Into Thin Air (17 page)

It turned out that Ian Woodall, Cathy O’Dowd, and Bruce Herrod were in the Icefall, making their way down from Camp Two, but Woodall’s girlfriend, Alexandrine Gaudin, was present, as was his brother, Philip. Also in the mess tent was an effervescent young woman who introduced herself as Deshun Deysel and immediately invited Andy and me in for tea. The three teammates seemed unconcerned by the reports of Ian’s reprehensible behavior and rumors predicting their expedition’s imminent disintegration.

“I went ice climbing for the first time the other day,” Deysel offered enthusiastically, gesturing toward a nearby serac where climbers from several expeditions had been practicing their ice craft. “I thought it was quite exciting. I hope to go up the Icefall in a few days.” I’d intended to ask her about Ian’s dishonesty and how she felt when she learned she’d been left off the Everest permit, but she was so cheerful and ingenuous that I didn’t have the stomach for it. After chatting for twenty minutes Andy extended an invitation to their whole team, including Ian, “to come ’round our camp for a wee snort” later that evening.

I arrived back at our own camp to find Rob, Dr. Caroline Mackenzie, and Scott Fischer’s doctor, Ingrid Hunt, engaged in a tense radio conversation with someone higher on the mountain. Earlier in the day, Fischer was descending from Camp Two to Base Camp when he encountered one of his Sherpas, Ngawang Topche, sitting on the glacier at 21,000 feet. A veteran thirty-eight-year-old climber from the Rolwaling Valley, gap-toothed and sweet-natured, Ngawang had been hauling loads and performing other duties above Base Camp for three days, but his Sherpa cohorts complained that he had been sitting around a lot and not doing his share of the work.

When Fischer questioned Ngawang, he admitted that he’d been feeling weak, groggy, and short of breath for more than two days, so Fischer directed him to descend to Base Camp immediately. But there is an element of machismo in the Sherpa culture that makes many men extremely reluctant to acknowledge physical infirmities. Sherpas aren’t supposed to get altitude illness, especially those from Rolwaling, a region famous for its powerful climbers. Those who do become sick and openly acknowledge it, moreover, will often be blacklisted from future employment on expeditions. Thus it came to pass that Ngawang ignored Scott’s instructions and, instead of going down, went up to Camp Two to spend the night.

By the time he arrived at the tents late that afternoon Ngawang was delirious, stumbling like a drunk, and coughing up pink, blood-laced froth: symptoms indicating an advanced case of High Altitude Pulmonary Edema, or HAPE—a mysterious, potentially lethal illness typically brought on by climbing too high, too fast in which the lungs fill with fluid.
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The only real cure for HAPE is rapid descent; if the victim remains at high altitude very long, death is the most likely outcome.

Unlike Hall, who insisted that our group stay together while climbing above Base Camp, under the close watch of the guides, Fischer believed in giving his clients free rein to go up and down the mountain independently during the acclimatization period. As a consequence, when it was recognized that Ngawang was seriously ill at Camp Two, four of Fischer’s clients were present—Dale Kruse, Pete Schoening, Klev Schoening, and Tim Madsen—but no guides. Responsibility for initiating Ngawang’s rescue thus fell to Kev Schoening and Madsen—the latter a thirty-three-year-old ski patrolman from Aspen, Colorado, who’d never been higher than 14,000 feet before this expedition, which he had been persuaded to join by his girlfriend, Himalayan veteran Charlotte Fox.

When I walked into Hall’s mess tent, Dr. Mackenzie was on the radio telling somebody at Camp Two, “give Ngawang acetazolamide, dexamethasone, and ten milligrams of sublingual nifedipine.… Yes, I know the risk. Give it to him anyway.… I’m telling you, the danger that he will die from HAPE before we can get him down is much, much greater than the danger that the nifedipine will reduce his blood pressure to a dangerous level. Please, trust me on this! Just give him the medication! Quickly!”

None of the drugs seemed to help, however, nor did giving Ngawang supplemental oxygen or placing him inside a Gamow Bag—an inflatable plastic chamber about the size of a coffin in which the atmospheric pressure is increased to simulate a lower altitude. With daylight waning, Schoening and Madsen therefore began dragging Ngawang laboriously down the mountain, using the deflated Gamow Bag as a makeshift toboggan, while guide Neal Beidleman and a team of Sherpas climbed as quickly as they could from Base Camp to meet them.

