StarTalk Radio - #ICYMI - Conquering Mountains, with Vanessa O’Brien

Episode Date: October 4, 2018

In case you missed this episode on the Playing with Science channel… Explore the world of mountaineering as hosts Chuck Nice and Gary O’Reilly take a mental expedition to the world’s highest peaks alongside world-record breaking mountain climber Vanessa O’Brien and mountain guide and physician Alan Oram, D.O. Photo Credit: Photo taken by Vanessa O’Brien (using a timer) on October 4, 2011 near the summit of Shishapangma, the world’s 14th highest mountain climbing from Tibet. [CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0)], via http://vobonline.com/. Subscribe to SiriusXM Podcasts+ on Apple Podcasts to listen to new episodes ad-free and a whole week early.

I'm Gary O'Reilly. And I'm Chuck Nice. And this is Playing With Science. Life, it seems, is full of mountains. Some we conquer, some we don't. And then for some of us, one is not enough. We have to find more. Yes, that will be seven to be exact.

Each the highest mountain on each of the seven continents. And because it's still not enough, some of us have to do it quicker than anyone else before them. Our special guest today is a rock star of the highest order. Vanessa O'Brien is the owner of the Seven Summits world record. But even that was not enough. She has conquered K2. And this is the scariest sack I think I've ever said. The mountain that claims one in four who attempt it. And she has skied the last degree at both poles. No doubt it's just for kicks and giggles.

As we know, though, summiting is incredibly dangerous for your health. Yeah, really, no kidding. So, Chuck, if you had to pick, who would be your best mountain guide? I'm going to go with God himself, because that's the only way you will find me on a mountain. It will be a cold day in hell. No, actually, I want somebody who's a trained physician, especially a medical emergency trained physician with a good bedside manner. And who better to be that than Dr. Alan O'Ram, who is one of only two currently registered in the USA. He will no doubt, along with his medical know-how, be bringing us insight into high altitude

science. Yes, but before we get to the good doctor, let's meet our very special guest, shall we? I said she is a rock star of the highest order, and you knew exactly what I meant by that. Vanessa O'Brien. Wow. It is so great to have you here. Nice to be here. How are you guys?

I got to tell you, I'm a- Explorer of the year. Explorer of the year. Fantastic. Yeah. You're just, first of all, so I spent so much time on YouTube watching you and the climb and all the footage of you. And, you know, I have to say that it is, I was cold and tired, exhausted and hurt after watching the video. It is a monumental undertaking, any summit. So I'm going to ask you, everybody says K2 is the hardest, so I'm going to go

completely opposite. What's the easiest? Well, so of the seven summits, the easiest is probably Kosciuszko. And that's in Australia. That's Australia. So that is, and you mentioned seven summits. So right there, I'll have to hedge and say there's really eight. There's really eight. And that's because there's two sets of seven summits and what I like to call the CYA seven summits.

So there's a seventh summit choice for the seven summits based on two lists. There's the Bass list and the Mesner list. The Bass list is based on Richard Dick Bass, who was a businessman, who was the first to come up with the concept of the seven summits. He was a layman, looked out at a map of the world, naturally looked and chose, when looking at continents, Australia as the seventh summit. And therefore, Kosciuszko, which is 7,310 feet, not much larger than Mount Washington. Okay.

7,310 feet. Not much larger than Mount Washington. Okay. Mesner, being a mountaineer, looked at Australia and said it would take longer to fly there than to climb it and wouldn't really waste his time. So he developed a notion of Oceania, or Australasia,

and therefore chose Kirsten's Pyramid as the seventh summit. Therefore, the CYA, which you know stands for? Cover your ass. I wasn't going to say it. But yes, so if you want to do both lists, you would effectively do eight. So where's Kirsten's Pyramid? That's western New Guinea, which is Papua. So it's the old Irian Jawa. Cool. And they're quite different because that's 16,050 feet. So imagine 7,000, 16,000.

And the Mesner list of Carson's Pyramid, he introduced the only rock climbing. Oh, okay. Okay, in the Seven Summits series. So very, very different choice of… Different challenge altogether. Different challenge altogether. Let's go back to the beginning. You weren't born a rock climber.

You weren't born a mountaineer, I'm guessing. You wake up one morning and say, I'm doing it. I'm going to be a mountaineer. It's Everest. It's K2. Whatever you got, bring it on. Then what happens? You can't just say, I've packed my bag.

