- Email: [email protected]
In England Now
741
deaths in our series were from cancer, and half of them were due to bronchogenic carcinoma. Diabetes.-Diabetics formed 3% of the total group. The late mortality is high and is principally due to myocardial infarction. However, 5 of the 7 patients Thus aorto-iliac died with patent reconstructions. reconstruction in the diabetic patient appears no less satisfactory than in the usual type of patient with aortoiliac disease. We thank Dr. David Sutton for his immense help radiologically and the department of biochemistry for chemical measurements.
Requests
for
reprints should
be addressed
to
W. T. I.
REFERENCES
Haimovici, H., Steinman, C. Surgery, St. Louis, 1969, 65, 232. Minken, S. L., DeWeese, J. A., Southgate, W. A., Mahoney, E. B., Rob, C. G. Surgery Gynec. Obstet. 1968, 126, 1056. 3. Staple, T. W. Surgery, St. Louis, 1968, 64, 569. 4. Cannon, J. A., Kawakami, I. G., Barker, W. F. Archs Surg., Chicago, 1961, 82, 813. 5. Darling, R. C. New Engl. J. Med. 1969, 280, 84. 1. 2.
Occasional Book EGOS ON EVEREST TAKING
years to organise and costing in the region the International Himalayan Expedition to Mount Everest in 1971 was possibly the most expensive party to set foot on the mountain. It was certainly more racked by illness and dissension than any other. Doctor on Everest1 is the record of one man, Peter Steele, who was in medical charge of the party. His account reveals some clinical details of his patients, and he very properly obtained consent to these disclosures from the members of the expedition. With a Sunday Times reporter and B.B.C. cameramen on the expedition, many of the incidents recorded in this book have been reported in the Press and on television. The object of this mammoth excursion was to climb Everest by two routes-the South Face and the West Ridge. The South Face is a most formidable problem, and a Japanese party had failed there the year before. The West Ridge had been climbed by an American party led by the leader of the 1971 expedition, Norman Dyhrenfurth. For this purpose, a party of very good mountaineers two
of$200,000,
from
France, Britain, Japan, America, Switzerland, Austria, Italy, Norway, and India had been gathered. The expedition was split into distinct groups, and Dyhrenfurth and Steele stayed in the West Cwm at the common starting-point. All was going well until the Indian mountaineer, Harsh Bahuguna, died in circumstances that required an inquiry into the incident. This tragedy was followed by a period of bad weather; and the morale of the party was eroded by inactivity, remorse, and then sickness. A vote was then invited by the leader as to whether the West Ridge party wished to continue on the ridge, divert the normal South Col route, or concentrate on the South Face. Personal discontents erupted, and, incredibly, the " honour of France " became an issue. Pierre Mazeaud, a Gaullist deputy, refused to join the South Face team and is reported as saying: I am not going to be a Sherpa carrying for Anglo-Saxons. It is not only me but France that you have insulted ". The party split in two-Latins to
"
on Everest. By PETER STEELE. Stoughton. 1972. Pp. 222. £2.50.