Beidleman reached Ngawang at sunset near the top of the Icefall and took over the rescue, allowing Schoening and Madsen to return to Camp Two to continue their acclimatization. The sick Sherpa had so much fluid in his lungs, Beidleman recalled, “that when he breathed it sounded like a straw slurping a milkshake from the bottom of a glass. Halfway down the Icefall, Ngawang took off his oxygen mask and reached inside to clear some snot from the intake valve. When he pulled his hand out I shined my headlamp on his glove and it was totally red, soaked with blood he’d been coughing up into the mask. Then I shined the light on his face and it was covered with blood, too.

“Ngawang’s eyes met mine and I could see how frightened he was,” Beidleman continued. “Thinking fast, I lied and told him not to worry, that the blood was from a cut on his lip. That calmed him a little, and we continued down.” To keep Ngawang from having to exert himself, which would have exacerbated his edema, at several points during the descent, Beidleman picked up the ailing Sherpa and carried him on his back. It was after midnight by the time they arrived in Base Camp.

Kept on oxygen and watched closely throughout the night by Dr. Hunt, by morning Ngawang was doing slightly better. Fischer, Hunt, and most of the other doctors involved were confident that the Sherpa’s condition would continue to improve now that he was 3,700 feet lower than Camp Two; descending as little as 2,000 feet is typically enough to bring about complete recovery from HAPE. For this reason, Hunt explains, “there was no discussion of a helicopter” to evacuate Ngawang from Base Camp to Kathmandu, which would have cost $5,000.

“Unfortunately,” says Hunt, Ngawang “did not continue to improve. By late morning he started to deteriorate again.” At this point Hunt concluded that he needed to be evacuated, but by now the sky had turned cloudy, ruling out the possibility of a helicopter flight. She proposed to Ngima Kale Sherpa, Fischer’s Base Camp sirdar, that they assemble a team of Sherpas to take Ngawang down the valley on foot. Ngima balked at this idea, however. According to Hunt, the sirdar was adamant that Ngawang didn’t have HAPE or any other form of altitude illness, “but rather was suffering from ‘gastric,’ the Nepali term for stomachache,” and that an evacuation was unnecessary.

Hunt persuaded Ngima to allow two Sherpas to help her escort Ngawang to a lower elevation. The stricken man walked so slowly and with such difficulty, though, that after covering less than a quarter-mile it became obvious to Hunt that he couldn’t travel under his own power, and that she would need a lot more help. So she turned around and brought Ngawang back to the Mountain Madness encampment, she says, “to reconsider my options.”

Ngawang’s condition continued to worsen as the day dragged on. When Hunt attempted to put him back in the Gamow Bag, Ngawang refused, arguing, as Ngima had, that he didn’t have HAPE. Hunt consulted with the other doctors at Base Camp (as she had throughout the expedition), but she didn’t have an opportunity to discuss the situation with Fischer: By this time Scott had embarked for Camp Two to bring down Tim Madsen, who had overexerted himself while hauling Ngawang down the Western Cwm and had subsequently come down with HAPE himself. With Fischer absent, the Sherpas were disinclined to do what Hunt asked of them. The situation was growing more critical by the hour. As one of her fellow physicians observed, “Ingrid was in way over her head.”

Thirty-two years old, Hunt had completed her residency only the previous July. Although she had no prior experience in the specialized field of high-altitude medicine, she had spent four months doing volunteer medical-relief work in the foothills of eastern Nepal. She’d met Fischer by chance some months earlier in Kathmandu when he was finalizing his Everest permit, and he subsequently invited her to accompany his upcoming Everest expedition in the dual roles of team physician and Base Camp manager.

Although she expressed some ambivalence about the invitation in a letter Fischer received in January, ultimately Hunt accepted the unpaid job and met the team in Nepal at the end of March, eager to contribute to the expedition’s success. But the demands of simultaneously running Base Camp and meeting the medical needs of some twenty-five people in a remote, high-altitude environment proved to be more than she’d bargained for. (By comparison, Rob Hall paid two highly experienced staff members—team physician Caroline Mackenzie and Base Camp manager Helen Wilton—to do what Hunt did alone, without pay.) Compounding her difficulties, moreover, Hunt had trouble acclimatizing and suffered severe headaches and shortness of breath during most of her stay at Base Camp.