I'm off. I'll see you in a year. How do you go about the process of preparing? Do you make your way down to the local playground and start on the monkey bars? I mean, so, so really, uh, okay. So there is, there is, um, you know, there's book knowledge, right. That we can all gain through research knowledge, you know, and that's great. Everybody should undertake that. That's for free. Then there is experiential knowledge. You have to go out and do it. You have to make those

mistakes. There really aren't, there aren't courses per se in mountaineering the way you and I might take a course, you know, in motor racing or something like that in these car schools or something that teach you how to drive. It doesn't really work like that. So the best thing to do is really just sign up for something where you have to go and put on that kit. You have to learn what a harness is. You have to learn what a helmet is. You have to learn what crampons are, how they work, and, you know, just start to use them and start to make those mistakes. Not the bad ones. Well, you hope that by the time you get into a bad situation, you have accumulated knowledge and experience where you're not going to, you know, blow it or do something too dangerous. So what is the appeal? Once you've, I want to say mastered, once you've got a grip, literally,

on a lot of the things you need to know, what's the thrill? What's the appeal? What's the drive behind wanting to summit one of these big peaks? Well, I don't know really of much. I don't know of anything that's a harder challenge. It's kind of, you know, man versus nature. You know, it's much more than physical. It's a mental, spiritual, physical.

It's like everything that could possibly be put on the table is out there with that challenge. There's nothing that I know of that you can do otherwise that can really give you that entire challenge in your life. So there's no assignment at work that you can be given, let's say, that can stimulate you in that same way. Does each mountain teach you something different about you? Yeah, it teaches you something different about you, about your teams, about how you work with others, nature. It teaches you all sorts of things you know that um you know depending on your experience and what happens so when you talk about uh okay so the k2 uh summit you are the

first woman to successfully summit and by successful i mean to go up and return because incorrect no really you said first woman. That's not true. I'm the 50th woman and the first American and British woman. Oh, I'm sorry. The first American and British woman. Right. Here's the stat, Chuck. There are more women who've gone to space than have summited K2.

Correct. Three times more. Does that kind of put things in perspective? That's pretty incredible. 150 women have been to space. Right. And only 50 have actually summited. Me too.

Right. But there are American women that have come before you that have reached the top, right? No. Never? Never. Okay. Who were two British women who got to the top and died at the top? And they died at the top.

Which is why I said that one in four. Yep. So that was Julie Tullis and Alison Hargraves. Right. And so it does show that, you know, it's a very dangerous pursuit because, you know, 85% of dust happened on the way down. So that's not just K2 though. That could be any 8,000 meter peak.

I was going to say that. They say the same thing about Everest as well. It's not getting up. It's getting down. That's, that's really the, why is that? Why is it that, because you think that there's intuitively, it would seem that there's less energy needed to get down. It would seem that there's less, you exert yourself less. I mean, and that's only because all of us have climbed a tree when we were a kid.

And we know how hard it was to get up there. And then, you know, getting down is not the hard part. So why? So we're playing with science. So let's take a step back. Okay, thank you. Let's go with the air we breathe. Take a breath.

We're in New York. I'd rather not take a breath. But we're in the studio. It could be safer. Absolutely. All right, so whether you're on the radio with us now or whether you're in the studio now, 78% of the air we breathe is what oxygen no pollution

it is it is a gas it's nitrogen right nitrogen correct 78 of the air we breathe is nitrogen 21.9 is i'll give you i'll give you a vowel oxygen rightygen. Right. Okay. So that's primarily the two things. There's trace gases for the rest. It's argon, CO2, everything else. Right. That is the air we breathe. That is the same at sea level as it is on the top of Everest. So what changes? Go ahead. Something changes, but it's not the composition of air. Right. What changes, but it's not the composition of air. Right.

What changes is pressure. Okay. So the higher we climb, the lower the atmospheric pressure. Okay. So when we're sitting here, there's lots and lots of these molecules. And when we take a breath, there's lots of molecules that enter our system. When we're at the top of the mountain, all these molecules are so spread apart. Stretched out.

That's why you see a climber take one breath. One molecule comes in. They're huffing and puffing. Another molecule comes in, huffing and puffing. It's more painful than watching golf. So it's funny because what you just said there is really fascinating because most people say when you climb a mountain, there's no oxygen up there. Into thin air. Into thin air, there's no oxygen up there. Into thin air. Into thin air.

