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To the Summit


 

Thirty years ago I was a medical resident at Duke University (Durham, N.C.). When I entered private practice there was very little time for family, much less outside activities. Little did I know that I would become a mountain climber with a desire to scale the world’s highest mountain: Mount Everest at 29,035 feet.

As the years passed I learned that to stay healthy and to meet all the demands that life seemed to dish out, I needed some balance. So I learned to play as hard I worked. I always loved to run and hike and eventually became a competitive distance runner. I ran marathons, including New York and Boston. I’ve also competed in ultra-marathons ranging from 100- to 50,000- mile distances. I completed two of three 100-mile races, running one in 23 hours. My favorite trail ultra-marathons are in the mountains of Colorado. My first 50-mile race was in the San Juan Mountains with elevations up to 12,000 feet.

My love of the mountains and endurance sports eventually led me to rock climbing, ice climbing, and alpine mountaineering. I’ve climbed multiple alpine and ice routes in Colorado. I have also climbed Mount Rainier (Washington state), and in the St. Elias, Chugach, and Alaskan ranges in Alaska, including expeditions to Denali and Moose’s Tooth.

In 2003 I got my first taste of the Himalayas while climbing Mount Ama Dablam—22,467 feet. Ama Dablam is a neighbor of Everest’s and one of the most stunning mountains in the entire Himalayan chain. I felt at home in the Himalayas and with the Sherpa people of the region. I knew I would return and attempt Mount Everest. I eventually teamed up with a Leadville, Colo.-based group of climbers who call themselves “Team No Limits.”

Above: Dr. Rigsby on the summit of Ama Dablam in 2003.

In the spring of 2004 I joined an Everest Expedition to the North—or Tibetan—side of Everest. I was only permitted to climb to the North Col at 23,000 feet. I performed a full polysomnography (sleep study) at 21,000 feet, comparing the sleep of Sherpas with that of Western climbers. This was valuable experience for my scheduled summit attempt in 2006. (Interestingly, our oxygen saturations were all in the high 60s at that height, and we were asymptomatic.)

Team No Limits worked hard in their preparation for the 2006 expedition. We planned to climb from the South—or Nepal—side of Everest, choosing the Hillary or South Col route. We were extremely fortunate in that we were able to contract with the legendary Apa Sherpa to be our sirdar, or head Sherpa guide. Apa held the world’s record for the most number of successful summit attempts on Everest: 15.

Our four-member team departed for the mountain in March 2006 with hopes for a summit bid in late April or early May. The first stop was in Katmandu, Nepal, and then a nine-day trek through the Himalayas to the Everest Base Camp. Shortly after arrival at base camp one of our team members became ill with altitude illness and subsequently had to descend to a lower altitude to recover. Little did we know that this would be the second deadliest season on Everest—second only to the 1996 climbing season.

On our climb the team was struck by tragedy. Early one morning several Team No Limits members were carrying loads through the dreaded Khumbu Ice Fall when a large ice avalanche came down, killing two of our Sherpas and injuring several others. Initially we were uncertain about continuing, but eventually we decided to continue the climb.

Dr. Rigsby (left) and a Sherpa guide. When this photo was taken, Dr. Rigsby was battling pulmonary edema on the Everest climb.

My expedition ended shortly after the Sherpas’ deaths. One cold, windy morning while climbing to the top of the icefall, I noticed something was wrong. My breathing became very labored, and every step took great effort. When I reached the Western Cwm close to Camp One I collapsed, unable to go farther. I knew I was in grave trouble and might not make it out alive. I had pulmonary edema, a condition I knew well from my hospital experience, but in a totally different setting.

Luckily, one of our Sherpas came upon me and assisted me to Camp One. It was a long night, but I survived with the assistance of my teammates and Sherpas. I was already on nifedipine for hypertension and as a prophylactic and acetazolamide (Diamox) and was hypotensive. I took a sildenafil (Viagra; this is not at all funny if you don’t regularly use Viagra), which improved my pulmonary volume status. Sildenafil citrate inhibits cGMP specific phosphodiesterase type-5 in smooth muscle, where it is responsible for degradation of cGMP; it increases cGMP within vascular smooth muscle cells resulting in relaxation and vasodilation, leading to the vasodilation of my pulmonary vascular bed. This was the only type of bed I was thinking about.

I was able to descend to Base Camp the next day and felt better as I went to a lower altitude. But I knew my climb was over. Another team member had a suspected heart condition and was later airlifted off the mountain by helicopter.

The rest of our team was eventually successful, however. The last man standing, Doug Tumminello, a lawyer from Denver, successfully summitted the mountain on May 22. Apa Sherpa also was successful, taking his world record from 15 to 16 summits.

Before returning home I trekked to the village of Thame, Nepal, the home of the deceased Sherpas. I wanted to pay my respects to their families and friends.

Being a hospitalist suits my lifestyle very well. Now I do a good job of working hard and playing hard. The ability to play hard has allowed me to work even harder and to keep my passion for medicine alive.

Now when I have a patient in pulmonary edema—whatever the cause—I have a greater understanding of the sensation and discomfort of dyspnea and the limitations of the human body. Despite not summitting, I would not have missed the ride for the world. I have no desire to climb Everest again, but hope to continue climbing for many years to come. TH

Dr. Rigsby, Everest climber and grandfather of eight, is a 55-year-old internal medicine physician. He is a practicing hospitalist at Memorial Hospital in Chattanooga, Tenn., and a consultant for Eagle Hospitalists in Atlanta.

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