On The Other Side of The Mountain

Behind his polarized sunglasses, Dalgety squinted into the shearing, chill wind blowing off the scarp. He heard the loud howling and thought the wind was angry that it could not move the mountain as much as it could move the men climbing up the mountain.   

For safety, the six climbers were roped to each other. Ropes swayed in the wind, and sometimes, a climber would sway, nearly losing his footing. But the ropes held.   

Along with the cold, the wind carried grit that worked its way into the wrap-around sunglasses that Dalgety had strapped on using a thick elastic band.   

He was not pleased with the grit inside his sunglasses, but he was less pleased about the condition of the men over a thousand vertical feet above him, near the summit of the 20,320 foot mountain. He breathed heavily, feeling the effects of low oxygen at the 18,570 altitude.   

He took a whiff from his oxygen tank and immediately felt his head clear. Taking care of his altitude induced headache would have to wait until he reached a much lower altitude. At which time, Dalgety told himself somewhat annoyedly, the headache would disappear without any help from him.  

Overhead, the slate colored clouds appeared to cover the summit, and down below at base camp, Dalgety knew people were worried about the September snow storm already howling to the west and rapidly moving eastwards. He also realized that time was of the essence for the two medically distressed climbers who were huddled near the summit.

Helicopters are useless after nineteen thousand feet, for there isn’t enough oxygen in the atmosphere to provide lift. Wind shear alone could down a chopper and weather conditions on the ground were already severe enough to negate a helicopter evacuation, thus dashing Dalgety’s hopes that a helicopter could deposit rescuers at the 19,000 foot mark where they could climb the remaining 880 feet to get to the distressed climbers.   

So at 7:08 am, eight minutes after the radioed distress call had been received at base camp, the decision had been made to send six climbers up to 19,880 feet, a difficult twenty eight hundred foot climb through the vanguard of a coming early September snow storm, and forcing climbers to walk through shearing, bone-chilling winds.   

The proposed rescue climb just before a snowstorm was due to strike, was a climb which most of the climbers at base camp were unwilling to make, even to save fellow climbers. No one was going to blame them. The proposed ascent was to be rapid, and rapid ascent to a high altitude can have devastating medical consequences, as the two distressed climbers demonstrated.   

And so it was that a hastily formed rescue climbing team was prepared for the rescue climb. No one at base camp, even those unwilling to go, wanted a repeat of the Mount Everest tragedy, which, although the deaths had occured seven years ago, was still fresh in every climber’s mind.   

Those sentiments ran along the same lines as Dalgety’s: “that could be me up there one day, caught in a freak storm, with high altitude sickness and possibly walking off a sheer drop of thousands of meters, never to be found. Or perhaps I’d be found near the summit, frozen, my eyes open forever in surprise and anger at the unexpectedness of my death.”  

But Simon McAlister held out hope that by the time the rescue climbing team returned to base camp with the injured climbers, the wind would have abated enough so that a helicopter would be able to evacuate the ill men. The Mountain Rescue Team had promised they would give it the old college try, a phrase which was explained to Dalgety as meaning “we’ll do our best.”  

But, warned the MRT, the climbing rescue team had to be prepared to carry the men several thousand feet down the mountain to a level where helicopter evacuation would be possible in the approaching snowstorm. Base camp was just under the 17,200 foot altitude, the MRT drily reminded everyone. Dalgety had a feeling of despair sink over his heart, even as a voice crackled reassurance over the radio.  

As he continued to plod wearily upwards through the screaming, shearing wind, Dalgety now remembered reading an account of the Mount Everest tragedy during his first mountain climb back in May.  

Required reading,” his new benefactor had told him as they made their way through the airport. “I brought a copy for ya,” the guide had grinned as Dalgety retrieved his large suitcase from the conveyor belt.   

The Everest tragedy?” Dalgety had asked as he had swung the suitcase off the conveyor belt. “Ah, I remember reading about that on the internet, following the trek through the fly-on-the-wall reports of the rich woman climber.”  

So in a motel room, the curtains opened to a picture show of the Aurora Borealis casting multicolored streaks in the sky, Dalgety lay on a warm bed, reading about the author’s disturbing discovery of two dessicated frozen corpses on the ascent to Camp Two, located at an altitude of 21,300 feet--and one of the corpses, the author thought, had been there for a good ten or fifteen years.   

The howling wind was snapping at Dalgety's tether rope, threatening to break the rope. Dalgety remembered the words of one of the guides.

Denali is unhappy today,” the guide had told Dalgety when the news about the two climbers had come in earlier this morning, and now as he squinted into the wind, Dalgety shuddered inside, hoping that the mountain also known as Mount McKinley would not receive as sacrifice two more men today. 

As Dalgety trudged upwards step by step, making sure he placed his feet directly in the footsteps of the climber in front of him, he was glad that Simon McAlister had insisted on roping the rescue climbers.  

He was glad that Simon McAlister had insisted on roping the rescue climbers.   

He was glad that Simon McAlister had insisted on roping the rescue climbers.   

With a start, Dalgety realized his mind was beginning to become sludgy, now prone to repeating itself. He drew several careful breaths through his oxygen mask. He felt better and his mind cleared of cobwebs, although his altitude induced headache was throbbing.   

Throbbing like a bass guitar,” Dalgety now thought, damning himself for not taking a course on treatment of high altitude illnesses. Dalgety carefully placed his left foot into the print left by the climber in front of him. He next turned his oxygen regulator on full and breathed deeply through his mask, knowing that the thin mountain air could cause a number of physical reactions. He knew he would have to watch his oxygen but he felt so much better with the regulator on full blast.  