Tuesday evening, after the evacuation was aborted and Ngawang returned to Base Camp, the Sherpa grew increasingly sick, partly because both he and Ngima stubbornly confounded Hunt’s efforts to treat him, continuing to insist that he didn’t have HAPE. Earlier in the day, Dr. Mackenzie had sent an urgent radio message to the American doctor Jim Litch, requesting that he hurry to Base Camp to assist in Ngawang’s treatment. Dr. Litch—a respected expert in high-altitude medicine who had summitted Everest in 1995—arrived at 7:00 P.M. after running up from Pheriche, where he was serving as a volunteer at the Himalayan Rescue Association clinic. He found Ngawang lying in a tent, attended by a Sherpa who had allowed Ngawang to remove his oxygen mask. Profoundly alarmed by Ngawang’s condition, Litch was shocked that he wasn’t on oxygen and didn’t understand why he hadn’t been evacuated from Base Camp. Litch located Hunt, ill in her own tent, and expressed his concerns.

By this time Ngawang was breathing with extreme difficulty. He was immediately put back on oxygen, and a helicopter evacuation was requested for first light the following morning, Wednesday, April 24. When clouds and snow squalls made a flight impossible, Ngawang was loaded into a basket and, under Hunt’s care, carried down the glacier to Pheriche on the backs of Sherpas.

That afternoon Hall’s furrowed brow betrayed his concern. “Ngawang is in a bad way,” he said. “He has one of the worst cases of pulmonary edema I’ve ever seen. They should have flown him out yesterday morning when they had a chance. If it had been one of Scott’s clients who was this sick, instead of a Sherpa, I don’t think he would have been treated so haphazardly. By the time they get Ngawang down to Pheriche, it may be too late to save him.”

When the sick Sherpa arrived in Pheriche Wednesday evening after a nine-hour journey from Base Camp, his condition continued its downward spiral, despite the fact that he had been kept on bottled oxygen and was now at 14,000 feet, an elevation not substantially higher than the village where he’d spent most of his life. Perplexed, Hunt decided to put him inside the pressurized Gamow Bag, which was set up in a lodge adjacent to the HRA clinic. Unable to grasp the potential benefits of the inflatable chamber and terrified of it, Ngawang asked that a Buddhist lama be summoned. Before consenting to being zipped into its claustrophobic interior, he requested that prayer books be placed in the bag with him.

For the Gamow Bag to function properly, an attendant must continuously inject fresh air into the chamber with a foot pump. Two Sherpas took turns at the pump while an exhausted Hunt monitored Ngawang’s condition through a plastic window at the head of the bag. Around 8:00 P.M., one of the Sherpas, Jeta, noticed that Ngawang was frothing at the mouth and had apparently stopped breathing; Hunt immediately tore open the bag and determined that he had gone into cardiac arrest, apparently after aspirating on some vomit. As she commenced cardiopulmonary resuscitation, she yelled for Dr. Larry Silver, one of the volunteers staffing the HRA clinic, who was in the next room.

“I got there in a few seconds,” Silver recalls. “Ngawang’s skin looked blue. He had vomited all over the place, and his face and chest were covered with frothy pink sputum. It was an ugly mess. Ingrid was giving him mouth-to-mouth through all the vomit. I took one look at the situation and thought, ‘This guy is going to die unless he gets intubated.’” Silver sprinted to the nearby clinic for emergency equipment, inserted an endotracheal tube down Ngawang’s throat, and began forcing oxygen into his lungs, first by mouth and then with a manual pump known as an “ambu bag,” at which point the Sherpa spontaneously regained a pulse and blood pressure. By the time Ngawang’s heart started beating again, however, a period of approximately ten minutes had passed in which little oxygen had reached his brain. As Silver observes, “Ten minutes without a pulse or sufficient blood oxygen levels is more than enough time to do severe neurological damage.”

For the next forty hours, Silver, Hunt, and Litch took turns pumping oxygen into Ngawang’s lungs with the ambu bag, squeezing it by hand twenty times each minute. When secretions built up and clogged the tube down the Sherpa’s throat, Hunt would suck the tube clear with her mouth. Finally, on Friday, April 26, the weather improved enough to allow a helicopter evacuation, and Ngawang was flown to a hospital in Kathmandu, but he did not recover. Over the weeks that followed he languished in the hospital, arms curled grotesquely at his sides, muscles atrophying, his weight dropping below 80 pounds. By mid-June Ngawang would be dead, leaving behind a wife and four daughters in Rolwaling.