equipment and got in touch. Days later we found ourselves at a French ski resort standing in a car park beside a freshly bulldozed mound of snow. We quickly set to work burying volunteers and measuring their vital signs. Despite a language barrier or two, most of the volunteers quickly got to grips with the “Snow Snorkel” (Jim included!) and patiently sat for an hour or so buried under a few feet of snow. However this all changed with the removal of Edwin’s device. As large volumes of carbon dioxide rapidly accumulated around the face, volunteers quickly kicked and punched their way out of the confined environment in a frantic search for fresh air. Jim was in his element – meticulously recording data, checking equipment and offering words of encouragement and reassurance to nervous volunteers awaiting their turn. I wondered if this sort of thing brought back memories of the Silver Hut. So I asked Jim if Griffith Pugh, his supervisor at the time, would have approved of our field work. Very slowly he smiled and said, “Yes, but we would have pushed a little harder…”.
A volunteer about to be buried with the Snow Snorkel
Of course, Jim was right. In our willingness to obtain ethical approval we had agreed to stop the trial at the first sign of discomfort. Whilst this meant that many volunteers failed to complete the time allocation, the vital signs we obtained lacked a certain drama and left us all feeling a little crestfallen. Nevertheless, Jim had showed that a very simple invention could make a difference to the breathing of avalanche victims and in turn, have the potential to save lives. Only with Jim's enthusiasm and vision could this have been done. Thanks Jim for letting me be a part of the adventure!
The study can be found here."
Authors Jim Milledge, Michael Ward and John West with the first edition of High Altitude Medicine and Physiology. Professor Andy Luks writes, "For the past few years, I have had the pleasure of working on the 6th edition of the major text book that Jim originally co-wrote and then edit the 5 subsequent editions. As I’ve worked on this project it has not been hard to see how much he has contributed to the field. Between all the studies that came out of the Silver Hut and his other projects, he has left a high standard for us all to follow. He’s been a great friend and mentor along the way…"
Dr Nick Mason, Consultant Anaesthetist and Chair of Trustees for the International Porter Protection Group (IPPG), writes...
"I had High Altitude Medicine and Physiology out on almost permanent loan from our hospital library as a junior doctor and so it was with some trepidation that I first met Jim Milledge, author, researcher and veteran of the Silver Hut and the American Medical Research Expedition to Mt Everest (AMREE) at Plas y Brenin in April 1993. Little did I realise that within months Jim would be providing generous advice, not to mention an insightful and rigorous critique, for the projects that I was involved with on the 1994 British Mount Everest Medical Expedition. He would become a valued mentor and friend to those of us taking our first tentative steps in the world of high altitude research on that expedition.
Dr Tom Hornbein, formerly professor of anaesthesiology at Washington University School of Medicine and with Willi Unsoeld made the first ascent of the West Ridge of Mt Everest in 1963, summed up Jim's impact on friends and colleagues when he recently wrote, "He's been a great role model"
There is so much that one could write about Jim but his skill as a raconteur is second to none. Anybody who was at Henriette van Ruiten’s party in the Netherlands in 2000 will surely never forget the account he gave of trying the circus trapeze, at the age of almost 70, in Whistler during the 1999 WMS conference. Everybody in the room was convulsed with laughter and on the edge of their seats, transported to Canada and wanting Jim to succeed and to fly safely into the hands of his waiting catcher. Alas, he did not. The memory of Jim telling that story still has me chuckling to myself as I write this, more than 20 years later.
There was a wonderful symmetry for me when Jim, whose help had launched my high altitude career, was selected to be one of my external examiners for my PhD in Brussels. But it is a comment he made to me when I was beginning my PhD that I think gives the measure of him. During a telephone call Jim asked me how I was getting on. I replied that it was a challenge switching from full time clinical work and I was struggling to get to grips with electrophysiology. “But isn’t it wonderful,” replied Jim, “to have the opportunity to learn something completely new and be challenged!” That comment has lived with me as a touchstone ever since. It is that joyful enthusiasm, curiosity and willingness to always step beyond the comfortable that has made Jim such an inspiration to those of us who have been privileged to know him.
Happy 90th birthday Jim!"
Professor Brownie Schoene, a colleague from AMREE, also describes the trepidation he felt on his first meeting with Jim,
'In 1981, I was one of the “young” climber-scientists on the American Medical Research Expedition to Mt Everest, a time when no one else was there. For me, as a 34 year old kid with a passion for mountains and physiology, I felt so lucky to join in with legends like John West, Jim Milledge and Sukhamay Lahiri. I had read about them and the 1960-61 "Silver Hut" Expedition when I was truly a kid.
Our journey to base camp was a wonderful trek through the foothills and cultures of the Himalaya. One day I had the opportunity to spend the day trekking with Jim Milledge. I considered myself very fit and fast. I was that, but Jim took off on a hill hike, up and down, talking and laughing all the way while I tried not to let on that I could barely keep up with him, let alone carry on a profound conversation. I knew that I was in the big leagues.
