Surviving the Extremes: A Doctor's Journey to the Limits of Human Endurance (47 page)

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www.explorers.org

THE SPIRIT OF EXPLORATION
is a powerful force that links individuals all over the world. It can override geography, ethnicity, culture, religion, politics, social standing, and any and all other civilized differences. The common bonds that it creates form an invisible network that covers the earth, and being one strand in that network has given me access to the most remote corners of the planet, the people who study those corners, and the people who live there. I have benefited enormously from observing nature up close—through my own eyes but also, and maybe even more so, through the eyes of other explorers—from those who have M.D. or Ph.D. educations to those who don’t know how to read. My teachers have been doctors and scientists trained in universities and research labs, field explorers taught by experience and necessity, and local natives imbued with the wisdom of their elders. The synthesis of knowledge that this book represents is the fruit of their teachings, of their enthusiasm for the natural world, and of the spirit they show in surviving the extremes.

The idea for the book grew out of my dual enthusiasms for exploration and medicine. In the course of casual conversations and formal lectures, I realized that many people are as intrigued by the workings of the human body as they are by the remote, mysterious corners of the world. It would provide fascinating reading, I thought, to take a continuous journey from the outer limits of the earth to the inner limits of the body. I held the thought for a while, until at an
Explorers Club dinner, I was not-so-casually asked by the person seated next to me if I had any ideas for a book. He was the literary agent Andrew Stuart, and he was immediately taken by the book I envisaged. He energized my idea, supplying continuous sparks to keep me writing and trenchant analysis to channel my efforts. Together we developed the framework of the book and its unifying theme. Once he was satisfied with the manuscript, he became my guide through the extreme environment of publishing, providing me with direction, encouragement, and reassurance as needed. He had an uncanny understanding of what editors and publishers were looking for, and I was repeatedly amazed by his prescient advice. All his optimistic predictions came to pass. I’ve learned that if Andrew tells you something, believe it.

To gather the additional information I would need to supplement my own files, I brought Alison Mitchko on board—a research assistant with a deft hand at the computer and a wry sense of humor. She was often tested to the limit on both counts—most especially on one occasion when I woke her up in the middle of the night asking for some arcane information on penguin anatomy. I insisted it be faxed to me immediately since I was calling from a bakery six time zones away that was about to close. She got it done, remembering that our research had shown that maintaining a sense of humor is critical to survival in extreme situations.

My manuscript was dictated and submitted in sections for typing, always on short notice and behind schedule, but always completed with amazing speed and accuracy by my typist, Rochelle Garmise.

Three editors were on my team. Sam Weiss, my longtime friend and neighbor and an editor for the
New York Times
, volunteered to read my manuscript and improved it with a newspaperman’s objective analysis and timely suggestions. My freelance editor and background researcher was David Groff. He and I communicated on the same frequency throughout the preparation of the manuscript. He had an intuitive feel for my writing and read the text with sensitivity and uncommon insight. His subtle suggestions and grand ideas were always on target and the book is much the better for them. At St. Martin’s Press, senior editor Tim Bent believed strongly in the book right from
the beginning. Though I was an instinctive writer with no formal training in literature and he was a self-described “reformed academic,” he had the insight to see that we could develop a synergy that would elevate the book into the realm of literature. To the extent that we have succeeded, I owe him my thanks. But even more, I am grateful to Tim for showing me that, in developing and polishing a manuscript, everything from defining the theme to appreciating the power of semicolons can be a joyful experience. We educated each other, and our interchange of ideas stimulated and uplifted us throughout the long writing and editing process. Our marathon sessions sometimes left me exhausted, but always left me exhilarated.

