ER at 17,000 Feet

ER at 17,000 Feet

Thielman-Ibes, Kim
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For two months of the year, set upon an inhospitable rock- and ice-filled landscape nesting around 17,600 feet, sits the Everest Base Camp Clinic. This is the first, and only, extreme-altitude emergency room ever established on top of the world. The patients vary from well-prepared, elite members of the climbing community to the sometimes unprepared, less-practiced outdoorsman. In a busy year, over 10,000 people walk to the base of the mountain just to say they’ve been there.

Thanks to the efforts of Dr. Luanne Freer, a board-certified emergency physician from Bozeman, and under the auspices of the Himalayan Rescue Association (HRA), trekkers and mountaineers intent on summiting the world’s highest peak have professional medical assistance when they may need it the most. “Our mission,” Luanne says, “is to reduce casualties of high-altitude sickness. Many expeditions felt it was cost-effective as well as comforting to be treated by altitude-experienced physicians who were well-acquainted with the health system and challenges in Nepal.” With the exception of a paid Nepali interpreter, the tent-based clinic is all-volunteer. The staff consists of Luanne, one additional board-certified physician, and a small band of medical students.

Since opening in April of 2003 (which coincidentally marked the 50th anniversary of Hillary and Norgay’s first ascent) the clinic has come to the aid of over 685 patients and advised countless more via satellite phone and the web. Working at the top of the world has its share of challenges. The first year, the power source failed. They’ve experienced several deadly helicopter crashes in base camp. Additional daily nuggets include working in an oxygen-deprived environment under unpredictable extreme-force winds with an individualistic multilanguage climbing community full of inhabitants who bathe once a week at best.

Luanne explains that because most of the climbers are well acquainted with the prevention of altitude and cold injuries, she and her staff spend a good amount of time stabilizing the critically ill until they’re able to evacuate. In addition to high-altitude related issues, more common diagnoses at base camp include gastrointestinal illnesses and the "Khumbu cough"—a cough serious enough to break a rib.

Over half of the clinic’s patients have been the climbing teams' support staff—both sherpas and Nepalese. Many Nepali believe they cannot get sick from altitude. This misconception, combined with the fact that many sherpas push themselves to carry heavier loads, places them at a higher risk for the development of HAPE—high altitude pulmonary edema. The clinic uses the funds provided by the non-Nepalese climbers to finance free and low-cost healthcare for these locals.

Unlike Everest mountaineers, base camp is the last stop for Luanne and her staff. “Our staff will not climb with any team, even in the event of an emergency,” says Luanne, as they do not possess a climbing permit. Climbers in need of assistance beyond base camp have to find their way back via their own steam, climbing team, sherpas, and in some extreme cases, helicopter—or utilize their satellite phones for remote assistance.

The base camp staff conducts its work in a 20’ x 12’ white tent with a red cross adorned on the side. The medical equipment, which has primarily been donated, runs on solar power. Within their 240-square-foot imprint they house a small group of electronic monitoring units, an oxygen concentrator, a portable hyperbaric chamber, and two patient cots, along with a well-stocked pharmacy. Enough to both treat and stabilize patients for evacuation, descent, or to continue their Mount Everest endeavors.

For two months each spring life at the clinic mimics that of life in Bozeman—albeit under much more meager and inhospitable standards. Within the microcosmic tent city the staff members have their own cooks, bathroom, and they even enjoy some recreation. However, the bathroom consists of a big plastic barrel surrounded by a flimsy tent, and recreation varies from lunching with the Nepalese army to bowling on the glacier. So how does one make the leap?

“Every year I forget money, clothes, cars, and the trappings of Western civilization. Our sherpas reorient me as to what’s important in life and that’s the biggest gift of all,” says Luanne. This spring will be the fifth year for the clinic. “This year,” Luanne notes, “we hope to serve more patients and conduct much-needed altitude research. But these projects need funding.” Though the clinic is set up as a nonprofit based in Nepal, Luanne spends a great deal of time fundraising through events and motivational speaking engagements. To date they have achieved roughly one-third of their goal—a $200,000 endowment. To aid in this effort and to follow the adventures of the Everest Base Camp clinic, log on to
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