‘I want to make one thing clear. I am the expedition's official medical officer... but I have never practised in my life. I beg you in no circumstances to seek my professional advice since it would almost certainly be wrong. I am, however, willing if necessary to sign a death certificate.’
Thus spake Dr T G Longstaff to his fellow climbers before the first attempt on Everest in 1922. Unlike Longstaff many mountaineers are practising doctors whose skills, including issuing death certificates, are often needed on the mountain. Michael Ward, the author of this book, is a mountaineer and writer and was doctor to the first successful Everest ascent in 1953. It was he who discovered the southerly route to the summit subsequently taken by that expedition, and with Eric Shipton in 1951 launched the brilliant reconnaissance which first forced a way up one of its most formidable sections.
This book is not about the scenery and atmosphere of the mountain, first introduced to the outside world in lectures, films and books immediately after the 1953 ascent and repeated now on the 50th anniversary. For those who know the Himalayas the book gives a marvellous description of how the topographical knowledge was gradually discovered and recorded. For others such as myself who are unfamiliar with the geography, the rather unsatisfactory maps (monochromatic drawings reminiscent of Tolkein) can be supplemented by reference to the three-dimensional projection now available on the National Geographic website (nationalgeographic.com/ngm/0305).
The subtitle, A Thousand Years of Exploration, is a modest exaggeration; the geographic work dates mainly from 1700 and the mountaineering is dominated by the period 1918-1953. Nevertheless, this was when big advances were made and each of the pioneering expeditions is carefully described and well referenced. Ward introduces a remarkable cast—London establishment committeemen, the Abominable Snowman, the Abbot of Rongbuk and the Everest mountaineers themselves. The latter are gritty, often polyglot, army officers, public school and Oxbridge men, FRSs, sherpas and a few antipodeans. Like characters in Alice in Wonderland they pop up on almost every page, disappear then reappear again and reflect the eccentricities of a bygone age in a remote but newly charted region that is now being overwhelmed by mass tourism and its detritus. There is a common theme; each expedition starts with squabbles and knives flashing at the Everest/Himalayan committee in London, but the climbers are soon away panting up the mountain where much is learned and later described in the Alpine Journal. The 1953 expedition was successful because it built on these experiences as well as many new lessons from the Second World War. For once, physiology and excellent management (John Hunt), were to the fore. Crucial physiological groundwork was accomplished on the 1951 and 1952 reconnaissance expeditions and applied by Tom Bourdillon, John Cotes and Griffith Pugh.
Alice would feel at home in the Wonderland story of supplementary oxygen on Everest. Here the problem of adaptation to high altitude (‘Will you walk a little faster...?’), whether supplementary oxygen should be used (‘Will you, won't you...?’), how to deliver it and when, rumbles on through the book. In the 1920s, Oxbridge physiologists expressed their views and experiments were carried out in decompression chambers, but these contributed little of practical use to climbers. More useful were the proposals of non-physiologists such as A M Kellas (a physical chemist at Middlesex Hospital), P J H Unna (a civil engineer) and particularly G I Finch (professor of physical chemistry at London University). Mallory is given some negative spin in this book, but in 1924 with Irvine, a ‘wizard’ with their oxygen sets, he was the first to take supplementary oxygen almost to the summit. Advances in aviation medicine made by the RAF during the Second World War are glossed over with a single reference to Roxburgh (the open-circuit oxygen sets first used to reach the summit included ‘Economisers’ built for RAF bombers). The fact that the barometric pressure on the top of Everest varies around 250 mmHg explains why it is just possible for a few well-adapted individuals to climb the mountain without oxygen supplements. Throughout his book Ward often repeats the mantra ‘4 L/min of oxygen is right but 2 L/min is not’. Hillary, in sight of the summit, increased his oxygen flow to 5 L/min and ‘Changed up a gear’. In this regard it would be good to know the oxygen requirement when climbing near the summit and how well this demand is met by the flow of oxygen into, and the design of, the open-circuit breathing systems.
Mercifully this is not a book on evidence-based mountain medicine, but there is a list of medical prerequisites which are intuitively obvious. These are prior physical fitness, food hygiene, adaptation to altitude, weatherproof clothing, appropriate food and water and the use of oxygen. I note that tobacco was recommended and was certainly used on all expeditions in pipes and cigarettes at exceptionally high altitude. There were no worries about passive smoking but pipes did not draw well at altitude. To bring the reader up to date there is a useful chapter on ‘The Mysteries that have gone’ but no hint is given of the oxygen equipment used by the massed Everest climbers of today.
Ward's book is an epic of the British on Everest with several tragic vignettes. The most poignant is the story of Bourdillon and Evans, who with their closed-circuit system climbed in one go from 25 800 feet to within 300 feet of the summit before turning back. Three days later Hillary and Tenzing, starting 2100 feet higher, were successful.