What altitude sickness taught me about myself: turns out I have a killer personality
I recently completed a two week 130km round trip trek to Everest Base Camp, and it was an epic experience. It was one of the best adventures I’ve done, but what really added to the experience was having reasonably severe altitude sickness for about 36 hours.
Pushing through that sickness was physically the hardest thing I’ve done. But in the process I learnt a few very important things about myself, and one thing in particular that I need to change about my psychology before it kills me. Literally.
In the grand scheme of life, what I experienced was pretty much insignificant, but any experience is a great opportunity for self reflection and improvement.
So here goes…
About the trip
The trip was led by the awesome adventurer and great mate Ben Southall from Best Life Adventures. In total, 46 of us completed the trek across two separate trips, along the way raising close to $200,000 for the amazing work of the MND & Me Foundation (if you can, please support them here).
In the back of my mind I’ve always been curious about summiting Everest, so when the chance came up to go Base Camp it was a no-brainer. I was really curious to know how I would feel once I saw Everest, and whether the urge to summit would consume me as a new goal.
During the whole trek I heard tales from our amazing sherpas (including Tenji who has summited Everest 9 times) and from Ben (who was at Base Camp for 3 months filming a documentary series for Everest Air on the Travel Channel).
The number one thing that stands out from those stories is the high risk of death. There are over 290 documented deaths of those attempting to summit Everest since 1921, and apparently many more that are undocumented. But don’t confuse that with trekking to Base Camp, which is incredibly safe.
From all the stories of failed summit attempts, what became evident is that an underlying cause of death is psychological. A combination of get-there-itis with ego. That is, pushing ahead when you should turn back.
What this trek confirmed to me is that I have that killer personality type. If I ever attempted to summit Everest, I could be one of those that pushes myself to my own death. It was a confronting realisation, and it’s why I’m writing this blog, to help me re-program that aspect of my psychology.
But back to the story…
I felt great the whole time from Kathmandu into Lukla, through Namche Bazaar, Tengboche, Pangboche, Dingboche, and Lobuche. We had relatively great weather, a great group, great conversations, some great acclimatisation days, and amazing sherpas.
Amongst the group there was a lot of very minor altitude sickness symptoms on the way up — headaches, nausea, diarrhoea and mild vomiting. These were all to be expected, and on the whole everyone was doing well and in high spirits. As a result, we actually adjusted the schedule to shoot for Base Camp a day earlier than originally planned. Everyone was pumped.
In fact, on day 8 hiking into Lobuche (at an elevation of 4,940 metres or 16,210 ft) I felt amazing. I felt so amazing I even ran a few short parts of it, which in hindsight is probably what depleted my blood oxygen levels.
That night, after a small kitchen fire (ok, the flames may have been touching the roof for a while) I went to bed reasonably early and feeling pretty good, albeit with an unsettled stomach.
Almost all of us were taking diamox as a preventative for altitude sickness. We were also consuming two to six litres of water every day, to combat both the altitude sickness and the dehydrating effects of the diamox.
That triple combo of altitude, diamox, and high water consumption mean that sleeping at altitude is basically a sequence of short bursts of sleep broken by the frequent need to get up to pee. Oh, that and wild dogs barking all night.
The thing is, getting up to pee in that environment involves putting on several layers of clothing to protect against the freezing cold. So you don’t really sleep as much as lie in your sleeping bag debating whether you really need to pee enough to warrant the effort, or whether you can hold it in a few more hours (spoiler alert: you can’t hold it in).
That particular night in Lobuche I felt very sick. Every time I rolled over in my sleeping bag I felt like I was going to vomit and also massively out of breath. To the point the slightest movement would take me a couple of minutes for my breathing to settle from the exertion.
My mild diarrhoea that I’d had for a few days also suddenly got much worse that night. Diarrhoea is not fun at the best of times, but even less so in the freezing cold with non-western toilets and putting your used toilet paper in a basket for all to see.
In my mind, I just put the sickness down to something I ate. After all, it’s very common to pick up some kind of stomach bug on the trek and I assumed that’s all it was.
By the next morning I couldn’t eat or even stand the sight or smell of food. By the time we started walking towards Gorak Shep I realised I wasn’t well. The hike from Lobuche to Gorak Shep is less than 5km, but it takes close to 3 hours because with the oxygen at that altitude, you just move incredibly slow. Well, that and the vertical climb that also makes it slow trekking.
And I was very slow. I quickly dropped from normally being at the front-end of the group, to way, way, way behind the entire group. I couldn’t carry my day pack (only about 6kgs) and so a sherpa volunteered to carry it for me.
We made it into Gorak Shep for lunch, which for me meant avoiding food and sitting on the toilet. I remember Ben coming up to me and saying “I know you are going to go anyway, but are you sure you want to push to Base Camp today?” He knows me well. No matter how I felt, I was going.
Leaving my day pack behind, and giving my water to others to carry, the hike from Gorak Shep to Base Camp was the hardest thing I have ever done. Even completely free of a pack, I could still only muster steps that were barely the length of one of my feet. I struggled to walk straight, or to lift my feet over even small rocks, meaning I was stumbling often (I’m normally quite sure-footed). I could feel every single part of my quads contracting with each step, but none of their usual strength was produced.