His experience in high-altitude mountain climbing was sketchy at best, and although he had boned up on high-altitude medicine before his first McKinley trip, he had little experience with high altitude sickness aside from minor medical ailments like diarrhea and minor injuries. He now reminded himself  to find a course in treatment of high-altitude illnesses--and then enroll in that course.  

He certainly had no experience climbing in altitudes above 16,000 feet, a fact which was brought to light this morning as it was decided who would be on the rescue climb. And being at just over 17,000 feet had increased the intensity of his headache. Earlier this morning, two experienced climbers had hotly argued against Dalgety’s inclusion with the rescue team.   

Chad Hanson, one of the two current McKinley expedition leaders, had argued that a newly-minted physician had been brought on board as team physician and base camp manager to one of the May 1996 Everest Teams.   

It was Chad’s opinion (and he had looked sharply at Dalgety) that the doc’s inexperience with high altitude illnesses delayed proper treatment of High Altitude Pulmonary Edema which eventually killed one of the Sherpa mountain climbers when his lungs filled with fluid.   

The doctor had no experience in mountain climbing and was unused to high altitudes; she was frequently ill herself with headaches and other ills for most of her time on Mount Everest, including the time she was in direct charge of the late Sherpa’s medical treatment for HAPE.   

Plus, Chad informed everyone within listening distance, we all know that HAPE is brought on by climbing too high, too fast, and with the storm fast approaching, we need to get up twenty eight hundred feet of McKinley fast. Dalgety, in Chad’s opinion, didn’t have the necessary acclimitization for the ascent.   

Despite his own headache, a stubborn Dalgety had won over the other rescuers when he pointed out that the two men needed immediate meds, that they had no medications with them, and that he could help control the mens’ medical conditions while the rescue team carried the men down Denali. "Besides,"  Dalgety had commented, looking directly at Chad. "Simon says there needs to be six climbers. To beat the odds."   

Thus, just a mere twenty minutes after the distress call had come in, Dalgety had taken an additional dosage of Diamox, was packed into his climbing gear, with medical supplies, meds and supplemental oxygen tanks strapped to his back. A grumbling Chad wasn’t happy about the situation, but he had agreed and Chad’s word was law.   

Now the wind wanted to knock Dalgety off Denali and tumble him to his death, thousands of meters below. But Denali hadn’t counted on Dalgety’s iron will and she discovered that although she could sway his guide lines, Dalgety himself would not budge more than a few inches.   

The wind sighed. With a last burst of fresh wind, Denali seemed to give up her quest to bring Dalgety to his death and she ordered the wind to leave Dalgety alone for the time being. Everything, for the moment, was quiet on Denali and he found the silence disturbing, as if the silence of death had already descended on the men trapped near the summit.  

Pleased by the small victory he might not be treating himself for frostbite straight away, Dalgety continued to plod methodically upward, each step bringing him closer to 19,880 feet above sea level, the altitude where the two men were stranded. He turned down the level of oxygen he was receiving from his tank. He needed to save the other oxygen canisters for Edward and Kenny.  

Dalgety had been climbing mountains forever, but he had been physically climbing mountains since early spring. Gina’s sudden death in a car accident last year had left a huge void in his life. The financial difficulties of the HMO and subsequent closure of the Mish--perhaps permanently, perhaps not--had left Dalgety’s days empty as well as his nights.   

Truth be told, he hadn’t missed the Mish as much as he thought he would. Dalgety had spent a few days worrying that the uncertainty of his employment would jeopardize his green card status. Then a call had come and Dalgety discovered himself signed on at will with the World Health Organization. He then found himself in the early spring California sun, giving vaccinations to the migrant farm workers and their children.   

Surprisingly, Dalgety had enjoyed the work, moving from site to site, slowly acquiring oral fluency in Spanish. Certainly a change from wielding a scapel, vaccinating children gave Dalgety a kind of peace, a back to basics feeling he hadn’t had since he didn’t know when.   

Then one blustery day early in March while on a gourmet grocery run, he’d seen a notice on the store’s bulletin board:   

    swsw Doc wanted to assist team of disabled mountain climbers in scaling Mount McKinley this Memorial Day weekend. Must pre-register with Park Service 60 days in advance, unless exempted (if you don't know your exemption status, then you're not exempted & must pre-register 60 days in advance. We'll take care of pre-registration).

    No pay, but air, motel @  Fairbanks
    , transport to Denali National Park, other expenses (including $150 special-use fee) and climbing equipment provided.

    More details: 555-3098 or ethanhurley@hotmail.com
"Well, Robert,” he had told himself. “Either you’ve gone bonkers or you’ve just hit the jackpot, mate. Beginning mountain climbing in your forties! But, you must admit, any way you look at it, you get a free trip to Alaska, something you need at this time.”  

So Dalgety had noted the contact information, then phoned and emailed Ethan, and in the last week of May had found himself on a surprisingly comfortable Air Alaska flight heading for Fairbanks. The ascent was a training climb, Ethan had told him. They would not reach the summit during that climb but would camp at nine thousand feet and ascend to thirteen or fourteen thousand feet to acclimitize the climbers to the thin mountain air.  

During his newbie climb (“risky,” commented one climber upon learning Dalgerty’s newbie status, “but yer quite fit,’ Dalgety had been told), Dalgety was to tend to the various cuts and scrapes of his team. Happily, it turned out that he had to treat no major illnesses or major injuries. Aside from cuts and scrapes, the only minor injury he had had to treat was another climber's broken elbow. As his own climbing team was starting out on their climb, another climber had slipped at  three thousand feet, breaking her elbow.  Dalgety splinted her elbow and had accompanied her down the mountainside before making the short three thousand foot ascent back up to where his team waited.   