John West, Jim Milledge and Sukhamay Lahiri photographed together during AMREE
As a scientist on the mountain, Jim was fully enthusiastic, supportive, and experienced. He was a pleasure to have as my senior colleague and mentor. He and I probably did at least 90% of the exercise tests as he taught and nurtured me, his junior colleague.
Over the years, our relationship grew as we intersected at many gatherings and meetings. His inviting me to be a part of the Plas Y Brenin mountain medicine meetings in North Wales, of which there were many, was a highlight of my academic career. He showed that one can overlap one’s passions with one’s work.
I cherish my good fortunes to know Jim. The only problem is that I have spent most of my adult life wanting to grow up and be like him!"
Here's Harriet Tuckey, author of Everest - The First Ascent recalling the time she spent with Jim in Nepal...
"I first met Jim in 2003 when I visited him at his house in Rickmansworth to ask about his memories of my father Griffith Pugh, former scientific leader of the 1960-61 "Silver Hut" Expedition of which Jim had been an important member. I wasn’t sure what to expect and felt at a disadvantage because I knew nothing about physiology and very little about my father from whom I had been estranged for many years, yet I was proposing to try and write a biography about him. Jim, as a distinguished former colleague and friend of Griffith’s might, understandably, have felt that I had lacked the qualifications to do so.
Jim could not have been more welcoming or hospitable, nor more helpful. His vivid, insightful, often humorous recollections of meeting and working with Griffith before, during and after the Silver Hut, opened up a completely new perspective on my father - allowing me to begin to view him in a far more positive way than I had ever done before. Also, Jim is brilliant at explaining physiological concepts in terms a layman can understand; he introduced me to people, helped me gain access to research conferences and archives, read and criticised meandering early drafts of my book, and was incredibly selfless and generous in the help he gave me. I owe him a huge debt of gratitude. He became not just a treasured friend, but also a crucial emotional link between me and my father which is hard to describe.
Griffith Pugh's photograph of Changmatang taken during the 1960-61 "Silver Hut" Expedition
One memorable experience came in 2011 by which time I had already been working on my book for nearly 8 years. I had never been able to bring myself to visit Nepal. I had a dread of joining a modern tourist Everest trek when all my thoughts and imaginings about Nepal were derived from my father’s diaries and letters and the recollections of people like Jim and survivors of the Everest team who were there in the 1950s and early 1960s. Jim suggested that I might like to join a trek that he was going on himself to celebrate the anniversary of the Silver Hut expedition. Another team member, Norman Hardie (who summited Kangchenjunga in 1955), would also be there as well. The main aim was to visit the site of the Silver Hut base camp at Mingbo (4630m) below Ama Dablam. It was the greatest privilege to be on the anniversary trek with 2 members of the original expedition.
Jim always gave high priority to the health of the local inhabitants of Nepal, holding daily clinics on the march out in 1960 and working to help local people improve their health facilities during his many subsequent visits. All along the route, and especially in the Khumbu region, local people came out to greet Jim and Norman joyfully – we visited several of the little health centres Jim had been involved with and some of which Hardie, an engineer, had helped to build.
One unique experience came just beyond Thyanboche where I knew from Griffith’s diary that the Silver Hut team had had a storage camp at a little place called Changmatang. Griffith had spent some time living there at the start of the expedition and had written detailed descriptions of it in his diary. I was longing to see it but neither Jim nor Norman could quite remember where the camp had been and there wasn’t the slightest sign of it anywhere, just tall thick rhododendron scrub lining the path. Eventually we noticed a tiny house almost hidden from view, nestling among the rhododendrons on the side of the valley, well above the path. Jim climbed up to it and a very friendly elderly man came out who told us he had been a porter on what he called “the Hillary expedition” all those years ago. “Yes”, he said, he could remember where the store camp had been.
He led us along a mysterious narrow path between high rhododendrons stretching well above out heads, invisible from the trekking route below. After about ten minutes’ walk it opened out into a gently sloped clearing of about a quarter of an acre with a small hut. Jim recognised it immediately. It was quite wonderful to hear him animatedly describing how it was used and what was kept where and pointing out the exact place – a small depression in the ground - where they had built themselves a sauna and explaining how it had worked. It brought the whole experience to life for me in the most magical way."
Finally, here’s Andy Pollard, author of the High Altitude Medicine Handbook and Professor of Paediatric Infection and Immunity at Oxford University,
One of my favourite memories of the past 30 or so years that I have known you, was a trip to a high altitude conference in Japan, where we had an exhilarating international group excursion up a snowy peak, followed by recovery in a traditional Japanese hotel. The entertainment for the assembled “rugged” medical mountaineers including communal bathing followed by dinner wearing a (too short) Japanese style bath robe cross-legged on the floor. After dinner performance was fuelled by flowing Japanese wine and we led the international karaoke competition together singing “On Ilkley Moor Ba Tat” in parts, followed by “Let It Be”. Not sure if we won, but at least it sounded good to us! Thanks for all you have taught me about physiology, the mountains and enjoyment of life, without taking it too seriously."
Happy Birthday Jim!
Many thanks to all those who have contributed to this tribute.
A serialised version of Jim's autobiography "Mountains My Lab" can be found here.
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