I was massively out of breath. I had to stop frequently to rest and take 5–10 minutes for my breathing and pulse rate to come back down. I could feel every rapid beat of my heart resonate through my chest like a bass drum. I had a weird sensation of being acutely aware of every organ in my torso, like they had been individually plunged into an ice bath. But externally, I had a fever.
I was regularly vomiting into my mouth, and belching a horrible smell that is most appropriately described as very off ginger lemon tea. I’m not sure I can drink ginger lemon tea every again.
I felt incredibly dehydrated no matter how much water I drank, although a sip would cost me desperate breathing time that took a while to recover from. I struggled to talk, and was barely able to give delayed one-word answers to questions. But I was always mentally cognisant and rational, which is the more concerning symptom to watch for.
I remember twice thinking I could not continue. But I should say I always felt completely safe.
The (literally) shit bit…
As we got close to base camp itself, I had a sudden and desperate case of explosive diarrhoea. I had to scramble towards the only large hiding spot I could find — a boulder sitting halfway down a loose rocky slope. As I almost ran down the slope (time was of the essence) the rocks slowly started their own mini avalanche. At one point both my legs were buried up to my knees in a sliding rock fall and I was being pushed forward. I actually pictured myself having to be rescued from under a layer of rock, meanwhile covered in my own faeces. It gave me a thought to laugh about.
Luckily I made it to the shelter of the boulder literally just in time. Something else I learned: the act of squatting obviously activates your quads, which are your largest muscle and hence also consume the most oxygen. So it turns out that squatting for explosive diarrhoea at altitude requires a lot of breathing!
My business done, I slowly scrambled back out of the rocky valley of doom (if it wasn’t that before my business, then it is now) to rejoin the path and plod my way into Base Camp itself.
During the lead-up to the trip I had made all sorts of plans for what I wanted to do once I was at Base Camp. But now that I was there, my sole focus was simply not to soil myself or vomit, and instead just breath. I composed myself enough for a few photos, and to grab a few rocks for the kids, but otherwise disappeared to vomit in my own little piece of this alien-looking landscape.
I struggled even more on the two hour hike back to Gorak Shep. I soiled myself as I walked. More than once. But by that point I didn’t care. Luckily I had prepared for this at the lunch break by wearing multiple layers of boxer shorts in addition to my thermals. And ensuring I had my black hiking pants on, not my khaki ones, just in case anything made it through. Yep, I had anticipated shitting myself on the mountain.
I was also very emotional, and I was grateful for my sunglasses and buffs because they allowed me to silently cry without anyone noticing. It wasn’t sadness (I was actually quite happy). It was just overwhelm.
In an interesting quirk of the universe, it was also that afternoon that I received messages about two separate deaths of people I know back home. Nothing like getting perspective in a moment like that.
As dusk was setting and the temperature dropping, we eventually made it back to Gorak Shep. I went straight to my room and climbed into my sleeping bag and went to sleep. Yes, in all my disgustingness. I slept for an hour and half before my roommate woke me to join everyone for dinner.
Sitting at the dinner table I had no interest in food, and no doubt my smell would have put anyone else off theirs.
Then help came to me…
Luckily, the awesome human that is Paul Olds noticed how I was, and spoke with Ben. Ben quickly realised my state and took me out into the cooler corridor to assess me. He then grabbed the lead sherpa and took my blood oxygen level reading, which was down to 70 despite a good solid sleep and not much else over the past 2 hours. Ben then grabbed Jo Smith, a midwife nurse who happened to be in the group, travelling with her amazing family.
Jo was awesome. She asked me all the questions, diagnosed me, and then loaded me up with all sorts of good stuff. Like really good hospital stuff, not the chemist/GP stuff I had. The plan was for me to sleep, and depending how the night unfolded, potentially put me on oxygen to sustain me for the night until a potential evac on foot, donkey, horse or helicopter the next morning. But thanks to Paul, Ben and Jo, it turns out that wasn’t necessary.
What you need to understand about that night in Gorak Shep…
Gorak Shep means “dead ravens,” because of the complete lack of any kind of vegetation in this place to support animal life. It sits at approximately 5200m (17000ft) above sea level. Yes, that’s 5km vertically above my home in Brisbane in Australia.
The oxygen level in the air at that altitude is 54% that of sea level. That means us non-locals have to breath much faster than normal, and you have an elevated heart rate even when doing absolutely nothing, just to get the same oxygen content into your body. The lower blood oxygen level also means your body doesn’t heal as well as it normally does, so any sickness is exaggerated.
And it was cold. That night it got down to minus 17. Luckily I have an amazing sleeping bag that acts like a furnace.
The recovery was quick…
I slept well enough. It was still short stints of broken sleep but I only got up for one toilet visit that night. Although I was so unbalanced that my walk to the toilet reminded me of when my kids play ten pin bowling and the ball bounces between the bumpers a bazillion times as it slowly makes its way down the lane.
