The Kathmandu Guest House, nestled in the heart of the Thamel tourist district, is an oasis of tranquility surrounded by a bee's nest of shops, street vendors, rickshaws, honking cars and motorcycles. It is the refuge to many groups starting or finishing a trip through the nearby Himalayas but for us, for the next week, it'll be our lab.
I'm here with my MSc student Stephen Busch and 21 other mountain researchers from around the world to start data collection on a group of Sherpa who have been flown down from the mountains to meet us. The Sherpa, as a people, thrive in the mountains; four of them have summited Everest and a number of others have been part of expeditions to some of the tallest peaks in the world.
We're here, in part, to study the differences in the Sherpa's physiology that make these feats possible.
The Sherpa people's physiology has enabled them to thrive at high elevations for thousands of years.
Our hotel rooms are quickly converted. Beds are stacked to make more room, Pelican cases are emptied and become tables, equipment is connected and tested, and sheets of plastic are taped to the wall as whiteboards-our room has become a fully functional autonomic function lab. The same process is happening in other rooms. Day one is used to do a dry run of our data collection, using ourselves as guinea pigs. We circulate between rooms in a co-ordinated dance. In one, we have blood samples taken, in another we have our blood vessel function assessed. Down the patio is a room to test respiratory function. In yet another, we conduct echocardiography, using ultra sounds to investigate the action of the heart. Upstairs, we're calibrating our equipment and testing our system for electrical noise and artifacts. In the lab most of this is taken for granted, but on the road, until things are set up, fingers remain crossed. All goes well-the equipment has survived the first part of the trip and the system is running without any problem. Then the power goes out.
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The electrical wiring in Kathmandu is reminiscent of a suspended bowl of spaghetti, with wires criss-crossed and jumbled in knotted masses. Combined with fragile circuits and rolling blackouts, stable power is an issue. The next five days are difficult. At one point, a major piece of equipment and a laptop get fried. We struggle with data collection. Tensions mount. We've come a long way and invested heavily in the expedition. Not returning with the data we came for would be a major failure. Thinking on our feet and going through the scenarios we've planned for, our team starts to come up with contingencies. Our protocol and methods are scaled to maximize collecting what data we can. At the end of the week, we've manage to collect a portion of the data we had hoped for. Luckily, this isn't the major part of the expedition for us. As we pack our gear, we go over the protocols to be carried out at altitude and how to address any similar issues there. We'll have a week of trekking to plan.
• Heading to great heights in the name of research
Flying to one of the most dangerous airports in the world
The following morning, we're at the Kathmandu airport shortly after 5 a.m., lined up with the throng of people at the domestic terminal, each of us bearing a cart full of equipment and gear. Our bags are scanned and our tickets issued. We then wait nervously in the departure area. We're flying to Lukla, one of the most dangerous airports in the world. It's where our trek will start. The Lukla airport is 2,800 metres above sea level, perched on the side of a mountain. Its runway is a mere 500 metres long, bracketed by a cliff at one end and a mountainside at the other. There is no radar to assist pilots; they approach using line-of-sight flying. Due to the mountainous terrain, flights occur only on clear days. Today looks like a good day to fly.
We finally board a bus and rattle to our plane. We cram ourselves into a plane that has seen better days. The cabin is a tight fit for the 16 passengers and the seats are well worn, but these are the workhorses of the Khumbu, shuttling trekkers and locals up and down the valley daily. Soon we're airborne and the sprawling cityscape of Kathmandu is quickly replaced by rolling hills, farms and small villages below. We fly through the valleys and crest breathtakingly close to hillsides and passes. Then the co-pilot points and we're banking. We're on the final approach to Lukla. Buttons are pushed, switches are switched and there is lot of pointing. The runway appears through the front window. It is sloped upwards to assist with stopping in such a short distance. Combined with our descent, it really does look like we're going to nosedive into the ground. Due to the surrounding mountains, there aren't any second chances-once we've started our descent we HAVE to land. We touch down and a collective cheer erupts as the pilot and co-pilot jam on the brakes!
We spill from the plane, a bit wobbly, and collect at the side of the runway. Our bags and the rest of our team are on one of the next flights. After everyone and everything has arrived safely, we walk the short distance into Lukla for some lunch. Finally, we head out on the trail to Monjo. After 13 kilometres and hours of hiking, we haven't gained a single metre in elevation yet. We grab keys to our rooms and change into warm, dry clothes. Then, after grabbing some water, we head off one by one to have various tests done. After having some blood taken, our hearts and blood vessels imaged and some questionnaires filled out, we grab dinner in the dining area. Everyone is in good spirits, but after a long day of travel, we retire early.
Nearing Mount Everest National Park
The next morning, it's still cloudy; the monsoon season is running later this year and the weather has been unpredictable. We repack our bags and bring them out to be loaded on yaks on the patio of the lodge. Today we are headed to Namche Bazaar. The hike will be shorter, only eight kilometres, but we will gain 500 metres in altitude-most of that in one final two-hour climb. First, we roll out of Monjo and past the police checkpoint that marks the entrance to Sagarmatha National Park. Sagarmatha is the Nepalese word for Mt. Everest. Suddenly, it hits home, hard, that we're actually headed there. We criss-cross up the valley over suspension bridges swaying and bouncing over gorges and rivers.
