I recalled the story of the woman who fell down a well in England. The fire brigade came and lowered a chap in to check on her. He pronounced that she had broken her leg and needed to be winched out and taken to hospital, but that she was conscious and generally in good health.
The head fireman said the winch could only support one person, so health and safety regulations meant they could not risk two people on it, and as the woman was not trained in the winch process (health and safety regulations again) she could not be allowed to go on it by herself.
He had to call his boss. After locating his boss an hour later, they got the reply that he wasn’t sure either, because of health and safety concerns, and that he would need to contact the area manager.
Another hour went by and still the woman was down the well, and starting to suffer from hypothermia along with the broken leg. The area manager was not sure because of health and safety issues, and by this time, the media was interested, so everybody was afraid to make a decision, in case something went wrong and they got blamed after the event.
So they decided not to take any action until they could get a bigger winch in. Several hours later, a bigger winch arrived and the woman was lifted out. By now she was suffering from acute hypothermia. She later died in hospital.
This story was a fair warning to me of the perils of inaction.
That smell, though…
Those people in the worst conditions in that tent were clearly fearing for their lives. They knew the severity of the conditions at Base Camp – they’d been here for weeks now. They knew it was a tough enough environment to survive in when you’re in peak physical condition, but with the temperature plummeting to -15°C at night, and with injuries and loss of blood, they must have been petrified that they would not last the night.
I made my way around from casualty to casualty, checking each person over, assessing them and making a rudimentary attempt to prioritise their injuries. There was very little I could do, but I checked if they were conscious, if they were aware of where they were – I held up fingers and asked them to tell me how many, checked if they knew their names and where they were from. I thought their responses would at least let me know who was in a serious condition, who required immediate medical attention.
I dished out painkillers to whoever needed them, which was virtually everybody. Lincoln had provided me with a bucket-load of blue tablets in a clear plastic bag, which he told me were Paracetamol. I wasn’t about to question him at this point; the situation was so dire.
After the assessment and treatment for pain, I asked those with minor injuries to go to the white pod. It was now time for phase two – to organise the space properly, so that we could get more people lying down, and arrange them so that we could access them all without tripping over anyone. It really was that chaotic.
I asked the people sitting on chairs in the middle of the tent – most of whom had head injuries – if they would like to lie down.
“No,” one of them said, in a strong Nepalese accent.
“No problem…” I paused – we had people coming in with more severe injuries. “We need to make more space. Do you think you could move to the side of the tent? We can do it slowly and I can help you.” I wanted to keep the middle clear. They obliged, with some assistance.
More bodies were still coming in – a flow of confused, injured folk looking for some sort of help. We didn’t have the facilities to cope with them all. They were supposed to be going to the IMG tent, not ours. We were supposed to be taking the non-injured in our camp, and we had only one doctor – Taka – on site.
What could I do? I couldn’t exactly send them away and say we couldn’t help them. Some of them could barely walk; some had no idea where they were.
Our expedition had two mess tents that seated 18 each on a long table down the middle. These ended up serving as makeshift hospital tents. Both became full, with approximately 25 injured people crammed into the small space, and barely enough room to move between them.
Taka was looking after the injured people in the other tent, so it was left to me to take charge in the one I was in. I had to work out where my limited medical skills could make the greatest impact.
I rolled up my sleeves, took a deep breath and got stuck in. I wasn’t feeling 100 per cent, but I had to put that to one side for now and focus on the task in hand. I had to try to keep these people alive until help arrived…whenever that might be.
I knew by now that the avalanche had been caused by a huge earthquake. Some expeditions had satellite phones and had managed to make calls, and news had flowed in that the earthquake had devastated large areas of Nepal, so the helicopters would be drafted to help with rescue operations. I had no idea if the casualties on top of Everest were a high priority – or even if they were a priority at all – so there was no telling how long we would have to make do and deal with the casualties ourselves, with no real medical supplies, in freezing, unforgiving conditions.
I put those thoughts out of my mind. Taka and I needed to work together. The trouble was, he spoke very little English, and I didn’t speak a word of Japanese, so communication was very difficult. The other Japanese member of our expedition – Hachiro – acted as interpreter, enabling us to converse in a rudimentary way.
I told Taka who was the most injured, who concerned me the most, and he checked everyone over once more. We discussed the injuries – we only had Ibuprofen and Paracetamol, so there was a limited amount we could do. Once we had discussed everybody, he returned to his tent to care for his patients.
It was basically up to me from that point.
By the time I had completed the initial assessment of everybody, organised the tent, and done what I could with Taka, bandages and painkillers, three hours had passed since the avalanche. Many people had either left BC, or come to our expedition camp or IMG’s. The flow of bodies had slowed right down.
I remembered I had promised to check on Katherine. I asked one of the other expedition members to take charge for five minutes while I nipped back to the white pod to see her.