1. Doctor
London:
Hodder &
Anglo-Saxons; tempers rose and the Latins left in high dudgeon and highly vocal. Then an illness resembling glandular fever, with a temperature, enlarged cervical glands, and a sore throat, assailed the remainder. Unfortunately this affected the leader, Norman Dyhrenfurth, who, before the expedition, and
had had Hashimoto’s disease. He had to be restarted on steroids and evacuated. Despite this depletion in manpower, the South Face party, including two dour and earthy Anglo-Saxons, Whillans and Haston, and two impassive Japanese, removed themselves and continued to 27,500 ft. There, with virtually no oxygen, no food, and minimal support, they were forced at last to retreat. It is far too easy to criticise, but basic mistakes were made in that there was no common tongue and hence communication was always difficult. Team spirit, too, was certainly lacking in the vital middle period. This is, after all, a device for winning and an imperative to success in any corporate enterprise. With it the Latins, like everyone else, would have ferried loads and it is likely the South Face could have been climbed, and perhaps by one of them. For Peter Steele, medical conditions were prolific,22 varied, and interesting, and all his skills were needed. His obvious empathy with the local Sherpas helped the whole party a great deal. Inevitably this book mirrors the author’s feelings, and a quality of resigned endurance rather than one of active pleasure comes through in the text. As Steele himself says, he lost interest in the climbing about half-way through the expedition and stuck to the job that he had gone to do. He did this very well, and he has written a most illuminating book. MICHAEL WARD.*
In
England Now
Rachel was just 23 years old when she died. They had been tremendous years and they ended as they began, in the quiet comfort of a suburban home or the painless anonymity of a hospital bed, but in the filthy corner of her gypsy caravan. She died of stomach cancer, with both her children beside her in the only bed, and another eleven of her family with her, faceless in the dark shadows of the single candle. She did not " go gentle into that good night "; as I covered her face, her mother gave out one piercing visceral wail that cut the air and was taken up in ululation by the twenty or thirty that stood in the bleak darkness outside; such a cry as you hear in an African night or in India, but very seldom in our proud selfconscious England. Next day, the town was full of her people and later her grave was covered in a caravan of flowers. There is no moral to this tale, no reproach: diagnosis was not delayed, operation timely but ineffective. She died as she had lived, true to her people, in England but not of England. All our fine science, all our million-pound hospitals, all our social services were offered and refusedfinally irrelevant to her because we had failed to make them acceptable on terms she could understand. I set the story down because it happened in 1972 and because it is fitting that our profession should record it, since no-one else will.
not not
*
*
*
A question from a recent surgical examination: " How would you investigate an outbreak of clean wounds in a <:m’tr!fF)1
warc3 ?"
A
neat comment
nn nnf
2. Steele, P. Lancet, 1971, ii, 32. *Mr. Ward was one of the doctors Everest expedition.—ED. L.
on
timeq
the successful 1953
deaths in our series were from cancer, and half of them were due to bronchogenic carcinoma. Diabetes.-Diabetics formed 3% of the total group. The late mortality is high and is principally due to myocardial infarction. However, 5 of the 7 patients Thus aorto-iliac died with patent reconstructions. reconstruction in the diabetic patient appears no less satisfactory than in the usual type of patient with aortoiliac disease. We thank Dr. David Sutton for his immense help radiologically and the department of biochemistry for chemical measurements.
Requests
for
reprints should
be addressed
to
W. T. I.
REFERENCES
Haimovici, H., Steinman, C. Surgery, St. Louis, 1969, 65, 232. Minken, S. L., DeWeese, J. A., Southgate, W. A., Mahoney, E. B., Rob, C. G. Surgery Gynec. Obstet. 1968, 126, 1056. 3. Staple, T. W. Surgery, St. Louis, 1968, 64, 569. 4. Cannon, J. A., Kawakami, I. G., Barker, W. F. Archs Surg., Chicago, 1961, 82, 813. 5. Darling, R. C. New Engl. J. Med. 1969, 280, 84. 1. 2.
