Step with me, if you will, into the Little Shop of Lofty Horrors managed by Kenneth Kamler, hand surgeon and cloud-dwelling emergency doc. The specialties of the house include bad things that can happen to climbers at heights greater than 18,000 feet or so, such as: "Those failing to acclimate themselves to the thin air must breathe deeply and rapidly to get enough oxygen, but this stepped-up activity can lead to the perverse situation in which the very act of breathing will use more energy than it creates." A tent mate of Kamler's experienced the Cheyne-Stokes phenomenon, a cousin to sleep apnea that is characterized by drawn-out pauses between each breath. "The body depends on a buildup of carbon dioxide to stimulate respiration," Kamler explains, "but in thin air short, frequent breaths keep its concentration in the blood too low. Lungs forget to breathe until the gas slowly reaccumulates and then gets them going again." Kamler himself suffered from a nearly stratospheric toothache: "When there is reduced atmospheric pressure, air that may have gotten trapped between a tooth and its filling expands against a nerve."
A Frenchwoman whom Kamler treated on Mount Everest apparently suffered a tear in "the intercostal muscles that expand the ribs for deep breathing" because she was, well, breathing too deeply. Among the many traumas suffered by American climber Beck Weathers, who was given up for dead but survived on Everest in 1996, was a bizarre loss of vision. "He had had a radial keratomy to correct his sight," Kamler notes, "but the operation leaves scars on the corneas. At high altitude, his corneas swelled, but the expansion made the swelling uneven, causing blurry images." (The condition righted itself as he descended. Weathers, you may recall from reading Jon Krakauer's "Into Thin Air," ended up losing all of one hand and most of the other to severe frostbite.)
This a grisly lineup, and it doesn't include other tortures -- such as hypothermia and snow blindness -- inflicted by the intense cold prevalent on high slopes. Kamler has made four attempts to reach the summit of Everest, all of them unsuccessful. But as a physician who knows what equipment to pack and how to use it under extreme conditions, he seems to have been an indispensable figure on every trek he has taken. "Doctor on Everest" is his account of these expeditions, with special emphasis on the 1996 "disaster" that became the subject matter of Krakauer's bestseller.
In that book Krakauer was candid almost to the point of self-laceration about his failure to save a fellow climber's life on the way down from the summit. (He may have overdone the breast beating, though: At the time, conditions were arguably such that every man had to fend for himself.) Kamler has yet to face such a dilemma, but he is no less frank about his own me-first impulses. During his third attempt on the mountain, one of the Sherpas plunged into a deep crevasse. When he heard the news, Kamler's first impulse was to defend against an interruption that might scotch his summit attempt. "It would be a lot easier for me if he was dead," the doctor recalls thinking. "The selfish, repugnant thought had surfaced immediately and I was ashamed to discover it within me. I couldn't allow it a chance to even fully form in my head so I quickly reburied it by focusing on how to proceed if he was still alive."
As Kamler soon learned, the Sherpa had indeed died, after failing to attach himself to a safety line and then suffering a fall. Such heedlessness is apparently not unusual: The Sherpas have developed their own form of macho daredevilry. Clipping into safety ropes "takes time," Kamler explains, "and they always want to show each other how fast they can go." This observation leads him to another moment of self-examination. "Enticing people to risk their lives for us is an abuse of power. We exploit them in the name of sport, offering them easy money and expedition glamour, and they don't stand a chance."
But wait. The money's not all that easy -- acting as a load-bearing Sherpa seems like arduous work to me -- and what's all this about expedition glamour? Who cops more of that particular commodity, a Sherpa or a Westerner with a book contract? To his credit, Kamler eventually recognizes the irony here. That poor Sherpa, he admits, "was responding to a deeply felt need to prove himself, impress others, taste glory, or whatever else it is that brings people to the highest mountains. In that way, he was no different than us." But Kamler leaves a more tender spot unprobed. What's so glorious about climbing Mount Everest these days, anyhow? By now more than 700 people have done it -- 300 more than what I've always considered to be the largest a group could reach and still be elite, the fabled 400 of old New York high society (said to be the number of East Coast swells who could fit into Mrs. Astor's ballroom) -- and the cost of doing so has escalated to a sum that rivals what the average American family makes in a year. To "conquer" Everest, you have to be rich or sponsored, and even then the achievement has become rather commonplace and showoffy -- the mountaineering equivalent of riding around in a stretch limo. Kamler makes a game attempt at invoking the human spirit as it copes with ultimate adventure and underscoring the nobility of realizing a grand dream, but more and more the climbing of the world's highest mountain looks like rushing a costly fraternity that isn't nearly as exclusive as it used to be.
That said, Kamler tells a good story and impresses the reader as a reliable guide. Though he's not in Krakauer's league as a stylist, the good doctor's book complements "Into Thin Air" with his ability to translate medical arcana into terms comprehensible to the general reader. And in his rendering, the centerpiece of the 1996 disaster -- the death of Rob Hall, freezing near the summit while he and his wife tried to comfort each other via cellphone -- becomes one of the most poignant anomalies the telecommunications age has ever spawned. What a strange time we live in -- your voice can be in your loved one's bedroom thousands of miles away at the same time that your soul is gradually slipping into the void.