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Question:

Hey, I was just reading your dispatch about the rescue that Marc Twight and Scott Backes among other courageous people, were involved in. I could have sworn that Scott told me that he was retiring at a trade show a couple of years back. Yet I still hear his name popping up in articles and through word of mouth. I'm sure that the person being rescued was glad to find that wasn't necessarily the case. I guess that my question, mostly directed towards Pete Athans would have to be: what do you think about the degenerative state of peoples skill levels on serious mountains, and the risks that it creates for people like yourself. I've climbed Denali three times now, and it seems that every year there have been more and more rescues-obviously directly related to the growing number of attempts every year-but in conjunction with that it seems to me that people just don't have the respect for Denali in particular that they should.

P.S. Dr. Hackett I just finished your book Going Higher, and all I can say is Wow!

Brian Block
Ames, IA

Response from Liesl Clark:

Denali's status as the highest mountain in North America draws a much more varied skill level of climber than it would were it any one of a hundred other similar peaks in the area. It seems the highest on any continent always draws a pilgrimage of people to the top. If you go to nearby Hunter or Foraker, you will find climbers there with very high skill levels. There is the illusion on Denali of "safety in numbers" and the myriad of climbers creates an atmosphere of carnival, but the fact is that when the weather goes bad climbers can get caught out. There is a deception that goes on, also, with the relative easy technical level of this route.

Question:

Liesl—How many women have you encountered on the mountain? My niece and my husband are currently on Denali, at Camp II and climbing, as of 6/15. Expedition name is "Massive Headache", if you see then on your way down. This is Lauren's first Denali attempt, and a word of encouragement from another female would mean a lot to her.

John—Because of the pill, are you still able to drink hot fluids, etc.—without impacting the core temp experiment in some way? And, of course I have to ask.... As an explorer of space, do you believe that life on other planets is possible? What's next on your exploration agenda?

Response from Liesl Clark:

We love your niece's expedition name. Just so you know, the patrol up here at 14,200 ft is largely women and a female ranger, Meg Perdue, is in charge. But, certainly, there are very few women up here. I'll look out for Lauren.

Yes, drinking fluids does affect John's core temp readouts. John thinks that, considering the number of planets out there, it is very likely that life is out there.

Question:

Don't mean to embarrass you guys up there, but how do you go to the bathroom? I can see how during camping trips that can be easily achieved; however, at those extreme temperatures I can see how even a few minutes could freeze your anatomy :o) What happens if you get sick to your stomach? How do you handle that??

Patty
Dallas, TX

Response from Liesl Clark:

Going to the bathroom can be a challenge up here due to cold temperatures and the inevitable public display. There are actually little boxes over deep holes up here that everyone uses. When we are travelling as a team roped together, we have to ask our ropemates to turn around as we do our duty. We've found that the best clothing for expeditions have access panels on both inner and outer layers that can be unzipped quickly. All human waste, at all other camps, must be carried to designated crevasses and discarded.

The Park Service is currently reconsidering the environmental impact of this practice.

Question:

Greetings from New Zealand to the entire team, we are avidly following your dispatches and the data from the remote sensors. I was turned on to your site by the good folks at USARIEM who gave me Dr. Hackett's email address.

Here at Mt. Cook National Park we are trying to upgrade our hypothermia treatment protocols, to include aggressive re-warming pre-hospital. As is potentially the case for your situation, extraction time and transport times from our area to tertiary care can be prolonged. We are looking at rewarming using humidified heated oxygen, externally applied chemical thermo-packs, and perhaps the new carbon-fiber resistance blankets. Of course hyperkalemia and cardiac instability becomes of concern, my idea was to anticipate rhythm degradation by monitoring ECG changes (elevation of T waves, PACs, A-V- Block) and treat with Ca-gluconate, or dextrose-insulin. Now I understand Abbot and others put out field-capable blood chemistry analyzers, do you folks use one at M-14, have you thoughts on their efficacy?

Would it be possible to have a copy of your hypothermia protocol? Your choices for active re-warming? Other tools, such as pulse oximiter, thermometer (assuming your patient is unable to swallow one of John's neat pills!) How aggressive are you folks capable of being—extracorporeal bypass?

Look forward to hearing from you, and again just love your site and project!

Keith J. Ulisse M.D.
Alpine S.A.R.
Aoraki/Mt. Cook New Zealand

Response from Howard Donner:

High altitude rescues preclude the use of ECG monitoring in this environment where it's all a rescue team can do to package a patient and get them down alive. Once a patient is at the medical tent at 14K, we use a miniature cardiac monitor called a pro-pac for diagnosis of obvious arrhythmias. Currently we are looking at an investigational device generically referred to as "NPR" (Negative Pressure Rewarming) which creates a negative pressure environment over the hand wrist and forearm overcoming the natural vaso-constriction associated with hypothermic vaso-constriction and volume contraction. Heat is then applied to the skin of this area and some evidence suggests this can efficiently rewarm patients. The device has yet to be proved in severe hypothermic patients under these conditions. If you're interested in more information contact Dennis Grahn at the Dept of Human Physiology at Stanford University. We also use conventional rescue methods including warm IV fluids and chemical heat packs. We currently do not use warm gas re-breathing systems although they certainly are an efficient method to add additional heat but we don't use them because of the added complication.

You obviously have very interesting questions. I'll try to get in touch with you when I'm back at sea level.

Question:

I have a brother climbing Mt. Denali now. His name is Charles Bickes. I don't know the team he is with but they landed Sunday 6/11/00 to start their ascent. Will he and his team members be part of your experiment? Are you keeping track of other climbers to include in your experiments? As a nurse I find your experiment most interesting. Also are there any bugs that the climbers have to contend with? Thank you for your time. Best of luck in your experiment. Safe climbing.

Char Major
Manchester, MI

Response from Liesl Clark:

Close quarters and the hygiene challenges of the expedition environment can often create fertile ground for spreading infections. The most common infections are either respiratory or gastro-intestinal, specifically diarrheal illness.

We are using climbers from other expeditions to take blood samples for our study on the bio-chemical cause of altitude sickness.

Question:

To Liesl Clark,
Thank you for the outstanding coverage in your dispatch of June 13. As Joe Reichert's dad I feel a great pride in what he is doing, especially when he is able to help another person. Your coverage of Denali is helping me to better understand what it is like there and the lengths climbers and their rescuers will go to help each other. I will be following your climb day by day! Best wishes to all for a safe trip!

George Reichert
Blandford, MA

Response from Liesl Clark:

As we are reading this, Joe is finishing his climb of the classic Cassin Ridge route. He just called us from above 18,000 and should top out today. Your son's a stud.