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Dayhiker with HACE on Mt Whitney
#44857 11/21/15 10:24 PM
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Steve C Offline OP
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I recently made a connection with Elizabeth Wenk, author of eight hiking books -- mostly Sierra and JMT-related. She shared the text below that was included in several forums, but not on WhitneyZone. Her report describes finding a man near the summit of Mt Whitney making almost no progress descending. She and her husband helped him descend to Trail Camp and put him into their tent. He made a miraculous recovery after sleeping for some hours.

Here is Elizabeth's report:

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A slow descent of Mt. Whitney

The following event occurred nearly in early August 2013 and I've never taken the time to write a detailed recount. But have long wanted to, because it is one of the most exhausting experiences I've had hiking and mountaineering in the Sierra. Described below is a long night helping a man descend Mt. Whitney who was likely suffering from High Altitude Cerebral Edema (HACE).

Douglas (my husband) and I were on the second-to-last day of a week-long trip along the JMT corridor. We'd entered at Taboose Pass and followed the JMT south. Despite lots of rain, we'd had a wonderful trip, especially a detour to Harrison Pass and the headwaters of the Kern River. On the morning of this story, we'd woken up on the Bighorn Plateau and had an early morning climb up Tawny Point. We'd reached Crabtree Meadows for lunch and spent it chatting with Rob P., the long-time Crabtree ranger. Our plans for the afternoon were a bit uncertain; we still weren't sure if we'd camp at the last water before ascending Mt. Whitney or near the summit. We walked along, reached the final campsites above Guitar Lake by ~3:30 and decided to continue upward. We planned to camp near the junction of the Mt. Whitney Trail and the JMT and summit Mt. Whitney just before sunset. We reached the collection of bivy sites, dumped our gear, and continued to the summit, reaching it around 6 p.m. A little below the summit I had noted a lone hiker sitting, head bent downward, and made a half-conscious mental note to make sure he'd moved onward by the time we descended. We spent a lovely hour on the summit, chatting with other hikers we'd crossed paths with along the JMT, and then headed down to reach our camp by dark.

We'd walked only 5 minutes when we came upon the same hiker, sitting in the same slouched position, only about 200 feet down the trail from his position an hour earlier. I noted to Douglas that we needed to check how he was doing. The man's response to my queries on his well-being was an unconvincing "fine", and we probed further. He knew his name, wasn't sure if he had any water or food left to consume and wasn't sure how long he'd been sitting there. He also didn't know when he'd left Whitney Portal and said he was tired and wanted to rest. We looked at each other and knew the answer was "get down now". At this point perhaps one of us should have headed back up to the summit to borrow someone's cell phone and alert authorities to his condition. We discounted it because with less than an hour of daylight remaining we were fairly sure it was already too late to initiate a helicopter evacuation. We also assumed he would be able to walk downward if we motivated him and worked on getting food and water in him and didn't want to waste any daylight. My thought at this time was that one of us would walk with him to Trail Crest and by then he'd be able to keep moving on his own. For the first mile, we made slow, but steady progress - it took an hour. He drank a little, ate a little, and would walk for a minute or two before sitting for a few seconds. He did have sufficient clothes - several layers on top, gloves, and a warm hat. He was not overweight and seemed fit. One of the first things I noticed was his lack of balance, ataxia, but also that he had clearly hiked a fair bit, because he picked his steps well. However, if he had to step over a rock or down a little more than usual, his balance was atrocious and we'd have to help him. The sun set as we passed around the base of Keeler Needle. The traverse across the pinnacles went on and on and I needed Douglas to help balance him whenever there was a drop-off, because I didn't trust that he wouldn't push me off the trail. The fact that he was suffering from the early symptoms of HACE became ever clearer in my mind.

By this point I was watching the final hints of deep red and blue above the Kaweah Peaks and knew it would soon be very dark. Luckily we all had headlamps. Douglas and I now realized someone needed to help him get several 1000 feet lower for the night - and that someone was us. It was a chilly, windy evening and we didn't have the spare gear to outfit him at 13,500 feet. And we were fairly certain he needed to get even lower. We set ourselves the goal of reaching Trail Camp, located on the east side of Mt. Whitney at 12,000 feet. Once past the pinnacles, Douglas ran back to camp to cook up some hot soup for all of us and pack his pack. He met us at the trail junction with steaming cups. This has to have been a savior, for with the hot, salty drink and noodles in his stomach, our friend made it up the 200 foot climb to Trail Crest with relatively little trouble. He and Douglas had just reached the pass when I caught them - having detoured briefly to get my own pack. It was now between 9-9:30 pm and Douglas and I breathed a premature sigh of relief. We'd done the two-mile flat traverse and the brief uphill. Now it was just downhill and we'd be at ever lower elevations. We discovered that the man had a cell phone (we didn't) and from Trail Crest we tried to call his wife - who was purportedly waiting for him at Whitney Portal. We simply wanted to indicate our location and that he was with others. The connection went through, but then cut out before we could speak to her. We also tried to call the sheriff with a similar outcome.

