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Altitude Sickness By Dan Johnson
I had spent less time on the pass than any of the motley crew I’d been hiking with for over a week. I’d pushed very hard on the early morning hike from Thorung Phedi at 14,500 feet, struggling for breath in the thin air. I ended up on the side of the trail, five hundred feet from the top, leaning over my trekking poles, nearly immobilized by an axe blade headache. After several minutes of heavy breathing and water drinking, I got moving again, five steps, pause, breathe, five steps, pause, breathe. I made it to the top of the Thorung La in another hour. Anthony and Joachin had made it before me, and were sitting on a small rise, leaning against a flag-festooned gompa, sharing a pair of headphones and a Discman. I left my big pack at the bottom of the rise and huffed my way up. "Welcome," said Joachin. "Good on ya," said Anthony. I couldn’t answer, and thudded down next to the two of them, staring down at my boots. "Here," said Joachin, "Listen. Look." He put the headphones over my ears and I raised my head up. In front of me the Himalayas traced an unbroken line to the east, a dragon’s mouth of jagged white peaks and frozen rivers of ice. Joachin’s music of choice crescendoed in my ears: Beethoven’s third. I watched and listened for a few minutes; the eye-level clouds marched steadily in the breeze, and the violins played soaring arpeggios. "Not bad, is it," he said after I gave him his phones back. "No," I said. "I have to go." I did. My headache was still there, and I felt like I’d just run fourteen quarter-mile sprints and been punched in the gut. "I’ll go with you," said Francisca, who had joined us not a minute before. "I feel terrible." We ran into Kit on the downside of the Thorung La pass. We saw him a bit below, a small figure stumbling along on the arms of a skinny Bhotiya guide with ragged pants. We caught up in no time. The little man was wobbling like a bobble head doll. I wondered where he had left his backpack; he carried only a waist bag with a water bottle holster, and one of the small bags of chalk used by rock climbers. "What’s wrong?" I asked, although it was easy to see: His legs didn’t seem to be working anymore. He’d take a step, and the weight of his tiny body would turn the limbs into jiggling Jell-O. He looked out of place; wearing only a belt pouch with a water bottle, when every foreigner I’d see in the past two weeks was toting a big pack or walking with porters. His guide carried only a stick and a shoulder sash. "Got a bit o’ a case o’ the wobblies," he said. He spoke in a thick British accent, which always startles me when it comes from an Asian. I was startled even here, crouched among the gravel and scree, naked to the sun and the wind. "I’m from Hong Kong," he said. "Name’s Kit. You’re an American? Why are all of you so fookin’ big?" I shrugged. I’m five foot nine in shoes, one hundred and forty pounds on a good well-fed day. As it was, I’d been hiking around the Annapurna massif for over a week on a diet of rice, potatoes and deep-fried Snickers; I’d have been lucky to break one-thirty. Kit nearly fell down again and Francisca caught his arm. "What’s wrong?" I asked the guide. He was shorter and thinner than myself, pale under his brown skin. "We go up to the top today," he said. "Then come down. Twenty minute ago, he just fall over. I try to hold him up, but hard. I am not very good myself." He proffered a bulb of garlic. "This will make him better." Garlic is a Nepali folk remedy for altitude sickness; the strong flavor is supposed to salve the headache and vomiting that can come with time up high. Kit needed something stronger than garlic, though. His drunken gait and slurred words were clear symptoms of severe mountain sickness, and possibly cerebral edema (HACE). The former is bad enough, but the brain swelling of HACE can be lethal within hours. Immediate descent is the only cure. Unfortunately, immediate descent wasn’t on Kit’s to-do list. The guide forced a clove into Kit’s mouth and he spit it right out. "I could use a nap," he mumbled, stumbling again. "No, no," said Francisca, reaching over and grabbing his shoulder. He responded by pulling on her long blonde hair. "You can’t sleep," she said. "We have to get you down." Her English was the result of a year at Princeton for graduate studies in psychology and sounded a tad formal, like Grace Kelly. I thrust one of my trekking poles into Kit’s hand to use as a cane, hoping that he would be sober enough to use it. No dice; it slipped through his fingers and clattered on the scree, rolling down the near-cliff to the right of the trail. I had to jump to rescue it—no mean feat with a twenty-pound pack, a touchy stomach and a tinge of a headache. I looked at Francisca; she shrugged and took one of Kit’s arms. With their arms linked like that the two of them were wider than the trail. . I walked ahead, shouting if I encountered a dip or a