S T A N F O R D M E D I C I N E
Volume 16 Number 4, SUMMER 1999
doc on top
This summer Rich Lee, MD,
practiced medicine in a place so high
it was almost
out of this world.
MAY IS CLIMBING SEASON ON MOUNT EVEREST AND STANFORD DOCTOR RICHARD LEE, MD, WAS THERE THIS YEAR DURING THE PEAK PERIOD TO SEE THAT THE CLIMBERS UNDER HIS CARE MADE A SUCCESSFUL SUMMIT BID. Each of the three climbers in Lee's team conquered the highest mountain on Earth and two of them threw in an ascent of neighboring Nuptse for good measure.
Lee remained at Base Camp on the south side of Everest, a mere 17,500 feet, while the climbers in the expedition picked their way to 29,000 feet, where the air has one-third the amount of oxygen available at sea level and people at rest breathe at three times the normal rate. In addition to the expedition that included Lee and the three climbers Charles Corfield, Pete Athans and Bill Crouse, 15 other Everest expeditions were clustered on the mountainside in the last three weeks of May. Two hundred tents jostled for space in an area equivalent to that of three city blocks.
For Lee, a 1991 graduate of the Stanford family practice residency program and a physician at the clinic, it was an exhilarating once-in-a-lifetime experience. "It was an honor to be there," he says. "It was definitely a learning experience for me, and I think some good will come of it from what I gained in treating these people."
Lee -- whose father, Richard S. Lee, class of '45, three uncles and an aunt are all alumni of Stanford University School of Medicine -- has been rock climbing and ski mountaineering for the past 25 years. He has had an enduring interest in wilderness medicine and has been involved in many mountain rescues in Yosemite National Park. Fortunately he had no extreme medical emergencies to deal with on the Everest expedition.
His most rewarding case was to minister to Corfield and another climber who were both suffering from severe bouts of bronchitis and laryngitis. Lee successfully treated Corfield with a new asthma medicine and other drugs to clear his breathing and relieve the wracking cough that plagued him, as it does most climbers at high altitude. Six days later Corfield stood on top of the world.
It was Corfield who invited Lee to participate in the Everest Millennium Expedition, which was largely funded by National Geographic and the Boston Museum of Science. "We invited Dr. Lee to Base Camp due to his original ideas on high-altitude issues, which have proved useful in previous expeditions, both in managing deleterious effects of altitude as well as in improving performance," says Corfield.
The two have been friends for three years, since Corfield first became a patient of Lee's. During Corfield's previous Everest expeditions in '97 and '98, Lee ministered to Corfield by e-mail from Base Camp. When Corfield returned to California, doctor and patient would brainstorm about solutions to some of the high-altitude medical problems he or his team members had experienced. "He was my guinea pig basically, and it was time to put [my advice] to the test," says Lee.
Lee was able to prescribe medicines to treat several of the common problems suffered by climbers at extreme altitude (above 22,000 feet). Difficulties with digestion were alleviated with a drug that improves the motility of the gastrointestinal tract, and climbers' complaints of congestion and mucus buildup in the upper airway, arising from hyperventilation of the thin dry air, were treated with a nasal spray that seemed to help greatly.
Lee also helped climbers from neighboring expeditions suffering from diarrhea, infected frostbite or other skin conditions. Many of the medicines, some of which had been donated by pharmaceutical companies, had been transported to Base Camp according to a list that Lee and Corfield had composed. Lee brought additional drugs with him. "I tried to think about what everyone else would bring and then fill in the gaps," he says. Extra supplies could be requested by e-mail to Kathmandu and a relay of porters would deliver them in two days, which sounds like a long time until you consider that six days is a speed trek to Base Camp and Lee's group took nine days to walk the distance safely and comfortably.
Other than a bout of gastroenteritis, Lee didn't experience any health problems himself but he was aware of the stresses on the human body at such high altitude. "You don't have the energy and you don't have the same quickness and confidence. Simple tasks take so much more concentration up there," he says. He found himself double-checking everything and handwriting all his instructions to patients. "When you don't have the energy, you want to make sure that you don't make mistakes mentally as well," he says.
When Lee was not doling out medicines and advice to the climbers, he was true to his "job description" and spent his time fixing communications equipment and tending power supplies. Before embarking on the trip, Lee had asked Corfield, "What kind of doctors are useful on an Everest expedition?" "Ones that can fix generators, troubleshoot electronics and other things," Corfield had jokingly replied. -- KW