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Exhaustion, Exposure, Hypothermia, Inadequate Equipment, Party Separated, Weather, Alaska, Mount McKinley

EXHAUSTION, EXPOSURE, HYPOTHERMIA, INADEQUATE EQUIPMENT,

PARTY SEPARATED, WEATHER

Alaska, Mount McKinley

On May 18, 1988, a nine member Genet Expeditions climbing team departed the 5200 meter high camp on the West Buttress of Mount McKinley and began their ascent toward the summit. Chief Guide was Vern Tejas, and the assistant guide was John Schweider. When the party reached the 5900 meter level, they split up. Schwei- der took the weaker members and descended back toward their high camp. Tejas continued on toward the summit with three clients: Mike Moss (49), Dave Kazel (28), and Lynne Salerno (31). After climbing several hundred feet, Salerno became tired and was unable to keep pace with the other expedition members. Tejas told Salerno she was not going to be able to continue and they both untied from the rope and descended about 60 meters while Moss and Kazel continued on toward the summit. While Tejas and Salerno waited for the summit team, Salerno was able to convince Tejas to allow the two of them to once again begin climbing. Salerno climbed toward the summit while Tejas moved between the two teams. Moss, Kazel and Tejas reached the summit first. Tejas then descended to meet Salerno and escort her along the summit ridge. At the summit, Tejas noticed Salerno had frostbite on her cheek. As they began to descend, Salerno began to experience difficulty in walking due to exhaustion. She appeared to be suffering from exhaustion which rapidly deteriorated into hypothermia. Salerno became incoherent and decreasingly mobile. Weather also rapidly deteriorated and the group encountered 20-40 kph winds, whiteout conditions along with temperatures of-30 degrees C. At the 5900 meter level, Tejas decided they must seek shelter. A snow trench was dug while Tejas descended to retrieve additional equipment which the team had left lower on the route. Salerno became unresponsive and lost signs of life shortly after being placed in the snow trench. When Tejas returned, he confirmed Salerno had no signs of life and began a descent with Moss and Kazel to the high camp at 5200 meters. Moss sustained frostbite and was later evacuated along with Genet assistant guide John Schweider. Salerno’s parents requested that her body be left on the mountain if recovery operations would in any way place those people in danger. The decision was made to leave her body at the 5900 meter level. (Source: Bob Seibert, Mountaineering Ranger, Denali National Park)

Analysis

Salerno was a very highly motivated person who totally committed herself to any project she undertook. Apparently she approached the goal of reaching the summit of Mount McKinley with that same zeal and intensity. The summit was the goal she focused upon, not a safe return from the summit. All evidence points toward Salerno having expended all of her physical reserves reaching the summit. There she experienced a physical collapse similar to a marathon runner at the finish line of an exhausting race. Without energy reserves, her body was unable to produce the heat necessary to maintain her core temperature. She rapidly became hypothermic and immobile. She died approximately two hours later.

In an interview with Jack Salerno (father) and Mark Salerno (brother), I discovered:

Very early in Lynne Salerno’s life, she contracted encephalitis which damaged her speech, reading and writing center of her brain. She was almost six years old before she began to speak. She also suffered from dyslexia, a visual perception disorder where letters and words appear reversed or upside down. She was able to overcome these handicaps through an extremely intense commitment to her rehabilitation efforts. This dedication to reaching and completing a goal was carried throughout her life.

Lynne approached everything in her life with similar commitment. She has been an overachiever her entire life. If she had not succeeded in reaching the summit, this would have been the first thing in her life in which she was unsuccessful. I cannot think of anything she could not do once she made the decision to do it.”

As a result of the brain damage Salerno experienced as an infant, she was unable to feel certain levels of pain. In other words, she had a very high tolerance for pain. (For the same reason, she also had a high tolerance for cold. She normally kept the inside temperature of her home at 10 degrees C.)

In an interview with Vern Tejas, I learned that he was not aware of Lynne Salerno’s medical problems, and further, that:

Salerno was the slowest person of the nine member Genet expedition.

Salerno had developed a persistent cough lower on the mountain. She described it as a “winter cough” that she had experienced before and said it was nothing to worry about.

3 On May 9 the group ascended around Windy Corner. During the ascent Salerno became very tired. In an effort to keep the group moving, other expedition members carried much of her gear.

On May 12, Salerno’s morning pulse rate was high. Tejas had Salerno layover a day at the 4300 meter camp while other expedition members made a carry to the 4900 meter level.

Once Salerno collapsed at the summit, her physical deterioration progressed very rapidly. The combination of altitude, weather, lack of shelter and distance to help were so great that even the strongest team would have been hard pressed to reverse her deterioration. Much of the group gear carried on the summit climb was left at lower elevations and was not readily available to the team. Effective shelter at or above the 5900 meter level would have taken much longer to construct than Salerno could survive. Even an immediate descent with strong team members carrying or dragging her would probably have taken too long.