hole, looking back if I heard a slip, ready to catch Kit if he tumbled forward. We made slow progress; Francisca and I switched off on arm duty when the other became tired. Walking with Kit was like holding up a melting Gumby. He stumbled this way and that, his weight threw me left and right, nearly taking the three of us for a tumble several times. I tried to keep him talking. "How long have you been in-country?" I asked. "Three days," he said. "Can I catch forty winks now?" "No," I said. "Where have you been?" "Flew into Kathmandu," he said. "Then to Pokhara, then flew to Jomosom. Walked to Muktinath yesterday, woke up at three in the morning and hiked up to the Thorung La today. Pretty hardy, eh?" Pretty stupid. Pokhara is at 1700 feet, Jomosom 8300, Muktinath 12,300. The pass tops out at 17,500 feet. We had come from the other side of the pass, where the Himalayan Rescue Association runs an aid and educational station for trekkers. They recommend a maximum thousand foot per day gain when you’re above 12,000 feet. Kit had gained nearly three vertical miles in two days and the blood vessels in his head had expanded rapidly, putting the same pressure on his brain that would result from a garden-variety cerebral hemorrhage. If he went to sleep, he’d never wake up, a casualty not of the mountains but of his own stupidity. After twenty minutes of on-again, off-again movement, we were joined by Roger, a six foot four inch American on a month’s holiday from a banking job in London. I’d met him earlier in the morning; he had been leaning over a precipice, throwing up his breakfast rolls. He took in the scene quickly and offered to help. We were grateful; he was stronger than both of us. "Dumbass," he said, wrapping one arm around Kit’s waist. "Why are all you Americans so bloody big?" said Kit. "Because we’re not so damned stupid," said Roger, grabbing Kit’s other arm. "Hold on, hold on," said Kit. "I can walk, really. Let’s all just walk down." Roger and Francisca let go of his arms; Kit took a step, and pitched forward onto his face, not bothering to throw his arms out to break the fall. "Oops," he said, giggling. Kit’s guide had recovered a bit at that point, and he and Roger took both of Kit’s arms and started to drag him down the mountain. The trail was winding down at a near-suicidal grade, cutting down across a rock field without the benefit of switchbacks. I slipped down a few inches with every step I took, and had zipped up my jacket all the way to guard against wind-borne gravel and dust. Our little group continued to swell, as other hikers bound for Muktinath got caught behind us; some offered to help, some simply waited for the trail to widen and powered around without a backward glance. Then Kit fell down and didn’t get up. He was as limp as an arrested anti-globalization protester. Roger and I tried to pick him up but couldn’t—he was flaccid and laughing. "Can I help?" It was a porter, one of those inhumanly strong Nepalis who carry the load of two Westerners up rocky trails wearing nothing but flip-flops and an old Chicago Bulls sweatshirt. This one had a backpack on his back and front, and his short legs were spider webbed with veins. "He’s sick," I said. "Can you help carry him?" "I can carry," he said. "But someone must carry my packs. Can you?" I shook my head. "Not strong enough," I said. I looked at Roger. He shook his head no. "OK, then, I go," said the porter, and continued along his way. "What the hell is this?" said a familiar Australian voice. It was Gav, the cheerfully obscene Aussie who had joined our hiking group a few days into the trek. He had been in Nepal for three months, teaching English, and was doing the Circuit as his last hurrah before heading west around the world. "He’s got edema," I said. "We’re having trouble moving him." "I’m not feeling so hot meself," Gav said. "Had to sit on my arse, tryin’ to grab some sorta breath. We sang the national anthem up there, though. Joachin filmed us with the flag I brought along." He grinned. "Good stuff, eh?" "Is that an Aussie?" said Kit from the ground. "Aussies are fookin’ funny blokes. Let me see ‘im." I brought Gav up to speed on the Kit situation. "Why don’t you just leave the bastard?" Gav said. "It’s his own fault he’s up here all buggered. If you carry him down, he could fall and take you with him, and it’s a fuck of a way down." He gestured at the gorge to our right, bottomed out in a dry wash at least fifteen hundred feet below. "Can’t do that," I said. "What if he dies? I don’t want that on my hands." Gav sighed. "Neither do I," he said. "Let’s get him up." Roger, Gav and I leaned over and propped up Kit. I smacked him in the face. The slap made a dry thwack. "Up and at ‘em!" I yelled. Kit’s eyes fluttered open. "Why’d you hit me?" he said. "Because if you go to sleep, you’re going to die," I said. "I don’t give a rat’s ass if you die on your own, but none of us here want to have anything to do with it. Let’s go down this fucking