Since then, Dalgety’s name was making the rounds in climbing circles as a doc-on-call, and he began to receive calls for inclusion on a climbing team, along with offers of climbing training.  All of which he had happily accepted, in between his stints with the World Health Organization, telling the climbers that he must keep some employment to satisfy certain immigration officials.  

But on that first trip to McKinley, Dalgety had discovered something wonderful about himself: he enjoyed mountain climbing. The sheer challenge, the sheer joy of ascent had been liberating and Dalgety had felt his worries drop from his chest as if they were bits of down.   

He had felt free of the bonds which bound him hand and foot: the bonds of his duties at the Mish, which had required him to work odd hours, and the emotions which ran high when his surgical patient didn’t make it. Free from the frustrations when the HMO denied a patient the treatment Dalgety recommended.   

Gone also was the shame of accepting responsibility for a stupid, a totally stupid mistake of cutting into someone’s abdomen two full inches above the correct incision line for an non-laparascopic appendectomy.   

Dalgety had had to write the mistake down in his surgeon’s report. Depending on one’s point of view, during the surgery he had discovered the patient had cysts on his liver, one of which was a Stage 1 malignancy. The opening incision had revealed the presence of a lemon sized liver cyst and Dalgety's mistake turned out to be a life-saving mistake. But there were other mistakes, albeit small, but which in Dalgety’s mind, added up either to a growing ennui with the status quo or added up to stress. And in Dalgety's opinion, a surgeon who is bored or stressed is not a good surgeon at all. So when the news came that the Mish was to be temporarily closed, Dalgety took the news rather happily.   

Standing on Denali’s face in May, Dalgety discovered that by mountain climbing, he could accept Gina’s death. Looking at his first sunrise at 15,000 feet, somewhat higher than the climbing team’s original goal, Dalgety discovered he didn’t want his continual mourning to bind Gina’s spirit to this plane. He knew the time had come to let her spirit find its own destiny.  

A sharp tug on his guide line and a call of “Whoa!” jarred him from his remembrances. Dalgety halted. He drew in his breath, mindful of his oxygen supply, but he couldn’t help himself. He needed the extra oxygen; and at this high altitude, his heart was pounding.   

Disregarding his discomfort, Dalgety took a moment to look around him. He'd not been this high on Denali his first two ascents. Even with heavy cloud cover close overhead, the Alaskan vista spread beneath him was breathtaking.  

“What’s wrong?” he called, hoping someone would answer him. The figure in front of him turned around and he could see several tufts of red hair sticking out from under a hood.   

Mary. Mary Abraham had red hair. He had thought Douglas or Simon was in front of him. “They need to secure the guide ropes,” she called back.  

Dalgety grimaced but he doubted Mary could see his face. She was at least twenty feet ahead of him and his face was nearly covered with protective gear.   

“Tell them that HAPE does not fuck around!” Dalgety hoped he had the right mix of anger and annoyance in his tone. Evidently he did, for Mary nodded, then turned around to call up the line of climbers.  

Shortly, she turned around again. “Few more minutes.”  

Dalgety shook his head, gesticulating angrily. “Now,” he told her.  

“If we don’t have the guide ropes, we ain’t gonna get up to them, nor are we gonna get them back down. They’ll tug the ropes when they’re done.”  

Dalgety’s shoulders slumped but he knew Mary was right. One of the many conflicting reasons for the Everest Tragedy was that one of the sherpas had short roped a climber instead of fixing the guide ropes. Dalgety nodded in defeat and Mary turned around again.   

He'd been in Base Camp for a month for acclimitization at the 17,000 foot altitude and he'd made small excursions between 1,000 and 1,500 feet higher to get himself accustomed to a higher altitude. Mary was the other climber who had protested about his inclusion on the rescue team.    

He has never ascended above seventeen thousand feet. And you know damn well, Simon, that a doc on the 96 Everest Team had altitude induced headaches most of her time at base camp. Dalgety was planning on descending this morning because of his headaches. There’s only five of us willing to go, excluding him,” Mary had jerked her thumb at Dalgety before finishing, “We can’t bring down a third man off Denali today. Not with the storm brewing out west.”  

And those facts were true, Dalgety now mused, taking a look at the altimeter on his watch: 18,991. When he woke up this morning at dawn, he’d discovered that his headache was no better. At six thirty am, Dalgety had told Chad about his plans to descend to another camp located at 10,000 feet, an altitude to which he was well acclimitized.  

Then the radio distress call had come in at 7 am and Dalgety promptly forgot his own physical problems when he heard the symptoms of the two climbers: both had suspected HAPE and would die without prompt medical treatment. HAPE treatment was usually--usually--quite simple: a rapid descent to a lower altitude. Left too long without treatment, HAPE could kill rapidly.   

Now, at an altitude of 18,991 feet, Dalgety was feeling light-headed, his breath was coming thickly, as if his lungs were full of molasses and his heart was jackhammering. He was ascending too fast, and conditions for the development of HAPE were slowly gelling, a fact of which Dalgety was not unaware.   

But he wasn’t going to complain. Not now. He knew he was taking a huge risk but he was the only doctor amongst the thirty-odd climbers at McKinley base camp in this second week of September. He was the person with whom Death would battle this day.   

And he would fight Death for the two mens’ lives until he himself either won and the men survived, or he himself lost out to Death at the 19,980 foot altitude. Time was ticking away.  

And he knew that soon he would have to decide to whether or not to administer nifedipine to the ill men. Nifedipine could reduce blood pressure to a dangerous level, but Dalgety was much more worried that HAPE would kill the two men before the nifidepine could lower their blood pressure to dangerous levels.  