After two hours of hiking, we start to climb. Stairs and switchbacks lead to more stairs and switchbacks. We follow each other in breathless single file. We climb like this, with our hearts beating in our ears, for the next hour. Finally, we take a break. As we catch our breath and empty our water bottles, we're told that through the trees is our first view of Everest … through the trees and the thick cloud. We eventually lug our packs onto our sweaty backs and continue uphill. We climb again for another hour or so before staggering into Namche Bazaar. Namche is set in a bowl on the mountainside, and the town curls up and around us. This is a proper town with shops, bakeries and pubs. But right now we are looking to make it to our lodge, which happens to be high on the slope. We climb stairs through town until we reach our lodge. We drop our bags in the entrance before climbing one last cruel set of stairs to the dining room. We collapse into chairs, steam literally rising from our backs. Namche Bazaar is located at 3,450 metres, just on the cusp of "high altitude" (3,500m), and we will take the next two days to recover and acclimatize.
Keep on trekking
As we leave Namche Bazaar and are short distance out of town, we discover that two of our group are missing. They've taken a wrong turn and headed in the wrong direction. One of our Sherpa guides heads back to find them, although "heads back" isn't an apt depiction. Our guide sprints off as easily as you or I might here, then sprints back 15 minutes later just as easily to let us know he's found them and they're now on the right track, following up the trail. The ease with which the Sherpa can exercise and work at altitude is amazing to see in action.
Our trek for the day takes us to Deboche, which is at 3,820 metres, where our routine repeats itself. We arrive relatively late, undergo ascent testing and then head to bed. The next morning, we head to Pheriche, 4,200 metres, hiking through the fog and emerging above the treeline. The air is thin and has an acrid smell, the result of smoke from yak-dung fires. People are starting to feel unwell at this altitude-headache, fatigue, loss of appetite. We've avoided taking the typical drugs to aid acclimatization because they would interfere with the studies we are all conducting. Thus, we have taken a cautious ascent profile, but there is a real risk of becoming ill. We will spend another acclimatization day in Periche, and it is needed.
This is our last stop before we arriving at the famous Pyramid laboratory, and where we will retest people. It's 800-metre climb to the lab, which exceeds the recommended daily ascent at this altitude, but there is little option. I still feel OK as we leave Periche, fingers crossed that I'm one of the ones who happens to fare OK at altitude. Trekking uphill above 4,000 metres is extremely hard. It seems there is no middle ground; once you start hiking up you're red-lined. I'm almost breathless and my heart rate is 160. We keep trudging and climbing up switchbacks. After a final push, we eventually reach Thokla pass and the expansive memorial to those who have lost their lives climbing in the Himalayas. We rest looking out over the rock cairns dedicated to climbers and Sherpa. Behind us is the drop into Periche, with Ama Dablam high in the distance.
It is relatively flat from this point onwards, but we can feel the altitude. I'm breathless and dizzy; my ears are buzzing. My fingers have pins and needles and I can feel a headache coming on. These are sure signs of acute mountain sickness. Luckily the Pyramid is not much further on. We pass Lobuche, where a sign directs us up a narrow valley to the left and soon I can see the sun reflecting off the solar panels mounted on the research station. This will be our home and lab for the next two weeks.
The failures we experienced in Kathmandu are completely offset by the success we achieve at the Pyramid. Over the next two weeks, we work in a 12- to 14-hour routine, performing two or three experiments a day. Despite sub-zero temperatures in our lab in the morning and evening, a small electrical fire, a bout of food poisoning and the general fatigue of living at 5,000 metres, we manage to successfully collect data in all 14 people assessed in Kelowna, two additional lowlanders not previously tested, and 10 Sherpa. Everyone on our team is ecstatic!
Even with a full testing schedule, we manage to schedule a day off to explore. Having acclimatized for a week, we trek four hours up the Khumbu valley to Kala Pattar, a 5,600-metre peak from which Everest and the rest of the valley can be seen. Even after a week, the 600-metre hike up Kala Pattar is gruelling. The terrain is like any other mountain hike I've done in the Canadian Rockies, but I stop frequently and gasp to catch my breath. Finally, reaching the summit, the toil is worth it. Across from us the grey hulk of Everest rises behind Nuptse. The sheer scale of the range is incredible. We sit, catch our breath and take it in. We've struggled to get to this point, yet across the valley, Everest stands over three kilometres higher.
Understanding how the body adapts-or fails-in this environment is what has drawn us to this place. We have collected a figurative mountain of data that will help shed light on the internal process of acclimatization. In working with the Sherpa, the kings of the mountains, we hope to be able to understand the physiological traits that have allowed them to thrive here for thousands of years. We also hope that, with this understanding, we will also be able to better understand the pathophysiology and maladaptation that lead to illness in patients with impaired ability to take up, transport or utilize oxygen effectively.
It was a long journey, but in the end we've worked with some of the top researchers in altitude physiology (now close friends), collected enough data to keep us busy for the next couple of years and had an incredibly memorable experience along the way.
- Craig Steinback is an assistant professor in the Faculty of Physical Education and Recreation