Wednesday, September 21, 2011

Surviving the Extremes, by Kenneth Kamler

Kenneth Kamler gives a medical perspective in Surviving the Extremes: A Doctor's Journey to the Limits of Human Endurance. He describes the reaction of the body to extreme environments, including the jungle, the high seas, the desert, underwater, high altitude, and outer space. For the chapters on the jungle, underwater, and high altitude, he draws primarily on personal experience for his survival situations, and for the others he relates the personal experiences of others. I found that the two types of chapters had entirely different characters, with his personal experiences focusing on the wilderness medicine he had the privilege to perform and his patients, while the other chapters were somewhat more hollow, relating merely the physiological reactions of the body to the stresses it faces under such conditions along with some of the things the protagonists did to survive. In the high seas chapter, he talks about Steve Callahan's (see Callahan's Adrift) fishing exploits and his trouble with the solar still during his 76 days in a life raft, but overlooks the weeks of treatment he received in a local hospital after his rescue. I think the strength of this book is Kamler's on-site extreme environment medical practice stories, and I found I was looking for more on-site medicine stories in the secondary source chapters, such as a Jerri Nielsen story (who operated on herself for cancer at the South Pole) or similar. The stories of survival he includes are harrowing, however, and throughout, he provides detailed descriptions of the body's response to the extremes and what the modern adventurer can do to mitigate such risks.

Kamler has spent several seasons on Mount Everest (chronicled in his Doctor on Everest). He writes a bit about the day-to-day workings of a high-altitude hospital in this book, but he focuses on his worst-off patients, including Pasang, who fell 80 feet down a crevasse onto his head; Konga, who contracted pulmonary edema; and the 1996 disaster survivors Makalu Gau and Beck Weathers, both with severe frostbite. He discusses the body's response to high altitude, as well as how the bodies of Sherpas and other high-altitude natives have adjusted to their home environments. I found it fascinating that their muscles have developed to store significantly larger quantities of oxygen and that they don't have lactic acid build up in their system. I'm a bit curious if the muscle storage mechanism is what develops to give lowlanders the long-term acclimatization that lasts over months or years. I appreciated Kamler's admitting that he could think of no medical reason why Beck Weathers should be alive and his focus on the will's contribution to human survival in seemingly insurmountable circumstances.

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