For that matter, Dalgety was worried the rescue team would find two frozen corpses just under Denali’s cloud-covered summit.   

Dalgety’s growing dizziness and pounding headache gave him silent testimony that Death was already knocking on Dalgety’s door at the 18,991 foot altitude. He himself could fall victim to either HAPE or another well-known high altitude illness: hypoxia. In a state of hypoxic dementia, Dalgety knew that he could take a very long step off Denali’s rocky side.   

Turning his oxygen regulator to full, Dalgety took several deep, slow breaths of oxygen and immediately felt his mind clear. It wasn’t HAPE he was developing. Dalgety took several more slow deep breaths and his thoughts became crystal clear.   

He was developing hypoxia, or oxygen depletion, a common occurence at high altitudes. Hypoxia can affect even the most experienced of climbers, causing disorientation and forgetfulness and yes, Death made frequent rounds of those with hypoxia. Dalgety was relieved that he hadn't developed rales, the labored breathing that sounded like a paper bag crumpling. Rales is a tell-tale sign of HAPE, Dalgety now remembered from his brief study of high-altitude medicine, and he now gave thanks that he had plenty of oxygen. 

Dalgety knew that several of the 1996 Mount Everest disaster survivors had suffered from hypoxia; and of that group, Everest had claimed several sacrifices.   

Now Dalgety felt the guide lines tug and he looked at Mary. She gave him a thumbs up and Dalgety again began placing one foot in front of the other, hoping the two men were still alive near the summit. Denali had grown angry again and the wind began with more force than before, telling Dalgety that the storm which blew in the west was close, very close to Denali.   

As he plodded upwards and taking deep slow breaths through his oxygen mask, Dalgety fretted. He knew there had been no radio contact with the injured climbers since they had radioed at 7 am and he saw that it was just after 10 am. Almost three hours to ascend nearly nineteen hundred feet.   

Three hours without supplemental oxygen; three hours without proper supplies; three hours at an altitude of 19,980 feet without dexamethasone. Dalgety was more than worried about the medical condition of his two patients. He was downright terrified for them.   

During the radio call at 7 am, Edward Reining had relayed his and his brother Kenny’s symptoms, symptoms which all of the climbers huddled around the radio had recogized as HAPE.   

Then in an eerily calm voice, Edward had delivered the shocking news that excepting the radio, the shearing high winds had torn from their backs the packs which contained all their supplies, including supplemental oxygen, medical supplies and the crucial dexamethasone, which alleviated high altitude sickness.  

Next had come a sharp cry, and then, radio silence. The conjecture in base camp was that the wind had blown the radio over the edge.  

A sharp gust of wind brought Dalgety back into the here and how. He grimaced and plodded upwards.  

Less than a thousand feet, Robert. You can do it,” he told himself.  

A weird song was beginning to play out in Dalgety’s head and he wondered if he was going crazy: “Nine hundred eighty nine feet to go, a step and now nine hundred eighty eight feet! Count them down, keep your eyes on the ground, nine hundred eighty seven feet left to go!”  

A sharp tug on the rope caused Dalgety to look up.   

“Don’t go day-dreaming there, Dalgety!” called Mary’s voice over the wind. He smiled at her, then realized she could not see his face. He gave her the thumbs up.   

And trudged step by step the remaining nine hundred eighty six feet. 

“I know what the risks are!” Dalgety shouted into the brutal howling wind. He was twenty feet below the summit of Denali, attending now to Edward, and despite the difficult climb, Dalgety knew he would return next year so he could summit the fierce mountain in a more pleasurable manner.   

The wind blew away the speaker’s response and Dalgety waved the speaker towards him before turning back to his preparations. Douglas was helping Chad to prepare the guide ropes for Edward. Simon and Michael were getting Kenny down from the summit.  

Amazedly, Edward and Kenny, despite their medical distress, had actually climbed upward for an additional three hundred forty feet to the summit and Kenny was actually on the summit of Denali. Edward was some twenty feet down the mountain.  To Dalgety’s dismay, he discovered that Kenny was leaning against a rapidly dwindling snowbank on the summit, curled into a squatting fetal position--not a good sign. Upon their arrival, Dalgety had to triage the two men, and had determined Kenny was the worse affected. Dalgety had instructed Chad to administer oxygen to Edward while he himself attended to Kenny.  

Simon had thought the brothers had thought the brothers mistakenly climbed higher instead of descending rapidly to alleviate their HAPE symptoms. But Douglas thought perhaps the brothers had wanted to summit after their radio distress call and as proof, he had pointed to a small, bright orange flag, partly embedded in the snow under Kenny’s hand. Douglas had brushed the snow off the flag, and as the wind unfurled the flag, the rescue team saw the name Kenny Reining on the flag.   

A second bright orange flag was deeply embedded in the snow about two feet away from the first flag, still waving despite a thick coating of snow. It read: Edward Reining. Douglas brushed the snow off the flags, then took a photo of the two flags before turning his photographic attention towards the rest of the rescue team.  

Still, as he had administered the necessary meds and oxygen to Kenny, Dalgety had gazed outwards and downwards as best he could through the blowing snow. As soon as the oxygen began to flow into Kenny, he began to revive, moaning. Seeing Kenny's reaction reminded Dalgety of pathologist Beck Weathers, one of the 96 Everest Disaster survivors who managed to cheat death repeatedly, losing both hands and half his face to the brutal cold of Everest. 

The sight was beautiful and breathtaking. Dalgety had summited Denali, but he couldn’t stop to take the time to enjoy it. Simon had come to rope Kenny and after the rope job was done, Simon had quickly placed several small flags deep into the remaining snow on the summit.   

