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Brush With Death
The following text is a transcript of the radio (walkie talkie) communications from the 1997 NOVA Everest expedition. The radio calls were recorded at Base Camp at 17,600 feet. The first call in this transcript is from David Breashears at Advance Base Camp (ABC), also known as Camp II at 23, 100 feet. He is there with his other team members: Ed Viesturs, David Carter, and Pete Athans. The climbers have been on Everest, acclimatizing and waiting for the weather to improve, for nearly two months, and time is running out for them to make an attempt on the summit. Howard Donner, the expedition doctor, receives the call at Base Camp. Printable version of this page.

May 20, 1997
DAVID BREASHEARS: ABC to Base, ABC to Base. This is David. Over.

HOWARD DONNER: David, this is Base. What's up?

DAVID BREASHEARS: Oh, it's a misty evening up here at ABC. I'm in my tent, and we got a weather forecast, and things don't look really good, but they look a little better. So we're going to leave tomorrow morning at six a.m. for Camp III. Over.

HOWARD DONNER: We copy you. You're leaving early tomorrow for Camp III. How's everybody doing, David? Over.

DAVID BREASHEARS: Ed's strong as usual. That's to be expected. David Carter's feeling fine, slightly under the weather with some type of chest cold. I feel really good. Nothing to complain about. Been sleeping fairly well, eating well. And just ready to get this show on the road. Over.

HOWARD DONNER: We copy that, David. What's the weather doing now? Over.

DAVID BREASHEARS: Well, I can't comment on the upper mountain, I can't see through this mist. But reports from people who were up higher is it's very windy. Other weather reports we have forecast high wind day after day. So nothing positive to wait for. We've all decided we can climb in the wind and we'll give it our best shot and see what happens.

HOWARD DONNER: Sounds good, David. We're all wishing our best. Get some rest and we'll be standing by.


May 21, 1997
HOWARD DONNER: David, this is Base, where are you guys? Over.

DAVE CARTER: Hey Doc, it's Dave. We're basically at the bottom of the Lhtose face where our elevation is at 22,300, and it's about 8:00 in the morning.

HOWARD DONNER: We got that, David. How's, how are you feeling? Over.

DAVE CARTER: Not too bad. I could be feeling a little bit better right now. Sun's just about ready to hit us, so when that comes up it should be a little bit better here. Got some information for you.

HOWARD DONNER: We're ready, David, go ahead.

DAVE CARTER: Pulse is around 140 when I rolled in, and blood oxygen saturation was at 60. Do you copy?

HOWARD DONNER: Got a sat at 60 and a pulse at 140 just after rolling in. How soon was the sat taken from the time that you were actually exercising? Over.

DAVE CARTER: Right when I rolled in, I mean I was still moving.

HOWARD DONNER: All right, do you have a respiratory rate, David? Over.

DAVE CARTER: Respiratory rate is at 32 when I came in.

HOWARD DONNER: All right, we got that, David. We're going to get some additional data from you later, including your sleep, nutrition, fluids and such, but we'll wait until a little later to get that from you. Thanks for calling in, David, and hello to everybody up there, and hope you keep going strong. Anything else?

DAVE CARTER: That's about it, Doc, everything's going good here. We'll talk to you later on.

HOWARD DONNER: Great, David. We'll be standing by, thinking about you guys up there. This is Base standing by.


Two hours later
LIESL: So that you know, I'm recording on digital audio tape here, and this will possibly be used as voice-over in the film. Your throat is hurting. What's going on?

DAVE CARTER: Well, my throat is feeling really pretty good now. I think the medicine is kicking in. The main problem now, which I expected, is I'm getting that high altitude cough and I did take 30 milligrams of codeine about an hour ago and it seems to be helping. Over.

LIESL: I copy. Great. Well, you sound, even though your voice sounds a little sultry, you've got that normal David Carter pep going on. Tell me a little bit about tonight. You'll be breathing oxygen at Camp III? If you can describe what you think it might feel like or whether it's even going to be easy to sleep with it.

DAVE CARTER: Tonight I will be breathing oxygen. I'll be on a half-liter flow, and we've already— I've kind of had it on for 20 minutes today and it's going to be interesting. I don't know if I'm going to go to sleep with it. It does make a difference. We had the oxygen meter (pulse oximeter) on ... when I first put it on it was right around 71 or 72 without the oxygen, and then after about five to eight minutes with the oxygen, it jumped up to about 84, and what I did, I breathed it before I ate my lunch to get my appetite back up, and it really helped, it was amazing.

LIESL: So you had lost your appetite; were you feeling any nausea or anything?

DAVE CARTER: No, I have had no nausea. I just didn't have an appetite, and the oxygen really helped that. And right now, I'm not breathing any oxygen. I feel great right now, this is the best I've felt all day, so I really think the oxygen is going to make a big difference for me, especially, and I think other people are affected in different ways and it really doesn't affect them that much, but some people maybe it's affecting a lot. Over.

LIESL: Great. This is my last question, and I'll let you go so you can keep feeling good. This is just a status check on how you're feeling, a little bit more on how you're feeling right here and now, you're at Camp III and on Everest, and you may not be back there again.

DAVE CARTER: Right now, I feel pretty good. I'm hydrated. Coming up today from Camp II, I felt fair, I didn't feel my best. I think that head cold is still dragging me down a little bit. But I really, I'm looking forward to tomorrow and seeing how I feel, and I think I'll feel fine tomorrow. Over.

LIESL: Okay, great, thanks Carter.


May 22, 1997: The climbers are headed to Camp IV.
LIESL: How long do you think it'll take you to get to Camp IV?

DAVID BREASHEARS: We're planning to have a break for shooting and taking juice. There's a nice place here in about 30 minutes, 20 minutes. Then it's probably an hour-and-a-half to two hours. To my right is the summit gully up to Lhtose and we take about 10 steps up here before we rest and catch our breath. Looking at the ... several thousand feet ahead of me, well, 2,000 feet anyway. I see Sherpas, eight or nine Sherpas, some resting, some moving. Break.

DAVID BREASHEARS: We're going to give you Ed's sat level with a mask on at two liters a minute to see how it contrasted to 300 feet lower. Okay?

LIESL: Got it.

DAVID BREASHEARS: 72, 120 for Ed with the mask on, just having stopped.

LIESL: That's 72, 120 just have taken the mask off.

DAVID BREASHEARS: We're all just getting ready to head back up the trail. Anything else?

LIESL: Just hoping that you guys are going to be ready for these psych tests. We're getting ready and we're prepared for you to say you only want to do half of them or whatever, but hopefully you'll be able to stick with us.

DAVID BREASHEARS: Well, we'll do our best. My problem, the problem is going to be me having to shoot all those different tests and that's when we should be in our sleeping bags trying to rest, so I'll see how many I can get through.

LIESL: We totally understand and we're going to try to make them as quick and painless as possible. So Base Camp standing by and we're breathing with you every step of the way.

DAVID BREASHEARS: Yes, we probably won't call again till we get to the top of the Geneva Spur, which is— Yes, and it could be windy. So don't worry if you don't hear from us.


An hour or so later at the Geneva Spur
DAVID BREASHEARS: Yes. So it's real breezy now. I'll call when we get to the Col, but won't call you for a little while.

HOWARD DONNER: Great, David, I'm glad you guys are making good time. Hope the wind stays moderate, and we're just here waiting to hear from you. Over.


Several hours later. The climbers are at Camp IV
LIESL: Carter, your voice sounds very small. Do you think it could be due to battery power, or are you actually losing your voice?