There's no oxygen up there. But you're saying the mixture is the same. Mixture's the same. The reason it's thin air is because the pressure is pushing the molecules apart. And therefore, the composition's the same. It's just that these molecules are now so... Your body's working harder to bring that in. Yeah, and you're under exertion,

of course. But here, if I were to draw all these molecules really close together, now pressure's spread them all apart. You're just not getting it. You're not getting it. Wow. So, now, what does the body do? Because the body's very clever. You're going higher, and it's sensing

you don't have what you need. Did the oxygen no it's building red blood cells oh so it goes into an automatic defense mechanism hemoglobin starts producing more and more red blood cells naturally gotcha now where have we heard this before blood blank doping yes ding ding ding ding ding yeah blood doping go there straight away now it's you know how i feel about doping exactly so it's free it's natural and it's necessary right we're getting this epo which is you know completely natural it's stimulated by the kidneys this is something that mountaineers are getting as we climb higher, naturally stimulated. And this is what we're getting is the nice red blood cells to help us with this oxygen deprivation. The problem is that this thick oxygen that's now in our blood system is really, really thick and puts us at twice the risk for a heart attack and stroke.

Okay. Something good, but there's a shadow. And that shadow is that thickness, right? So we work really, really, really, really hard to get to the top, give all this energy to get there. And people will say, hey, you know, sometimes people burn all that, you know, energy to get there and they don't leave that reserve. So when that 85% statistic comes in,

they've given everything thinking that the summit is the goal. The summit is never the goal. It's round trip return. Round trip return. Got it. Yeah. No, no.

Because there's no point. We're programmed, we're pre-programmed to get to the top of the mountain. That's it. End of story. But that's never the goal. The goal is return trip, round trip return. Because, and Hillary, get to the top of the mountain. That's it. End of story. But that's never the goal.

The goal is return trip, round trip return. Because, and Hillary, you know, Sir Edmund Hillary fought this for years. You know, unless you returned, there was no point. There was no point because there was no one to tell the tale. We will take a break now, but don't panic. Vanessa O'Brien will still be with us after this break. now, but don't panic, Vanessa O'Brien will still be with us after this break. Welcome back, you're listening to Playing With Science and this is our very special mountaineering show and we are honoured to have the extraordinary Vanessa O'Brien as our special

guest. Now, just before the break, we got stuck into what it takes to be a top mountaineer. Even before you get to base camp, you've got to not only prepare yourself, but as a team leader, as you were and are, past tense, present tense, how do you select your team? What are the key factors for you strategizing to build a team that you know will successfully summit and come back again? So I have never been fortunate enough to select a team because of funding. In most cases, their sponsorship does not really exist in high altitude mountaineering. That makes sense. Because it is deemed too high risk. Of course. I mean, listen, think about it. Think about it. I'm Nissan, right? And I want to sponsor your team and I make a big to-do out of it. And then you freaking die. I just wasted a lot of money because I can't say a word

to anybody. But think about it also, there's no better way to get that message being number one, getting to the top, the hard work that goes into, you know, driven to explore, which happened to be one of Mercedes sponsorships at a mountain. Right. You know, I'm putting my brand, yep, hard earned brand loyalty, brand value, 100% there. And I'm rolling it. No, but it's a big risk, but it's a big payoff. It's a big, big payoff. And that's the point. Risk and reward payoff, right? The higher the risk, the higher the reward. However, people never talk about mitigating risk. So here's how you would mitigate the risk is what you publish and when you publish it. You would capture everything.

Of course you would. But if you were really risk averse, you wouldn't publish a single thing until that expedition was finished. Right. And then everything would go into production. Right. If you were very risk averse. Right. You would never not capture it. Of course.

If you weren't risk averse, like I had a play with credit cards where every camp you would pick a name and pay off a credit card bill, let's say. How fun because you get your entire, you off a credit card bill, let's say. How fun, because you get your entire customer base involved, let's say. Now, something like that can be very consumer-driven and a lot of fun, but now you're 100% vested and engaged, so you are open to taking the risk with the consumer. Did you guess that Vanessa has a background in finance? Now, okay, but putting all that stuff aside. Okay. Now, the problem with, you know, these expeditions is it there is one of economics, right? So it takes X number of people to make a trip economically feasible. Okay. So what I mean

by that is, in choosing a team, it tends without sponsorship, it tends to be the number of people looking to go. And so people tend to be put together who have similar like-minded goals and want to do similar things. Do they have to go through psychological testing and profiling before they get onto a team? No, it's nothing like that. No, okay. No, I mean, it's... What are the credentials that are necessary? Like, for instance, if I just showed up and I was like, hey, so you guys climbing today?

