High-Altitude Doctor Read online

Everyone was feeling the effects of the altitude. The girls were quiet and Sally complained of feeling dizzy, but both seemed determined to make it to their final destination before turning back.

  They followed the line of the glacier as it turned to the east and finally the grey, almost lunar landscape gave way to a splash of colour. A city of brightly coloured tents, all bearing different logos, lay ahead of them. A small, man-made village which would stay on the glacier for the time it took the various expeditions to make their attempts on the mountain.

  They had reached Everest Base Camp.

  CHAPTER FIVE

  Everest Base Camp, 5400 metres above sea level

  CLIMBING Everest demanded a gradual process of acclimatisation. Four camps were established between Base Camp and the summit, and climbers moved between them over a period of weeks, allowing their bodies to make adjustments to the altitude, increasing their chances of reaching the summit at the point when the weather might permit such an attempt.

  But, for now, Base Camp was home.

  There were more than four hundred people, a mixture of climbers and Sherpas, on the mountain that season, and Base Camp was busy, a village of brightly coloured tents perched on some of the most inhospitable terrain on earth.

  The tents for Everest expeditions were clustered together on a prime spot, near a water supply and away from the toilet.

  Sally and Diane were so exhausted they could barely drag themselves the final few metres towards the tents, the walk having left them wheezing and breathless.

  ‘There’s no air up here. I feel as though I’m suffocating,’ Sally gasped as she sank onto a boulder to rest. Juliet nodded, feeling the lack of oxygen herself.

  ‘Your lungs have to work twice as hard to take in the oxygen they need because air pressure here is only half what it is at sea level.’

  The plan was that the trekkers would spend a night at Base Camp before beginning the trek back down the valley and home.

  Juliet had barely had time to take the rucksack off her back and greet Billy, the expedition leader, when their Base Camp manager hurried towards her.

  ‘There’s been an accident in the icefall. A Swedish climber didn’t clip on properly and he fell into a crevasse as they were descending. He’s broken his ankle and they think he’s developing frostbite. There are some American climbers at Camp I who are helping him, but they need medical advice and were wondering who would help. I’ve asked Finn to give us a hand, too.’

  Juliet looked up at the huge, tumbling cascade of broken ice and snow that formed the Khumbu Icefall. It must rank as one of the most inhospitable places on earth to sustain an injury of any sort.

  Constantly shifting and moving, this section of Everest formed the most technically demanding and dangerous section of the climb. Successful negotiation of the icefall meant passing under numerous seracs, sections of ice as large as tower blocks, that could crash down without warning in an avalanche, burying anyone crossing beneath. The route up to Camp l also meant passing over deep crevasses by means of ladders roped together. As the sun melted the snow and ice the ladders sometimes shifted and fell deep into the bowels of the mountain.

  Climbers tackling the icefall did so early in the day, before the sun hit the slopes and increased the risk still further.

  At the beginning of the season, Sherpas and climbers anchored a static line of rope from the bottom of the icefall to the top, and each climber was expected to tether themselves to this fixed line.

  Clearly the injured climber had neglected to secure himself to the fixed rope.

  ‘Any other injuries? Head injury?’ Despite her own lack of physical reserves, Juliet immediately snapped into doctor mode. ‘What have they done to the ankle?’

  She knew that if they didn’t splint the damaged limb carefully, there could be permanent damage.

  ‘We’ve got them on the radio in the tent.’

  Still gasping for air, Juliet walked as quickly as she could to the tent so that she could issue advice over the radio, worrying about the prospect of delivering medical care to a potentially seriously injured climber when she hadn’t even had time to unpack her supplies.

  She sank down onto a crate that was serving as a seat and took the radio. ‘What was he doing in the icefall this late in the day, anyway?’

  The sun on the ice would have made it lethal. That was why so much climbing at high altitude took place in darkness with the aid of flashlights. The conditions were more stable in the chill of the night.

  ‘He was on his way down when he fell. Apparently it took the Americans ages to get him out because he wasn’t roped up.’