DAVE CARTER: [INAUDIBLE]

LIESL: Carter, we didn't copy that, so I'm thinking if and when you get a chance, if you can just change the batteries in your radio. Maybe that'll help.

DAVE CARTER: [INAUDIBLE]

LIESL: Also, big question, have you set up your tent? Are you in a tent, or are you outside?

DAVE CARTER: [INAUDIBLE]

LIESL: We didn't copy that. We're going to hold out for better options, if you can somehow reposition or change batteries. Hopefully that'll help.

ED VIESTURS: Copy that?

LIESL: Yes, much better. I take it that's Ed?

ED VIESTURS: Yes, Carter's losing his voice basically, and I guess the reception from here is quite marginal, but ... getting my head from the top of the tent.

LIESL: I take it you're in your tent. I just want to get a sense of whether you're in or outside?

ED VIESTURS: Yes, no, we got here, all our tents were up. David and Pete are just now getting theirs set up, but all of our group, we're in our tents drinking milk tea and having snacks.


Several hours later from Camp IV
DAVID BREASHEARS: I'm having serious doubts about going up today. I'm,— Something about climbing with all these people can really fast become—Well, first we'll be trail breaking. Then I'll be putting pressure on you guys to stop and take tests. At which time, we may be overtaken if there are strong climbers. I don't know. I'm trying to sort it out. It's got me bothered in the way that a few days last year had me bothered and—It's just mountaineer's intuition, but I'm trying to sort it out. What do you think?

ED VIESTURS: [INAUDIBLE]

DAVID BREASHEARS: Yes. Well, I'm not going to climb up there and not take the tests, because we're behind schedule. The object isn't to climb Everest, it's to take those tests. And, they are much shorter, less time consuming. But I don't know. How many people do you think are heading up today? 50 or 60?

ED VIESTURS: [INAUDIBLE]

DAVID BREASHEARS: It seems like the wind's diminished, don't you think?

ED VIESTURS: [INAUDIBLE]

DAVID BREASHEARS: It just seems like there's a lot of people to have a collapse. I mean, who looks after who up there, you know? How do you sort that out?

ED VIESTURS: [INAUDIBLE]

DAVID BREASHEARS: What's actually got me most worried is getting back down. I know Guy has this great idea, but I don't like to be around people staggering around like that and may be in need of help or—I don't know. I mean, Pete and I are thinking of staying for a day and I can get up there and take the tests. It's not as good as if we all took them, but I don't know. I'd like to see this day just kind of sort itself out without me in it.


Several hours later at 10:00 p.m. We believe the climbers are leaving for the summit, but due to the inaudible radio calls from David Breashears, we never really know for sure whether he has decided to go
LIESL: Go ahead, David.

DAVID BREASHEARS: Hello. [INAUDIBLE] That's all there is to say. Talk to you later.

LIESL: What? I didn't hear it. Sorry. I didn't copy. Over. Well, [INAUDIBLE]

DAVID BREASHEARS: Beautiful evening. Talk to you later.

LIESL: Can you get on—Does that mean you're going?

HOWARD DONNER: David, this is Howard. Can you tell us if you are going up or not? Over.

DAVID BREASHEARS: Thank you very much, talk to you later.


Several hours later, May 23, 1997, 5 a.m.
DAVID BREASHEARS: We're on the South Summit. [INAUDIBLE] is at 700 feet.

LIESL: [SCREAMS] Oh, my God. You guys are going so fast I can't believe it! That's so great. Wow!! So how are you feeling? Is everybody doing okay?

DAVID BREASHEARS: [INAUDIBLE] It's a beautiful night. And it's a little cold and windy. And I'm having camera problems. We're cleaning it out.


6:50 a.m.
DAVID BREASHEARS: Base Camp, Base Camp. This is David. Do you read me?

HOWARD DONNER: David, we read you loud and clear. How are you? Over.

DAVID BREASHEARS: Howard. I'm top of the world! We made it.

HOWARD DONNER: [LAUGHS] No way! What's it like up there? Over.

DAVID BREASHEARS: Well, Howard, I've had a very rough day. I left camp and a 1,000 feet later I threw up three times and thought I would turn back. But we're here. Over. And Jangbu's here, happy to say hello.

HOWARD DONNER: God. Who am I talking to? Jangbu! How are you, man?

JANGBU: I'm here. [INAUDIBLE]

HOWARD DONNER: You guys made it. We can't believe it. It's unbelievable. And you climbed the mountain in the middle of the night and you're standing up there in the early morning. It's unheard of! How's everybody? Over.

DAVID BREASHEARS: Well, everybody's tired. I had the best time. I arrived here first with Tashi Tenzing (Tenzing Norgay's grandson) and we walked arm in arm to the summit. [INAUDIBLE] Over.

HOWARD DONNER: Alright, David. I heard that you were climbing with Tashi. You're breaking up badly. If you can reposition. We're really excited for you. But if you can reposition so we can copy. Over.

DAVID BREASHEARS: Yes. 6:50, 6:50. We made the summit. I can see Makalu, I can see everywhere. It's just so beautiful. I wish I could, you could see this. It's a very, very cold wind though. I'm not going to be able to stay here very long.

LIESL: Congratulations. This is such a thrill, even for us at Base Camp. Any chance that we can talk to David Carter?

ED VIESTURS: We really have to get out of here. Maybe could we do it at the South Summit? It's really cold and we've been here for a while and we've got to start getting down before the crowd.

LIESL: Okay. Understood. Go ahead and get yourselves out of there. Get down quickly. We've got a lot of partying to do and give our best to David Carter. We're really excited for him and we've got the computer going right now to send a note to his brother.


11:30 a.m.
LIESL: Hi, David, come again.

DAVID BREASHEARS: How's that?

LIESL: Much better. How are you doing? How are you doing? What's going on?

DAVID BREASHEARS: Well, I'm just lying out here in the scree. I can't get into my tent. I don't have the energy yet. But it was a good [INAUDIBLE] I've been climbing. A minor, minor one in filmmaking. We'll just have to do what we can.

LIESL: David, what do you mean you can't get into your tent? Are you warm?

DAVID BREASHEARS: I'm too tired. It's night(?). I'm just lying out here in the scree.

LIESL: But you're just outside your tent? Is that correct? David, do you copy?

DAVID BREASHEARS: Yes, you copied.

LIESL: I just want to know if you're close to your tent.

DAVID BREASHEARS: Yes. Five feet.

DAVID BREASHEARS: Liesl. How'd I do on my summit test?

LIESL: You did great. You're not going to believe it, because you—I wish you would have made a mistake. [INAUDIBLE]

DAVID BREASHEARS: What about Carter? Carter can't talk. Carter's a problem. I—We can't even hear him when you're two feet from him.

LIESL: Okay. Understood. Are you going to be okay? I'm really worried.

DAVID BREASHEARS: I'm alright. I just need to talk to Howard.

HOWARD DONNER: Yes, David. We, we can tell. We're all standing around the microphone. Everybody knows that you're totally pooped and you've been barfing up there and you need to rest. We have just a few questions about the status of everybody on your team. And if you have patience for it, I'm going to ask you a few questions about where and how everybody is. Over.

DAVID BREASHEARS: Sure. I'm ready when you are.

HOWARD DONNER: Well, if you could just give us a, a run down on,— We're all interested in how Ed is doing. We assume he's doing well. We haven't heard much about Pete and we haven't talked to Dave Carter yet. So if you could just give us a run down on everybody's status, including the Sherpas, we'd sure appreciate it. Over.

