Do you think you have what it takes to climb Mount Everest? Did you ever think about what it might be like, and if you did it, would you kill a bunch of brain cells and come home…..different? Or, maybe not at all….?
Fact is, today’s guest feels that a person of moderate physical capacity could take on The Big E given the right conditions, with the use of bottled oxygen....
He also says to climb Everest it really helps to have been born with what he calls The Stupid Gene...the quality of being able to suffer for long periods of time, even willingly, in order to achieve a goal.
Today’s guest on The Happiness Quotient is Dr. Peter Hackett….he LITERALLY wrote the book on altitude sickness….it’s called Mountain Sickness: Prevention, Recognition and Treatment (American Alpine Club Climber's Guide).
Peter is no ordinary doctor...he’s a mountaineer. He climbed Everest in 1981 as a member and doctor on the American Medical Expedition...when he summited he was the 111th person ever to summit….it was well before the first guided expedition changed the game on the Mother Goddess of Mountains. It was also before more than one team was allowed on the same route….
I first met Peter in 2000, we were working on a documentary for PBS Nova called Deadly Ascent, a film endeavoring to solve the mystery of high-altitude deaths on one of the most dangerous mountains on Earth: Denali. I was the high altitude cinematographer and Peter was the doctor, the main character. We were there to chronicle the season, ready to capture on film daring mountain rescues and emergency medical evacuations….
In 2007 Peter found the Institute for Altitude Medicine in conjunction with the Telluride Medical Center and the University of Colorado to provide clinical care and consultation, conduct research and develop educational programs to optimize health as well treat medical issues affecting people who either live at, or travel to, high altitudes.
Fast forward to 2019….I was on Mount Everest, filming Lost on Everest for National Geographic and Disney….while at 21,000 feet, the evening before leaving for our tam’s final summit bid….I began to show some signs of an altitude induced TIA….a trans ischemic attack, or a minor stroke. The symptoms were minor, numbing of the face.... More than 7,000 miles away Dr. Peter Hackett was summoned via Mark Synnott’s text messages.
Peter was at a medical conference at the time...and he consulted with other physicians about my condition...many texts went back and forth. Basically he said this: 50-percent chance it’s really nothing, a migraine thing that will disappear and have no impact on me at altitude. The flip side is that if it IS a TIA and it re-appears on my summit bid….I die. He and the doctors suggested I remove myself from the summit team.
That afternoon I was in Base Camp. Maybe I don’t have as much of that Stupid Gene as I used to….
So, do you have what it takes to climb Everest? What happens up there when someone climbs into the DEath Zone?
A few facts:
Let’s take the 2019 season, the season I was there on the Chinese side, as an example
There were 11 deaths….eight of those deaths are basically unexplained, the cause of death listed as either altitude sickness (3 of the climbers) or exhaustion during descent,...listed for six of them….and of those 11 deaths, six of those were climbers in their 50’s or 60’s, where the possibility of dying at altitude increases. What is going on at altitude and how is the body responding to the extremes of the death zone?
Here’s my conversation with Peter Hackett, Doctor of the Death Zone… We spoke in May of 2021, at the end of the climbing season on Everest, during thatSupport the show
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Happiness Jones?Thom Pollard:
Do you think you have what it takes to climb Mount Everest? Did you ever think about what it might be like? And if you did it, would you kill a bunch of brain cells and come home different or maybe not come home at all? Fact is today's guest feels that a person of moderate physical capacity and good health could take on the biggie given the right conditions with the use of bottled oxygen. He also says that to climb Everest, it really helps to have been born with what he calls the stupid gene, the quality of being able to suffer for long periods of time even willingly in order to achieve a goal. Today's guest on the happiness quotient is Dr. Peter Hackett. He literally wrote the book on altitude sickness. It's called mountain sickness prevention, recognition and treatment. It's an American Alpine club climbers guide. Peter is no ordinary doctor. He's a mountaineer. He climbed Everest in 1981 as a member and doctor on the American Medical expedition, and when he submitted he was the 100 and 11th person ever to get to the top. It was well before the first guided expedition changed the game. And it was also before more than one team was allowed on the same route. I first met Peter in 2000, we were working on a documentary for PBS Nova called deadly ascent, a film endeavoring to solve the mystery of high altitude deaths on one of the most dangerous mountains on Earth, Denali in Alaska. I was the high altitude cinematographer and Peter was the main character the doctor, the consultant of the film, we were there to chronicle the entire season, ready to capture daring mountain rescues and emergency medical evacuations. In 2007, Peter founded the Institute for altitude medicine in conjunction with the telluride Medical Center and the University of Colorado to provide clinical care and