  ‘He was lucky that they managed to get him out at all,’ Finn muttered as he joined them in the tent. ‘And what was he doing up there in the icefall this early in the season? Most of the teams haven’t even got their gear sorted out yet.’

  ‘Obviously wanted to steal a march on everyone else,’ Billy said wearily, handing Juliet the radio. ‘It’s all yours. There are two American climbers helping them out, but they’re nervous about their first-aid abilities. I think they’re worried that they’ve missed an injury. He fell a long way, apparently.’

  Finn unzipped his jacket. ‘How the hell did they get him out?’

  ‘Landed on a ledge and they managed to get a rope down to him. From what I can gather, it was a mixture of him climbing the ice wall and them pulling from the top.’

  ‘It’s early in the season for accidents like that.’

  Aware that Sally had joined her in the tent and was slumped on the floor, watching and listening, Juliet lifted the radio and spoke to the climbers who were dealing with the injured man.

  After a series of questions she was able to ascertain that the climber was conscious and lucid but had injured his ankle and lost his boot.

  ‘Lost his boot?’ Juliet stared incredulously at the radio for a moment, wondering if she’d misheard. ‘How can he have lost his boot?’

  The radio crackled to life and the American climber who was co-ordinating the rescue from the icefall explained that the Swedish man had insisted on removing the boot and had then let it fall into a crevasse.

  ‘Seems pretty odd behaviour.’ Finn McEwan sat down beside her, his broad shoulders tense. ‘He could be suffering from HACE.’

  Sally glanced between them. ‘That’s high-altitude cerebral oedema, yes?’

  ‘It’s a potentially fatal condition that results from the sudden increase in pressure in the brain due to swelling,’ Juliet told her, ‘but it’s often characterised by confusion and an inability to think clearly. Maybe that’s what happened to this guy.’

  ‘It would certainly explain why he didn’t clip onto the rope,’ Finn said harshly, and Juliet looked at him, knowing exactly why he was so tense.

  More skeletons in their cupboard.

  Their eyes met and held.

  For a moment the past threatened to swamp Juliet, but she pushed the darkness back and forced herself to concentrate on the present.

  ‘We need to ask some questions and try and get a feel for what’s going on. I can do that.’ She hesitated and put a hand on his arm in silent communication. Not here. Not now. ‘Why don’t you try and find your tents?’

  This wasn’t the place to talk about the darkness she saw in his eyes.

  A faint smile touched his hard mouth. ‘Are you trying to get rid of me, Dr Adams?’

  Aware that they had an interested audience, she shook her head and forced herself to look relaxed. ‘Why would I try and get rid of you?’ Except that you’re finding this situation every bit as hard as I am and I’m giving you a way out. ‘I just thought that since you’ve barely had a moment to check into this hotel, you might like some time to find your tents.’

  ‘I already have and they’re right next to yours.’ His voice was soft and slightly mocking. ‘So this trip is promising to be really, really cosy.’

  ‘Oh.’ His tents were right next to hers? Her hand dropped to her side and she stared
at him in consternation.

  ‘Something wrong, Dr Adams?’ Finn lifted an eyebrow and she swallowed hard.

  Yes. She didn’t want his tents next to hers. She wanted them as far away as possible. Preferably in a different mountain range. She couldn’t concentrate with him so close to her and she wouldn’t be able to get on with her job if he was going to be breathing down her neck.

  ‘I can handle this situation,’ she said stiffly. ‘I don’t want to hold you up.’

  He seemed to have completely recovered his composure.

  ‘Well, that’s the great thing about Base Camp. There isn’t anywhere else I have to be,’ he said in a lazy drawl. ‘And you know as well as I do that, at this altitude, two heads are better than one. Even if one of them is stubborn and belongs to you.’

  Billy gave a snort of amusement while Sally stared, wide-eyed and openly fascinated by the exchange.

  Juliet gritted her teeth, knowing that she would be foolish to send him away. At this height, two heads were better than one and she knew that Finn was an excellent doctor. Promising herself that she’d deal with the emotional side of the problem later, she picked up the radio and asked a series of questions, satisfying herself that the first aid administered so far hadn’t put the patient at further risk.