DAVID BREASHEARS: Okay. The two teams that left, which were Jangbu, Kami, and Dorge on our team, along with Pete and myself. And on the Guy Cotter team, we had Veika, David Carter, Tashi Tenzing, Guy Cotter, and Ed Viesturs. Along with their two Sherpas, whose names I can give you later. We all left here at 10 a.m. Actually at 10:15. And we reached the summit between 6:50 and 7:05, the last person arrived on top.

HOWARD DONNER: We copy David. I'm curious, is that any kind of a record? Getting up there before 7:00 a.m.? Over.

DAVID BREASHEARS: No. People on the North Side get up that early. It's very rarely done on this side. People very rarely have the discipline to get up and leave that early. To tell you the truth, it was tough for the filmmaking and the sun didn't hit till we were at 28,700 feet. I expected to have been climbing for a few hours by then and the, cameras would have warmed up. Because you've never seen anything more beautiful in your life. I'll describe it to you in a second. Break.

HOWARD DONNER: We copy. This is great, David, go ahead.

DAVID BREASHEARS: It's a once in a lifetime opportunity and, due to my condition this morning, I—I didn't want to bring my still camera. I said, "Look, you're going to concentrate on the, on the video." Around—Oh, God, I don't know. Five to 5:30 a.m., Everest cast a perfectly black, perfectly symmetrical pyramid shadow out into the blue sky to the east. And say 40 degrees directly above the shadow that it was cas— above the pinnacle of the shadow was a full moon.

HOWARD DONNER: It sounds incredible. We copy.

HOWARD DONNER: Did you use Guy Cotter's down rope on Hillary Step? Over.

DAVID BREASHEARS: No. Everyone moved fairly quickly and we didn't need it. Bruce was there. [a dead climber] It's obvious the nature of his accident, he's still hanging upside down from his figure eight and I just—it's very gruesome because his face is extraordinarily well preserved, it's just very black and round. And both his hands are slung back over his head. But unfortunately, he was cut down and gone when we came back across the traverse. So we didn't have a chance to look for the camera for his girlfriend. We were going to devote time for that on the return.

HOWARD DONNER: David, thank you. Can you comment on Pete Athans? We're, we're all waiting to hear a little bit about how Pete's doing. Over.

DAVID BREASHEARS: Okay, Pete was in the batch of people that reached the summit. He's been taking photos and doing some filming on the way down and he is in good—completely good condition. And should be here in less than an hour.

HOWARD DONNER: Great. And do you know any more about Dave Carter and his throat and his health status? Over.

DAVID BREASHEARS: Dave Carter was a powerhouse today. He kept up with everybody. I think he just lost his voice. But his health is okay. It's just one of those things up here. Dorge, our Sherpa, lost his voice but he went up and he's back and he just was a powerhouse all day.

HOWARD DONNER: Anybody have questions? Anybody? David, we're curious, now that you've been to the top and you're feeling the endorphin release of descent, do you think this was your last trip up this mountain? Over.

DAVID BREASHEARS: Well, you know, there were a lot of reasons I didn't want to go and, in the end, I did what I promised I would do. It's the hardest day I've ever had on the mountain and I have no intention of ever going to the top of Everest again. And I need lots of people to prevent me from changing my mind.


Two hours later
HOWARD DONNER: Pete, I know this is a hard question, but, when you look at Carter right now, does he look like he's in distress? Or if I was to look at him, does he look pretty comfortable? Over.

PETE ATHANS: He would, he would look distressed.

HOWARD DONNER: Okay. A couple of questions, jumping right to it. Well, let me ask you a few more about his history. Did you by chance stick your ear or a stethoscope on his chest? Over.

PETE ATHANS: No. I don't have a stethoscope up here. I did ask him if he had very strong inspirations, whether he's starting to cough and would there appear to be [INAUDIBLE] and he said no.

HOWARD DONNER: Do you get the sense of gross wheezing, wheezing that you can hear just when he's breathing next to you? Over.

PETE ATHANS: Not particularly.

HOWARD DONNER: Alright, Pete. A couple of questions about what you have up there. Question one, I noticed in your Base Camp kits that you do carry metered dose inhalers with albuterol. Do you have any of those up there? Over.

PETE ATHANS: The only thing I have here is that nasal steroid you prescribed for me.

HOWARD DONNER: Alright. Listen, Pete, it's hard for me to tell what's going on from here. But if he is definitely having some form of allergic reactive airway problems, i.e. acute asthmatic attack, really the only thing you're going to be able to treat him with up there is going to be steroids. Which is actually a great medicine for asthma. It's what we use in emergency rooms for when people have severe asthma attacks. I would definitely start him on Decadron. It's the only steroid you have up there.

If he were in the real world, the sea level world, we'd put him on Prednisone. But Decadron is going to be fine. And if he has some airway edema, swelling, that is progressive and is going to compromise his airways, the Decadron will definitely reverse that. It's an amazing drug for that. Over.

PETE ATHANS: Yes, I copy that. We've also been in touch with our own doctor who prescribed Decadron and Nifedipine.

HOWARD DONNER: Right. You know, Nifedipine probably won't hurt him. You know, I'm not sure that's the drug I would still choose first. Only in that it's primarily a pulmonary artery dilator for [INAUDIBLE] pulmonary edema. If there is no suggestion in your mind that he has pulmonary edema, I might start with the Decadron. If you think it could be a mixed presentation, I think that's a reasonable choice. Over.

PETE ATHANS: Yes I think that that's probably what Dave over in the New Zealand camp is thinking. Over.

HOWARD DONNER: You've been to altitudes more than most. What's your impression as to his HAPE [high altitude pulmonary edema] component in this particular presentation? Over.

PETE ATHANS: I don't really hear the accompanying rails or noise that I would expect to hear. David is also—he came up here with an upper respiratory infection and he has been producing some, you know, some cough and things like that. And, you know, I think it may relative to that rather than from pulmonary edema. But it would be smart to treat that as well.

HOWARD DONNER: Here's my best guess. And then I'll tell you what I would do and it sounds like you're going to do it. I think he has an upper respiratory infection. I know he does. I think he has probably an asthmatic bronchitis or a reactive airway component associated with his respiratory infection. I think that may or may not be predisposing him as well to high altitude pulmonary edema. It's hard for me to tell from here. Even if I was there, it would be hard to differentiate. The steroid, the Decadron, normally I wouldn't give for Higgs, but for his reactive airways, it can definitely help with his breathing.

And I think the Nifedipine is a reasonable idea. Although if you're going to have him on reasonable flow oxygen, there may be no reason for it. So before I finish, what would be his maximal oxygen flow that you could provide him with? Over.

PETE ATHANS: Yes, they want to descend right at this moment on a four liter(?) [INAUDIBLE] with the same medications that we've discussed. And I think given that the clock's ticking, we should just let them go.

HOWARD DONNER: I got you. We'll start the Decadron. I think if he's going to be on four liters, I'd probably hold off on the Nifedipine for the moment. But I'll leave that one up to you. Over.

PETE ATHANS: Okay, thanks a lot, Howard. I appreciate that. These guys are—have already given medications in those dosages are on their way to Camp II.

HOWARD DONNER: Alright. Is David going down with Carter? Over.

PETE ATHANS: No, Ed is going now.

HOWARD DONNER: Okay, so David's there with you? Over.

PETE ATHANS: Yes.


A few hours later, Ed Viesturs is heading down to Camp III with Dave Carter.
HOWARD DONNER: In terms of relieving some of that wheezing and that airway component that Carter is really probably making him kind of nervous. The Decadron's really going to work for that. But it may take up to four or five hours to kick in. Over.

ED VIESTURS: Okay. Let me know when you might want to repeat it.

HOWARD DONNER: Yes. In case we lose touch with each other, just as a default plan, why don't you repeat it in four hours for the first dose, for the second dose. Repeat in four hours from his initial dose. Over.

