EXHAUSTION, CEREBRAL EDEMA, INEXPERIENCE, SELF-ADMINISTERED DRUGS

Alaska, Mount McKinley

Bob Wheeler (age unknown) was a member of the North Cascades Alpine School guided expedition to the West Buttress of Mount McKinley. The group, led by guides Alan Kearney and Tim Boyer, reached the summit late in the day on June 22. Wheeler was exhausted by the effort. He arrived at the high camp at 17,200 feet late in the evening and took 60 mg of codeine sulfate and 30 mg of dalmane from a personal supply without telling the guides.

At noon on June 23, Kearney and Boyer reported to NPS Mountaineering Ranger Buchanan, who was in the same area, that Wheeler was really exhausted and that they thought they would wait a day to descend. Around 2:00 p.m., Buchanan observed that Wheeler could not stand without assistance and had significant coordination problems.

A radio contact was established with Dr. Drummond Rennie in Talkeetna about 1:00 p.m. and the situation was discussed. Besides motor problems, Wheeler had a bad headache and pain in his kidneys during urination. Rennie recommended immediate descent and not to “sleep on it.”

The group packed immediately and departed the high camp at 6:45 p.m. NPS personnel Ralph Baldwin and Scott Gill accompanied the group down the West Buttress to help haul loads and assist in belays. Buchanan coordinated radio communication for the high camp. The group reached the fixed lines at midnight where Gill and Baldwin left to return to the high camp. Wheeler was lowered to the camp at 14,200 feet where all spent the night exhausted from the efforts.

The following day, Wheeler had not improved and late on June 24, he was taken to a lower elevation by sled. He reached Kahiltna base camp early on June 25, still without showing significant improvement, and was immediately flown to Talkeetna. He improved on the descent to Talkeetna. Several doctors en route diagnosed Wheeler as having cerebral edema. (Source: Dave Buchanan, Mountaineering Ranger, Denali National Park)

Analysis

Aside from the obvious fact that guides can rarely know their clients well before they arrive, the situation encountered here points out that the problem is exacerbated when a client resorts to clandestine activities such as self-medication. Another example of this case occured during a semester-long climbing/outdoor leadership school program this past year when a client, separated from the guides for several days, became hypothermic. The problem was not just the hypothermia, which, in fact, the clients dealt with, although it took them 36 hours; the more disconcerting aspect was that the clients did not tell the guides (who were in contact with them by radio) what was happening because they were concerned about “letting the guides and other clients down.” The general point to be made is that trying to please others, especially by not informing them of your condition or by administering self-prescribed medication, may result in achieving the opposite effects from those desired. (Source: J. Williamson)