She was still sitting, looking blankly into space, rocking slightly to and fro. I took her hand in mine, explaining, that I was busy with the wounded and asked if she would be all right.
“Yeah, I’m fine, I’m fine. Don’t worry.”
I didn’t realise, at the time, that she would wake up every night, screaming, clawing in the darkness at some unknown spectre. From across the campsite, in the dead of night, we’d hear a shrill scream cut into the silence, followed by sobbing and crying. It was horrific – I don’t know that she’ll ever fully recover from what she saw.
I made my way back to the mess tent, blocking out the immediate chaos that surrounded me, knowing that I was in it for the long haul.
I turned the small gas heater on in an attempt to keep the injured warm. It was now the dreaded 4pm, and the temperature was plummeting. We only had a limited amount of fuel, so rationing the heat was very important. Luckily, as every person at Everest Base Camp was prepared for adverse weather conditions, there was no shortage of downing climbing gear and downing sleeping bags available. We collected as many as we could from the nearby area.
Soon after, a group of Sherpas arrived, carrying what appeared to be a camp bed. They were quiet, very sombre, and there was no noise coming from the shape on the bed.
Half of those in the tent, for all their injuries and ailments, were in strong voice – they moaned and groaned and continually asked for water. This, I knew, was a good sign – a moaning patient is a very conscious patient. This was infinitely reassuring to me, as I knew their injuries were less likely to be life-threatening.
The quietness, stillness of this camp bed was disconcerting. The Sherpas carrying it in seemed to be acting almost like pallbearers.
On the bed, wrapped in an array of camping equipment, was another Sherpa. His body seemed to lie
with an unusual flatness, his limbs limp and lifeless.
His eyes were sunken, unreflective, without the usual spark of life, and his breathing was very laboured and stilted, the air rattling in his lungs uselessly.
I knew there was very little I could do – I had some bandages, painkillers, plasters; I could maybe make a rudimentary splint for a broken arm. He was too weak to swallow anything.
His left arm and lower body were soaked in blood. It was impossible in the dim light of the tent to determine the true extent of his injuries, but I knew it was bad.
I decided we should try to keep him warm, and see if we could get some fluid into his body.
I asked the kitchen to prepare some flasks of warm water, which I then poured into a plastic mug, making sure it was not too hot.
I asked one of the Sherpas who had brought the injured man in to pour a few drops on his lips very, very slowly. I checked that he understood what I meant – he nodded, took the cup and gently lowered it onto the man’s lips.
A short while later, I felt a tugging at my sleeve and turned to face the Sherpa I had just spoken to. He clutched the plastic mug and pointed over to his friend.
I rushed over – the man’s eyes had rolled back and he had stopped breathing. I felt his neck for a pulse. There was nothing. He was dead. He died in my mess tent, wrapped in sleeping bags, on a camp bed at Everest Base Camp. I never knew his name, where he came from or anything about him. I was in his company for less than five minutes, in which time he breathed his last breath and departed from this world.
I felt a sudden wave of nausea wash over me at the sheer desperation of the situation. These people were depending on me and I had very little to give – no real medical supplies, no bandages, no syringes, no real medicine. I felt as though I was going to cry.
“Pull yourself together, you idiot,” I muttered, and slapped myself hard.
It must have been a very strange sight for the Sherpas – their friend had just died, and this crazed Westerner was slapping himself around the face.
I closed the dead Sherpa’s eyes, pulling the sleeping bag over his head.
The Sherpas who had carried him in, and those who had followed, surrounded his body and began to chant. A low, rumbling chant with a haunting, ghostly tone.
The injured people in the tent began looking over, fear glinting in their eyes – many seemed in that specific moment to realise the true severity of the situation.
“What are you doing?” I asked one of the Sherpas.
The Sherpas have a very strict and traditional rite of passage – the ceremony is very particular. At the time of death, the body should be washed and covered in a white shroud. A lock of the deceased’s hair should be cut off so that the life breath of the departed can leave the body – the sacred texts are read and there is a lot of chanting.
I had every respect for their religious ceremony; I was well aware how important it must be to Sherpa culture. But I was also aware that my patients were beginning to become unnerved, and that was the last thing I needed.
I dashed out of the tent, grabbed the nearest person and explained that we needed to find somewhere for the Sherpas to do their prayer ceremony – somewhere that wasn’t my hospital tent.
Next to the kitchen was a wash tent, about three metres by three metres in size. I asked the Sherpas if that would be a suitable place for them and they agreed, lifting the makeshift stretcher with its lifeless body out of the mess tent and away.
I heaved a sigh of relief – but it wasn’t long before the next problem walked through the door.
I’d started to fear what would come through the entrance of the tent. I knew that, any second, somebody else might be carried in, clinging desperately to life, and there would be very little I could do.
It didn’t take long for my fears to be realised.