Like, that's... Well... You can't do that. No, I mean... You would have to have some credentials. To get on a permit in either Nepal or Pakistan, this is the Karakoram in the Himalayas, you would have to have some climbing experience. So they are looking for every permit that they issue that every member has, you know, at least climbed an 8,000 meter peak, let's say, if you're

going to an 8,000 meter peak. Okay. You know, this doesn't apply for the cooks or the base camp staff because they're just going to be walking, you know. That's where they're staying. They're staying there. Okay, so now let me ask you this. What can you give us? When we think of teams, of course, this is a sports show, a sports science show, but still sports. When we think of teams, we think of positions, okay? And like, you know, in football, you have a quarterback,

you have a wide receiver, and you have a lineman, okay? In soccer, you have a striker, you have a forward. So now when your team, do you have positions and what are they responsible for? What do you guys, how do you divvy up the responsibilities? Yeah, I mean. What are the responsibilities? No, I mean, we do. So, you know, if the team has Sherpa or high altitude porters,

those team members tend to go out and investigate the route, put in some of the fixed lines before, say, team members go up to, you know, in advance of team members setting up camp. So, and that's because some of the, some of the, there are some bottlenecks in some of these areas. So Hillary's step is a good one on Everest. There's House's Chimney and the Black Pyramid on K2. It sounds like a Harry Potter book. It is, I know. So when you say bottleneck, this is like extremely narrow passages, right?

And so I saw in your video at one point, there was like a single person passage that you were going through. And you were all in a single file. It looked absolutely terrifying. It was not just climbing like like you're mountain climbing, but it was also like rock climbing while you were mountain climbing. Do you know what that is? Would you be able to tell me where that was? It could be one of two, three things. I mean, so sometimes on, and this does get a little bit into climate a little bit. So with climate change, a lot of these, so if you look at a mountain at a distance, it looks like it's full of snow.

But when you're actually on it, it's full of rock. But when you're actually on it, it's full of rock. And unfortunately, over the years, with climate change, and I would prefer that word over, say, global warming, these mountains are so high. How high are they? So let's talk about that. This is, you know, let's say 8,000, 9,000 meters or 26,000 to 29,000 feet, this is at the very, very top of the troposphere. All weather, all weather takes place here and below. So when you have these jet streams pounding on these mountains at 200, 300 miles an hour, first of all, all the snow is just getting ripped off. You've also got all these, you know, really, really hot weather, sun

baking on these mountains, melting all the snow and ice. So increasingly with, you know, the climate change that's happening, you've got less and less snow and ice. When I talk to the old mountaineers from the 60s and 70s who are still alive, they simply say, thank God I'm not climbing this stuff now. Because I was wearing crampons and I had ice and snow. I have to wear crampons and I'm often having to wear crampons on rock, which is the wrong tool for the job. Gotcha. I can't switch footwear.

Oh, crap. Yeah, big crap. Probably not what she said. Tell me you didn't. You're far too polite to say things like that. Oh, bang. So, you know, what are you two? Okay.

So, you know, really to answer your question, it's just, it's very, very hard when there's a lot of rock and you're in these single file positions because the traffic is the same way up as it is down. And if you're at a really high altitude, you are stuck. If somebody's taking an hour to get up there, you're an hour behind them. Oh, what we are learning, well, I am most certainly, is that I never want to do this. That we knew. And I might not be far behind you. Over the course of decades, mountains have changed because of the climate change. But I guess from a day-to-day basis, this thing almost has its own life force. And the mountain you start climbing at the beginning of the day isn't the mountain halfway through the day or at the end of the day. Not at all. How on earth do

you plan for hour to hour to deal with basically what is a living rock? Well, this is a big deal on Everest. Everest has that Khumbu icefall, which is the first thing out of base camp. So it's a 3,000-foot shifting maze of, you know, glacial ice that is constantly shifting and moving. So it becomes very dangerous. Wow. When to get through it, because... How many people turn around and go, oh, that's it, forget it?

Well, you know, there's been people, 16 people killed in one day if towering Sirocs come down and get right on top of them. So it's probably the most dangerous part of the whole mountain, actually, is right at the beginning. So each mountain has its little idiosyncrasies. Now, funny enough, Everest this year had the highest number of summits ever on the record of history. In 2018, it had 700 summits. It surpassed 2013, I think, was the previous record. Almost sounds like there's a rush hour. Well, 700 is a lot.