  ‘The ankle is cold and they can’t feel a pulse.’ She looked at Finn. ‘They need to try and straighten it.’

  ‘They could do more damage.’

  ‘But if they do nothing and his circulation is impaired, he could lose the foot.’

  They were thinking aloud, going through the options, aware that they were dealing with people with limited medical skills operating in the harshest of conditions.

  ‘It’s hardly an ideal scenario.’

  ‘Which is presumably why you enjoy hands-on high-altitude medicine,’ Finn drawled lightly, pushing the radio towards her. ‘You like working against the odds. This is medicine in the raw. Do nothing and the guy risks losing the foot. Or maybe even worse if they don’t evacuate him before he dies of hypothermia.’

  They looked at each other, each of them aware that out here in the wild the ideal scenario just didn’t exist.

  ‘They need to try and straighten the ankle,’ she said finally, and Finn nodded.

  ‘And then get him down. We’ll deal with any frostbite down here. So they need to splint that ankle. Are you going to talk them through it?’

  She put her hand on the radio, wondering how on earth you talked someone through something so potentially serious.

  She took a deep breath and spoke to the American climbers again, asking questions about the exact nature of the fracture, establishing as many facts as she could before giving instructions on splinting.

  They made do with what they had—ice axes, ropes, sleeping pads—and Juliet calmly talked them through it, step by step, occasionally pausing to confer with Finn.

  More questions revealed that the climber wasn’t displaying symptoms of altitude sickness and had merely been careless in not clipping onto the fixed rope.

  ‘Big mistake,’ Juliet muttered, and Finn gave a wry smile.

  ‘Easy enough for you to say because you’re little. Try clipping onto a rope on the ground when you’re over six foot. Believe me, the temptation not to bother if the ground looks safe is pretty strong.’

  ‘I’m not little!’ She sat up straight and glared at him. ‘I’m not.’

  ‘You’re five foot four,’ he drawled softly, ‘so you’re hardly a giant.’

  Deciding that this conversation was becoming all too personal, Juliet steered the subject back to how they were going to bring the patient down. ‘Clearly he can’t walk down. Can we send a team up with a stretcher?’ She looked over her shoulder to where Billy was hovering in the entrance of the tent.

  He pulled a face. ‘Hard to say whether anyone will be prepared to brave the icefall for a guy who climbs on his own and can’t be bothered to clip onto a rope, but I’ll see what I can do.’

  He left the tent and Juliet carried on talking to the climbers at Camp I. ‘Can you feel pulses in his feet?’

  ‘Yes.’

  Satisfied that, for now at least, the injured climber’s circulation wasn’t compromised, Juliet turned her attention to the other risks. ‘We need to keep his foot warm.’

  The radio crackled. ‘We’ve rigged something up. No worries.’

  ‘Is he showing any other signs of injuries?’

  ‘Not so far. He had new boots for this trip and they’re too small. Hence the frostbite.’

  Juliet sighed. ‘Everest is not the place to break in a new pair of boots,’ she explained to Sally, ‘Tight foot-wear is one of the risk factors for frostbite.’

  Finn walked back into the tent, carrying two steaming mugs of hot tea. ‘Drink this.’ He put a mug down beside her. ‘You had a long, strenuous walk today. You need fluids and recovery time or you’ll be the next patient.’

  She took the tea gratefully. ‘What’s happening about the stretcher? Any luck?’

  Finn hesitated. ‘A few of us are going up now. It’s going to take us hours so you get some rest. If I need you I’ll radio.’

  She felt her heart lurch. ‘You’re going into the icefall?’

  He gave a wry smile. ‘It’s part of climbing Everest. You’re going to be doing it, too.’

  ‘But you’ve already walked today and—’

  ‘Worrying about me, Jules?’

  She licked dry lips. ‘I just think maybe someone else should go.’

  ‘Who, precisely?’ His voice was weary as he walked back towards the entrance of the tent. ‘Mountain rescue is a bit thin on the ground around here, as you well know. The Americans can’t bring him down without a stretcher so we need to take one up.’