ED VIESTURS: I'll do that.

HOWARD DONNER: Okay, you guys, be careful coming down. I think Carter's going to feel better as he gets lower. I think it's great that he's on those and coming down and I think things will go real well. We'll be on the hand held for about 30 minutes and very close to base station. Base station standing by.


A few minutes later. Howard, at Base Camp, is unable to hear Ed Viesturs' radio transmissions from where he is on his way down to Camp III. David Breashears (at Camp IV) relays messages to Howard from Ed.
DAVID BREASHEARS: Howard, this is David.

HOWARD DONNER: Got you, David. Go ahead.

DAVID BREASHEARS: Ed just gave it to him.

HOWARD DONNER: Excellent. David, how much oxygen do they have currently for use today and tonight? Over.

DAVID BREASHEARS: They have a bottle with Ed and a bottle with Carter and they're sending two more bottles down with sleeping bags for an unexpected stop in Camp III.

HOWARD DONNER: Copy that.

ED VIESTURS: ...[INAUDIBLE] I have one full bottle I'm carrying. Carter is about two-thirds down. And then I have one bottle about half way.

HOWARD DONNER: Alright, Ed, in your mind, what is Carter's biggest problem right now? Does he sound wheezy or do his lungs sound full of water? I know it's hard to tell the difference, but give it your best. Over.

ED VIESTURS: His main complaint is ...throat constriction.

HOWARD DONNER: Alright. The second Decadron is definitely a good idea. Stand by. I need to ruminate.

ED VIESTURS: He says he's a little wheezy.

HOWARD DONNER: Ed, I was able to procure a bronchodilator for Carter at Camp II. The Canadians have a climber that has asthma that has an inhaled bronchodilator. The problem now of course, you're not going to be at II this evening I guess. Give me a second. Give me about 20 seconds to think and I'll get back to you. Over. David Breashears, Howard.

LIESL: We've lost David.

HOWARD DONNER: Well, I want to talk to David for one second.

DAVID BREASHEARS: Howard, this is South Col.

HOWARD DONNER: David, I can handle the medical end of this. I'm wondering, from a logistical standpoint if you have any input, anything that I need to know about in terms of recommending the best bivy spot for them, etc. Over.

DAVID BREASHEARS: You know, Guy is with me. He just came over. He's worked that out. I'm wondering if once they get him to a level spot and he's relaxed, if they could reduce the flow of oxygen. Do you see any real benefit to four versus three? When he's horizontal so they can extend their oxygen supply?

HOWARD DONNER: I think all they need to do is maintain, a saturation at 90% or so. If they can do that on three, there's no reason to use more. Over.

ED VIESTURS: Right now, I read 90 ...[INAUDIBLE]

HOWARD DONNER: Okay, Ed, this is Howard. If you get him to a rest spot and you want to conserve oxygen, if you can keep him around 90%, 88, 89, 90, 91, that's plenty. Giving him any more oxygen probably won't help at this point. It may help a little bit, but it's more important for you to maintain your reserves. So just keep him at 90. Give him that next Decadron and I won't bother you anymore. Why don't you keep moving to the best spot that David and Guy have for you and, we'll contact you as soon as you're resting. Over.

ED VIESTURS: Well, we've been resting now. He's on four liters and he's on 90.

HOWARD DONNER: My hope is that when the Decadron kicks in, that may be reduced. If this is in fact a reactive airway, the Decadron's going to help him. The only problem with Decadron is, unlike a lot of other asthma medicine, it takes time. By time, I mean, many, many hours to kick in. So, we'll know more in a few hours. Especially with this higher dose now that you've given him a double whammy. Over. Ed, I know you're busy. This is base station. We'll be standing by.

ED VIESTURS: Should I keep him on at four liters for another half hour?

HOWARD DONNER: I'd keep him on four liters while you're moving for sure, because his increased exertion is going to demand higher flows. But my guess is you'll have him down to three by the time you're at camp or bivying tonight. Over.

ED VIESTURS: Okay, I'm going to keep him at four.

HOWARD DONNER: Great, Ed. We'll be around. Just give us a call whenever you need and, we're with you here. Base standing by.

[break]

HOWARD DONNER: Yes, David, my guess is this is either a huge reactive airway problem or he has some kind of infection similar to the one that the Canadians had. Some kind of a soft tissue infection of the lower part of his throat. And I may want to talk to—actually, is Pete with you? Pete may know which antibiotics you have sitting over at II. We may want to bump him to a broader spectrum antibiotic. Over.

PETE ATHANS: Okay. Augmentin and Cipro.

HOWARD DONNER: Yes, good. Augmentin would be perfect if this is a soft tissue infection. Augmentin would be better than what he's on, which is erythromycin, for his sore throat. So, we'll try to—if Pete wants to communicate that before I do, that's fine. Otherwise I will. I think we should start him on Augmentin, assuming he does not have any allergies to penicillin. Over.

__: No, he's been on it.

PETE ATHANS: Guy has it here at IV and can send it down with the Sherpa that's bringing the extra O2, so Carter can start it tonight.

HOWARD DONNER: Sounds good. If Pete ends up talking to him, main side affect is diarrhea. But I guess, David, Dr. David, was just on telling me that Carter's been on Augmentin before and I guess he tolerates it. Over.

DAVID BREASHEARS: Yes, another thing and Liesl's familiar with this. When last year I was moving up to III, I got a bad chest infection, upper respiratory. 1923-24, Somerville had one. Which I claimed constricted my passageway by nearly 50%. Until in one mighty cough, I coughed up something of the size of a small egg. And Somerville became incapacitated at 27,000 feet and thought he was going to die and grabbed his chest and squeezed and squirmed around and popped out something similar. So anyway, I wouldn't forego some kind of constriction of the airway due to infection.

HOWARD DONNER: Yes. What you're talking about is something often called bronchorrhea. And it's a possibility, David. But I think more likely it may be some bronchorrhea combined with also some swelling of the airway, due in part of inflammation and in part to who knows what. He may have some cold-induced asthma, exercise-induced asthma, maybe even some altitude-induced asthma. No one's ever, been able to show exactly what happens at altitude.

It may just be the cold and the exercise and the low humidity, but the altitude may actually cause some, some bronchia constriction as well. At any rate, we're giving him the most powerful bronchodilators we know, which are steroids and we'll bump him up to a broader spectrum antibiotic. He'll stay on the O's, get some rest, rehydrate, and I think, from my end, that's about all we can do. Over.

[break]

DAVID BREASHEARS: Is there anything we could—that we have here in terms of drinks that aren't too acidic or that won't irritate him? When he gets there, what should Ed be feeding him in terms of liquids?

HOWARD DONNER: I think the best thing for him would be anything that he's able to tolerate. I would avoid really high, sugary drinks like pure apple cider or acidic drinks like orange juice. But if you have broth, if you have any kind of chicken or vegetable broth that has some salt in it that he can tolerate and he's going to feel like, that's going to be great. Over.

DAVID BREASHEARS: Yes. Fortunately, Ed can overhear both of us. And, what about just nice hot water?

HOWARD DONNER: Hot water's perfect. There's another thing, David. I didn't realize we had the option of still sending stuff down from IV. There may be some bronchodilators up at IV. Specifically a drug called albuterol. If you have a Sherpa that hasn't left yet, I may be able to organize a way to get that albuterol to your Sherpa prior to bringing it down. Over.

DAVID BREASHEARS: You have to ask David if he would have put albuterol in Guy's medical kit.

HOWARD DONNER: Well, the albuterol would be with the Canadians. If their camp is anywhere near yours. Over.