A lot of people in one a lot of people a lot of people in one season i've seen um actual pictures of that where it looks like the people are lined up in a conga line going up yeah and uh i i say it's because you know in nepal they have this um you know this sherpa community that um they are so good at uh being able to take people up. And they, by the way, have the highest risk involved because they're always going before. And as a result, they are the most susceptible to avalanche. And you have a great many of the people in the community

who are dying so that tourists can actually go up Everest. Yep. Now, I believe last year, the year before, who are dying so that tourists can actually go up Everest, you know. Yep. Now, I believe last year, the year before, they now allow equipment to be helicoptered up to Camp 1 so the Sherpa are not taking that equipment. Thank God. So there's a change. That will have environmental effects, though, because, you know, I don't know that a helicopter... Helicopters don't know that a helicopter it's probably helicopters don't belong

up there yeah but you know just i mean really what should happen is and it's a shame that it's become such a part of their economy but what should happen is we shouldn't be people like you should be doing this people like me who want to go to a cocktail party and talk about it shouldn't be doing this like mountaineers, I don't mind. You know, certain other people who are doing it for research, people who are doing it to write about it. Like purposeful summiting, which I'll call it that, makes sense to me.

Well, you know, a mountaineer starts somewhere. So I think it depends what your purpose is in wanting to do it, right? So, you know, if somebody wants to really train hard what your purpose is in wanting to do it, right? Right. So, you know, if somebody wants to really train hard and, you know, do it the right way, you know. I don't have a problem with that. I don't have a problem with that. No, because you're making the commitment. That's what I'm saying.

It's like if you're making the commitment. I'm talking about somebody who just, you know, like who wants to say, I did it. Yeah. I want to do it just so I can tell a do it just so as I can tell a story. Yeah, so I can tell a story at a cocktail party. If it's, yeah. I'm a little, I'm a little, I got a little problem with that. If it's on the bucket list, then that's not a, that's not cool.

Gosh. There's no doubt about that. Well, we got to take a break. We have. But you're going to stay with us, right? Absolutely. And I got to read you this quote when we come back. I just want to get your, it's a, do you know this French alpinist?

His name is Gaston Rebouffat. Rebouffat. Wait, our producer is... Nowhere near. Our producer is French. Johnny, is it Gaston Rebouffat? He went like this. Clusinef Rebouffat.

Lovely. So anyway, he says this I really hate you Alright, so this is what This is what he said Mountains provide a mirror of stone and ice A mirror which helps us Know ourselves Reaching a mountain summit requires that we confront

The reflection we find in the stone mirror Working with all that is weak, lazy, and fearful within ourselves. Do you agree with that? I think that's a great quote. I know one I always go back to is Reinhold Messner, who says, mountains aren't fair or unfair, they're just dangerous. Oh, I like that. I have several girlfriends. Fit that description. Well, you can substitute girlfriends for mountains then. Oh, I already have. And if Mrs. Nice is listening.

Are you kidding me? Mrs. Nice was the last one. Gary's going to keep his mouth shut. All right, let's take that break. Vanessa O'Brien, the fabulous Vanessa O'Brien, will be with us. that break, Vanessa O'Brien, the fabulous Vanessa O'Brien, will be with us and we'll be speaking to one of only two registered mountaineering guides who is a qualified physician, Dr. Alan Oram. That's all when we get back. Welcome back to Playing With Science. As you will be more than aware, if you've been listening from the beginning, we do hope you are,

Vanessa O'Brien, the lady who summited the seven summits faster than anyone else in the world. A Guinness World Record holder. Is with us and still with us. But now we are honored to have Dr. Alan Oram on the show. One of only two registered mountaineering guides. In the US. In the US of A, that is a registered physician and in particular emergency medicine physician. Yeah. So, doctor, welcome to Playing With Science. So, how are you?

I'm fine. Thank you. How are you? I'm fine. Thank you. If you were actually on a mountain with a team, what is the most common sort of predicament or problem that you face as far as you're concerned? I think, I mean, I help people with a variety of things. I think at altitude, the problems that most climbers experience do have to do with altitude. Some are obvious, some are less so.

Injuries, I think, are pretty obvious. But the question about high-altitude illness is, I think, probably the more common thing that I get calls about. Or often it may just be a text through satellite technology. But altitude, I think, is probably the most common issue that I have to deal with. So with altitude, is that the AMS, this acute mountain sickness, or is that something different? Acute mountain sickness is one of the common forms of altitude illness. There's also high altitude cerebral edema and high altitude pulmonary edema. Acute mountain sickness is more common, but you don't, you wouldn't die from AMS. High altitude pulmonary edema, it would be the thing that would really kind of do you in as well as HACE or cerebral edema. Vanessa, I mean,

you've been there on a number of occasions. How do you self-manage yourself? Do you say, no, no, no, it's not a problem. I can get through this. Or do you have to go, I need to deal with this now. If you get this acute mountain sickness, if you get these conditions, how do you deal with these? Well, I think, first of all, in the high-altitude medical kits, we do carry medicines. So things like dexamethasone, nifedipine, azetazolamide or Diamox. You know, these are all tools in the toolkit, if you will, for emergencies if they occur.