When I woke the next morning, I wasn’t feeling better, and as I slowly packed my kit I was hoping I had the resilience to hike out. I had a wet wipe shower (I used a LOT of wet wipes that morning) and changed into less-unfresh clothes (we hadn’t had clean laundry in a while) but stuck with my tactic of multi-layer boxer shorts and black hiking pants in case I had another accident.
As soon as we started walking I felt much better, and with every metre of altitude we descended, I could feel myself returning to my normal state of energy. By lunch we were already down to 4620m and by evening we settled in at Pheriche (4240m or 13901ft). I was back to feeling great, and loving every minute of it.
So my altitude sickness had lasted all of about 36 hours, and in that time it was physically the hardest thing I had ever had to push through. But without doubt that absolutely added to the experience and made it even more valuable.
I have to say thanks…
Nicholas Burge, Ben Southall, Jo Smith, and Paul Olds are amazing people because they went out of their way to help me. Nick in particular — mate, you are an absolute legend. You walked with me without being asked, you knew exactly how to support me by simply being there in the moment with me. Not just once, but the entire time I was sick. The level to which you displayed genuine care for me was beyond anything I expected. I owe you a lot, and I have massive respect for you as a human.
Those awesome humans were actually the reason I had a little cry on the mountain. In my life, I give a lot without expecting anything in return. So when I am on the receiving end of someone else’s kindness, I literally don’t know how to handle it. I’m overwhelmed by the thought that someone else would actually care about me on that level (yes, I obviously have some shit to work through here).
So here’s what I learnt about myself…
- I suck at asking for help. Even when Jo was asking me my symptoms, I held back giving complete answers (like I didn’t mention I had been passing blood). The logic was that I didn’t want to alarm or burden anyone. And I was worried that sharing an extra symptom might push me over some threshold of being evacuated or causing more commotion and workload for others.
- I have get-there-itis. I’ve actually known this for a long time. I get fixated on the goal, the target, the objective. I pride myself on pushing through. I love the challenge. The harder the challenge, the more I love it. It’s a trait that has served me really well in my business life and in my career. Well actually, it’s also proven to be amazing in my personal life. But I need to be conscious of knowing that one day I will hit that point where it doesn’t serve me well. I haven’t found that point yet, but I need to admit it exists.
The problem is, these two traits, especially when combined together, literally kill people. So hence I want to work on myself, particularly the trait of not asking for help. The most successful people in the world actually seek the help of others the most — they always ask WHO instead of HOW.
So why write a blog publicly sharing that I shat my pants at altitude?
I’m writing this blog because I need to overcome this stupid mindset of not asking for help. Part of that is developing my vulnerability through sharing my personal grossness to make me care less about what people think of me, so that next time I’m in need of help, I actually ask for it, and ask for it early. So that I don’t hold back sharing my weaknesses.
I need to give less fucks about what others think. It’s a similar trait that sometimes causes me to hold back calling things out in meetings or conversations. I’m getting much, much, much better recently, but still need more work here.
“When you realise your vulnerability, you can be strong. When you’re brave enough to ask for help, you can be lifted up” — Prince Harry, Duke of Sussex, at the closing of the Invictus Games in Sydney
The thing is, I know that these personality traits come from my mother. I’ve written before about my mum and her insane level of resilience, stubbornness, and stoicism that also manifests as a deep desire not to burden others. It’s not healthy. So I need to calibrate some of that programming from my childhood, and more of these types of adventures and challenges are the way to do it.
So am I keen to summit Everest now? (I’ve been asked this a lot)
Absolutely not. No way.
I remember Mark Sowerby telling me that when he was deciding between swimming the English Channel or summiting Everest, he chose the channel because he didn’t want to die. I completely get that now. While I won’t go into the full details of what is involved in summiting, what I learnt from all the stories and insights was that you can do everything perfectly right and still die because of someone else’s poor choice. So no thanks.
So how do I feel now I’m back?
The trek gave me a real sense of calm. It’s hard to describe, but I have a lot going on in my life at the moment, and despite it all, I’m incredibly calm. I think the experience stretched the axis and asymptotes of normality, reminded my of what actually matters, and hence gave perspective to what I am currently facing. So I’m just calm.
I’ve always been aware of my personality traits of not asking for help and get-there-itis, but previously I saw them solely as virtues. Increasingly I’ve realised that while they can be virtuous, they can also be dangerous in manifesting sub-optimal outcomes and behaviours. So now that I’m back, I’m actively re-programming myself through consciously seeking help, being more publicly vulnerable (sorry in advance for the upcoming oversharing), and practising patience, which is where the new sense of calm is incredibly powerful.
If you’ve made it this far then thanks for reading about my shitness. Hope it helps unlock some thoughts for others.
Want an adventure? I can’t recommend Ben Southall and Best Life Adventures enough. Ben is running more trips to Everest Base Camp next year, as well as other adventures. Check them out!
If you would to see more photos from our trip they are saved in my Instagram account highlights.