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Climbing without O's
by John B. West, M.D., Ph.D.
The successful ascent of Everest without supplementary oxygen
is one of the great sagas of the 20th century. In addition to
being a triumph of the human spirit, it raises some of the
most intriguing questions in human physiology.
Ever since I was invited by Sir Edmund Hillary to take part in
the Himalayan Scientific and Mountaineering Expedition of
1960-1961 I have had a special interest in the critical
factors that allow climbers to reach extreme
altitudes—particularly the summit of
Everest—without supplementary oxygen. Back in 1960,
Messner and Habeler had yet
to make their ascent of Everest without supplemental oxygen,
and many believed that it was physiologically impossible.
Over the course of our scientific expedition more than three
decades ago, a group of physiologists spent about five months
at an altitude of 5800 m (19,000 ft) on a glacier about 10
miles south of Mt. Everest. We lived in a prefabricated hut
known as the "Silver Hut" because of its color. The scientific
leader was Dr. Griffith Pugh and we made an extensive study of
the process of acclimatization to this very high altitude.
In the spring, we were joined by a climbing party who
attempted (unsuccessfully) to reach the summit of Makalu (8481
m) without supplementary oxygen. A bicycle ergometer (which
measures the amount of work done by the exercising subject)
was assembled on the Makalu Col just east of Everest and we
made measurements of maximal work capacity at an altitude of
7440 m (24,400 ft). These remain the highest measurements of
work capacity ever made on a mountain.
When the line relating maximal oxygen consumption to altitude
was extrapolated all the way to the summit of Mt. Everest, it
looked as though the mountain could not be climbed without
supplementary oxygen. The same conclusion had been reached by
other physiologists in the 1930s. Therefore when Messner and
Habeler finally made their "oxygenless" ascent in 1978, we
naturally wondered how they did it.
When we planned the 1981 American Medical Research Expedition
to Everest, we ambitiously decided to try to make a few
measurements on the summit to try to answer that question. We
identified three critical measurements. The first was the
atmospheric pressure, because it was clear that the amount of work that a climber
could do was extremely sensitive to this; atmospheric pressure
determines how much oxygen is in the air, and the lower the
pressure, the lower the amount of oxygen. Furthermore, some
physiologists had previously predicted the pressure on the
summit from the so-called Standard Atmosphere and we knew that
this was far too low based on measurements made at lower
altitudes on Everest.
In any case, the first direct measurement of atmospheric
pressure on the summit was made on our expedition by Dr.
Christopher Pizzo, and the figure of 253 mmHg was rather
higher than even we expected—suggesting that there was
more oxygen at the summit of Everest than you would predict
from theory.
This year, David Breashears was able to take another
measurement on the summit. As soon as we are able to check the
calibration of the instrument we will know more about this
critically important variable—and therefore have a
better sense of how much oxygen is actually available at the
tallest point on earth.
The second critical variable was the extent to which the
climbers increased their ventilation, because this process
maintains the oxygen level in the alveoli in the depths of the
lung at a viable level. Pizzo measured his ventilation by
taking samples of air from the depths of his lung while
sitting on the Everest summit. The results showed that he had
increased his ventilation about five to six-fold, which was
much more than we expected.
The third critical measurement was the maximal oxygen
consumption on the summit. Previous predictions were that this
was insufficient for a climber to reach the summit without
supplementary oxygen. It was not possible to put a bicycle
ergometer on the top of Mt. Everest; there is a limit to what
can be done in the field! However we had extremely
well-acclimatized climbers breathe 14% oxygen (normal air has
21%) in our laboratory at 6300 m (21,000 ft). The low inspired
oxygen mixture gave them the same oxygen pressure as on the
Everest summit. We found that the maximal oxygen consumption
was about one liter per minute. This is a miserable value,
equivalent to that of someone walking slowly on level ground.
However it is just sufficient to allow a climber to reach the
summit without supplementary oxygen. A simulated climb of
Everest carried out in a low-pressure chamber four years later
(Operation Everest II) found almost exactly the same maximal
oxygen consumption.
Although we now have a much clearer idea of how a climber can
make an "oxygenless" ascent of Mt. Everest, a number of areas
of ignorance remain. One is the degree to which the blood
becomes alkaline as a result of the extreme increase in
ventilation. Pizzo's measurements suggested a very severe
degree of alkalinity which interestingly enough helps
to load oxygen onto the blood in the lung. However some people
have challenged this finding and we badly need more data.
Another area of ignorance is whether the body produces
lactate—a normal byproduct of exercise—under these
conditions of extreme oxygen deprivation. Making lactate
allows the muscles to do work in the absence of oxygen.
Exercising muscles normally produce large amounts of lactate
when they are starved of oxygen. Paradoxically, this does not
seem to be the case in acclimatized people at extreme
altitude. Indeed, predictions based on measurements at
somewhat lower altitudes suggest that no lactate at all is
produced near the summit of Mt. Everest.
John West
is Professor of Medicine and Physiology in the School of
Medicine, University of California San Diego. He was a
physiologist on Sir Edmund Hillary's Silver Hut expedition
in 1960-1961, and led the 1981 American Medical Research
Expedition to Everest.
Photos: (1,2) Liesl Clark; (3) David Breashears; (4) Ed
Viesturs; (5) J. West.
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