Occasional Book EGOS ON EVEREST TAKING
years to organise and costing in the region the International Himalayan Expedition to Mount Everest in 1971 was possibly the most expensive party to set foot on the mountain. It was certainly more racked by illness and dissension than any other. Doctor on Everest1 is the record of one man, Peter Steele, who was in medical charge of the party. His account reveals some clinical details of his patients, and he very properly obtained consent to these disclosures from the members of the expedition. With a Sunday Times reporter and B.B.C. cameramen on the expedition, many of the incidents recorded in this book have been reported in the Press and on television. The object of this mammoth excursion was to climb Everest by two routes-the South Face and the West Ridge. The South Face is a most formidable problem, and a Japanese party had failed there the year before. The West Ridge had been climbed by an American party led by the leader of the 1971 expedition, Norman Dyhrenfurth. For this purpose, a party of very good mountaineers two
of$200,000,
from
France, Britain, Japan, America, Switzerland, Austria, Italy, Norway, and India had been gathered. The expedition was split into distinct groups, and Dyhrenfurth and Steele stayed in the West Cwm at the common starting-point. All was going well until the Indian mountaineer, Harsh Bahuguna, died in circumstances that required an inquiry into the incident. This tragedy was followed by a period of bad weather; and the morale of the party was eroded by inactivity, remorse, and then sickness. A vote was then invited by the leader as to whether the West Ridge party wished to continue on the ridge, divert the normal South Col route, or concentrate on the South Face. Personal discontents erupted, and, incredibly, the " honour of France " became an issue. Pierre Mazeaud, a Gaullist deputy, refused to join the South Face team and is reported as saying: I am not going to be a Sherpa carrying for Anglo-Saxons. It is not only me but France that you have insulted ". The party split in two-Latins to
"
on Everest. By PETER STEELE. Stoughton. 1972. Pp. 222. £2.50.
1. Doctor
London:
Hodder &
Anglo-Saxons; tempers rose and the Latins left in high dudgeon and highly vocal. Then an illness resembling glandular fever, with a temperature, enlarged cervical glands, and a sore throat, assailed the remainder. Unfortunately this affected the leader, Norman Dyhrenfurth, who, before the expedition, and
had had Hashimoto’s disease. He had to be restarted on steroids and evacuated. Despite this depletion in manpower, the South Face party, including two dour and earthy Anglo-Saxons, Whillans and Haston, and two impassive Japanese, removed themselves and continued to 27,500 ft. There, with virtually no oxygen, no food, and minimal support, they were forced at last to retreat. It is far too easy to criticise, but basic mistakes were made in that there was no common tongue and hence communication was always difficult. Team spirit, too, was certainly lacking in the vital middle period. This is, after all, a device for winning and an imperative to success in any corporate enterprise. With it the Latins, like everyone else, would have ferried loads and it is likely the South Face could have been climbed, and perhaps by one of them. For Peter Steele, medical conditions were prolific,22 varied, and interesting, and all his skills were needed. His obvious empathy with the local Sherpas helped the whole party a great deal. Inevitably this book mirrors the author’s feelings, and a quality of resigned endurance rather than one of active pleasure comes through in the text. As Steele himself says, he lost interest in the climbing about half-way through the expedition and stuck to the job that he had gone to do. He did this very well, and he has written a most illuminating book. MICHAEL WARD.*
In
England Now
Rachel was just 23 years old when she died. They had been tremendous years and they ended as they began, in the quiet comfort of a suburban home or the painless anonymity of a hospital bed, but in the filthy corner of her gypsy caravan. She died of stomach cancer, with both her children beside her in the only bed, and another eleven of her family with her, faceless in the dark shadows of the single candle. She did not " go gentle into that good night "; as I covered her face, her mother gave out one piercing visceral wail that cut the air and was taken up in ululation by the twenty or thirty that stood in the bleak darkness outside; such a cry as you hear in an African night or in India, but very seldom in our proud selfconscious England. Next day, the town was full of her people and later her grave was covered in a caravan of flowers. There is no moral to this tale, no reproach: diagnosis was not delayed, operation timely but ineffective. She died as she had lived, true to her people, in England but not of England. All our fine science, all our million-pound hospitals, all our social services were offered and refusedfinally irrelevant to her because we had failed to make them acceptable on terms she could understand. I set the story down because it happened in 1972 and because it is fitting that our profession should record it, since no-one else will.
not not
*
*
*
A question from a recent surgical examination: " How would you investigate an outbreak of clean wounds in a <:m’tr!fF)1
warc3 ?"
A
neat comment
nn nnf
2. Steele, P. Lancet, 1971, ii, 32. *Mr. Ward was one of the doctors Everest expedition.—ED. L.
on
timeq
the successful 1953