Our spirits may initially have been high, but those two miles had obviously sapped the last energy our friend could muster and his pace rapidly lessened and lessened. I think the pitch blackness around him was also disorienting, exasperating his mental difficulties. Douglas and I have been up and down the trail enough times - and simply have a good sense of our surroundings - so we knew exactly where we were: Going down a good trail on the east side of Mt. Whitney. Our goal, Trail Camp was a mere 2.2 miles below us; about an hour on a good day. Our friend however, became very concerned that we were leading him astray. He could no longer see Mt. Whitney - or anything beyond the beam of his headlamp, and began asking us why we were still making him walk when we'd climbed down the mountain. He said he understood why we'd made him walk down the mountain to the nearest campsite and he appreciated that, but now we'd gotten there, so why did we have to keep going? Why were we torturing him by making him walk around and around in circles? Were we kidnapping him and were then going to murder him? Our answers weren't very creative - I guess we were past thinking outside the box - and we simply tried to reassure him that we were helping him and would be there "soon".

The pace of the walk was surreal. I had my GPS running, to have some sense of progress, but it was painful to be excited about each 10 foot descent in altitude. It also made me realize just how sick this man was. Even my kids as pre-schoolers, at their most tired, could always summon more energy than this to reach a destination. We'd sit for long periods and finally urge him to stand up, hold his hand and lead him onwards, only to have him collapse on a rock again after 20 steps. Neither Douglas nor I were strong enough to fully support his weight or to pull him back to a stand. The colder it became, the harder it was. We were wearing all our layers, but were still cold. While I never once regretted our decision to walk him down, mixed into all this were our emotions of being a little miffed at having given up our lovely alpine perch on our final night of our trip, and now a night of sleep. The less cooperative he became, the harder it was for me to keep urging him on. Being told again and again that I was torturing him and kidnapping him was difficult to stomach. Eventually Douglas and I began taking turns for 10 minutes, while one of us could sit on our own. We made sure never to get mad at him, only to try and explain that he was sick and we were helping him. We explained that we were both experienced in the mountains and were good people to be with him. We told him that as soon as we reached the campsite he'd get to sleep as much as he wanted. But hearing the same concerns about being kidnapped and murdered voiced again and again wore us down. The hours just kept ticking by and we moved slower and slower. He begged us to just let him rest and sleep and we contemplated it, but knew it was an unusually cold night and the slopes were steep. What if we fell asleep and he got up, stumbled and fell? Once below the icy section with the rope, the terrain is a bit more moderate, and we started looking for little nooks, but never settled upon one, for it didn't seem like a sensible plan - and we weren't able to detach ourselves enough from wanting all of us to reach Trail Camp to formulate an alternative plan - so on we walked.

Around 1 a.m. we were about 500 feet above Trail Camp and were questioning how much longer we could continue without voicing any frustration with the situation. For us the issue was being cold and the lack of progress, not exhaustion, fortunately. We could see some lights still on in tents and decided we needed a relief team. We decided we were close enough to the bottom now that, if we summoned others to help us for a few hours, we wouldn't jeopardize their summit attempts in the morning. Douglas walked ahead and called in at the first tent he reached, explaining the situation and requesting help. Two guys rapidly emerged and good humoredly agreed to walk up to me and relieve me. They did what I was unable to - break the spell, by having an everyday conversation with our friend. What were his favorite movies? What were his hobbies? Suddenly he felt comfortable, the images of being murdered faded. He picked up the pace a little and worked his way down to Trail Camp, arriving between 2-2:30 a.m. In the meantime I got to go ahead. Douglas and I found an open place to pitch our tent - we'd already agreed that our friend would get the tent, my thermarest, and an emergency blanket, while we'd sleep outside. Upon reaching Trail Camp, he readily climbed into our tent and was soon asleep. We crossed our fingers that he'd be OK in the morning.