consultation, conduct research and develop educational programs to optimize health as well as treat medical issues affecting people who either live at or travel to high altitudes. Hint hint, anybody going to mount everest might want to look this guy up. Fast forward to 2019. I was on Mount Everest again, filming last on Everest for National Geographic. And while at 21,000 feet the evening before leaving for the team's final summit bid. I began to show some signs of an altitude induced Tia, a trans ischemic attack. Basically, it's like a minor stroke that goes away. The symptoms for me were minor numbing of the face primarily. And more than 7000 miles away. Dr. Peter Hackett was summoned via my climbing partner marks in its text messages. Peter happened to be at a medical conference at the time, and he consulted with other physicians about my condition, many texts went back and forth. And basically Peter said this 50% chance, it's really nothing a migraine event that will disappear and have no impact whatsoever on me at altitude. But the flip side is that if it is or was a Tia and reappears during my summit bid, I will die. He and the doctors suggested I removed myself from the summit team immediately. That afternoon I was in base camp. Maybe I don't have as much of that stupid gene as I used to. So it's a gene that fades with age perhaps. Do you have what it takes to climb Everest? What happens up there when someone climbs into the depths? And what's more important is after you listen to this episode, will you even want to climb Everest? Let's take a few facts into consideration in two 1019 the season I was there, on the Chinese side of the mountain, there were 11 deaths. eight of those deaths are basically unexplained, the cause of death was listed as either altitude sickness, three of the climbers, or exhaustion during descent listed for six of them. And of those 11 deaths, six of those people were climbers in their 50s, or 60s, with the possibility of dying at altitude increases, what's going on at altitude? And how is the body responding to the extremes of the death zone? Here's my conversation with Peter Hackett doctor of the death zone, we spoke in May of 2021, right near the end of the climbing and summit season on Everest. And during that season, there were four deaths, the cause of two of them have been listed as exhaustion. Well, that's the that's the essence of it. Maybe that's the crux of the biscuit. It's like, you know, all these people. Now, and you know, Mark senate talks, the idea that, you know, back in the day, you had to be kind of the young guy with a lot of talent and have an American Alpine club or your Alpine clubs, you know, backing and now it's guys who are, you know, in their 50s and have some money in the bank, and they want to live out their dream. And so there's this new trend happening on Everest, and as we saw in 2019, people are just literally dropping dead. Yeah,Dr. Peter Hackett:
we don't have a good explanation for a lot of I mean, you know, you can explain ice fogs classes and these deaths. Very a pie and the mountain. Yeah, I mean, you have avalanches, that sort of thing. But there's something that's to keep the right perspective, the chances of dying on Everest. going on, when you get up on that summit day above 1500 For those that Cobo Basecamp is around 1% or so. And it's gotten meters, even. So, there's a number of factors, number one, better over the past decades, and the success rate has gone up if you run out of oxygen, okay, that's an easy explanation. quite a bit. Although for people over 60, it's much more You're not really a climate, you can't to climatized that kind of dangerous, much higher death rate and much lower success altitude, and you've gotten only as high as you've gotten, rate. And for people without oxygen, much higher death rate, probably because you are on oxygen. And the oxygen, there's much lower success rate. So the last thing I'd recommend is anybody over 60 training without oxygen, that would be a double no question the oxygen makes you move faster, allows you to move whammy. But But what are these mysterious deaths? faster, prevents frostbite and hypothermia. I mean, there's only one performance enhancing drug. Because the drug, oxygen is listed as a drug by the FDA. And that's oxygen for performance at high altitude. And if you run it, if you're depending on it, and you run out, you could be in big trouble. I mean, I could list a lot of climbers that have died that way. It's very well known ones even back in the late 70s, and 80s. But like recently, in the last couple weeks, these people dying of so called exhausted are on oxygen. As far as I know, we don't have all the details. But as far as I know, they didn't run out. So what could be causing their deaths? If they're using supplemental oxygen? The Sherpas call it exhaustion. And there may indeed be an element of it. If you're on oxygen, you can certainly get exhausted. So let's say you're on four liters oxygen going towards the summit. Well, your body physiologically is more like it 23,000 feet instead of 28,000 feet. And you can still get exhausted because you put it in a 6000 foot day, 3000 feet up 3000 feet. And that can exhaust you even at sea level. Right? Yeah, especially if it's real windy and you're fighting the winds and it's real cold. Sometimes I'm sure it's a sudden cardiac event from the exertion and the low oxygen levels despite the supplemental oxygen. I'm sure some of these males especially have heart attacks. And you never know what it is, you