DAVID BREASHEARS: Yes, I'll have Guy check.

HOWARD DONNER: David, so you don't need to do the footwork there, let me go talk to Dr. Doug. He's got a radio. He can talk to the Canadians. If they have it, they can bring it to you. Because otherwise, you're just going to be running around on a wild goose chase. So let us do it from this end. Just tell me what the ETD is for your Sherpa heading down. Over.

DAVID BREASHEARS: He's ready to go. Pete, just go down and talk to him. Actually we—Jason's up here. Jason knows medicine.

HOWARD DONNER: Okay. Tell Jason that I talked to Doug. One of the Canadian climbers, for some reason, is on albuterol. Trade name Ventolin or Preventol(sp?). It would come in a little metered dose inhaler that you would inhale. And if Jason knows what I'm talking about, and it's not needed at IV, maybe you could send it down and I can tell Carter how to use it at II or wherever they end up. Over.

ED VIESTURS: Okay, this is Ed.

DAVID BREASHEARS: Yes, go ahead.

ED VIESTURS: ...[INAUDIBLE] ascending?

DAVID BREASHEARS: [COUGHS] We're making up the package. Two oxygen, two sleeping bags, two thermo rests. Sleeping mats. Stove. Gas. Pot. Lighter. Augmenting the ...[INAUDIBLE] and we're checking now on a powerful upper respiratory track anti-inflammatory steroid inhaler to send with them.

[break]

DAVID BREASHEARS: Okay, Ed, all they're doing is taking a quick check for this medication which should help David. And then he'll be on his way in four or five minutes.

HOWARD DONNER: Alright, David. It's maybe too late if they've already headed off. But Dr. Doug, at the Canadian camp, who is in radio communication might be able to help Jason locate this medicine. Over.

DAVID BREASHEARS: Jason knows this medicine. He's had sinus surgery and sinus problems.

HOWARD DONNER: Got it. Ed sounded very frustrated.

DAVID BREASHEARS: Yes, Howard, I think you should give Ed instructions on handling the patient to get him calm, and should he be held level and just to get David very calm and breathing very smoothly. So maybe when they get in or maybe you'll want to give it now. But I think he'll find that useful information.

HOWARD DONNER: David, what is your impression of their current position versus their probable bivy location? Over.

DAVID BREASHEARS: Ed, where are you right now and when will you arrive at Camp III? Howard, he's above the yellow band. He needs about two hours and then he'll be in the Himalayan Hotel with sleeping bags and thermo rests. They'll probably catch him by the time he gets there at this rate. And so he'll be—That's the set up.

HOWARD DONNER: We copy that, David. David, on the other end, do you think Ed would appreciate me talking to him now about Carter's comfort or wait until he's in a better position to discuss that? Over.

ED VIESTURS: This is Ed now. Do that when we're in the tent.

HOWARD DONNER: Okay, Ed. We'll be standing by of course. And definitely I'll have some things to talk to you about helping Carter feel more comfortable in terms of his sleeping position and such. You know—Ed, you and I have been talking and Dave and I have been talking. Just I want you to know that everyone here is thinking about Carter and just know that everybody here is sending Carter their love and we're sure that he's going to pull through this and things are only going to get better once he's warm, hydrated, and full of steroids. So we're very optimistic. And tell Carter that he'll get through this. I assure you. Over.

ED VIESTURS: Thank you for that. If he could talk, he would thank you immeasurably.

HOWARD DONNER: Okay, you guys, keep beating feet and we'll be standing by of course. Base Camp standing by.

DAVID BREASHEARS: Howard, one thing to keep in mind is many of us have climbed Everest, having fought off this infection like Carter had, we'd just be blasted. I mean, just the thought of having me, you know, having to leave here or Pete and go down there, it's just—It's just so exhausting when you—You know, we've been on the go now who knows how many hours and a lot of this sitting down and—It's just pure fatigue, you know. Just total dehydration and exhaustion and—I think you're right. When he gets him into Camp III and he's fed and rested, he's going to be a new man.

HOWARD DONNER: David, this is so obvious I don't want to even offend Ed with this, but what are their—What is Ed's ability to hydrate Carter on the road? Over.

DAVID BREASHEARS: None. Whatever they have taken with them. They can't stop and brew up. When you're at the top of the yellow band, at 4:00 p.m., it looks like a long way down to III. But it's a good trail with good fixed rope.

HOWARD DONNER: Okay. And lastly, David, do you know if they're carrying any vitamin D, as in Dextran? Over.

DAVID BREASHEARS: Ed or? Do you mean—what do you mean? Vitamin D or Dextran? Are they—Oh. I'll call. Ed, I doubt you have it. They're wondering about something called Vitamin D or also called Dextran. Can you name the brand of the speed?

HOWARD DONNER: Yes, when I said vitamin D, I was being silly, David. I meant Dextran. Which is amphetamines, speed, any kind. Over.

DAVID BREASHEARS: Yes, he's carrying speed and trying to find out the brand name. Ed, do you know it by—Or is it a trouble to get it out of your pack?

ED VIESTURS: I don't know the brand name. It's just ...[INAUDIBLE]

DAVID BREASHEARS: He has a triangular pink pill. So it's Dextran. Is it scored? Does it have a slash in the middle, Ed? So he has a triangular pink pill with a score in the middle. Which by Pete's reckoning, Howard, is Dextran.

HOWARD DONNER: Got it. I think at this point—Let's see what happens over the next, say 30 minutes. We need to know that he has that on reserve. It may be that we come to administering that at some point. Over.

DAVID BREASHEARS: Okay. Ed will have overheard that. And I know he's busy. So let him keep working. But, I guess you're saying if he just kind of comes to a stop that that's the next step.

HOWARD DONNER: Yes, you know, David, it's so controversial and you know, people say that you have no business giving speed in the mountains—what are you doing? But, you know, we have big decisions to make. And if the decision is to have Carter somewhere between IV and III sitting in the trail versus getting him to Camp III, I opt for the latter. And if it takes some amphetamine, it should be okay. You know, if he has a normal heart, doesn't suffer from hypertension, you know, is an otherwise healthy guy. It will—you know, side-effect-wise, I think he'll tolerate it fine. Over.

DAVID BREASHEARS: Ed just wanted to say the pill is orange. It says SKF something 319 and then it's scored on the other side. So are we still dealing with the same drug?

HOWARD DONNER: It sounds like 5-milligram Dextran to me and that's exactly what we're looking for. Over.

DAVID BREASHEARS: Yes, Pete is nodding here. And the other thing is, yes, at Hackett's lecture, he talked about the triple D, which is to be used when you're not going to have—when you're not going to be leaving someone out overnight. So I don't know what the third D is. Obviously, we don't have it. But, anyway—Oh, that's Diamox. Dextran and Decadron.

HOWARD DONNER: Yes, David, I think we're going to get—In my mind, we're pretty close to that call to use Dextran. Everyone makes it sound like it's some hideous thing and, you know, suddenly something horrendous will happen if you give it. It's really not that big a deal. It's like drinking four cups of coffee. And I think if we need to use it, we'll use it. Over.

DAVID BREASHEARS: Okay. Send some up here please for me and Pete. Like about ten caps each.

HOWARD DONNER: We got that. Listen, David, I'll be just sitting in the com tent by the base station standing by.

DAVID BREASHEARS: I really appreciate that. I mean, I appreciate it on Ed's and David's behalf because I know Ed's got his hands really full. It's terrifying to be out on the mountain slope like this with someone not doing too well and having you guide him must help a lot. So thank you very much.