  ‘All right.’ Juliet shivered and glanced around her. ‘I’ll sleep here. That way I can speak to you on the radio if you encounter problems.’

  She dosed fitfully and woke periodically to speak to the climbers on the radio to ascertain their position and talk through any new problems.

  At 5 a.m. she was woken by loud bells as a large herd of yaks lumbered past, grunting and snorting as they carried their loads into the camp.

  Billy stuck his head out of the tent. ‘Base Camp is filling up,’ he muttered, dragging his fingers through his dark hair and stifling a yawn. ‘Just about all the expeditions will be here by the end of today. Are you all right?’

  Juliet sat up, her head muzzy from lack of sleep and lack of oxygen. ‘I’m just great,’ she muttered, reaching for the radio again and checking the frequency.

  ‘Don’t bother,’ Billy said. ‘I can see them. They’re just coming into Base Camp now.’

  He went to meet them, and Finn and several other climbers arrived with the stretcher and the injured climber. The young Swedish man had been climbing alone and he was very sheepish and apologetic as Juliet redid his ankle and checked him over.

  ‘You were very lucky,’ she announced finally, as she finished splinting the ankle.

  Finn walked back into the tent. ‘The winds are too high for a helicopter evacuation so some of the Sherpas are going to walk down the valley with him. The doctor from the Spanish expedition is going down to pick up some supplies so he’ll provide the escort.’

  He looked exhausted and Juliet looked at him in concern. ‘You need to go to bed.’

  His gaze mocked her. ‘Is that an invitation, Dr Adams?’

  She blushed and turned her attention back to the injured climber, preparing him for evacuation. She knew that the most important thing was to stabilise his injuries and then get him off the mountain where he could be cared for properly.

  In the end, the remaining trekkers left with them.

  Sally and Diane were feeling the effects of altitude and were keen to rejoin Simon and Gary farther down the valley.

  Having said her farewells, Juliet watched them go with mixed emotions. Now that the trekkers had left it was time to turn her attention to the serious job o
f climbing the mountain.

  She returned to the medical tent and started unpacking her supplies. Everything had arrived safely and it was just a question of sorting it out into logical order so that she wouldn’t be rummaging around if an emergency arose.

  The sun had risen and Base Camp was surprisingly warm. Juliet stripped down to a thin top and her combat trousers, her baseball cap still pulled firmly over her eyes as she worked.

  She checked and sorted, stacking equipment and deciding what she was going to carry with her when she made her first foray into the icefall in a few days’ time.

  ‘Still planning to climb, then?’

  Finn stood in the entrance of the tent, his feet planted firmly apart, his shoulders blocking the light.

  She felt a shiver of awareness and hated herself for it. She didn’t want to react that way to him.

  ‘Of course I’m climbing.’ She stooped to unpack another crate. It was a way of not looking at him. ‘You think I came all this way just to sit around and watch other people?’

  ‘No. I don’t think that.’ He strolled into the tent. ‘What are you doing here, Jules?’

  ‘I’m living my life!’ She shouted the words and he grabbed her shoulders and shook her.

  ‘Are you? Or are you living his life? This is what he wanted, not you. Yes, you’ve climbed since you were small but every handhold you took was because he was driving you on, because it was what he wanted and expected. You didn’t do it for you, Jules, you did it for him. And I think you’re still doing it for him.’

  Her eyes filled with tears. ‘I had a great childhood.’

  ‘He’s dead, angel, and you can’t bring him back. Climbing a mountain you don’t want to climb isn’t going to lessen the pain of losing him.’

  ‘How do you know?’

  ‘I just know that if you’re searching for peace, you’re not going to find it here in this windswept, desolate place.’

  There was something in his tone that made her stop what she was doing. ‘Look, Finn—’ Juliet broke off and rose to her feet, choosing her words carefully. ‘You don’t need to worry about me.’

  He folded his arms across his chest and a hint of a smile touched his hard mouth. ‘You and I have unfinished business, Jules, and it isn’t a good idea to climb this mountain with things left unsaid. Let’s talk about what happened. All of it.’