One pale blue flag, Dalgety noticed, had Dalgety’s name on it. He smiled then remembered the flag he had brought along on the last two trips in case he managed to summit Denali. Glancing at his other patient, and seeing Edward move his arms and legs in response to the administration of oxygen, Dalgety made his decision then quickly took the pale pink flag out of an outer pocket. He stuck the flag into the snow near his own flag. The wind unfurled the small flag. Simon looked at the flag, then looked down, and nodded.  He knew the score; sometimes good friends were lost to the mountain; sometimes, you summited the mountain in memory of a good friend.

The pale pink flag read: In Memory of Gina Reyes.

Then Dalgety noticed Simon taking photos, including a close up vertical photo of Dalgety next to Gina's pale pink flag. He was momentarily disgusted at Simon, then he remembered that summit photos and the planting of flags are quite common. Dalgety then thought that Gina's family might like to see a photo of Gina's flag on Denali's summit; at least, he could have the photo taken and then ask her family if they'd like a copy.  Pulling down his protective face covering and pushing up his wrap-around sunglasses, Dalgety crouched next to Gina's flag, and smiled at the camera. Simon had handed the camera to Dalgety and motioned that he wanted a photo. 

Now, as he watched Mary doggedly slog the few steps towards him and Edward, Dalgety was surprised he had time to think about all this in the short time it took Mary to reach him. It seemed that time telescoped at high altitude, or perhaps he needed to take a deep breath from his oxygen.  

He could see that Mary was shaking her head. Chad had his back turned to Dalgety for the moment.   

Dalgety had already administered acetazolamide and dexamethasone to Edward and he’d administed dex to himself as a precaution. Now he was going to give twenty milligrams nifedipine to Edward. Dalgety leaned close to Edward's ear.

"Edward," Dalgety. Edward moaned and moved his head.

"Edward, I need to give you nifedipine by mouth. Can you open your mouth? Can you do that for me?"

"Thhhhhh," was Edward's reply. Replacing the oxygen mask, Dalgety took out the nifedipine, keeping an eye on Mary as she approached.  

Mary took several steps closer until she was nearly in Dalgety’s face. She squatted so he could hear her quite clearly. Her face coverings were pushed down on her neck and her entire face, including her ears, was cherry red. 

“I can’t let you give nifedipine to them. Their blood pressure will drop drastically,” she angrily told him. Too late, Dalgety thought. Already gave nifedipine to Kenny and he's doing quite well. Sorry to disappoint you, lass.   

Dalgety half turned, squinted and eyed Mary closely. Standing, Mary towered over him. Squatting, Mary was nearly his height and without her sunglasses on, he could see that Mary had the slightest hint of scorn in her expression, as if she distrusted his medical expertise.   

“I am a doctor,” Dalgety reminded Mary.   

“You have never had experience with high altitude medicine,” Mary coldly reminded him.  

Dalgety ignored her and turned back to continue his ministrations. Just as he was about to administer the nifedipine, Dalgety felt his arm being yanked back. He closed his hand over the nifedipine pill. Bracing his feet, he half turned again, looked up and squinted at the very close face of Mary Abraham. Her breath was blowing hot on his face, fogging up his protective sunglasses.  

“I can’t let you do that!” she told him. Dalgety gritted his teeth. He had summited without a blackout, without developing hypoxia and without developing any other problem, including HAPE ("a bleedin miracle," proclaimed Simon).  Dalgety had experienced had no other physical problems except a pounding heart after reaching 18,000 feet and his worsening altitude induced headache.  

Then in his distress at seeing the two climbers near the summit, Dalgety, ignored his nearly blinding headache, and had determinedly walked the last three hundred forty feet to Denali’s summit to help the downed climbers. Damn Mary to hell and back. He was going to help his patients.    

Slowly now, lest he lose his footing on the precarious snowpack, Dalgety stood up. Beneath his protective coverings, his face was a grimace of anger.   

Mary stood up in tandem. He turned to face Mary. From the way she squinted her eyes, Dalgety knew she wasn’t trying to block out the sun. Mary meant to stop Dalgety from administering the nifediprine.   

Deliberately, slowly, Dalgety balled up his free hand, and punched Mary in the stomach.  

“Ooomph!” she said, bending over double. While she was thus distracted, Dalgety squatted again, then quickly administered nifedipine to Edward.   

“What was that about?” Chad shouted as he finished hitching Edward’s straps to his own.   

“Bastard hit me,”  Mary shouted over the wind.  

Dalgety took a few steps towards Chad so he could talk to Chad without shouting.  

“She wasn’t going to let me administer nifedipine,” Dalgety told Chad.  

“Isn’t that risky?” Chad asked.  

Dalgety nodded. “But it’s been nearly four hours since they radioed and HAPE is more dangerous than the possible blood pressure drop from the nifedipine. We can’t risk not giving them the meds.”  

Chad nodded. “You might want to avoid her for a while,” he said, indicating Mary. “Ready!” he shouted to others. “Ready?” he asked Dalgety.  

Again, Dalgety nodded affirmation. “They’ll survive until we can get them evacuated to sea level. After that, well, time will tell.”  

Chad then told him, “You walk behind Douglas.” He pointed and Mary jerked her head towards the back of the line.  She took a few steps closer to him.

“I hope you’re correct about the nifedipine. Tu eres como cerdos cojones.” Mary pronounced the ce as th, indicating she had studied Castillian Spanish.   