[break]

HOWARD DONNER: Okay, Dave. We're going to need to get a hold of Guy for David—For Ed, I'm sorry. So please stand by. This is going to be a different subject for a few moments.

DAVID BREASHEARS: Okay. Guy Carter's sitting in our tent.

LIESL: Okay, what's up, Dave?

HOWARD DONNER: Okay, David's coming up to the microphone.

ED VIESTURS: Guy, has the Sherpa left yet?

GUY CARTER: Yes, he's just left. Over. Do you want any other assistance? Do you want me to come down too, Ed?

ED VIESTURS: Oh, it's just Dave's had some hot water, it helped him with his throat. But I have some water in my pack, but it's not hot.

GUY CARTER: Sorry, mates. Sorry, a couple of minutes earlier and I would have been able to do it. I'll be going back to my radio soon. So just, if you at any time want my assistance, just yell out and I'll be down there in an hour.

ED VIESTURS: Okay, thanks for that.

GUY CARTER: You're doing a good job, mate. Hang in there. It's not easy after climbing Everest.

ED VIESTURS: Man, you can say that again.

[break]

ED VIESTURS: Okay, I just got the medicine. I'm going through it.

DAVID BREASHEARS: Okay. Pete, I'll ask Pete how to administer it.

LIESL: We're getting Howard over to the base station, if that's of any use.

DAVID BREASHEARS: Yes, I would like Howard to specifically tell Ed how to administer it and for Ed to be ready to tell Howard, either through me if there's no coms exactly what he has in his hands.

LIESL: Okay, we copy that. Howard is just sprinting over here.

DAVID BREASHEARS: Okay, Howard will be there soon, Ed. Have a break.

LIESL: Drugs are arriving here.

HOWARD DONNER: Hey, Ed, it's Howard. Go ahead.

ED VIESTURS: I have this Ventolin stuff.

HOWARD DONNER: Excellent. Okay, I'll go over the instructions with you. And then before you give it to Carter, if you could just repeat them for me. Break. Okay, Ed, it's an inhaler and the first thing you want to do is just grab it and gently shake it. Shake, shake, shake, shake. Gently. Over.

ED VIESTURS: Got it.

HOWARD DONNER: In there. Now there's a plastic component with a hole in it that Carter's going to put his lips around. And then there's a canister that will stand up vertically that you're going to put your index finger on and your thumb underneath on the plastic component. Break.

ED VIESTURS: Got it.

HOWARD DONNER: So your index finger will sort of be up in the air and your thumb will be down and your index finger will be ready to push on the canister as your thumb supports the plastic portion. Now I'm going to cut through all the bullshit here. I don't usually say this to my patients, but the simplest way to think about this is it would be like smoking dope. Carter wants to blow all his air out and then he wants to [BREATHES] inhale the medicine in as you push. Break.

ED VIESTURS: Okay. How long should I push?

HOWARD DONNER: It doesn't matter. Once you push, it's a metered dose. It gives you one spritz, pssst, and that's it. Over.

ED VIESTURS: Okay, we're ready.

HOWARD DONNER: So the important thing here is that Carter, and this sounds so simple but I don't—I want you to get it right so Carter gets the medicine. He's got to gently blow all of his air out. You put the little round part—He puts his lips around the little round part, and as he begins to inhale, you push once and he'll inhale the medicine. Break.

ED VIESTURS: Will he find immediate results?

HOWARD DONNER: Sometimes, if he's never had it before. It may taste a little bit like you just sucked part of a swimming pool. It's a little chlorine tasting. But he won't get immediate results. We're going to do it again a minute later and then he'll have results within five to 10 minutes. Over.

ED VIESTURS: Great. Okay, I'm ready.

HOWARD DONNER: Go when ready and just watch him and make sure he's taken the medicine in on that inhalation. Over.

ED VIESTURS: Okay, he's going for it.

HOWARD DONNER: It's still amazing how simple it sounds, but people go—And they just—Okay, Ed, what was your qualitative assessment of how much he was able to get in? Over.

ED VIESTURS: 70 to 80%.

HOWARD DONNER: Excellent. Okay, now on this next one, I want you to wait a minute. That will give him a chance to dilate a little bit and then the next dose will get him even further. This time, I want him to take it in, [BREATHES] and hold it, hold, hold, hold, hold, as long as he can and probably, since he's breathless, that won't be very long. But the longer he can hold it, the longer the medicine works for him. Over.

ED VIESTURS: I copy that.

HOWARD DONNER: Just wait another 30 seconds and try it again. [PAUSE] It's not like he's going to ...[INAUDIBLE]

ED VIESTURS: Howard, he says his throat is so dry. Will that have any affect on the medicine?

HOWARD DONNER: No. But if he wants to take a little swish of water, that's fine. Over.

ED VIESTURS: Okay.

HOWARD DONNER: If this is primarily reactive airways, he will feel some degree of relief. 5%, 80%, I don't know. But it works. The medicine's called [INAUDIBLE]. I'm not expecting miracles, but if the medicine's working within five to 10 minutes, Carter should say—You know, I don't expect him to suddenly start running circles around you, but he'll probably say he feels a little looser, a little more open and he'll feel better. Over.

ED VIESTURS: ...[INAUDIBLE]

HOWARD DONNER: Why don't you get moving? And at some point where you feel like you want to take a natural rest, can you give you a progress report say, from—in 10 to 20 minutes? Over.

ED VIESTURS: Okay. We take rests just about 20 seconds.

HOWARD DONNER: Ed, does Carter seem light-headed to you? When he stands up, does he get dizzy? Over.

ED VIESTURS: Not really, no.

HOWARD DONNER: And Ed, can you just take a 10 or 15 second pulse on Carter and just let me know what his pulse rate is, his heart rate? Over. Ed's a hero. God, if I was going to be on a mountain with somebody, it'd be him.

HOWARD DONNER: 58. That's good. Are you sure that's—Oh, 88 and how long, Ed?

ED VIESTURS: Oh, I counted 22 for 15 seconds.

HOWARD DONNER: Well, your brain's working. Good. Well, that's excellent. Ed, two questions quickly and I know you need to move. Question one, is there any bivy spot between where you are and Camp III? Over.

ED VIESTURS: Not really. Carter wants to go. We're almost a third of the way through the yellow band and it's just wide open. Nothing till we get to Camp III.

HOWARD DONNER: Okay. Sounds good. Give us a progress report if things aren't going well and we'll consider, you know, the other medication that you have. Over.

ED VIESTURS: Okay.

HOWARD DONNER: And just please let us know whenever it's convenient for you, how Carter's doing with his breathing. Give him at least another 10, 15 minutes to, to decide if it's helping. Over.

ED VIESTURS: Okay.

HOWARD DONNER: And Ed, don't respond to this. Just keep moving. But everybody here just wants to tell you you're doing a great job and, you know, nobody envies you. I know how tired both of you are and we're just here with you, and rooting for you, and we realize how much energy you're putting into this. So just keep on moving and we'll do all we can from here. Over.

ED VIESTURS: I'm just following instructions.


Several hours later (about 7:00 p.m.), Ed and Carter are finally at Camp III.
ED VIESTURS: It's Ed, you copy?

HOWARD DONNER: Ed, we copy. I'm at the base now. Go ahead.

ED VIESTURS: Well, we're in tight quarters. There's four of us in our Himalayan Hotel. So it's not like being in a private hospital room.

HOWARD DONNER: I got that. What's,— Give Carter's status. Over.

ED VIESTURS: He feels pretty good, but he still has labored breathing. His main thing seemed today he felt that, whenever he drank liquids, it would relieve his throat a little bit and it seemed like his respiratory distress would decrease slightly, although not very much. He could only go, you know, 20, 30 feet between breaks.

