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High Altitude House Calls
November 1999
by Bruce Fellman
Medical rounds started routinely enough at Yale–New Haven Hospital on the morning of May 14 as Richard Satava, professor of surgery at the School of Medicine, and his colleagues gathered to discuss the day’s cases. But in short order, there was pandemonium.
“It was a scene straight out of ER,” recalls Satava. “We got word that they'd brought someone in who was suffering from severe respiratory distress, and we had to go to work immediately.”
Of course, physicians are often called upon to handle emergencies, but this situation was unlike any most doctors have experienced. For the patient was half a world away—in Nepal, high up the slopes of Mount Everest—and he'd been carried by Sherpa guides down the mountain after running into trouble at Camp 4, the 26,000-foot-high spot from which climbers make their final push to the summit.
Fortunately for the mountaineer, there were doctors on the slope, four of whom were on call at the time in a tent at 17,500 feet that doubled as medical clinic and the research site of the Everest Extreme Expedition, a project sponsored by Yale, NASA, and a number of other government, private, and corporate organizations. E3, as the million-dollar endeavor is known, was designed to test the limits of telemedicine, a futuristic kind of health care that can bridge gaps between doctor and patient.
“If we can do this on Everest, we can do it anywhere,” says Satava, who headed a medical team based at Yale that was linked almost instantly via satellite to the E3 group on the world’s tallest mountain. Not only could the doctors talk to one another, but, because of technology the teams were testing, they could also exchange sophisticated information about their patient. With a digital stethoscope, physicians on Everest and in New Haven listened to telltale heart and breathing sounds. The results of blood work could be analyzed at the hospital almost immediately. A Doppler 3-D ultrasound scanner sent back images of the lungs, and a digital microscope en-abled the doctors to share views of the bacteria that had been isolated from the climber.
The diagnosis was pneumonia, and after a course of antibiotics, the patient made a complete recovery. “An experienced physician probably could have reached the same conclusion on intuition alone, but the kind of information we received took the guesswork out,” says Satava.
The E3 doctors were able to treat other lung ailments, as well as cases of snowblindness, with these digital diagnostic tools, which also enabled the investigators to study the way the human body adapts to the stress of life at high altitudes.
“The techniques we’ve developed on Everest will increase the access patients have to skilled physicians.” says Satava. “We’ll soon be able to make electronic housecalls.”
The ability to monitor vital signs constantly also helped ease Satava’s own anxiety about a particularly perilous part of the E3 mission: a climb to Camp 2 that required a traverse of the Khombu icefall at around 21,000 feet. As the physician examined the information coming in from the climbers, who were wearing monitors no bigger than cigarette packs, he breathed a sigh of relief. Base camp manager and medical technician Richard Satava Jr., his son, was just fine.  |
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