Hopefully, you don't have to use them, but they're there if you need them. You have to remember in many cases in the Himalayas, the Karakoram, we're miles and miles, 300 miles from the closest hospital, and there is no helicopter rescue in places like Pakistan. They don't have helicopters for hire, for example. They're fighting wars. You know, there's other uses for helicopters there. Right.

So, you know, we have to be self-sufficient with the medicine. So, and believe it or not, there is other medicine like Viagra, which may sound funny to you. No, no, I've heard of that being used. But that's, you know, it's a vasodilator. And, you know, it's important because... Because you never know when things might get sexy on a mountain. Just saying. Oh, dear. Oh, no, no, no, no.

Good time on the mountain. Nope, there's never that. Trust me, people don't take... You're getting voted off the mountain. People don't take showers. And this is not a sexy time. There is no sexy time on the mountain the sexy time so doctor a vasodilator by the way actually increases blood flow so that can be very important especially when you're in a high altitude uh scenario but go ahead no so the

doctor you know can take it from there but we need all those things because if the emergencies rise, then, you know, we have them for if and when they occur. So, Doc, let me ask you this. When it comes to injuries, falling, I would say, is something that you don't want to do while you're climbing. But people fall and they injure themselves. So now that we're talking about these type of illnesses that can beset a person at these altitudes, these kind of altitude sicknesses, does one precipitate the other? Does the person get sick and they fall? Is that a common occurrence

that the altitude sickness actually causes a person to fall? Like when somebody breaks a hip. Normally your hip broke and then you fell. People think you broke a hip because you fell. Normally it's your hip broke and made you fall. So which one is more common? Is it just human error that causes a person to fall or illness causes the person to fall? I would say it's probably human error and movement or the lack of ability for people to move in a smooth fashion. Generally, at least on the bigger 8,000-meter peaks, a lot of those routes have fixed lines, so you're always attached to a rope. But sometimes you're not, and you can certainly fall and injure yourself. Does one lead to the other?

does one lead to the other um i third i certainly think that fatigue and um uh having headaches and ams symptoms certainly can contribute um but uh i'm not so sure that there's you know one always begets the other i think just simply falling with uh because you can't move very well because of fatigue uh elevation, crampons, icy surfaces. I think all those things contribute. Cool. Okay. Okay. While your pair of you are here, firstly, hypoxia, if you can explain, doctor, exactly what that is, and then sort of mine the fact of what is the science and the physiology behind this condition. as i understand as well as any of our listeners who don't already know hypoxia is the the lack of oxygen delivered to the to the body whether that's through something central or peripheral and so in high altitude illness when we when we gain

altitude there's less available oxygen because of the um because of the low pressure such that you're not breathing the normal amount of oxygen that you normally would, say, at sea level. The effect of that is that your body has to work harder to do the work that it normally would have to do at altitude. And so the things that happen with hypoxia, at least to the body, are a combination of problems such as AMS, which can lead to cerebral edema, and then pulmonary edema as well, which is a type of edema that's related to hypoxia and elevated pressures in the pulmonary vessels in the heart. So if you're the guide on a summit and you are obviously looking after your own self-interests but you have a duty to the people you have with you, how difficult is it for you as a mountaineer and a doctor to manage those things in the best way?

That's a good question. I think that as a guide, I think you have to be very aware of how you feel and how you're performing at altitude. And the responsibility is to make sure that your safety is paramount. If you're not safe, your clients aren't safe. And so taking care of yourself either through medication or decision-making, which may mean going down, may be prudent. And I think that's a tough thing, especially with ego, finances, et cetera, to make that decision. As a physician, I think I tend to be very conservative when I'm climbing, and I will tend to pull back before I go forward if I'm not feeling right,

if my decision-making performance is off. I'm going to pay attention to that because of the safety of both myself and the team. Interesting. Thank you for that. Before you go on a climb, can you talk to us about the medical condition that a person wants to be in before they even attempt something like this? I mean, I would assume that there's a good and bad candidate for climbing. What makes you a bad candidate? Looking like you and I. Well, believe me, if you put my face up to bad candidate, I will not be disappointed or offended. Not disappointed or offended. I think that that, too, is an excellent question and one that I face frequently, maybe not at very, very high altitude.

