by Jon Krakauer
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.
Oddly, most climbers on Everest knew less about Ngawang’s plight than tens of thousands of people who were nowhere near the mountain. The information warp was due to the Internet, and to those of us at Base Camp it was nothing less than surreal. A teammate might call home on a satellite phone, for instance, and learn what the South Africans were doing at Camp Two from a spouse in New Zealand or Michigan who’d been surfing the World Wide Web.
At least five Internet sites were posting dispatches* from correspondents at Everest Base Camp. The South African team maintained a website, as did Mal Duff’s International Commercial Expedition. Nova, the PBS television show, produced an elaborate and very informative website featuring daily updates from Liesl Clark and the eminent Everest historian Audrey Salkeld, who were members of the MacGillivray Freeman IMAX expedition. (Headed by the award-winning filmmaker and expert climber David Breashears, who’d guided Dick Bass up Everest in 1985, the IMAX team was shooting a $5.5 million giant-screen movie about climbing the mountain.) Scott Fischer’s expedition had no less than two correspondents filing online dispatches for a pair of competing websites.
Jane Bromet, who phoned in daily reports for Outside Online,* was one of the correspondents on Fischer’s team, but she wasn’t a client and didn’t have permission to climb higher than Base Camp. The other Internet correspondent on Fischer’s expedition, however, was a client who intended to go all the way to the summit and file daily dispatches for NBC Interactive Media en route. Her name was Sandy Hill Pittman, and nobody on the mountain cut a higher profile or generated as much gossip.
Pittman, a millionaire socialite-cum-climber, was back for her third attempt on Everest. This year she was more determined than ever to reach the top and thereby complete her much publicized crusade to climb the Seven Summits.
In 1993 Pittman joined a guided expedition attempting the South Col and Southeast Ridge route, and she caused a minor stir by showing up at Base Camp with her nine-year-old son, Bo, along with a nanny to look after him. Pittman experienced a number of problems, however, and reached only 24,000 feet before turning around.
She was back on Everest in 1994 after raising more than a quarter of a million dollars from corporate sponsors to secure the talents of four of the finest alpinists in North America: Breashears (who was under contract to film the expedition for NBC television), Steve Swenson, Barry Blanchard, and Alex Lowe. Lowe—arguably the world’s pre-eminent all-around climber—was hired to be Sandy’s personal guide, a job for which he was paid a substantial sum. In advance of Pittman, the four men strung ropes partway up the Kangshung Face, an extremely difficult and hazardous wall on the Tibetan side of the mountain. With a great deal of assistance from Lowe, Pittman ascended the fixed ropes to 22,000 feet, but once again she was forced to surrender her attempt before the summit; this time the problem was dangerously unstable snow conditions that forced the whole team to abandon the mountain.
Until I bumped into her at Gorak Shep during the trek to Base Camp, I’d never met Pittman face-to-face, although I’d been hearing about her for years. In 1992, Men’s Journal assigned me to write an article about riding a Harley-Davidson motorcycle from New York to San Francisco in the company of Jann Wenner—the legendary, exceedingly rich publisher of Rolling Stone, Men’s Journal, and Us—and several of his wealthy friends, including Rocky Hill, Pittman’s brother, and her husband, Bob Pittman, the co-founder of MTV.
The ear-splitting, chrome-encrusted Hog that Jann loaned me was a thrilling ride, and my high-rolling companions were friendly enough. But I had precious little in common with any of them, and there was no forgetting that I had been brought along as Jann’s hired help. Over dinner Bob and Jann and Rocky compared the various aircraft they owned (Jann recommended a Gulfstream IV the next time I was in the market for a personal jet), discussed their country estates, and talked about Sandy—who happened to be climbing Mount McKinley at the time. “Hey,” Bob suggested when he learned that I, too, was a climber, “you and Sandy ought to get together and go climb a mountain.” Now, four years later, we were.
At five foot eleven, Sandy Pittman stood two inches taller than me. Her tomboyishly short hair looked expertly coiffed, even here at 17,000 feet. Ebullient and direct, she’d grown up in northern California, where her father had introduced her to camping, hiking, and skiing as a young girl. Delighting in the freedoms and pleasures of the hills, she continued to dabble in outdoor pursuits through her college years and beyond, although the frequency of her visits to the mountains diminished sharply after she moved to New York in the mid-1970s in the aftermath of a failed first marriage.
In Manhattan Pittman worked variously as a buyer at Bonwit Teller, a merchandising editor at Mademoiselle, and a beauty editor at a magazine called Bride’s, and in 1979 married Bob Pittman. An indefatigable seeker of public attention, Sandy made her name and picture regular fare in New York society columns. She hobnobbed with Blaine Trump, Tom and Meredith Brokaw, Isaac Mizrahi, Martha Stewart. In order to commute more efficiently between their opulent Connecticut manor and an art-filled apartment on Central Park West staffed with uniformed servants, she and her husband bought a helicopter and learned to fly it. In 1990 Sandy and Bob Pittman were featured on the cover of New York magazine as “The Couple of the Minute.”
Soon thereafter Sandy began her expensive, widely trumpeted campaign to become the first American woman to climb the Seven Summits. The last—Everest—proved elusive, however, and in March 1994 Pittman lost the race to a forty-seven-year-old Alaskan mountaineer and midwife named Dolly Lefever. She continued her dogged pursuit of Everest just the same.
As Beck Weathers observed one night at Base Camp, “when Sandy goes to climb a mountain, she doesn’t do it exactly like you and me.” In 1993 Beck had been in Antarctica making a guided ascent of Vinson Massif at the same time Pittman was climbing the mountain with a different guided group, and he recalled with a chuckle that “she brought this humongous duffel bag full of gourmet food that took about four people to even lift. She also brought a portable television and video player so she could watch movies in h
er tent. I mean, hey, you’ve got to hand it to Sandy: there aren’t too many people who climb mountains in that kind of high style.” Beck reported that Pittman had generously shared the swag she’d brought with the other climbers and that “she was pleasant and interesting to be around.”
For her assault on Everest in 1996, Pittman once again assembled the sort of kit not commonly seen in climbers’ encampments. The day before departing for Nepal, in one of her first Web postings for NBC Interactive Media, she gushed,
All my personal stuff is packed.… It looks like I’ll have as much computer and electronic equipment as I will have climbing gear.… Two IBM laptops, a video camera, three 35mm cameras, one Kodak digital camera, two tape recorders, a CD-ROM player, a printer, and enough (I hope) solar panels and batteries to power the whole project.… I wouldn’t dream of leaving town without an ample supply of Dean & DeLuca’s Near East blend and my espresso maker. Since we’ll be on Everest on Easter, I brought four wrapped chocolate eggs. An Easter egg hunt at 18,000 feet? We’ll see!
That night, the society columnist Billy Norwich hosted a farewell party for Pittman at Nell’s in downtown Manhattan. The guest list included Bianca Jagger and Calvin Klein. Fond of costumes, Sandy appeared wearing a high-altitude climbing suit over her evening dress, complemented by mountaineering boots, crampons, ice ax, and a bandolier of carabiners.