Summary

(2:40) Introducing Dr. Roger McMorrow

• His medical training and specialization in anesthesiology

• His role as Clinical Director of Dublin’s National Maternity Hospital

(3:30) The origins of his love of mountaineering

• Being expelled from Catholic school at 16 after a practical joke

• Transferring to Friends’ School in Lisburn

• His introduction to camping and hiking through The Duke of Edinburgh scheme

• Discovering the British Exploring Society ‘ ‘The Hogwart’s school of mountaineering’

• Learning survival, climbing and camping skills in northern Norway

• Joining the Queens University mountaineering club

(6:25) Always higher

• The main appeal of mountaineering: exploring strange and unusual places

• Mountaineering offers something for everyone, whether it’s bouldering, technical waking, or glacier travelling

• Roger’s first Alps climb in Chamonix-Mont Blanc

• How his Mont Blanc climb made him want to go even higher

(8:35) The pros and cons of Everest

• While most mountaineers like solitude, Everest offers the opposite

• Why several climbers have a love/hate relationship with Everest

(9:15) Roger’s team’s scientific studies

• The goal: to study the effects of low oxygen levels

• His principal colleagues: Nigel Hart and Michael O’Dwyer led by Mike Grocott, with UCL’s Caudwell Xtreme Everest group

• How lack of oxygen is a common cause of death in intensive care patients

• The ethics challenges of low oxygen experimentation

(12:20) Why Everest?

• Climbing Mount Everest is a well-supported undertaking

• Combining their medical career with their passion for mountaineering

• The result: over 100 scientific papers published

(13:20) The study’s findings and the science of low oxygen levels

• Humans can acclimate to oxygen levels on par with those of diving mammals, specifically the diving Weddell seal

• The lowest recorded oxygen level is 1/3 of the level that causes death in IC patients

• The role of mitochondria in our ability to acclimate

• Our body’s ability to rely more heavily if needed on low oxygen-tolerant cells

• Comparisons with the human fetus, who is able to survive on the low oxygen levels in the mother’s blood

• ‘We are born with this ability’

(15:58) Logistics of the climb

• Delivering much of their equipment in advance, some of it by helicopter

• The challenge of heavy, sensitive equipment

• Creating custom equipment, tents and generators

• The importance of Sherpa support and their unique acclimatization abilities

(19:41) Preliminary physical training

• Feeling like he had been practising since the age of 19

• The importance of simply sitting in place, acclimatizing

• The mental impact of just looking at the mountain

• Mike Grocott’s rule for the Everest climbers: having been above 8000 m

• Their climbing leader: Dr. Dylan, the only one who had been above 8000 m

• The 2 preliminary expeditions to Cho Oyu

• Their goal: getting an arterial blood gas sample

• The challenges: shrunken arteries because of the cold and preparing an operation area under difficult conditions and limited funding

(24:37) Learnings from Cho Oyu

• The effects of fatigue

• Proving that obtaining a blood gas sample was possible under these conditions

(26:42) Weight gain and weight loss

• Why one loses so much weight and muscle mass when climbing

• Attempting to gain weight in preparation. The key: late-night take-out

(28:49) Choosing to ascend the South side

• The multiple possible routes to Everest

• The logistical ease of bringing equipment through Nepal

• Building relationships with the companies on the South side

• Their priorities: 1) Safety ‘ 2) Science ‘ 3) Summit

(30:27) The challenges of the climb

• Why the biggest challenge is the mental challenge

• The difficulty of being away from family and children

• The importance of having alone time in separate tents

• How one discounts and rationalizes risk

• What it means to minimize risk

(35:27) Risk-taking in Roger’s professional life

• ‘I don’t like doing risky things’

• His job as an anaesthetist: making risky surgery less risky

• An important skill: remaining calm when things go wrong

(36:55) Medical responsibility

• Committing to join any rescue taking place on the mountain

• The trouble caused by logistical issues between different expeditions

(40:42) The Sherpas

• How the Sherpas were treated as members of team

• Their importance and large number due to the amount of equipment needed

• The hierarchical and familial nature of Sherpa work

• The respect and financial rewards that come with being a Sherpa

• Questions about the next generation of Sherpas

(45:12) ‘Summit fever’

• The effect of hypoxia on decision-making

• Their decision beforehand of deferring decisions to those at base camp

• Setting a hard turnaround time regardless of where they were

• The impact of late summits on death rates

(48:17) Unpredictable weather

• Since climbing Everest is often only done once, the urge to summit can lead to bad decision-making

• The 200 km/hr winds that make Everest unclimbable most of the year

• The difficulties and crowded trails caused by this short climbing window

• Their decision to hold back 3 days after the window of good weather opened

(51:32) Rescues

• Saving the life of a young Nepalese woman left for dead

• The limits of their medical field equipment

(58:45) Challenging areas

• Khumbu Icefall: ‘It’s like knowing someone wants to kill you, but you’re not sure when they’re going to pull the trigger or where they’re going to come from’

• Summit day: climbing in the dark, being far from help, and reaching the highest altitude of the whole trip

(1:02:47) Summit day

• Getting equipped with down suit, visor, oxygen mask

• Walking alone, hearing just your own breathing

• Breathing 8-10 breaths per step

(1:05:47) Nourishment

• How hard it is to eat, especially when not acclimatized

• Another challenge of altitude: a pot of water taking an hour to boil

(1:06:42) Acclimatization to altitude

• Increased respiratory rate

• How your brain adjusts to hyperventilation

• Chronic altitude problems and the impact on internal organs

• The highest stable human population: 4500m

(1:09:20) Serious health risks

• AMS (acute mountain sickness)

• Pulmonary oedema

• Cerebral oedema

• Losing brain mass after a trip to Everest

• The difficulty in predicting how well each person will acclimate

• The best advice: ‘Climb high, sleep low’ and ascend gradually

(1:14:47) The effects of age

• Why children perform worse at altitude and why young people acclimatize slower

• Why older athletes are the most common climbers

(1:16:00) Summit night

• The fear of the returning jet stream

• The feeling of familiarity at seeing the view from the summit

• Feeling a sense of melancholy when reaching the summit after working so long and hard to reach it

• The beautiful view and sunrise from the top

• Feeling hypoxia-induced confusion

• The phone call to Roger’s wife from the summit

(1:25:15) The descent

• Battling horrendous wind

• Feeling the effects of exhaustion

• Understanding how a small deterioration in conditions can turn a good day lethal

(1:27:17) Next time

• Feeling lucky to have been in such a well-organized expedition with like-minded people

• ‘You get what you pay for’ ‘ how to choose a commercial trip

(1:28:42) The legacy of the climb

• How it has defined and affected Roger’s life

• ‘It’s a great thing to have done rather than be doing’

• How preparing for the climb was hard on his family

(1:30:12) How his family deals with risk

• ‘It’s almost like a way of life’

• Taking his kids camping and climbing

(1:31:57) Climbing with his wife Sarah

• Their meeting in the Alps

• Sarah joining their team of 3 to climb an unnamed peak in India

• How they selected this particular unclimbed peak

• The epic descent down an unfamiliar face of the mountain

• Naming their new mountain: Dra’ocht Parbat