HOWARD DONNER: Got that, Ed. Ed, have you checked saturation on Carter of late? Over.

ED VIESTURS: We'll do that right now.

HOWARD DONNER: Ed, you don't have to respond, I know you're busy. Why don't you check his sat? Let me know what his liter flow is and what his sat is and let me know how long he's been resting when you give me the information. We'll be standing by.

ED VIESTURS: Okay, I'll call you in a few.

HOWARD DONNER: It sounds good. We're here.

[break]

ED VIESTURS: Been sitting here, moving around a little bit, but semi relaxing and his sat is 90 and his pulse is 121 and he's on three liters.

HOWARD DONNER: We copy. Sat of 90%, pulse of 121, he's on three liters. Ed, are you able to crank your oxygen down from three to two and a half or is it just whole numbers? Over.

ED VIESTURS: Yes, we can split it.

HOWARD DONNER: Yes. Just to save oxygen, I'd say go to two and a half and just check his sat in an hour if you're still awake. Over.

ED VIESTURS: Okay. Yes, we're just going to be trying to drink some fluids here.

HOWARD DONNER: Okay. Ed, a few things. One is, because of this potential infection that does not seem to be responding to the erythromycin, apparently there's some Augmentin there or some Augmentin was sent down to you. Did you receive that or do you have access to the Augmentin? Over.

ED VIESTURS: Yes, I got it. It was sent down to me.

HOWARD DONNER: Do you know what dose that is? Does it say on the bottle? Over.

ED VIESTURS: Yes, let me get my light.

HOWARD DONNER: Is someone trying to call base station? We did not copy. Over.

JASON: Howard, it's Jason at Camp II. Can I butt in for a minute?

HOWARD DONNER: Jason, we read that. Go ahead and butt in.

JASON: Hey, Dave. Dave and Ed, hey, congrats you guys. Way to go.

[break]

DAVID CARTER: Carter. Over.

HOWARD DONNER: Who we got here?

LIESL: Carter.

HOWARD DONNER: Carter, my man. How are you? We're all at base just waiting to hear from you. How you doing?

DAVID CARTER: Still alive. It's been a hell of a day. Like, it's just, I'm breathing. Over.

HOWARD DONNER: Carter, listen. I want to talk about your illness, but most—before that, I just want you to know that everybody here wants to offer you a huge congratulation and we know what a grueling descent you had down to III with your buddy, Ed. And just know that we can't even imagine what you've been through. Tell me, this is very important, Carter, I need to get a feeling for whether you feel like your lungs are full of fluid? Do you feel like it's difficult to get air? Do you feel really short of breath? Or do you feel more like it's wheezy in your upper airway, like you have asthma? Over.

DAVID CARTER: I really don't feel like I have anything in my lungs. It's, it feels like—hold on. It feels like my throat is closed up on me. Or I have asthma. Something like that. I have—Last night I was coughing and coughed [INAUDIBLE] hard, it's [INAUDIBLE] green. It wasn't as—

HOWARD DONNER: Carter, the beginning. You said, "Last night, I—" And then you broke up. Can you repeat? Over.

DAVID CARTER: Yes. I, I coughed up a, a lot of green, hard chunks. A couple of them had blood. Over.

HOWARD DONNER: Got that. Carter, how does it feel to be resting now in terms of your breathing? Do you feel like things are improving? Over.

DAVID CARTER: When I'm breathing, I'm having problems.

HOWARD DONNER: Alright, Carter. Just know we're all thinking about you. You have zillions of fans. Let me talk to your doctor, Ed Viesturs, please. Over.

ED VIESTURS: Yes, Howard.

HOWARD DONNER: Okay, Ed, I'm going to tell you a bunch of stuff. You can probably remember it. Unless you have easy access to paper and pencil. Over.

ED VIESTURS: I have a mind like a steel trap.

HOWARD DONNER: Viesturs, after what you've been through, I'm surprised you're not just slobbering and drooling. Okay, number one is let's switch Carter to the Augmentin. You can stop his erythromycin. I don't know what dose of Augmentin you have yet, but let me know when you can. Break.

ED VIESTURS: Okay, we have 500 milligrams of three times a day. David said that he might have a really hard time choking these days. Is it okay to dissolve it into a drink?

HOWARD DONNER: I think if you dissolve it in a drink, he may puke. It might be better to just crush it and put it into some kind of soft food if you have anything like that. Do you have any kind of a soft, fruity kind of a thing? Over.

ED VIESTURS: I'll just find something to cram it into.

HOWARD DONNER: I'm worried if you just mix it into a drink it will—it will be so bitter and awful, he won't be able to drink it. But if you sort of hide into some, you know, the thing that comes to mind in the real world would be apple sauce, something like that, he might be able to eat it. Okay, good. So start him on Augmentin three times a day and discontinue the erythromycin. That's number one. Break.

ED VIESTURS: Okay, he just choked one down.

HOWARD DONNER: Great. As far as the Decadron goes, I'd like to keep him on that. Those are those little pentagram tablets. They're four milligrams. Let's give him four milligram tablets four times a day. Four milligram tablets four times a day. Break.

ED VIESTURS: Okay. So it was probably about four hours ago that he had—or at least three hours ago that he had the last dose.

HOWARD DONNER: Right. So I'd try to make it about every six hours. It doesn't have to be exact. You know, I'd wait two, three hours and just give him another one. Over.

ED VIESTURS: Okay.

HOWARD DONNER: As far as hydration goes, I'm not going to tell you what to do there. I'm sure he is, his tank is way low. Do the best you can. But as far as his upper respiratory track - and Ed, I know you know these tricks, I'm not telling you anything you don't know, but just to remind - I think, Carter'd do really well if you could brew up something and get his head over the kettle without boiling his head accidentally and just, you know, cover the back of his head with some pile(?) or something and make a little humidity tent for him so he can humidify his upper airways. Break.

ED VIESTURS: Okay.

HOWARD DONNER: And then, you know, I know that you weren't impressed with the Ventolin, the inhaler. And it sounds like it didn't do much. But I'd like to keep him puffing that, maybe two puffs four times a day. Just until something changes. It's not going to hurt him. And even if it gives him a five, 10, 15, 20% increase in his airway capability, I think he's going to be more comfortable. Over.

ED VIESTURS: Okay, we'll do that too.

HOWARD DONNER: So. Augmentin 500 three times a day. Discontinue the erythromycin, really hydrate him up, try to hydrate his upper airways with the boiling steam, and I'd keep him on the Decadron and I'd keep him on the inhaler. And that's about all we can do tonight. I'd check his sat whenever, you know, whenever you can. You can't check it too much. I mean, I don't think you need to check it more than every couple of hours unless something changes. But every two, three hours when you're thinking about it. Check his sat on his O's and you can crank him down so that he stays around high 80s, low 90s. If he's way above that, you're probably using more oxygen than you need to. Over.

ED VIESTURS: Okay.

HOWARD DONNER: Do you have any questions, Ed? And by the way, you're fantastic. Do you have any questions for us? Over.

ED VIESTURS: I think all that will help and things will be under control and hopefully, this night we'll rejuvenate. I think he'll get down fine. We'll leave early and take it [INAUDIBLE] but he's got some oomph in him.

HOWARD DONNER: Good. Hey, Ed, without being too macho, how are you doing? Over.

ED VIESTURS: Oh, I'm fine. I mean, I'm tired. It was a long day and I got pretty dry. I think maybe I drank maybe a liter all day. But it was a long day, the whole day. But, what the hell?

HOWARD DONNER: Do you guys have lots of fuel for melting snow? Over.

ED VIESTURS: Yes, we're pretty fine here.