But where I work here in the Tetons, it's I think people's perception of what they're about to do or what they want to do is different than reality. Meaning that people's fitness is definitely not always the best and I think that when people come into these situations they really have to decide are they going to train or not and it shouldn't be just a simple decision it It takes work. I'm sure Vanessa trained hard for all the peaks she did. Success is paramount to fitness. Wow. Okay, Vanessa, so is there fit, and then is there mountain fit? And how do you get from one to the other? Yeah, how do you train? So it depends what I'm doing. So I think 8,000 meters is a little bit different because to me, that's really about VO2 max and it's about the utilization of oxygen. So the best training for high altitude is really cardiovascular. And muscle, a lot of muscle, will work against me. And what I mean by that is when oxygen is a limited resource, the brain and the lungs must have that.

And muscle will compete for that. So I need to have the highest VO2 max I can possibly achieve and be the most cardiovascular fit. If I become Mr. Atlas or Schwarzenegger or something like that, I'm going to fail. Back and get up the mountain. Well, that muscle will compete for the oxygen I don't have. Where did that come from? Get to the mountain. Go ahead.

Sorry, people. But now if I'm pulling sleds and I'm going to the North Pole, I need muscle and I'm going to the North Pole, I need muscle. Yes. And I'm not climbing very high. So I'm training very, very differently for that. Is it also to do with weight? Interesting.

You've got to haul that extra weight, albeit muscle. Well, you're not. If you're sledding, you're going horizontally, more or less. It's very deceiving. When you're climbing really, really high altitude, you are not carrying a lot of weight, not as much weight as you think you are. You're carrying enough from that final camp, let's say, whatever camp you end up at. And let's say it's four to summit. If you're with oxygen, oxygen might weigh 10 pounds, something like that.

You've got maybe two water bottles maybe a thermos change of clothes you're not carrying as much weight as you think you are um so you know but but if you're pulling sleds you are carrying the hardest part for you to to get to a condition where you felt in control and comfortable? Well, let me put it another way. You must show up in your best fitness self on any endeavor, which means that you have strength, that you have flexibility, you have a good core because you're not going to have a good balance in many occasions. So you must show up as your best fitness self.

Wow. But you should understand what you're undertaking and the difference in training for that. So that's the physicality. You don't just climb with your body. Surely you must engage a mental process. And not just I'm seeing, I'm doing it. But, and the doctor can probably attest to this, and he may have touched on it already,

if I'm a complete nutcase, and I turn up and say, I'm going to go and do this mountain thing, you know my mentality is nowhere near where it should be. Is it the kind of, I've got to dial everything down and be calm, be thoughtful, or do you have to have a different, or slightly, yeah, different approach than that? So fear plays an important role. You know, it's an obvious mechanism that tells you something is wrong and, you know, kicks in when it needs to kick in. But it can also be a devil's advocate and do the wrong thing, too.

So I've seen people use fear as an excuse, too. And, you know, some of these expeditions are six to eight weeks, right? This is a long time. So people start to psych themselves out. They start to see, like, bad weather. They start to see, like to psych themselves out. They start to see like bad weather. They start to see like avalanches. They start to like remember, you know, hey. How do you control that? Because you can't control the weather systems. You can't control how the mountain's going to behave that day.

So the thing you can control is what goes off in here. You've got to have, you know, a really strong focus and a mental, you know, you know, mental fortitude that keeps your focus, you know, where really strong focus and a mental, you know, you know, mental fortitude that, that keeps your focus, you know, where it should be, which is, you know, on, on the objective. Now, weather is, is just a wild card. So, you know, that reading is all over the place. But, but I've seen people, you know, start to spread fear about, you know, the weather looks bad, and it keeps looking bad, and there'll be no summit. And, you know, start to spread fear about, you know, the weather looks bad and it keeps looking bad and there'll be no summit. And, you know, they start to talk themselves out of a summit almost.

And they start to remember an anniversary back home and how they got to get home. And then they start to develop illnesses and suddenly like, you know, their head's not here. And when their head's not here, they're not here. So you're going home. So doc, when speaking of fear, so part of your training as a doctor is, you know, I guess they call it a bedside manner, but it's really psychology. If you think about it, it's like, it's pretty much getting into a patient's head and then allowing them to let you do your job. Do you, how much of that do you use when you're, when you're guiding someone or, or instructing or helping someone on a tour? how much of that do you use when you're when you're guiding someone or or instructing or helping someone on a tour? How much of that do you actually use when when it comes to what Vanessa was talking about?