Dalgety understood the insult and was bemused at Mary’s poor choice of Spanish insults, but he was dismayed with his descent position. “I’m more correct than you think,” he told Mary, as he helped the now-conscious Edward move into position between Michael and Douglas. Mary was descending behind Kenny who was behind Chad and Simon: a split descent team of four and four.   

Making his way slowly down the short line of climbers, Dalgety went to check on Kenny and saw that the formerly critical climber had an unbelievably hardy constitution. Again, Beck Weathers came to mind. After the dex took effect, and Kenny had been given several litres of oxygen, Kenny had revived to a good extent and was now busily humming to himself. 

Even more remarkably, Kenny was standing with only occasional assistance, a fact which forbode well for the rescue team’s ability to get Kenny off Denali’s summit.   

This rapid recovery made Dalgety wonder about the true medical diagnosis. Judging from the brothers’ response to an oxygen mask on full throttle, Dalgety was certain of his hypoxia diagnosis. The possibility existed that hypoxia dementia had caused the brothers to imagine themselves to have developed HAPE. This gave Dalgety some concern about the meds he had administered. He again reminded himself to get training in treatment of high altitude illness.  

Kenny was breathing deeply of his replaced oxygen tank and was merrily waving to the descent leader, Simon. Simon waved back and gave Dalgety a thumbs-up.

“Thanks, doc!” he greeted Dalgety. Kenny’s voice was weak. “Chad told me this is your first ascent over 16,000 and you have altitude headaches. What a hell of an introduction to McKinley!”  

Dalgety smiled wanly. He was pleased his patient was doing well and stunned that after finding Kenny in a near coma just a short while ago, Kenny was able to walk, albeit slowly, but walk he did under his own power.   

“That’s why I began climbing, for the challenge,” was Dalgety’s only reply. Then Dalgety cringed. “And that,” he told himself, “was a bald faced lie. You hoped to escape a bad period in your life, including Gina’s death, when you phoned Ethan Hurley in March. The sheer joy of climbing came after the fact, Robert. After.”  

Kenny nodded now, and wobbled a bit. Dalgety reached out an arm to steady him. "Easy there," Dalgety told the robust climber. 

"Thanks," Kenny told him, taking a deep breath of oxygen. 

“We need to get back down! Storm’s moving in fast!” Chad called back. Dalgety nodded, hoping Chad had radioed back to McKinley Base Camp, twenty eight hundred feet below them. Checking Kenny one more time, Dalgety slogged back to where Edward was roped between Mary and Douglas. Douglas handed him a camera.

"Take a picture of us descending," he ordered Dalgety. Out of concern for his patient, Dalgety chose to ignore the tone but he nodded and accepted the camera.  

Dalgety noticed Mary was now blabbering away to the mountain face and thinking that earlier she had been exhibiting  symptoms of hypoxia earlier, Dalgety turned on her oxygen regulator full blast before turning his attention to Edward.   

Unlike the hardy Kenny, Edward needed more help in getting down the mountain. He was more conscious now, wagging his head back and forth and able to stand wobbling by himself for a few seconds. Edward would need more help getting down Denali’s snowy, stony face.  

It was now that Dalgety mused Chad might be correct in making him walk the end of the line. If Edward or any of the rescue team fell or needed medical assistance, Dalgety would find it easier to go down not upwards to assist fallen climbers.   

And the reason for taking six rescue climbers suddenly made sense to Dalgety: at least four climbers were needed to ascend rapidly in order to get Kenny and Edward down from the summit. As Simon said, it was a matter of odds. When Simon had increased the rescue team by two, he ensured that at least five would be able to reach the summit.   

“You all right?” he asked Edward.   

“Yee. Eh. Eth,” Edward groggily replied. Dalgety grew concerned and his brow furrowed deeply. Although Edward was upright, his words came out slurred. Not a good sign. 

Dalgety thought a moment, then decided against administering more dexamethasone. Other than the basics, he was unfamiliar with high altitude medicine, and he wasn’t willing to risk a over-medication mistake.  Instead, Dalgety decided to replace Edward's oxygen tank again and when he checked the canister, Dalgety was surprised to discover the tank was empty. Replacing the oxygen canister, Dalgety turned the oxygen regulator to full and shortly, Edward was more perky. 

“Ready?” Mary shouted at him. Obviously the increased oxygen made her feel more perky and she gave him a playful little shove to get him moving. Dalgety silently vowed to get her back as soon as he saw Kenny and Edward safely evacuated.  

He moved to the back of the line and fixed himself to the guide lines which connected him to Douglas. He snapped a few photos of the climbers beginning their descent. At the front of the descent team, Dalgety noticed that Simon was taking a few photos of the rescue team.

Two tugs on the rope told him the rescue team was about to descend. He looked down in amazement as he passed someone’s footprints, perhaps his own, leading up to the summit. Taking one last look at Denali's summit, he saw the small flags still waving in the air. He tugged on the ropes three times to indicate he wanted to pause a moment. He wanted to have a last photo of the flags. Using the zoom function, he took a few photos of the flags waving on the summit. Gina's flag was closest to him and Dalgety hoped the photos would come out all right.

He tugged on the ropes twice to indicate he was ready to descend. With an eye turned towards his closer patient, Dalgety began step by step the descent down Denali.   

Dalgety hoped they would be met at the 19,000 foot mark by a helicopter.

In fact, the helicopter met them at 18,700 feet, the closest the pilot could maneuver his chopper given the harsh weather. He had guided the chopper up Denali at the first indication the winds were abating.   

The guide ropes were being tugged with some ferocity and Dalgety looked up to see Douglas waving at him.   

Douglas pointed ahead and over the screaming of the wind, Dalgety thought he heard a familiar sound: the thup, thup, thup of a helicopter though the chopper itself was still obscured by blowing snow.   