Douglas slept on his thermarest and me on our two backpacks. I slept fitfully - at best - even after the first hikers rose at 4 am and handed me a thermarest to sleep on. My sleeping bag was completely inadequate to break the wind and I shivered and shivered. At first light I got up and began to pace around. I'd have loved to have passed the time by hiking up Wotans Throne, but knew we had to stay put to greet our friend when he emerged. Around 6:30 a.m. he got up. Amazingly, he was happy, coherent, and understood completely what had happened the night before. He apologized for saying things he didn't mean. And he stared and stared up at the switchbacks and said, "You walked down all of those with me in the night?" We nodded our heads and he thanked us again and again, very aware that he'd been in a bad state and couldn't have gotten down on his own. As we talked to him over breakfast we were amazed at the change in person and all the things he could tell us in 15 minutes, but not during 7 hours the night before. Among others, that he had a graduate degree in forestry from Taiwan, but now worked in law enforcement in the Sacramento area. We had an interesting, intelligent conversation, which really drove home my appreciation of how impaired his mental capacity had been the night before. Being the last day of our trip, we could share all our bits and pieces of spare food. We served him tea and oatmeal for breakfast, handed him some granola bars for the day, and, of course, filled his water bottles.

We then decided we'd done our bit and he'd be OK from here - and we needed to be down at Whitney Portal by noon or would have people worrying about us. We gave him a 20 minute head start and he was approaching Trailside Meadow by the time we caught up with him and said our final farewells - all smiles now. We felt relieved and happy, but also a bit puzzled that no SAR team was coming up the mountain, since we knew his wife had expected him down the previous afternoon or evening - and as I describe below, suspected her husband was ill with altitude sickness. We hadn't expected one overnight, but anticipated someone first thing in the morning. Nothing. It was especially puzzling since upward bound hikers spoke of the sheriff being up at Whitney Portal with his wife during the middle of the night. We sent word with some speedy hikers who passed us that he was OK and they relayed that to his very concerned wife. We passed an upward bound ranger who had heard someone was on the mountain and likely suffering from severe altitude sickness, but hadn't given it any more thought and no, didn't think there was a SAR team en route. When we reached Whitney Portal a little before noon we received a warm welcome from his wife and sat down with her to a meal at the cafe.

Slowly the story emerged - mostly from his wife and a little from him in future e-mails. He knew he had altitude problems. A year earlier he had attempted the peak as an overnight trip with his wife. They had made it to Trail Camp and spent the night there, but she wouldn't let him continue upward because "he was just talking nonsense". For this Whitney attempt he had begun at 10 p.m. for a dayhike the following day - and on his own, ostensibly because his wife didn't think it was a sensible idea or want to be part of it. He had spent the previous days hiking at elevation to acclimate and had felt good when he started. Other hikers around Whitney Portal could say that by morning (the previous day) he'd been on the switchbacks above Trail Camp and by 2 p.m. hikers had seen him "barely moving" approaching the summit. He was still heading up at that point, because he signed the summit register only a few people ahead of us. I don't know if others had asked if he needed help, but his "I'm fine" would have been much easier to accept in the middle of the day, with dozens of others nearby, than at 7 p.m. when we knew we were the last people descending that day. Several hours earlier we'd probably have ignored it as well. (We also heard from others that the people who had helped us with that final hour of walking in the middle of the night had indeed made the summit - even for sunrise. We were glad not to have imposed on their trip.)

Later that day I called a friend in Bishop who has long been involved with SAR in the eastern Sierra and learned that 90%+ of their calls are for Mt. Whitney - an overwhelming number, such that not every stranded hiker on Mt. Whitney elicits a full SAR operation. They consider the person's condition and location and act accordingly, for many of the calls from Mt. Whitney, in particular, are for non-serious conditions; I suppose many people succeed in making cell phone contact with rescuers and can discuss their actual symptoms and location. As a result, some people do spend an uncomfortable night part way down the mountain and make it out in the morning. I also learned that SAR teams are frustrated by "phantom" (my word) searches on Mt. Whitney. Some people have called from the summit of Mt. Whitney and say they're too tired to hike down and a SAR team is called out. In the meantime, the person ends up resting for some hours and then hiking down on his (or her) own and never contacts the sheriff again, leaving the SAR team fruitlessly searching for the person who called; they crossed paths somewhere and the previously "incapacitated" person doesn't even acknowledge their identity.

All that said, our friend's history of altitude sickness and the fact that he was alone should have resulted in an immediate middle-of-the-night search. It isn't clear why one didn't materialize, because HACE-like symptoms are always taken very seriously by SAR. Bits and pieces of evidence should have led those at Whitney Portal to suspect HACE. His wife queried other dayhikers returning in the evening and into the night and they all reported seeing him near the summit, and all expressed that he didn't look well, was moving very slowly, and was still moving upwards, even as they were descending. She made very clear to me that she was familiar with the dangers of altitude sickness, her husband's propensity for altitude problems, and had spent the night very, very concerned for his well-being. After all, she knew just how many hours he had spent climbing upwards very slowly. She expressed many of these concerns to the sheriff, but I'm guessing a rescue didn't occur because his wife was soft-spoken and not a native-English speaker, and therefore I suspect not pushy enough about his probable need of help and previous altitude difficulties. I should add that I had a lovely hour-long conversation with her and had no difficulty understanding a single word she said.