A Sherpa, supported by two Westerners, each with an arm under his, was dragged into the tent. He was very dazed and confused, blood covering his jacket, his trousers; he was in a hell of a state. I couldn’t actually see his face properly, roughly applied bandages covered half of it, including his right eye – the rest of it was covered in glistening blood.
His one visible eye seemed entirely vacant.
We sat him gently down, and I grabbed the nearest Sherpa, whom I knew was able to speak English. “Translate for me,” I said. “Translate what I’m saying.”
I started to ask where he was in the most pain and the Sherpa began to translate. The man’s good eye half-focused on me.
“No…”
He wasn’t a Sherpa at all. The blood was so thick on his face wherever it was not bandaged, that it was impossible to tell.
“What’s your name?”
“Marr…”
“Mark?”
“Yeth…”
It was almost impossible to understand him. Blood began to seep out from under the bandages above his right eye.
He began to shake. He juddered and jerked uncontrollably as we stood over him.
I could see that he had lost so much blood that he was at risk of going into cardiac arrest, and if I didn’t act quickly to try to prevent it, it would be too late.
When the avalanche had hit, Mark had been walking in the open, with no protective cover nearby. He’d been hit by the full force of the impact, thrown unceremoniously around by it. It was amazing that he was alive at all.
I didn’t think he’d be alive much longer.
I ran to Taka for help.
Hachiro translated my message; it seemed to take an eternity.
All the while, blood was oozing out of the back of Mark’s neck.
Finally Taka got the message and rushed through to see him.
Mark was wearing a big downing jacket with a high collar, originally intended to protect his face and neck from the cold. Now it pressed against his wounds, acting as a compress.
There was an intense smell coming off him – sort of like fried pig, like bacon. The smell of his blood was almost overwhelming – he smelt like an abattoir. He continued to shake.
After Taka had quickly checked him over, we fashioned a splint for his neck out of a bit of polystyrene. We suspected he’d broken his neck, and any sudden movements could have been the end of him.
We duct-taped the polystyrene brace to his forehead and to his back as he sat in the chair.
“Where are you from?” I asked, doing my best to keep the panic out of my voice.
His breathing was shallow; he’d managed to control his shuddering slightly.
“Amsterrrrdammm,” he said, in a voice barely more than a whisper.
He was very, very cold, with no shoes on, just socks. We had to warm him up and get some fluid inside him to counteract the large amount of blood he was losing.
“Can you swallow?” I asked him.
He couldn’t. I wanted to get some Paracetamol into his system. I knew it wouldn’t do much, but it might take the edge off the pain slightly.
What I didn’t want was for him to jerk his head back in an attempt to swallow the tablets. There was severe damage to his neck, and if his vertebrae were broken, any violent movement could be fatal.
“Can you bite on these, crunch these up?”
There was a very faint nod and I pushed the blue Paracetamol tablets into his mouth.
I had a cup of warm water, which I had to make sure was not too hot with my dirty finger. I didn’t think he’d realise if he burned his mouth, let alone care.
I parted his lips for him – he could barely move them – and carefully poured a few drops of the water into his mouth. He gurgled slightly, as if he had no control over his neck muscles.
I froze, holding the cup next to his chapped and bloodied lips, praying he wouldn’t choke.
The water passed and he continued his shallow, laboured breathing. His good eye loo
ked up at me with thanks.
He would slurp some of the liquid, then slowly swallow it down, gasping all the while as if he was dying, like it was his dying breath. Every time he took some water, he gurgled – his throat was so dry.
It’s amazing what the human body can endure – this man should not have been alive; he should have been dead. I think it was only his will that was keeping him going. I was terrified he’d fall off the chair and finish his neck off.
“We’ve got to get you lying down; we’ve got to get you flat.”
I went out of the tent and shouted for a mattress and a sleeping bag. Time was of the essence, and the sooner I got Mark horizontal the better. I needed to make him as comfortable as it was possible to make someone in his state.
We made a space in the corner, moving chairs and bags out of the way.
“We’re going to get you into a lying position – we’re going to move you very slowly, OK?”
“Yeth,” he said, through gritted teeth.
John and one of the Sherpas, who were assisting me, held Mark under the arms, taking most of his body weight, while I positioned myself behind his head to support his head and keep his neck still, to negate any movement as we lowered him.
It took the three of us quite some time to lower him gingerly on to a mattress, covering him in sleeping bags to try and get some warmth back into his very cold body.
When we had positioned him on the floor, we tucked thin, sponge pillows underneath his shoulders and head to help support his neck. It was a laborious process, slowly tucking each pillow in, one at a time, all the while trying to keep him as still as possible. His breath was very short; it was clear that lying down had been a hugely exhausting process for him.
“Jeepers,” I thought, “this guy’s never going to make it if we can’t get him out of here, if we can’t get him on to a helicopter.” And yet moving him again was going to be highly risky too.
Aftershock: One Man's Quest and the Quake on Everest Page 11