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Sweet Death
Feb 14, 2005 10: 21 EST
January 2005, Pyrenees range, on the frontier between Spain and France:
A rescue patrol received an urgent call from a young mountaineer. He and his mate got lost at 3000m high in very bad weather. After 24 hours in the storm, they finally found the way back, but one of them was too exhausted to keep going. His mate left him to find help.
The rescue team, including a specialized MD, jumped in the chopper and soon got to the place where the stranded climber was. There was a soft smile on his pale face. They were too late. He was dead.
The ghost climbing-mate
October 2003, Kangchenjunga, Eastern Nepal:
After summiting in bad weather, Carlos Pauner lost sight of his climbing mates. In the middle of the whiteout, he now tries to find a way down a couloir, without sliding and falling to death.
He is at 8500 meters and night falls. He doesn’t feel too cold or worn out; just sleepy and a little clumsy. For no apparent reason, he is suddenly blind from one eye. He hears the voice of someone he can’t see, and has never met. “Hey dude, you should take a rest. You deserve it. You worked so hard and you should rest.” Carlos refuses. He does not want to stop. The ghost companion continues to tempt him. “Why not? You already reached the summit. Just lay down on the soft snow and close your eyes…”
Somewhere deep in Carlos’s confused mind, he knew that if he lied down, he would never get up.
Bargaining with death
“I recall very well his words and his arguments to make me stop,” Carlos said. “I could not convince him, so I negotiated with him, and finally reached an agreement: We would walk 100 steps down and rest for some minutes, then walk another 100 steps. That way I managed to climb down the couloir to 8000 meters. My imaginary mate stayed by me, complaining the whole night. After dawn I finally stopped for a couple of hours, but ordered myself not to sleep.”
Carlos Pauner spent two days in the middle of a white nightmare. He fell, lost a glove, and missed Camp 3. But he managed to find Camp 2 and got back to BC. For days, he was exposed to dehydration, cold and extreme altitude. He suffered amputations from serious frostbites that took almost a year to heal.
‘Mona Lisa’ smile
Both Pauner and the stranded climber were affected by hypothermia in different degrees. They both experienced symptoms of what is known as ‘the sweet death’.
When dying a ‘sweet death’, you feel an innocent desire to lie down and sleep. A certain feeling of wellness overcomes you. And with a sardonic ‘Mona Lisa’ smile on your face, you die.
Hypothermia was not the only thing to affect the climbers. In Pauner’s case, altitude and exposure made him hallucinate. But his strength, will power, and experience saved his life. As for the Pyrenees victim, he lacked the physical endurance, the will, and the knowledge necessary to avoid asleep. In the end, he couldn’t resist the temptation of the ‘sweet death’.
Everest 2004
After last year's Everest season, climbers trickled in to ExWeb's office bringing with them tales of summits but also some alarming news. All over the mountain, climbers had been falling asleep. All had been shook awake by Sherpas; most weren't aware how close to death they'd been. Almost all were novices to 8000+ altitude. They didn't feel cold, or thirsty, or too tired. They just had an overpowering urge to sit down, close their eyes - and rest for a while.
We asked an expert on the subject - about the facts, the danger and the truth about the legend of the sweet death. And - most of all - how to avoid it.
Asking an expert
Dr.Ramón Morandeira is a world-wide authority on mountain medicine and surgery. A professor of experimental surgery at Zaragoza University in Spain, his work and research has focused on mountain medicine for decades (he operated and healed Carlos Pauner’s frostbitten fingers).
Currently, he is the director of a graduate level course in Emergency Mountain Medicine. He teaches doctors who will later join the Spanish rescue patrols, considered among the best in the world, because there is a doctor in every team.
In the course, the doctors learn about mountain related illnesses, and how to reach a wounded person in hostile environments. They’re also taught the mountaineering skills needed to search for, cure, and evacuate people from mountain areas.
Morandeira has taken part in seven major expeditions, including Baruntse, Jannu and Makalu, both as climber and expedition doctor.
Hypothermia won’t kill you, but it’ll lead the way
His view on hypothermia is crystal clear: Nobody dies just of hypothermia in the mountains, but of generalized deterioration due to altitude, exhaustion, dehydration or all of these at the same time.
“Acute hypothermia is usually not the cause, but the final symptom of a global process of exhaustion, dehydration and exposure to altitude,” Morandeira said. “Hypothermia, understood as a general decrease in body temperature, is easy to diagnose, but generally is masking some other symptoms, mostly physical exhaustion.”
Hypothermia gives frostbite, exposure kills
“The real danger from cold is not the general hypothermia, but what happens afterwards. When exposed to the extreme cold, our body ‘sacrifices’ the limbs to keep its central inner organs — heart and brain — warm. This is an external hypothermia and the consequence is frostbite, one of the higher risks altitude climbers face.”
“Before entering a state of acute hypothermia, a stranded mountaineer suffers from exhaustion, dehydration and in some cases, AMS and lack of food as well. If he gets lost or the climb is too long and exposed for him, he will move until he can’t go on. Exhaustion leads the body to deteriorate in such a way that it can’t keep itself warm and, well, alive. He will end up hypothermic, yes, but only after fighting the mountain for many hours or days.”
The sad example of war
“Unless his state deteriorates first, a healthy, strong and well hydrated climber does not have to be struck by generalized hypothermia,” Morandeira said. “To avoid doing so, keep well hydrated and fed, and know when to stop and turn around - if that is possible.”
In war, when soldiers die of cold in the trenches, the real cause of death can’t be simply hypothermia. Unable to move, they fight the low temperatures for hours, shivering and consuming all the energy their bodies have. The same process can apply to a climber who falls in a crevasse.
Exceptions: Sudden exposure
The only circumstance in which a subject can suffer from lethal, acute hypothermia is when the whole body is suddenly exposed to a very low temperature. When it’s impossible for the body to regulate its inner temperature, the heart fails. Dr. Morandeira explains how this happens:
Immersion in cold water:
“The case would be, for instance, when crossing a frozen lake. If the ice breaks under his feet and he sinks. Thus, this kind of hypothermia is also a real danger for Arctic explorers.”
Buried under an avalanche:
“Deaths by avalanches are due to either the body being crushed under the weight of snow, or by asphyxia, because the victim inhales powder snow, which melts in the lungs, causing the victim to drown. Only in scarce cases can the victim actually breathe properly under the snow, but dies of hypothermia before being rescued.”
Can death be sweet at all?
About the nickname of “sweet death”, this is what Doc has to say: “Cold is anesthetic, this is a fact. In the same way we use ice to ease the pain on a swollen limb, cold tends to soften the pain from exhaustion or wounds. Thus the feeling of numbness. Moreover, in a state of exhaustion, thirst and hunger, all we want is to sit down and rest. The cold environment will ease the pain and lead to sleep.”
What about the smile, then? “The smile is a post-mortem grin, caused when the facial muscles freeze,” ends Morandeira.
Wrap up of this story: Whatever you do on Everest, buddy - DON'T FALL ASLEEP!
Image of a climber fighting sleep just outside high camp tent on Mount McKinley, Alaska. ExWeb files.
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