HOWARD DONNER: Okay, Ed. Well, listen, we'll stop bugging you.


An hour later
ED VIESTURS: Get Howard, go get Howard!!

LIESL: Howard! Is that Ed calling for Howard?!

ED VIESTURS: Get Howard! It's Ed. Please try to get him for me! This is Ed. [SEVERE GASPING IN BACKGROUND]

HOWARD DONNER: What's going on, Ed?

ED VIESTURS: David's dying! It's like his throat's obstructed.

HOWARD DONNER: Okay. Ed, do you know how to do a Heimlich maneuver? Over.

ED VIESTURS: Yes.

HOWARD DONNER: Why don't you try a Heimlich? And get him with his face down. Ed, I'm going to keep talking. You don't have to respond. Try to get him over so that he's on his belly face down. See if you can do a Heimlich. Get him to expel whatever's obstructing. Over. Ed, can you come on and tell me where you're at. Please. Over. Dave, Ed, listen to me. I'm not sure where you're at. If it's an obvious obstruction, you can push it out with a Heimlich, do that. If it just seems like Carter's airway is closing in, you need to breathe for him. Go ahead and start mouth to mouth ventilation. Over.

ED VIESTURS: Okay, hang on. I'll do it. I also did the Heimlich and it seemed to help.

HOWARD DONNER: Tell me what Carter's doing now. What is his respiratory status? Over.

ED VIESTURS: He is not quite as distressed. He was very distressed. Now he's calming down a little bit. Howard?

HOWARD DONNER: I'm with you, Ed. What position is Carter in right now? Over.

ED VIESTURS: Cannot breathe.

HOWARD DONNER: Ed, I'm going to keep talking. If Carter's breathing spontaneously and seems reasonably comfortable, have him sitting up. Have him sitting up. If he's not able to get enough air, what I want you to do is start mouth to mouth. And you can augment the amount of oxygen he's getting by sucking oxygen yourself and giving him mouth to mouth after breathing oxygen yourself. Over.

ED VIESTURS: Okay. He's sitting up. We did some more Heimlichs. It seems like he's calming down a little bit. Hang on.

HOWARD DONNER: Okay. What's very important, Carter, for you, is I want you to take nice easy, slow, deep breaths. Breathing quickly right now won't help you, Carter, and I know this is really scary. You're going to do fine, but I need you to breathe deep. In and out. And in and out. Slowly. And know that Ed and the rest of us are going to take care of you. Over. Who's trying to break through?

ED VIESTURS: Okay, he's, he's getting better.

HOWARD DONNER: Okay, Ed, here's what I want you to do. I want you to not to change anything. I want you to just stay nice and easy and calm and I want you to help Carter to breathe nice and easy and calm. And when things have calmed down in a few minutes, I want you to give him another albuterol treatment. When was his last? Over.

ED VIESTURS: When we did it up higher.

HOWARD DONNER: I don't want you to change anything for now. But as soon as Carter's calm, I want him to get another treatment. Over.

ED VIESTURS: Okay. [INAUDIBLE]

DAVID BREASHEARS: Howard, it's South Col.

HOWARD DONNER: Got you, David. Go ahead.

DAVID BREASHEARS: A similar thing happened to me last year and I'm curious to know when you want to ask what, if they got anything up and out.

HOWARD DONNER: I do, David, and it's a perfect question. I just want to give Ed a moment to get the scene under control and then we'll go into that. But that's an excellent question. Over.

ED VIESTURS: No, nothing came out.

HOWARD DONNER: Ed, why don't we give you about one minute. I want you to help Carter to continue to calm down and then I have some questions for you. So come back on when you feel calm and comfortable. Hopefully, within a minute or two. Over.

ED VIESTURS: I just have got a [INAUDIBLE] Yes, it's like a, a piece of chewed up, brown—what's the candy?

HOWARD DONNER: Ed, can you give us an estimation on how big this garbage is? You know, use maybe something the size of a walnut, something the size of an egg. Whatever you want. Over.

ED VIESTURS: A little bigger than a jelly bean.

HOWARD DONNER: Alright. Is Carter comfortable right now? Over.

ED VIESTURS: Yes, he's much more comfortable now. I'd like you to know that he peed his pants though.

HOWARD DONNER: I believe it. Ed, why don't you work on that easy breathing and try to figure out a way to get Carter back up at about 45 degrees tonight. I don't want him flat on his back. I know you probably don't have any extra gear there, but whatever you can stuff, stuff in there. You know, over boots or your down suits. And see if you can get his entire back at a 45 degree. And I don't mean his head bent at 45 degrees, I mean his entire back from the waist up should be about 45 degrees. Break.

ED VIESTURS: Yes, that's easy. We've got plenty of gear and there's not a lot of room in here. So we can do that easily.

[break]

ED VIESTURS: He does feel a lot better. He feels less of an obstruction now in his throat.

HOWARD DONNER: Okay. Ed, key things tonight. One, position. Two, I think that Decadron is going to be key. So just be sure that we're giving him those doses, at least every six hours. And I would give him another puff of Ventolin when he feels ready for it. And just go nice and smooth and easy. Nothing to, to really jerk Carter around. I want to keep this very relaxed and just give him a nice big inhalation, have him hold it for a second, two, three, whatever he's up to, and see how that goes. Over.

ED VIESTURS: I just do one dose instead of the two that we did before?

HOWARD DONNER: Why don't you start with one and see how he tolerates it? And if that just works well and smooth, give him a second. Over.

ED VIESTURS: Okay.

[break]

JASON: Ed, do you copy?

HOWARD DONNER: Barely.

ED VIESTURS: Jason, I copy.

JASON: You want to pass that down to Howard?

ED VIESTURS: Yes. He mentioned he had five available people.

HOWARD DONNER: Jason, I'm going to guess what you're saying. You're at II and you're saying that you've got five able bodies in case we need you for some form of intervention. Is that correct? Over.

JASON: Roger, roger.

HOWARD DONNER: Hey, Jason, that's good. We'll see what we can do for now. We appreciate your standing by. And we got your message. Thanks. By the way, I'm sorry. I'm totally—

ED VIESTURS: Thanks a lot, Jason.

HOWARD DONNER: I'm not sure what happened.

DAVID CARTER: (IN A FAINT VOICE) This is Dave. I still plan on having a few beers in Kathmandu with you.

HOWARD DONNER: Well, shit. I mean, that was the most God awful thing I've ever had to do on a radio. South Col. Do you copy over.

DAVID BREASHEARS: Hi, Howard.

HOWARD DONNER: Hey, David. Thanks for your help from Camp IV. I think we're over the hump with this one. Over.


May 24, 1997 early in the morning, Howard speaks to camera:
HOWARD DONNER: You know, it was really touch and go with Carter last night. We didn't know that he was going to make it. It's interesting, up in the mountain, Carter went from 26,000 to 29,000 feet in one day. You're moving a ton of air. He's got just a simple upper respiratory infection, but up there, things can get bad quickly. Even simple things. He's moving a whole bunch of cold, dry air, really irritating. He hasn't slept in days. He's dehydrated. He hasn't been eating. Maybe he's cold. Everything comes together up there on the mountain oftentimes and even little things can become really serious. Even the immune system doesn't work normally at those altitudes and it can take forever to get better. Carter got really sick and it started with a simple thing. And it's funny, you know, if you just look around the world and you ask yourself why don't people live at 17,000 feet? Why is it that people don't live at these altitudes? It just doesn't work. People, over the long term, they just don't do well. And you see a bunch of people here at Base Camp and on this mountain, but the truth is, all of us, after two or three months, we have to go down.


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