know that but that's called sudden cardiac death and that death is almost instant, so they just drop over dead. Whereas some of these other climbers, they sit down They're still conscious. And then they can't get up. And I mean, I can I can relate to it. From my own experience. I was I climbed solo from the south call up to the summit and on the way down, and I have very little oxygen that can lose one to two liters per minute because I was running low. And on the way down from the summit, where I had, where I fell down, the Hillary step barely survived, but eventually, because in those days, there were no fixed lines or anything. Then I had to go up to the south summit, in order to get over the South summit and down to the south call. And I was exhausted, and I spit is quite an ordeal, Hillary step. And I knew I wanted to lay down and rest. And I knew that if I did, I wouldn't get up. So I can I can relate to that kind of exhaustion, and I was on supplemental oxygen, but there's only like one liter a minute. And so I didn't want to lay down, I didn't want to stop. And it could be that some of these mysterious deaths are just just that. So without any autopsy material, we can't say what these mysterious deaths are, I call it mysterious, because we really don't know. And without a really clear story, from the Sherpas, or from their, their companions, minute to minute description of what happened. It's, it's really hard to know. But if it's if they just keel over, it's it has to be either their heart, or massive pulmonary embolus, or massive stroke, and it has to be a circulatory that's the only thing that kills you like that.Thom Pollard:
Yeah, if you've mentioned something earlier, that is of note as well. And there's a lot more people on the mountain now who haven't, if you will put the years in. And, and one of the things that gave me a lot more confidence on Everest, say, even though in 2014, everything was cut short, but but in 2016, especially, is every time you go, you know to say 25 or 26,000 feet, you learn something about how your body responds, and then you come back down. And then the next time you have that sensation, that feeling of like, I feel like I could die right now. You You're you're learning. And so I would get these feelings or sensations and go, Oh, I know what happens to my body here. I this is I'm not well, I'm, we're dying up there ultimately, I suppose. But I know that I can reach this, this level and survive. And so your experiential level allows you to kind of tag up a little bit more and more. Whereas some of the people who are going to Everest haven't even done Denali, they're just going to Everest pop in the oxygen mask on which they'd never worn before. And they don't know what those signs are. They don't even they don't know, this is I guess this is how it feels. I just think that the experience climbers are less inclined to just drop dead because they they know the signs? Well.Dr. Peter Hackett:
There's no question about the value of experience, extreme altitude it like in so many endeavors, you know, airline pilots are trained over and over again, to recognize the signs of hypoxia and know how to react to it. climbers that I mean, we've all had these experiences, the more experienced we get, the more we know what we can handle what we can, the less likely we are to freak out if something goes wrong, because we go we can say, oh, I've been in this situation before and I pull it through. Yeah. There's no question. It's, it's a unique experience climbing to these very high altitudes. And getting hypoxic to that to that degree. And someone without any experience, doesn't know how it feels, doesn't know how to pace themselves. extremely important. doesn't know how to match their breathing doesn't steps, very important. doesn't know how to breathe efficiently. Very important. I mean, my own opinion, I have a lot of people calling me that they want advice on climbing Everest with you know, their particular medical problem or how to stay alive on Everest, I always recommend a 7000 meter peak first, or at least a couple of 6000 meter peaks. And that's of course, that's what like you said, that's the way it always was in the old days. You wouldn't think of having somebody on Everest that hadn't done six or 7000 meter peaks, right. It's a different clientele now. And, you know, they feel like, some of them feel like oh, well, I'm paying this much money. I'm going to have that many guides and that many Sherpas and so much oxygen and fixed lines all the way to the top. It doesn't matter if I don't have much experience may be true if everything's perfect.Thom Pollard:
Yeah, you know, the interesting thing, and especially in 2016, where I encountered three gentlemen who lost their lives I'm, I've taken a, an interest in what people think about climbing Everest who have zero experience of it, but they have a certainly have an amazingly powerful opinion about it. And so, in one instance, where I crossed paths with a gentleman who I deemed to be dead and beyond any help whatsoever, and he did die, there was an article written in the New York Times and, and, and I've maintained contact with the with the writer, but he left out the sentence where I did my due diligence and spoke to two people that this guy was with who died and he did, he didn't put that in, I was like, are you guys? Are you good? Because I just felt like, we're just gonna be dragging a dead body back down. And there's no, there's no sense in doing that. I felt satisfied that we made the right decision in that circumstance. Of course, I think about it every day. So I'm not saying that it didn't come with some kind of Aftershock, if you will. But But I think that people have no idea even even if it's roped up and a walk up how hard it is physiologically, physically, and mentally to climb at altitude. Even if your oxygen is up to four liters a minute,Dr. Peter Hackett:
I've always said Everest is really a physiological problem more than a climbing problem. So, you know, think about this for other potential customers out there. If the base camp of if the base of Everest, were in the Fairweather range, say in Alaska, and at sea level, you'd have 11,500 foot climb to summit would be 11,500 feet above sea level. That's the vertical from Basecamp to the summit. And it's not particularly pretty Milan, probably wouldn't even be probably people wouldn't even bother with it.Unknown:
Right?Dr. Peter Hackett:
So what makes it really unique is is the the altitude, right? I mean, the winds can be just as bad Denali as on Everest, the temperatures can be worse on that alley than on Everest, or in Antarctica. I mean, with the only thing that's really unique about Everest is the altitude. And, of course, it's the highest point in the world. So everybody was had, you know, so many people want that as a goal. So if you were, now consider this, if you were to start from Basecamp, if you were well, climatized, at Basecamp, 17, five, or even if you weren't, but you flew in to Basecamp on oxygen, and you stayed on a high flow oxygen, in some sort of bubble suit, or some sort of apparatus that allowed you to do that wouldn't be that difficult to go all the way up to the top and back down. If your oxygen levels were the same as they were at sea level if you had enough oxygen, so you could do it, it'd be 11,500 foot climb, you can do it in a couple days. And, you know, that would be it. So what's really, it really is a physiologic problem, more than anything else. And some people can handle it without oxygen, they're genetically gifted that way, it's just a lottery really, yeah. Although training helps, of course, the more fit you are, the faster you can go up and down. But training doesn't help you with your climatisation doesn't help you deal with the altitude. So there has been a lot of research on exactly what the what we call a mask altitude, or what the physiologic altitude is at different levels on the mountain for those using supplemental oxygen. But if you're at rest on the south call you and you're just resting and you're breathing four liters per minute, your body thinks is said about 10,000 feet. Wow, it's dramatic. But as soon as you start to move, your body requires much more much more oxygen, of course. And then your oxygen levels will start to drop or you turn up the oxygen so that you can use more. So there is an enormous people don't realize the enormous difference between climbing Everest without oxygen and without. I mean, it's almost like two different endeavors. It's almost like the difference between free diving and scuba diving. Hmm, right. And those people that claim without oxygen need to be given a lot of credit. But it's also much more dangerous and some would consider it foolhardy. So But it's almost like a different sport, right? So anyway, let's get back to the people climbing with oxygen, which is 95% of all the people. Yeah. It's dangerous to have to rely on oxygen, just like if you were scuba dive and you were at 150 feet, and you suddenly ran out of air, you'd be in big trouble. It's not quite the same, obviously. But you, so you do need to take time to climatized. So that you don't have to start on oxygen until you get to camp three, you don't want to have to start out at a camp want to camp too. So you have to require a period of climatization to get used to camp one and camp two. And then if you're climatized, to camp two, and you run out of oxygen and camp for a stop call, you're not going to die, you'll be able to tolerate it well enough to give you time to get down. So climatization is really, really important. People do have to recognize the signs of hypoxia. And there are certain medications that can make you feel weird in a way that people have to be careful about their medication use. The hypoxia makes them more likely to get frostbite, more susceptible to hypothermia. There's a lot it suppresses your ability to eat and drink suppresses your appetite. It interferes with your ability to sleep, which is a huge issue. Because if you're sleep deprived, it throws off all sorts of physiological responses, including clear thinking. And then there's we know from our research, and many others that have done research that the brain just doesn't work quite as well. Now, once you get to about 18,000 feet, there's a bit of a threshold and the higher you go, the more often it becomes. So a camp to before you start on oxygen, you may not be sleeping well, you may not be thinking real well, you may need checklists, you may need somebody to remind you of what to take up to camp three, you may not be eating very well. And for people that have never experienced that before they it's miserable. I think that the most important gene that in my experience from my own high altitude climbing is the stupid gene is the ability to tolerate significant levels of discomfort over a long period of time, which is just plain stupid thinking that that's what's required for high altitude climbing, you have to be able to tolerate significant discomfort for more than a few hours, you know, for weeks at a time. Yeah. And people that have never done that. It's, you know, they're not used to that. And they find it hard to tolerate sometimes.Thom Pollard:
Yeah, sheer madness. I know, there's some, like, I think I I liked that aspect of it back in the day. And now I'm like, you know, even in 2019, you know, as I said, I'm 59 now in 2019, there were some uncomfortable times we are having, and I just thought like, what, why? Why am I doing this? Why am I doing this? Yeah, you certainly want to be have a gluttony of for punishment as part of your resume resume because it is it's, it's painful, and it takes weeks and weeks to recover. And, and Peter, this is the interesting thing after I came back and in 2019, and you know, as as you know, I was leaving advanced base camp and Mark we read your your text and use said you had consulted with some other doctors, and the general consensus was that I should stay back. And, and that's good. And you know, I'd already been to the summit. So you know, what's the big deal other than just wanting to be with my buddies, but I will say when I came back from that expedition, and this could be a factor of age a little bit, but it took me months, really months to even want to get off the couch and go for a hike months, months. It usually takes a few weeks, and I just laze around and eat like a big but it it was a long long recovery. And I'm not sure if there was some it just it maybe it was psychological a little bit. I was pretty depressed about it and worried until I got the MRI. But you know it, it's it packs a wall up and the people who go back time and time again. You got to wonder what the mental factor and the capacity is going to be when they are 70 or 80. If if there's some little loss every time you go into altitude that you know doing a crossword puzzle gets harder every time I thinkDr. Peter Hackett:
this whole issue of brain damage at high altitude is a very important one and one that needs to be researched. More. But clearly in the studies that have been done, there are structural changes. And there are functional changes in the brain at high altitude that can persist for months to years to many years after climbing to high altitude, mercy in those without oxygen, or in those that develop bad mountain sickness or three edema. I'd say that, for those that have been, I mean, the literature isn't great, but so far from what we can tell in the scientific literature, for those that go above 7000 meters without oxygen, about 10 to 15%, are going to have some sort of permanent neurologic finding. Now, if it's just a little plot on your MRI, it, but doesn't cause any functional changes, it doesn't matter much, but it's still a concern, right? I mean, there's been a functional and anatomical change in your brain. Either a part of your brain has shrunk, there's a little bit of atrophy, or we get what's called white matter. hyperintensities. It's this, these lesions we don't entirely understand. But if you get enough of them in lifetime, it is associated with dementia. You know, people ask me all the time, is there a risk of suffering brain damage on Everest? The answer is yes. How big is the risk?Thom Pollard:
Yes, I found this on the web. listening to you?Dr. Peter Hackett:
The answer is, it's really hard to say, yeah. If you're if you think that every single neuron in your brain is really precious, and you want to hang on to it, you should not go to Everest or any 8000 meter peak. I mean, some studies say even 6000 meter peaks, but I'm pretty skeptical of those of those studies, right. More importantly, is the functional stuff. So the psychological, neurocognitive reaction time, memory. After an ascent, there are abnormalities. Our Everest expedition, the American Medical Research Expedition Everest many years ago show that there were definite changes in them. Most of them resolved within two years. Almost all of them, except the ability to do repeated finger tapping, if you get more fatigued with the Bs, except maybe concert pianists should be careful about. So if you really want to protect your brain at high altitude, number one, you use oxygen. Number two, you don't get altitude sickness, especially cerebral edema, medium pulmonary game, or even bad mountain sickness, or three. Well, to prevent those illnesses, you climb with that as well, before you die. And fourthly, you pay attention to nutrition and hydration, and how you're feeling and don't push it beyond your means. So a lot of climbers asked me Are there any meds or drugs that will prevent the brain changes or neurologic damage at altitude? And there's really no evidence about a lot of these things you read about on the internet, or over the counter stuff, or even prescription medicines like dexa metazoan, which protects the brain quite a bit. But no one's ever done a study to see if people who take dexy methods on a summit they are less likely to have brain damage. I mean, it's hard to imagine this study like that are being done.Thom Pollard:
It would be pretty hard to do it, you'd have to have a lot of willing subjects, I would imagine. AndDr. Peter Hackett:
can you imagine any University Medical School IRB signing off on a project where they're gonna take people to 28,000 feet without oxygen and seeThom Pollard:
maybe 1950s military or something? Is that top secret? You know?Dr. Peter Hackett:
Exactly. Well, funny, you should mention that because operation Evers one in 1947, with Charlie Austin 40 days in and out to do chambers summit of Everest without oxygen, and then operation overs to 1985. Very similar thing. And they did look at neurologic function and there were some deficits, but you know, then you've got people like Tom Horne, buying it bivouacked at 28,000 feet without oxygen and ended up writing in an STC department, you know,Thom Pollard:
and he's in his 90s now and his 90s nowDr. Peter Hackett:
Yeah, so it's something I think people should seriously consider doing 1000 meter peak.Thom Pollard:
Are you is is the Institute for altitude medicine still, like when I say still is it would one of the functions of it be somebody let's just say I come along, I'd never been to Everest, I've climbed Denali or been up Aconcagua and I'm like, Wow, man. And I, I want to make sure that I'm doing this right what I theoretically go there and kind of go through with no guarantees for success, obviously. But would you put me through a little, you know, kind of a litany of tests and consult with me about what my chances are physical health was?Dr. Peter Hackett:
Well, it's a little embarrassing, but that's what I would have done when I was operating the Institute for allergy medicine. But now I've phased out into the altitude Research Center at the University of Colorado in Denver. And I'm kind of quasi retired. But what I do now, with people that want to do exactly with what you're saying is I can generally handle most of this virtually, and arrange for tests in their own time, certain kinds of tests. But sometimes we will have people come to Denver put them in and out to chamber if they have a particular issue like, like seizure disorder, or something or something funny is happening, I was too before that isn't clear. We might want to put them in the chamber and take them up there and see if we can provoke what happened to figure it out what it was, like people with migraine events, or Tia is like what, like what you might have had, we might take you up to 7000 meters in the chamber, and monitor your brainwaves and your heart rate and everything else and see what's going on. But those are fairly unique events, not not common. So most people that are reasonably fit, are well fit and reasonably healthy. You can can do Everest with oxygen. And that includes diabetics, people with high blood pressure that's well controlled, even people that have had coronary bypass surgery have gone in summit of Everest, even people with heart transplants. I mean, yeah, it's most problems can be dealt with. The only problem is that really got to be very careful about her lung disease. And most people with lung diseases are goingThom Pollard:
to Hi, how about COVID? What if you had COVID, and we're sick?Dr. Peter Hackett:
Well, you know, a Sherpa just submitted this week after he had had COVID realli. But if you had COVID pneumonia, and you were in an ICU, you're on ventilator as a last thing you want to do is challenge yourself at high altitude for the next few months at least. And you'd want to get some pulmonary function testing before going to high altitude. And what I do with most medical conditions, or a lot of them is out, I'll advise people to check things out at a lower altitude and gradually increase the altitude. So if you want to go to Everest, and you've got stable at one, let's say high blood pressure, or diabetes, or heart arrhythmia, well, maybe before you go to Everest, you should go out and trek in Nepal. Or you should come out to Pikes Peak, and we should climb in year or you should go into denial you should get get up to around 14 to 16 to 17,000 feet and see how you do monitor your condition and learn about your condition at altitude and how you how it responds to high altitude. And then if everything is going fine, or we work out a plan, how to manage things, then you can go to Everest. Yeah, that that is successful most of the time.Thom Pollard:
So do you still want to climb Everest? Do you think you could? And would you be willing to take the risks? Let me know your thoughts? I'd love to hear them. And what happened to me in 2019 when I experienced the symptoms of a Tia on Everest? Well, it's hard to say Peter told me that a Tia might be something akin to a blood vessel spasm that goes away never really gets to the point of being an obstructed blood vessel, which would be a stroke. Whether what happened to me would ever recur is unknown. At my age, I think I'm happy to leave my high altitude career in the rearview mirror. Thanks to the insight and friendship of Dr. Peter Hackett. Peter is now quasi retired as he said he raises yaks at his home in western Colorado. Oh, and he's also been the tour doctor for the Rolling Stones. I'm not kidding, the man is a rock star in his own right and not just for the people going to Mount Everest. I'll leave some links in the show notes about where you can find Dr. Hackett and a link to one of his lectures called altitude illness what you need to know. Peter, thanks so much. I appreciate it. And as always, thank you to the woods brothers and their management for the use of their song happiness Jones for our theme song here on the happiness quotient under their publicist Kevin Calabro for helping make it all happen. For more information about me, Tom dharmapala to inquire about personal coaching or public speaking in person or virtually, please visit me at ies open productions.com and write me anytime Tom dot Dharma dot firstname.lastname@example.org I'd love to hear your thoughts about this or any of the episodes that you listen to. Thank you for visiting the happiness quotient. I will see you all real soon.