People who might psych themselves out or or get afraid or freak out or something like that? I a ton. I think most of what we do is coaching. A bucket load, a large amount. I think motivation something that's, it's, you have to kind of coax people into believing in themselves and finding that calm and, and translating that to, uh, to success. And, uh, I think that it probably represents most of what we do as, as guide, as a guide, um, uh, to get people to their objective and to enjoy where they are um and you know not just objective but process and you know the whole the whole trip is is kind of more important to me than just a summit and i try to relate that to people it's really really difficult um and when you can get through it and people identify their fear and um and their weaknesses, and they overcome that.

They're hugely successful. Doctor, before you go, as a physician, and Vanessa has given me the impression that every time she's summited, she's learned something, she's faced something different. Have you approached it in a similar way? Has high-altitude mountaineering taught you any medical lessons? Have you found things that you probably wouldn't have found had you stayed closer to sea level? Well, sure. I mean, it's like any experience. The more experience you have in a variety of settings, the more knowledge you gain. You know, either traveling at a high altitude or dealing with folks who have illnesses at high altitude, it just creates a whole different avenue for learning. And I mean,

I'm always shocked at what I see and hear from people all the time. And it's kind of never ending. So let me ask both of you this. This will be my last question. So let me ask both of you this. This will be my last question. Okay. So you both are extraordinarily passionate about this. It's evident. Okay. And you're both proficient. And what I'd like to know is what can you tell me from your perspective, why should anybody do this? Go ahead, Vanessa. This is where you say ladies first, right? Why should anybody do this?

So I think, well, first of all, I'd never really advocate doing this per se. I like using mountaineering as a metaphor more than anything else. Okay. But in terms of taking one more step, but I do think people should get outside of their comfort zone and have more self-belief knowing that they always have a safety net. The safety net is all the knowledge, skills, and experience that they've ever acquired in life that can actually help them pivot and do something different because you can always go back. But what lies ahead is unknown. So taking that knowledge, skills, and experience allows you to pivot, take that, you know, not that much risk that you think it is because you can always go back. But trying something different, you never know what you'll discover.

You're up next, Doc. That's a hard one to beat. Doc's like, what she said. No, go ahead, Doc. Go ahead. Go ahead. Why should anyone do this? Well, I think that if we internalize it and ask ourselves why we do it, this is what I've done for almost my entire life. And I'm passionate about it. My life revolves around being in the mountains. And when you come to it as an older adult or just even as an adult, why? I think people come to it from all different directions. One is a challenge. people come from come to it from all different directions one one is a is a challenge um and i think i see a lot of people who just they just want to experience something different uh that

that comfort zone that we live in um does need to be challenged i think and um the mountains are definitely one way to challenge it um to step out of your comfort zone into into the box you've never stepped into before it's super valuable as uh as a growing process as a tool um being in places that are just absolutely stunning and uh locations you'll never go to again probably some of us make our living in those environments and and they're super valuable uh to me it's it's it's how i live my life and how I'd like others to live their lives too, in touch with their surroundings and engaging. Dr. Alarorum, thank you. Very cool. Vanessa, I mean, it's fabulous to have the pair of you on at the same time. Dr. Alarorum,

thank you so much for your time. Vanessa O'Brien, a superstar of the world's mountains. That's it, Chuck. Are we out of show? We are done. We have, I believe we have summited. We have. That's the easy bit, apparently. And now we've got to get down.

That won't happen on camera. And then what will happen is I'll die of a heart attack at the top of this mountain. Okay? Everybody else will descend. And then they have to leave me up here because you can't take your dad with you. He's got such a complex. You ain't got to die there, he's got such a complex you ain't gonna die there bro all right thank you doc thank you that famous bedside manner just got brought

forward that's why he's a guy he's encouraging me even now he's like you're not gonna die you're not gonna die up here bro you're not gonna die come out to the tea towns we'll get you up the grand tea town buddy all right you got it. All right. Meanwhile, on Magic Mountain. Right. If this show has inspired you, I am a happy person because these two people have been awesome. Right. I've been Gary O'Reilly. Who are you?

I'm still Chuck Nice. Yes, he is. I can vouch for that. From the ground, Chuck Nice. Yes. And this has been Playing With Science. And we'll catch you very, very soon, I'm sure.