To step back, my friend with SAR didn't know exactly how many cases of HACE are seen yearly on Mt. Whitney, but indicated it is at most a handful. This is probably because HACE generally develops only when an unacclimated and altitude sickness-prone person spends more than 24 hours at high elevations. Most people summiting Mt. Whitney are above 12,000 feet for ~5-9 hours, and therefore rarely develop HACE. In contrast, Acute Mountain Sickness (AMS) a far less serious form of altitude sickness has a very rapid onset and is commonly seen. To return to our story: Consider that our friend was above 12,000 feet for nearly 24 hours and had a known history of severe altitude sickness, both conditions that greatly increased his likelihood of developing HACE. (Another condition is High Altitude Pulmonary Edema (HAPE). It occurs somewhat more frequently than HACE and is also very serious, but because ataxia and mental impairment are not symptoms, people suffering from HAPE tend to be in a better position to be aware of their condition and self-evacuate down.)

Overall, describing our friend's symptoms both to doctors and to my friend at SAR, he was indeed in a very bad way, was almost certainly suffering from HACE, and it is possible he wouldn't have survived the cold night at 14,300 feet. It is good to know we made the correct decisions.

By the way, I've corresponded with this man a few times since this day and he's fine, and continuing to hike, just sticking to somewhat lower elevations.

Lizzy Wenk

Re: Dayhiker with HACE on Mt Whitney
Steve C #44866 11/22/15 02:45 PM
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Thanks for posting this Steve. The affects of altitude has always been my primary concern and of great interest. I've had more encounters with AMS than I care for, and have had the ominous gurgle in my lungs once before.

I had an experience very similar to this a few years ago when heading up Whitney. I had acclimated for two days and night though. I made it to Iceberg Lake in great spirits but by the time I reached the summit, I could barely walk and could not descend back down the North Fork. I literally took 5 steps before I had to stop to gasp for breath. This routine continued from the summit to Trail Crest before things normalized somewhat. It took about 6 hours for that short distance. Luckily my friend was with me and forced me down the switchbacks. I was so delirious and desperate that even though I had no ice axe, I wanted to glissade down Trail Crest to quickly get off the mountain.

Thumbs up to Elizabeth and her husband. There are some decent folks up those mountains.

Re: Dayhiker with HACE on Mt Whitney
Anonymous1 #44867 11/22/15 06:14 PM
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Elizabeth Wenks description is an astonishingly complete and accurate description of High Altitude Cerebral Edema (HACE).

She mentions the signs and symptoms that are the sine qua non for making the diagnosis; ataxia and altered mental status in a person with recent altitude gain with or even without (!) AMS findings like headache. And, her knowledge that even partial descent of 1,000 or 2,000 ft can be dramatic and life -saving, was in fact, life-saving. I salute Elizabeth and Douglas for their actions.

For more information, see
High Altitude Medical Guide HACE

Now, of course, I must add a mountaineering quote, this one from the most famous Everester of all time. He illustrates the problem of mental status changes with HACE at Himalayan altitude, but HACE is occasionally seen with rapidity and severity at "just" Whitney altitudes.


Mountaineers have often observed a lack of clarity in their mental state at high altitudes; it is difficult for the stupid mind to observe how stupid it is.
George Mallory, Chapters IV-VI, X-XI in
Bruce, CG, The Assault on Mount Everest 1922, page 129

Re: Dayhiker with HACE on Mt Whitney
Harvey Lankford #45253 02/04/16 04:36 PM
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Elizabeth Wenk is revising her book titled "One Best Hike: Mt. Whitney", and is inviting people here to make suggestions for updates and corrections.

I've just ordered a copy, so hope to see it soon.
    (Google link)

Re: Dayhiker with HACE on Mt Whitney
Steve C #48745 11/14/16 11:01 PM
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The Second Edition of the book is out:
One Best Hike: Mount Whitney

See this link

Re: Dayhiker with HACE on Mt Whitney
Steve C #51396 08/04/17 09:00 AM
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It looks like the effects of high altitude might be more lasting than we all think. Not a big study, but interesting to note:

https://www.scientificamerican.com/article/brain-cells-into-thin-air/#


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