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Makalu 18th May 2008

The moods of fate are fickle – the long awaited weather window seems to be opening on 21st May and extends as far as our forecast predicts (currently 25th May). Colin and Toby are at Camp 3, Rupert & Dick descended to Base Camp from Camp 3 after fixing most of the gendarme and are confident that the remaining section can be completed in a day. It's Colin's 45th birthday on 22nd May and after spending 7 years in pursuit of this dream, standing on the summit would be a fitting present. On the other side Lara and Matt reached the summit today and the other team is poised at Camp 4, hoping to summit tomorrow.

I suspect this will be their last chance; most other teams on the other side are also planning summit bids in the next 48 hours, so it will be busy, but hopefully not messy. For our team, it means the proposed traverse will be easier with fixed rope and footsteps to follow.

As you have no doubt realised, I am back at Base Camp. I went up the mountain with Colin a few days ago determined to make my peace with the notorious ridge. I went slowly, taking 4 hours for a journey that had previously taken me 3 hours and which Colin comfortably managed in 2 and a half. On the way up, I had plenty of time to think – not the agonised, slow thinking of a man sitting at Base Camp with too much time on his hands and too little to do, but the quick, clear thinking that comes with physical endeavor. A number of things dawned on me – if I didn't make a summit attempt, we would not need to find/borrow/steal another oxygen regulator, nor would we need to carry another sleeping bag, nor would 5 men (instead of 4) need to cram into a small tent on an even smaller ledge to sit out a cold Himalayan night wearing down suits, but no sleeping bags. But mostly I realised that I did not need to make peace with the ridge, or indeed, the mountain – merely myself, and that everything else I mentioned was merely an attempt to make me feel better about abandoning my summit aspirations. For most of the 4 hours, the clouds obscured any view, but as I scrambled through the rocks at 6 pm just before Advanced Base Camp, the sun broke through coating the rocks in golden light and revealing a beautiful vista of Himalayan peaks. It was then that I realised that I only needed to make peace with myself.

I informed Colin of my decision, which he accepted, but asked me to sleep on it – in fact I didn't sleep a wink as I ruminated over what I had said to him (was it the right decision, would my team mates think I was failing them, did I need to have, yet another, word with myself) and the myriad of uninvited and unrelated thoughts that occupy the insomniacs mind.

The morning was spectacular, with great views across to Everest (which looked like it had rather a lot of snow on the upper slopes) and of the route to Camp 1. We heard of the spectacular progress Dick & Rupert, with their Sherpas, had made on the gendarme, fixing in a single day, what the Japanese had taken about 9 days in 1970. Buoyed by this good news, Colin invited me to reconsider, but as tempting as this was, I just knew “it wasn't right”. This, of course, is an almost undefinable and ethereal concept, best defined in Winnie the Pooh when Pooh asks Eeyore how he is feeling - “Not Very How” was his poignant reply. I am extremely grateful to many of you who have provided guidance and support in the last few days as I have struggled with working out what to do.

I know I sounded low on my last blog. I am now calm, happy to be on my way home, and grateful for the company and challenges I have faced in the last few months. I will start walking out from here on 20th May and am quite looking forward to seeing a tree again, even one with hundreds of leeches waiting to drop onto me. I should reach the airhead at Tumlingtar on 25th May and fly to Kathmandu the following day.

This has been the first expedition where I have blogged, so I suspect many of you have witnessed a candid side of me that is not always displayed. This has only been possible due to the generosity of my great friend, Malcolm Russell and his team at Prometheus Medical Ltd. They have provided me with a fantastically small laptop, BGAN (satellite data and voice modem) and solar charging panel. This is by far and away the most robust, reliable and lightweight communications package I have ever seen. It fits comfortably inside a small sub-notebook sized case. The laptop uses a solid state hard drive which has performed exceptionally, easily handling a Video Skype conversation from Camp 1 (6,100m). I sincerely hope (and secretly know) that some of you will have need of such communications, be it wandering into the bush in Africa for a few days, or attempting previously unattained challenges in the remotest parts of the world, and would strongly urge you to look at the communication solutions Prometheus can offer (www.prometheusmed.com <http://www.prometheusmed.com/> and (+44)1568 613942).

Why are the moods of fate so fickle? If I had stayed with Colin, I would have been at Camp 2 last night. Instead, shortly before 8pm, I was asked to see a Trekking Guide with a headache. He had walked here without a rest day and had a previous history of High Altitude Cerebral Oedema(HACE) – a nasty and potentially fatal swelling of the brain (being enclosed in a rigid skull any swelling can not be accommodated so the brain ends up getting compressed – a bit like a boxer who suffers from a bleed inside the head, except HACE isn't treated by drilling a hole in the skull!).

When I initially saw him, he had a severe headache, but was fully conscious and could walk in a straight line without deviation or falling over. These are the distinguishing factors between HACE and severe Acute Mountain Sickness. I gave him the appropriate tablets and he went into our cook tent to be monitored. Some 40 minutes later, our Liaison Officer asked me to see him urgently – he had slumped forward, was barely conscious and his arms were rigidly flexed at the elbows (a dangerous, pre-terminal sign of brain compression). I immediately gave him an intravenous injection and we placed him in a Portable Altitude Chamber (a sort of giant reinforced tube attached to a foot pump). We rapidly pumped the chamber up – this increases the pressure inside the bag and effectively took him down a thousand metres or so in altitude. Initially he had an oxygen saturation of 40% (97-100% is the usual in healthy people at sea level) and a heart rate of 150 beats per minute. Once inside the pressurised bag, his oxygen saturation improved to around 70% and his heart rate fell to around 120 beats per minute. All of our oxygen is high on the mountain and the altitude chamber had only just been brought down as the team had acclimatised without difficulty. Without it, we would have had to take him down in the dark – this requires a robust stretcher and 16 people to be done properly – we had neither.

We maintained a vigil all night, keeping him in the bag for an hour or so at a time, but not allowing him to fall asleep and insisting that he maintained eye contact at all times. He was allowed out for a few minutes every now and then to drink some water and go for a pee. After few hours, he became more animated and by the morning was alert, orientated, co-operative and asking to eat. It was a fantastic team effort, effected without fuss or complaint. He has now safely descended to a lower altitude and advised not to come to these heights again. Medicine is a funny business – we undoubtedly saved his life, but in the same breath, may have taken away his livelihood. I am obligated to inform his employer who has a duty of care to not use him again at high altitude. It seems hard to tell him he's lucky to be alive under the circumstances, but he was very grateful when he left.

Oh, and the other fickleness ........well, having “failed” on this mountain, I have just been informed that I am being presented with a medal from a “High Government Official” on 29th May, which is celebrated in Nepal as International Mount Everest Day (Hillary and Tenzing first reached the summit on 29th May 1953). It's not as exciting as it sounds and I've not been singled out for any great endevour. During the Everest Jubilee celebrations in 2003, the Govt of Nepal issued a commemorative medal to everyone who had reached the summit of Everest in the first 50 years. I was busy with military operations at the time and therefore unable to receive mine. It should be a fun day and a double celebration as I'm promoted from 1st June, although the flight home the next day might be hazy. More worryingly, I'll have to find something smart to wear in Kathmandu – not something which usually troubles me.

STOP PRESS!!! I may be able to get a lift on a helicopter with a departing team (I can't afford my own at $6,000) and it would save walking through leech infested forests for 6 days.