Tom Buckman / Staff Grade in Emergency Medicine / Devon
South West Devon is not renowned for its prevalence of acute mountain sickness, so convincing the powers that be at Torbay Emergency Department that Expedition Medicine’s Mountain Medicine Course in the Nepal Himalayas would be a valuable use of my study leave was a challenging task. However, after some enthusiastic words on trauma, teamwork and communication skills I received the green light and set about gathering the contents of a seemingly never-ending kit list.
Before I knew it I was in bustling central Kathmandu ready to meet a trekking group from all corners of the globe. After a couple of days acclimatising and valuable teaching on the important considerations of pre-expedition planning, we were in a single propeller plane destined for the most exhilarating landing strip any of us will ever encounter at Lukla, altitude 2800m. The excitement was palpable as we set out at the start of our trek to Everest base camp, and the following two weeks exceeded all expectations.
My main concern prior to applying was a lack of experience at altitude, but I was pleased to discover that this had no bearing on eligibility, and in fact the majority of the group had never been to altitude before. Booking was a simple matter of accessing the Expedition and Wilderness medicine website and signing up. This can be done at any time leading up to the course as long as there are places, but obviously the earlier the better to give you time to gather kit, get vaccinations and hopefully get the cheap flights.
The course ran from October 22nd to November the 8th and cost £2795 in total. Although initially seeming expensive, this fee included all accommodation and food on the trek so there was little extra spending money required apart from for copious amounts of tea and apple pie at the charming local bakeries. Additionally a significant proportion of the profits from the expedition go towards supporting the work of Everest ER, which provides vital medical care to the hundreds of incredible climbing Sherpas that work in the area each season, as well as for the many visiting trekkers.
The leaders and course content
It was a privilege to gain knowledge and skills on both mountain medicine and broader aspects of expedition medicine from three enthusiastic and inspiring doctors with a huge amount of experience and expertise in the field. The presence of Dr Luanne Freer, the founder of Everest ER, as one of our leaders gave us the chance to gain a unique insight into the realities of working at altitude in the Himalayas.
Most days involved between six and eight hours trekking and ended with a couple of informal and interactive lectures on a wide variety of subjects. Particular attention was paid to the recognition and treatment of acute mountain sickness, high altitude cerebral oedema (HACE) and high altitude pulmonary oedema (HAPE), whilst other common presentations encountered in mountain medicine such as frostbite and hypothermia were covered in detail.
Additionally there was a wealth of teaching on subjects applicable to wilderness medicine in general including back country medical kits, water disinfection, trauma care, wound management and even wild animal attacks. Of most use was a day of simulated mountain rescue scenarios which helped to consolidate much of the theoretical knowledge gained whilst giving a real feel for the challenges and important factors to be aware of when co-ordinating a mountain rescue.
Words and even pictures cannot do justice to the incredible natural beauty and shear enormity of the Khumbu valley and the Everest range. It is not often that I contemplate the prospect of a 6.30am awakening with pleasure, but every day began with the excitement of what the day’s trek would bring and never disappointed. It was fascinating to learn about altitude related illness while experiencing and dealing with early symptoms yourself, as well as meeting other trekkers along the route who were struggling with the effects of altitude and needed help. There’s nothing like learning on the job.
By staying in tea houses the friendly, fun and accommodating nature of the mountain communities was really evident, and made for another rewarding part of the expedition. It was impossible not to become immediately attached to the generous locals, and in particular to the team of incredible Sherpas who were primarily responsible for our safe passage up the Khumbu valley but quickly became an integral part of the group and good friends. Whether leading from the front, helping those at the back, or serving up culinary delights the Sherpas were forever smiling and ensuring most importantly that everyone enjoyed the journey. It was a true pleasure to spend two weeks with them in their mountains.
Having had time to reflect, I still find myself struggling to think of anything but positives regarding this trip. As an educational opportunity it was outstanding, not only in the field of mountain and expedition medicine but also covering so many generic skills that are fundamental qualities of a competent medic. It has given me far greater insight into the opportunities available for those motivated to do something different and exciting with their careers, whether at altitude or within any of the many other branches of adventure medicine.