I saw this book as an opportunity to transmit to others my sense of awe and wonder for the forces that drive the human body. The more we understand the body the more fascinating it becomes. Therefore, I endeavored to provide as much detail as possible without losing clarity or overall understanding. Distilling huge volumes of medical information into straightforward logical descriptions and explanations runs the risk of inadvertantly being misleading or inaccurate. To guard against this possibility, the text was graciously reviewed by a number of doctors and scientists—established experts in their respective fields. At my invitation, each of them undertook the task not only willingly but eagerly and enthusiastically. In alphabetical order, my expert reviewers were: Michael V. Callahan, M.D., Professor of Infectious Diseases—Biothreat Detection, Massachusetts General Hospital, Boston, Massachusetts. William Forgey, M.D., past President, Wilderness Medical Society, Grown Point, Indiana. John J. Freiberger, M.D., Professor, Center for Hyperbaric Medicine and Environmental Physiology, Divers Alert Network, Duke University Medical Center, Durham, North Carolina. Bernard Gardette, M.D., Medical Director and Chief of Hyperbaric Medicine, Comex, Marseille, France. Davidson Hamer, M.D., Director, Travelers Health Service, New England Medical Center, Boston, Massachusetts. R.W. (Bill) Hamilton, Ph.D., Director, National Board of Diving and Hyperbaric Medical Technology, Tarry-town, New York. Michael Hawley, Ph.D., Director of Special Projects, Massachusetts Institute of Technology, Cambridge, Massachusetts. Jeffrey Hoffman, Ph.D., Astronaut, Professor of Aeronautics
and Astronautics, Massachusetts Institute of Technology, Cambridge, Massachusetts. Charles Houston, M.D., Emeritus Professor of Medicine, University of Vermont, Burlington, Vermont. David Johnson, M.D., President and Medical Director, Wilderness Medical Associates, Bryant Pond, Maine. Harold Koenig, M.D., Professor of Psychiatry and Medicine, Duke University Medical Center, Durham, North Carolina. Michael J. Manyak, M.D., Professor of Microbiology and Tropical Medicine, George Washington University, Washington, D.C. Victoria McKiernan, Scuba Divemaster, Washington, D.C. Christian F. Ockenhouse, M.D., Lt. Colonel U.S. Army, Department of Immunology, Walter Reed Army Hospital, Silver Springs, Maryland. Peter Pressman, M.D., Professor of Medicine, University of Southern California, Los Angeles, California. Richard Satava, M.D., Retired Lt. Colonel U.S. Army, Project Director, Defense Advanced Research Projects Agency, Professor of Surgery, University of Washington, Seattle, Washington. William Todd, Ph.D., Director of Spaceflight Simulations, Johnson Space Center, Houston, Texas. Richard Williams, M.D., Medical Director, NASA Astronaut Program, Washington, D.C. I am indebted to these experts for their careful analysis of my work. Their comments, corrections, and suggestions have added greatly to the accuracy of this book. Any errors, however, remain my sole responsibility.

To range so widely through geography and science I needed, and received, the help of a remarkably diverse collection of people, some listed above, whose assistance I specifically asked for, and some listed below, who might be surprised to see their names mentioned—perhaps unaware of the contributions they made to my education or experience. The logical place for me to begin thanking people is at the Explorers Club. I am forever grateful to a succession of Club presidents who fostered and encouraged my interest in exploration: Charles Brush, an anthropologist-archaeologist, who introduced me to the Club and invited me to join; John Levinson, a ship’s surgeon and consultant on high seas medicine, who encouraged me in my idea to collect the members’ medical experiences; John Loret, a professor of marine sciences and Director of the Science Museum of Long Island, who coincidentally had taught me to scuba dive while I was in college
and who transmitted to me then his enthusiasm for exploration and for the underwater world; and Alfred McLaren, a nuclear submarine captain and polar explorer, who put me in charge of research and education at the Club, an ideal position in which to meet, and learn from, the people who are actually out there at the frontiers.

I have learned much from Sylvia Earle, Explorer-in-Residence at the National Geographic Society and former Chief Scientist for the National Oceanographic and Atmospheric Administration. Her knowledge of seas is as vast as the seas themselves and I was constantly buoyed up by her enthusiasm for my project. I had many conversations with Jim Fowler, cohost of the TV show
Wild Kingdom
and Director of the Wildlife Conservation Center. He has given me great insight into the jungle and the interrelationship of man and the natural world. With Donn Haglund, Chairman of the Department of Geography at the University of Wisconsin, I studied the ways of the people and animals of the Arctic. With Max Galimore, airline pilot and scuba diver, I surveyed life in the sea and on land in the Galapagos Islands. Jeff Hoffman, an astronomer and one of the NASA astronauts who fixed the Hubble telescope, provided me with a personal account of life in outer space.