The key to the prevention of this tragedy was the early detection and proper evaluation of Salerno’s physical/mental state and to have turned back before she experienced the physical collapse. This, given Salerno’s background and her total commitment to her endeavors, might have been more difficult than with average clients. Tejas had already stopped Salerno during the ascent, but she was able to convince him that she could continue. Apparently she showed no abnormal signs of altitude problems or exhaustion. She was obviously very tired, but that is common. She never complained of being cold and never showed any sign of hypothermia until after her collapse at the summit.... at least none that the guide was able to identify as critical enough to begin a descent.

Denali is a demanding mountain to climb, but is even a more difficult mountain to lead clients under its extreme altitude and climatic conditions. Guides must constantly be alert to the client’s physical and mental weaknesses and limitations. Timely identification of these limitations can be extremely challenging, especially in the case of highly motivated, goal-oriented persons. In the absence of indications of poor judgment or orientation, signs of altitude illness or cold injury, guides often rely upon a client’s assessment of their own physical status. Herein lies the hazard. How many clients on guided expeditions know their physical limits? How many have pushed themselves previously, physically and mentally, to the extent that they do on a Mount McKinley expedition? How many know how their bodies react to the exhaustion threshhold? A high percentage of people who reach the summit of Denali have pushed themselves toward the outer edge of their personal limits.

While Salerno’s dedication and internal drive to accomplish her personal goals were probably the overriding cause of this tragedy, several additional factors combined to reduce the safety margin of this guided team.

First, sufficient group gear was taken from the high camp on summit day, but it was cached at various points along the route, making it of little value when it was needed. This is especially true of the bivy sack left below Denali Pass, the sleeping bag that was carried to the 5900 meter level but taken back down to the high camp with the portion of the original group who turned back at that level, the stove, fuel and pot which was left just above Denali Pass. The presence of this gear at the 5900 meter level, or even if it was carried to the summit, may or may not have made a difference in Salerno’s survival. Nevertheless, without these items, the group did not have the option to attempt to rewarm Salerno. Tejas had to leave the construction of the snow trench and whatever life sustaining care that could be administered to Salerno to two relatively inexperienced, exhausted clients while he descended to retrieve equipment.

Secondly, with the exception of the guide, the summit team was not a strong team. They had all moved slowly throughout the summit day. Kazel had already decided to turn back at the 5900 meter level and Salerno had been the slowest member of the entire group throughout the expedition.

Thirdly, many other groups were also making their way toward the summit, but by the time the Genet team was making their final summit bid, all the other teams were descending. Therefore, a tired, fairly weak team was alone on the summit very late in the day.

Finally, weather had been ideal throughout the day. The team did not count on the rapid deterioration that occurred after they reached the summit. This was not a major Denali storm, but the whiteout conditions, 20-40 kph winds, and -30 degree temperatures did create severe conditions—wind chill of-60 degrees C.

When Salerno collapsed at the summit, there were no realistic options left to stop and/or reverse her rapid loss of body heat which led to her death. (Source: Bob Seibert, Mountaineering Ranger, Denali National Park)

Analysis

The analysis of this death on Denali may prompt us to wonder why there aren’t more similar deaths. In fact, there are many “close calls” on Denali. The combination of extreme wind chill, dehydration, exhaustion, and hypoxia is more deadly than any of these factors alone. Although some degree of pulmonary or cerebral edema cannot be excluded, exhaustion appeared to be the most significant factor in this case. High heat production is essential to maintaining body temperature in this high heat-loss environment. Her inability to continue exercise reduced heat production and hypothermia quickly developed. Administration of decadron was appropriate, since she exhibited changing consciousness and ataxia, one could not exclude severe altitude illness. Amphetamines, if available, may have been useful, as would oxygen, to combat the hypoxia. Hard candies or other easily digestible carbohydrates can help replenish depleted energy substrate and fluids will improve dehydration.

Once severe hypothermia develops in this environment, treatment requires a shelter, which was not available to this group. Skin-to-skin warming in a sleeping bag, for example, would have required shelter for all members of the group.

Although the guide recognized that the victim may have still been alive while appearing dead from hypothermia, the decision had to be made to abandon her to save the lives of the others. If conditions had allowed it, we may have considered trying to airlift her to an Anchorage hospital to attempt a resuscitation from deep hypothermia. However, the altitude and conditions precluded this kind of attempt. Also, resuscitation is considered futile if core temperature drops below 18 degrees C, which would have taken only a few hours to reach in that environment. The somewhat unusual nature of this case raises the unanswserable question of whether her preexisting medical condition may have contributed to her collapse and demise, in other than the psychological aspect mentioned above. (Source: Dr. Peter Hackett, Director, Denali Medical Research Project)