Monday, March 24, 2008

Live and let die on Everest: A study by Forensic Psychiatrist Dr Erik Monasterio

Live and let die on Everest: A study by Forensic Psychiatrist Dr Erik Monasterio


"The risk that personal ambitions and economic pressures erode acceptable standards of behavior and moral values are sadly as present in adventure sports as in any other human endeavor," writes Dr Erik Monasterio. "Overall the personality of the base jumpers appears to be very similar to those of mountaineers.

These findings are similar to those of other personality studies of risk-taking sports people, which have found high scores on the measure of Sensation Seeking (essentially the same as Novelty-Seeking)." reports the doctor. In 2004, 39 year old X-gamer Valery Rozov climbed a new "Russian" route on Amin Brakk’s (5850m) West face and did a B.A.S.E. jump from the summit. Both images courtesy Mountain.ru.

Too many explorers get in trouble simply because they are ill-prepared or careless. But Andrew McAuley, a very seasoned kayaker, did everything right; even turning back in his first attempt after two days out in order to fix a problem of cold rather than taking the risk of having to call for a rescue later in the trip. Andrew's unfair death came as a shock to the entire community.

The soldiers kneeled and took potshots into a crowd of mostly kids on Cho Oyu, only 100 yards away from climbers. Two figures dropped to the snow, two struggled up and staggered on, one tried to crawl but then collapsed. No one said a word, until Luis sent ExWeb a message. Russell Brice stormed down Cho Oyu and yelled at him, "Paul told me you sent an email to ExplorersWeb, are you fucking crazy?" according to this months issue of Men's Journal. Image of Chinese officers in ABC with captured Tibetan children, looking back towards Nangpa La, courtesy of Pavle Kozjek.

"In life we have the ability to make choices," Irish Banjo Bannon wrote on ExplorersWeb. "These choices often define who we are as people and reflect the true nature of our character. It is my belief that every one of the people who walked over David on that day has revealed themselves as a coward." Image of Banjo enroute to K2, courtesy of his website. "I think there’s a lot of cruelty on Everest – it is actually different on all other mountains… Everest is more than a mountain: It is a symbol of power. Therefore most people attempting to reach that summit are not true climbers, they are rich guys searching for a trophy to take home," said Portuguese Joao Garcia. Comic by Ricardo Cabral. David Sharp's fate enraged the entire community. "I think the whole attitude towards climbing Mt Everest has become rather horrifying...people just want to get to the top, they don't give a damn for anybody else who may be in distress and it doesn't impress me at all that they leave someone lying under a rock to die,” said Edmund Hillary and he was not alone. A few month's later, this nun was shot before the eyes of the very expedition leader who was key in the David Sharp story. Image of the body of the Tibetan nun, left in a snow path on Nangpa La. Courtesy of Pavle Kozjek (click to enlarge). “That mountain [Everest] turned into a circus years ago, and it's getting worse – it's a classic - someone is in trouble, and people pass by, not even taking a quick look," Juanito’ Oiarzabal, the world's foremost high altitude summiteer with 21, 8000ers told ExWeb.

Locations of accidents on Everest north side in spring 2006. The graph shows that Lincoln was found - and saved - on higher altitude than David Sharp. He had also spent a longer time there. (Click to enlarge). "I can’t help thinking that if David had thought of shouting: 'I’ll give you a million dollars if you get me out of here,' he could still be alive," veteran climber and legendary altitude doctor Dr. Jose Ramon Morandeira told ExWeb. Image of David Sharp courtesy of Project-himalaya.com.

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Erik Monasterio is a Bolivian/New Zealand medical doctor and mountaineer. He specializes in Forensic Psychiatry and also has a research background as a Senior Clinical Lecturer with the University of Otago, Medical School. "I have been mountaineering for over 17 years and have climbed in the Andes, Himalayas, NZ, Alaska, Tibet," Monasterio told ExplorersWeb. "The reason I write is to submit an article based on my research interests." "I have prospectively studied a group of mountaineers, over four years to determine the risks involved in mountaineering and also exploring the personality characteristics of climbers and base jumpers.

The article I include also has a comment on the tragic events of the 2006 Everest season - Sad and heroic events juxtaposed in such proximity." Erik's qualifications are MBChB, FRANZCP and Sr. Clin Lecturer. Here goes his interesting paper: The risks of adventure sports (?) By Erik Monasterio Adventure and risk-taking sports such as mountaineering, kayaking, rock climbing, downhill mountain biking and base jumping have increased in popularity in recent years. These activities court significant dangers and attract individuals who are prepared to gamble their personal safety, and at times their life in search of a rush of excitement or an unusual accomplishment.