mountain, and you can kill yourself tomorrow when I’m long gone. "Okay, okay," he said. "Can I have one of those sticks?" With the aid of Roger and Gav and one of my trekking poles, we made it down another thousand feet of elevation with only minor mishaps. I could see a white building about a mile away on the precipice of a butte, the first teahouse since we’d passed high camp on the other side of the pass. Several small figures in bright jackets were lounging in the sitting area outside, clearly visible in the crisp air. "We should have left him," said Francisca, coming up from behind me. "He just spent five minutes talking about how he’s never slept with a German. This is worse than shepherding a drunk American college student." "Yeah," I said. "At least with the college kids you can leave them in the gutter and the cops will pick ‘em up. Here…" If we left him by the side of the trail he was liable to roll down the slope over thousands of razor-sharp rocks, ending up in the glacial wash a half a mile farther down. "Hey," said Roger from in front of me. "We might have a problem." "What’s that?" I said. "I’ve got an altimeter," he said. "We’re at 14,000 feet. Muktinath is at just under thirteen. What if we get him there and he’s not better?" "I don’t know," I said. "I guess we find someone to take him lower, see if he has any money and hire a horse. I think I’ll be pretty done in by then." It was true. My shins and legs felt heavy; I’d begun hiking that morning at four. "Yeah, me too," he said. "But will anyone be in any shape to carry this asshole down after another two hours of this? I’m just about done in." "I don’t know," I said. "Guess we’ll find out." We did. Right as Roger’s altimeter registered 13,500 feet, Kit’s brain cleared up. He was shuffling and ranting, legs bending every which way like a stoned cowboy, and then he was okay. He gripped the poles, stuck them in the ground, and looked back at the four of us. "Wow," he said. "I was pretty fucked, eh?" "You feeling better?" said Roger. "Yeah, I am," he said. "You all can go down, I’ll be okay. "Nice try," said Roger. We stayed with him until we hit the first teahouse. Francisca and I left him there with a few other hikers; he offered to buy us drinks but we declined. I was exhausted, thinking only of the thin mattress and warm food that awaited in Muktinath, a welcome oasis of buildings, intricate Buddhist temples, and terraced gardens slapped into the hills above the desert plateau. My group of six was staying at the Bob Marley Inn and Restaurant in the center of town—six buildings and innumerable wandering chickens. Gav had gone on ahead of us and was waiting at an outdoor table with three cups when the two of us showed up at a little past three o’clock. "I ordered you kids some milk tea," he said. "Figured you could use it. Did that little bugger die off or not?" "No, he’s back a ways," I said, sipping the steaming drink. "But he snapped out of it." "See the others?" "No," I said. "Not since the top. They were way behind us." "Hey, mate," he said, offering a hand. "We crossed that big bastard." "Yeah," I said, smacking the hand. "I think I’ll feel proud of myself in a couple of days." I drank my tea and went inside to the 24 Hour Solar Hot Shower that had been advertised on the front. I wasn’t expecting much, and was rewarded: it spewed out thirty-four degree water for five minutes before reluctantly warming up to a testicle-shrinking frigidity. I washed up in thirty seconds and bundled back up in layers of fleece and long underwear. I walked through the dark common room to the outside table, where Joachin and Anthony, two of my hiking buddies, were lounging with Kit and his guide. He was regaling them with tales of his rock climbing feats. "You going to the doctor down in Jomosom tomorrow?" I said. "Nah, I’m going to hike up on one of the glaciers," he said. "I figure I got all the altitude out of my system today, so tomorrow should be a snap." Cerebral edema can cause long-term damage to the brain, and after an attack you should stay low for a few days, only coming back up to altitude after a good period of acclimatization. Kit stood a good chance of repeating today’s episode, only on an avalanche-prone trail that was lucky to see four or five hikers a day. I thought about telling him this as he grinned his Cheshire smile. "Have fun," I said. I walked back inside, where Gav had rounded up a group of three Israeli post-military girls and was teaching them how to play 500 rummy, a game I’d taught him and he’d mutated into a combination of blackjack, gin, and euchre. "Get this," I said. "He’s going up to the glacier tomorrow." "Fuckwit," Gav said. "Can’t do anything about it, mate. That natural selection, she’s a bitch." Dan Johnson comes from California but has lived all over the place. One of his goals is to fill his passport before it expires in 2005, and there are two blank pages left. |
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