After a few more steps, Dalgety was sure his ears were telling the truth. He had spent too many months in military medical camps, listening for the sounds of the helicopters as they brought in the military wounded.   

Some of those wounded he had healed. For other wounded, he signed death certificates. Of those whose death certificates he signed, he had written a note to be sent along to the family. But always, always was the sound of helicopters in the background and Dalgety had grown weary of the sound.  

When he had taken employment at the Mish, Dalgety had hoped never to hear the sound of a helicopter again.   

Now, as he stood at an altitude of 18,820 feet, Dalgety realized he loved the thup, thup, thup sound of the helicopter, for this time, the sound meant life for his two patients.  

Surprisingly, Edward fared better during the short descent than Dalgety had hoped and which seemed to confirm the two men had hypoxia rather than HAPE. Still, his unfamiliarity with nifedipine caused Dalgety to worry about the administration of the medicine.  

Edward’s body was slower to metabolize the dexamethasone, a fact which Dalgety would file away for future reference. He had batted himself on the forehead for failing to realize that in high altitudes, abundant oxygen was required for proper metabolization.   

Now Edward turned and given Dalgety a thumbs up. Happy beyond belief, Dalgety slogged through the last 120 feet towards the waiting chopper, making sure he kept his head down to avoid the helicopter’s whirring blades.   

He felt himself stripped of his climbing gear and was grateful to assist the unknown hands.   

“In ya go, Doc!” he heard someone say and he felt himself being gently pushed into the chopper. “No hard feelings,” and Dalgety then knew that it was Mary who spoke. “Take these and have them developed. Be sure to come back with the cash!”   

And smiling, Dalgety had known then that he’d found his climbing team. He next felt a small bag thrust into his hand and then he heard the door shut behind him. Turning as best he could in the cramped helicopter (he was nearly sitting on Kenny’s lap) Dalgety looked at the rest of the rescue team through the small window. He raised his hand in silent salute as the chopper lifted off.  Below him, he saw three sets of climbing gear piled near Mary. Or maybe the gear was piled near Chad. Or Simon or Michael or Douglas. He couldn’t tell through the mist in his eyes.   

The thup, thup, thup was comforting to Dalgety. Strange how he'd hated the sounds of a chopper's blades. Now he couldn't figure out why he'd hated the sound; they sounded like sheer heaven.   

Shortly, the chopper left the five climbers looking like small dark dots on virgin snow. The climbers would descend the remaining distance to McKinley Base Camp. Before turning his attention to his patients, Dalgety looked in the small bag Mary had given him. It contained the cameras.   

“They took some pictures,” Kenny stated matter of factly, blowing on his hands to warm them.   

“Yeah. Got the flags, too,” Dalgety told him.   

“We summited?” Edward asked dazedly. "How the hell did we summit?" In the closeness of the chopper, Dalgety merely had to turn his head to see Edward. He nodded.    

“Damn,” Edward said. The two men had recovered so well with the administration of the oxygen and meds that Dalgety again wondered if the men had only suffered hypoxia. Then again, the only real cure for HAPE was rapid descent to a lower altitude. It appeared that the two mens’ rapid recovery was a medical mystery.   

"We were hoping the two of you could tell us how you managed to summit," Dalgety continued. "The only think we can think of is that you chaps decided to go the additional 340 feet."  

Edward scratched his stubbly chin. "Uh, doc? We were at 19,600 feet when we radioed. I remember looking at my altimeter as I radioed."  

Dalgety was surprised at this revelation. He shook his head. "You said you were at 19,880 feet."  

"No, doc," Kenny told him. "19,600 feet." 

"You sure? Hypoxia dementia can do strange things to your mind," Dalgety told him.   

"Weeell, no. Not sure. But if we did go up over seven hundred twenty additional feet, t's a damn miracle we didn't walk off the damn mountain," Edward said. He pointed to the bag on Dalgety's lap. "Uhm, are those the photos?"  

Dalgety nodded. “Gonna get them developed,” Dalgety said. “I’ll make sure you get copies.”   

Kenny snorted and Edward smiled, showing his blinding white teeth. "Damn right you will!" Edward laughed.   

“You’re kidding about us summitting, right doc?” Kenny now asked. "Just making us feel better?" He had an earnest look on his face. 

Dalgety turned his head to look at Kenny. “You really don’t remember summitting?”  

Kenny shook his head and Dalgety now asked, “What’s the last thing you remember?”  

“Wanting to eat a thick juicy steak in front of a roaring fire,” Edward said, grinning.  

Dalgety couldn't blame the chap, for Dalgety had had that thought himself while at McKinley Base Camp. Along with a pot of steaming Darjeeling tea. And what Dalgety wouldn't have given for a Scotman's Survival Kit to warm him up even better.   

“Making the radio distress call,” Kenny told him. 'That's what I remember doing last."   

“Do you know what you were suffering from?” Dalgety asked now.  

“HAPE. I think,” Kenny replied.  "That's what I thought." 

“Hypoxia for sure. Did you hear a sound like a paper bag crumpling?"

Kenny shook his head.

"I’m not sure about the HAPE diagnosis and rales is a tell-tale sign,” Dalgety admitted. “We’ll check you once we get you back on the ground.”  

Kenny rubbed his chin in thought. "The oxygen sure made me feel better,” Kenny commented.   

“Where’d you find us, anyways?” Kenny asked.  

“You,” Dalgety told him, “were on the summit, doggedly holding onto the flag you planted. And you,” he indicated Edward, “were about twenty feet below your brother but your flag was about an arm’s length away from his.”  