Public attention in these sports generally focuses on tragedies and as such is highly emotive and sensationalized. Dramatic accounts of accidents and hardships often lead to fierce debates on the merits and ethics of these sports. David Sharp Take as an example the controversial events surrounding double-amputee, Mark Inglis' successful climb of Everest in 2006. Over forty ascending climbers, most with significant team back-up and radio contact to base camp, walked past a dying English mountaineer, David Sharp. Recent accounts reveal that film footage of the unfortunate climber was gratuitously taken and despite David's poor health he was able to speak to the climbers. Tragically and incredulously despite the teams being well equipped with modern equipment, oxygen and medicine no rescue attempts were made. ...vs. Lincoln Hall Ambitious mountaineers walked around David and left him to die, choosing instead to direct their energy to the climb. They gave more value to the summit than to the life of a fellow mountaineer! The climbers once again stumbled past the moribund David on their way down, and still offered no help. The self-serving justifications that he was beyond help and that rescues at such high altitudes are impossible are not convincing, as ten days later another very sick mountaineer, Australian Lincoln Hall, was rescued from a position higher up the mountain.

Himalayan climbers, and the leader of the Inglis team, Russel Brice, know very well that many successful rescues have occurred beyond the “Death Zone” (over 8000m) and that it is notoriously difficult to predict who will die from mountain sickness. In 1996 on the same mountain, Texan pathologist Beck Weathers walked to safety despite twice having been deemed “essentially dead”. 1/3 of killed base jumpers died of other adventures or drugs/suicide Over time 245 mountaineers have died in their quest to climb New Zealand's highest mountain, Aoraki/ Mt Cook and more than one thousand in their quest for Europe's highest peak, Mt Blanc.

Australian sea kayaker Andrew McAuley tragically died attempting the first solo-crossing from Australia to New Zealand. Base jumping is probably the most dangerous sport in the world and involves parachute jumping from either tall natural features or man-made structures. The parachute is initially closed and is opened after a (short) free fall.

A comprehensive data base of base jumping fatalities reveals that 175 jumpers have died since the sport began (approximately 30 years ago). The surprising finding is that only 123 of those deaths were directly related to base jumping, the other deaths were related to other accidents, drug overdoses and suicides. Why? Taking these reports into consideration the understandable public perception is that adventure sport participants are an unusual, highly selfish or odd breed of people. Why else would they willfully choose to court danger and gamble with their lives? At times to the detriment of others. Sensationalized reports, although very good at capturing public attention, are seldom balanced or objective and therefore unhelpful in providing an understanding of the risks and motivations behind risk-taking sports.

Given that New Zealand currently promotes itself as an adventure destination, where risk-taking sports and activities are popular and traded commercially, it is an important and timely subject. As a mountaineer and psychiatrist I have been involved in scientific research to try to determine the rate of accidents in adventure sports. I am also interested in finding out whether people who engage in these activities have “unusual” or unique personalities, and whether there are any biological or genetic reasons to explain why people take up these sports.

The stats In a New Zealand based study of experienced and committed mountaineers, I found that almost half of them had suffered at least one climbing related injury. Two thirds of those injured were hospitalized and 20% required more than 3 months to recover or were left with long-term health problems. Four years after starting the study there was a 10% death rate (five deaths), four due to climbing accidents. Other studies of mountaineers have found similar results. For example Murray Malcolm, from the University of Otago found that the death rate from climbing in the Mount Cook National Park was 5000 times greater than from work-related injuries. The death rates from climbing on the highest peaks in the Park where similar to those of climbers to peaks over 7000m, approximately 4%. Easily bored I also found that the personality of climbers was quite different to that of average people. Climbers scored higher in the areas of Novelty-Seeking and Self-Directedness and lower on Harm-Avoidance. What this suggests is that climbers generally enjoy exploring unfamiliar places and situations. They are easily bored, try to avoid monotony and so tend to be quick-tempered, excitable and impulsive. They enjoy new experiences and seek out thrills and adventures, even if other people think that they are a waste of time. Climbers therefore also participate in other adventure sports, such as mountain biking. When confronted with uncertainty and risk climbers tend to be confident and relaxed. Difficult situations are often seen by climbers as a challenge or an opportunity. They are less responsive to danger and this can lead to foolhardy optimism. Climbers also have good self-esteem and self-reliance and therefore tend to be high-achievers. Initial study results of base jumpers sobering I am completing a similar study of base jumpers and the initial results are sobering as they show that almost two-thirds have suffered at least one base jumping accident. Almost all of those injured required hospital treatment and two-thirds needed more than 3 months to recover or were left with long-term health problems. All base jumpers estimated that they had had “near-misses” and all of them had friends die from the sport. Overall the personality of the base jumpers appears to be very similar to those of mountaineers. These findings are similar to those of other personality studies of risk-taking sports people, which have found high scores on the measure of Sensation Seeking (essentially the same as Novelty-Seeking). Blame dad - and lack of dope What these findings suggest is that biology and genetics play at least a moderate role in determining who will take up these sports.

We know that the amount of Harm-Avoidance, Novelty-Seeking and Sensation-Seeking are inherited from our parents and are determined by the levels of a number of brain neurotransmitters, called monoamines. These monoamines (Dopamine and Serotonin) are chemicals that pass information between lower and higher brain regions. High Novelty-Seeking and Sensation-Seeking are both associated with low levels of Dopamine and the current theory is that involvement in risk-taking activities helps to boost the levels of this brain neurotransmitter.

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