“Neither do we,” Kenny replied and Edward nodded in agreement. "But we're glad we did, and we're glad you all came to rescue us."

The chopper passed above McKinley Base Camp. 

“Hey! Look! They’re waving!” Kenny said, leaning to the side a bit so he could better see the camp. People were waving scarves and banging on pots and pans as the chopper flew over the camp. Kenny waved back and Edward called weakly, "Thanks!" although he must have known that McKinley Base Camp couldn't hear him.   

Dalgety smiled, then he laughed until tears rolled out of his eyes. Kenny and Edward looked at him, then chuckled, Chuckling was the best they could do given their condition.   

Today was a good day for Dalgety. He’d scaled the mountain, conquered it and along the way, he’d given help to two people who’d desperately needed him. Maybe now he could lay to rest the guilt he'd been carrying about Gina's death. He'd always remember how strangers left flowers and mementos at the roadside memorial. And he'd always remember Gina.   

His next thought was that perhaps wherever she was now, Gina would be proud of him.   


Dalgety leaned back in the plane seat and closed his eyes. He was flying on behalf of WHO and the plane was due to land in Geneva during the Swiss morning. In a few days, a conference would begin on vaccinations and Dalgety was attending.  WHO had phoned him a week ago, and had asked him to attend the conference. WHO had also mentioned that a short course in High Altitude Medicine was being given in Geneva and would he, by any chance, like to attend?

He suspected that he was being rescued from the intense interest in what the media referred to as the McKinley Miss, a moniker which confused Dalgety and the other rescue climbers. But Dalgety was glad of the distraction that WHO had arranged, for it would provide some relief from the cameras which now followed him around to the grocery store, to the movies, to the dry cleaners.   

Always, always, whenever someone from the media found him, a camera's staring, blind eye wanted to know: what was it like on Denali's summit? Were you afraid? Did you think you wouldn't make it on time? And most times, the how cold was it up there? question was thrown at him. "Like hell froze my balls," Dalgety always wanted to reply but always bit his lip just in time.   

As he settled in for a good nap, he remembered the events of his race against time on Mount McKinley.  

The two brothers, Edward and Kenny, had definitely suffered hypoxia, although both men’s lungs had shown some bloody fluid. Kenny had some frostbite on his ears and Edward had frostbite on his nose. Happily, they had spent less than a week in hospital and were now in their respective hometowns, a little worse for the wear, but otherwise all right.   

Mary too had suffered from early signs of hypoxia and Dalgety’s last minute crank on her oxygen regulator had saved her from further symptoms. She'd had moderately severe frostbite on her left hand, but the frostbite would heal and she'd be fine. From Fairbanks where she was still recuperating from frostbite, Mary had written Dalgety quite a long letter.  "Being ambidextrous is a mighty fine thing, my grandfather told me the first time I broke my left arm and now I'm finding grandfather's words to be true."

From that letter, he garnered that Mary was well on her way towards achieving her desire to ascend the Seven Summits (the highest peaks on each of the continents, she'd written). She'd invited Dalgety to ascend the 11,500 foot Mount San Gorgino in Southern California as a training climb. Dalgety had accepted.

Chad and Simon were going to go for an Everest ascent. During their joint phone call, Chad and Simon had lobbied Dalgety mighty hard for his inclusion on their '04 Everest Team, arguing that Dalgety would have been in training for over a year before the actual attempt on Everest. Neither Chad nor Simon had ascended Everest and they hoped their first attempt would get them to Camp Two, with the possibility that someone from their team ascending the summit. 

Chad and Simon had hooked up with one of the established Everest Teams and the two men had provided Dalgety with the background information and assuring that if he accepted their offer, Chad and Simon would ensure that Dalgety's name was on the Everest permit, in case he wanted to try either for Camp Two ascent or try for summitting.

An Everest permit was necessary to climb past Everest Base Camp at 17,600 feet, Simon informed Dalgety, and the cost is 10,000 dollars per climber, excluding other costs. With the media interest in the McKinley Miss, there was the possibility that an Everest Guide would want Dalgety as Base Camp physician (sometimes for pay; sometimes not) and Dalgety had said that he was planning on taking a course in the treatment of high-altitude illnesses during his time in Geneva.

After some consideration and checking into the Everest guide’s reliability, Dalgety had damned the cost, and agreed to the request, provided he receive more climbing training, especially at the higher elevations. Dalgety's response was met with enthusiasm from the team members. Mary, Michael and Douglas were thrilled when phoned and told about Dalgety’s inclusion on the '04 Everest Team.

Michael and Douglas had agreed to help Dalgety ascend Australia's Koscuisko during the Southern Hemisphere’s summer. They made plans for Dalgety's trip just after the New Year. "Excellent trout fishing in the summer," Douglas had told Dalgety. Michael had chimed in, "And you might be interested to visit the historic town of Dalgety, on the banks of the Snowy River."  Dalgety was indeed interested in visiting the town bearing his surname and plans were duly made for a side trip to historic Dalgety.

There was a loud snort from another passenger. Dalgety opened his eyes, thinking he'd forgotten something. After a moment's thought, he reached under his seat, rummaged around in the outer pocket of his carry-on bag and pulled out a double picture frame containing a picture of Gina and a second picture of himself crouching next to the pale pink flag bearing Gina's name that he had placed on Denali's summit. Dalgety folded the meal tray down and placed the picture frame on the tray. Although he had decided to let Gina's spirit find its own destiny, his decision did not mean that he had to stop missing her. 

"Night, luv," Dalgety whispered. He leaned back again and closed his eyes, letting the quietness in the plane lull him to sleep.