Bolivian Adventure: The Epic

Trip Start May 18, 2007
Trip End Jul 28, 2007

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Flag of Bolivia  ,
Monday, July 16, 2007

WARNING: there is much controversy related in the following account. To my fellow trekkers, if I have mis-represented ANY FACTS, please send me an email, so that I can make amends...
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I woke up choking the next morning. Could barely draw air in. Damn. The dreaded chest cold. I got up early, before the alarm, as I desperately needed to find a "privacy rock" closer to my tent than the far-away toilet tent... I found I was pretty short of breath, and had to sit on a rock and cough for a few minutes. Thank God this was a rest day... I would take some antibiotics (I'm pretty sure I had a sinus infection - justification for antibiotics), take it easy all day, and hope that I'd be in better shape for the next day's hike.

I got back to the tent, and found Catrina awake. We lay there for a bit, and soon realized that in the next tent over, Bo's and William's, someone was coughing - non-stop. It didn't sound good. I couldn't yet tell whether it was William or Bo. I then heard the Tom's walking nearby, chatting. They had already gone out for a short early-morning walk by the lake, and were on their way back to camp.

Bo called out in a loud whisper, asking Tom Sr. to come into his tent for a bit. I suspected that he wanted to consult his fellow physician with regards to the cough that, as it turns out, was plaguing him. He was coughing without interruption, and sounded as if he was choking. Not good.

After a few minutes, during which the rest of us slowly emerged from our respective tents, Bo and Tom Sr. came out and walked towards Kate, and William kind of stood there, looking a bit dumbfounded. I approached him, and said that I'd heard his Dad coughing, and asked how he was. William replied that Bo had been up coughing all night, and now thought he had High Altitude Pulmonary Edema, since he had coughed up some pink foam and felt a lot of fluid in his lungs. It was probable that Bo would have to be evacuated, said William.

Oh-oh. High Altitude Pulmonary Edema, or HAPE, results from the decreased concentration of oxygen at altitude, and is usually fatal, if the patient is not transported to a lower altitude immediately. If Bo and Tom Sr., both physicians, agreed on the diagnosis, it was obvious that something had to be done right away to help Bo.

There are two ways of bringing someone down to a lower altitude: the literal way, of physically getting them closer to sea level; or the artificial way, by use of a Gamow Bag, or "portable compression chamber". A Gamow Bag looks like a giant inflatable hot dog. The idea is to pump air in the bag (with the patient lying in it) until the air pressure is sufficiently increased, and therefore the oxygen concentration correspondingly higher, to simulate a descent to an acceptable lower altitude. It is by no means a cure, but it is designed to buy some time by temporarily halting the progression of the illness, hopefully long enough to allow the patient to physically go down.

The obvious thing to do, for Bo, was to get inside a Gamow Bag, while arrangements were made to get him physically down the mountain. That's what Bo, Tom Sr., and Kate concluded right away. Kate then went to find Piter to tell him to get the Gamow Bag.

The Gamow Bag was not there.

Kate asked Piter, Piter asked Nemesio the head porter - where was the Gamow Bag? After much loud whispering inside the cook tent, worried speculation by the rest of us waiting outside, continued coughing by Bo, the rumour spread that the Gamow Bag was not with us, because Nemesio had decided, at the first camp, that it was too heavy to carry. He had decided to send it back with the bus and the 4X4's, along with the 2nd toilet tent and a few other non-critical items.

This news raised outrage with all the clients - albeit with different reactions. While sitting at breakfast (Bo was able to eat a little), it soon became apparent that (1) a lowly porter had made the executive decision to leave a life-saving device behind, (2) neither the local guide Piter, or the KE tour leader Kate had been aware of this, or had verified that the Gamow Bag had come along, (3) Kate blamed Piter, but did not acknowledge her own responsibility in this, (4) without a Gamow Bag, it was now more critical then ever to get Bo lower ASAP, and... (5) the only way out of where we were, was UP AND OVER a high pass, before going down. Not good news for Bo.

The conversation took a slightly bizarre turn when Ro, upon hearing that the Gamow Bag wasn't there, and that we had no means of communicating with the outside world, exclaimed to Jeff and Judy, that it was "criminal!" for us to be without a Gamow Bag. As a lawyer, she quickly realized that she'd crossed a line by implying a crime had been committed, and went quiet. The rest of us, while speculating a bit, still tried to focus on the various options to get Bo lower, and fast.

While William started packing his and his Dad's gear, and Tom Sr. and Tom Jr. put in place their own plan to walk out with Bo and William, Kate marshalled the porters, and convinced them, with implied threats and promises of extra pay, to walk out and *carry* Bo up and over the pass. 

Now - we are talking here of several hours of steep uphill ascent, on narrow and uneven rock and scree trails, at well over 4600m, while carrying a very sick man of approximately 180lbs. The porters were not thrilled - it was supposed to be their day off, after spending two full days carrying loads ahead of us.

But whether it was the promise of more money, or their genuine care and concern for Bo, who was in visible distress, that led them to do it, is irrelevant. The porters got ready, grabbed some blankets and sheets that would be used to carry Bo, and started filing out. Even Nemesio, responsible for leaving the infamous Gamow Bag behind, started getting ready.

In addition to the Tom's, who had already decided to accompany Bo and William out, Catrina, Tully and Marcus decided to go with the group as far as the high pass, to provide whatever support they could along the way. Tully, with his medical training and supply of appropriate drugs, would be instrumental, and Catrina and Marcus were carrying food and water to help the others. Piter had already left ahead of the group, told by Kate to hurry to the "pueblito" on the low side of the pass to phone for a vehicle to come and drive Bo to La Paz. Kate and Piter both carried radios.

Impeded by my cold, and already a slower trekker than Catrina, Tully and Marcus, I had to stay behind, as I wouldn't have been able to help in any way. It bothered me that I couldn't go, but I knew it was the only smart thing for me to do: stay in camp, rest, and stay out of trouble.

As for Jeff, Judy and Ro, all three fairly fast trekkers (at least when they got competitive about it), they chose to stay in camp, without offering to go or help. I'm not sure what motivated them to stay - perhaps they felt, as I had felt, that there wasn't much they could do to help. Who knows. They didn't say anything about it.

After everyone's departure, the only people left in camp were Jeff, Judy, Ro and me, plus Pancho and Ruben. By late morning, Jeff, Judy, Ro and I sat in the mess tent, reading distractedly, and of course, wondering how things were going on the way to the pass. Shortly into the conversation, Judy asked, "And how is this going to affect our trek? I mean, the porters will be exhausted and may not even get back tonight, and we may not be able to go tomorrow!"

Needless to say, I found it quite disconcerting and upsetting that her main concern seemed to be what was going to happen to her vacation, and not Bo's health. To my shame, I kept my mouth shut, and only subsequently said that as long as Bo was going to be alright, the rest would fall into place somehow. I was, however, seething.

The conversation between the three of them continued with more speculation and finger-pointing (I will skip some details here on purpose), and Jeff repeatedly said, "I just wish I could have helped! I feel so helpless! Maybe I should have gone..."  I told him it was too late now, he hadn't gone, and frankly, there was probably little he could have done.

At some point, we overheard Kate's voice over a radio in the cook tent, and realized that Pancho and Ruben had another walkie-talkie through which they were listening to the group's progress. Some of the chatter was in Spanish, so I went into the cook tent to listen (Ro, Jeff and Judy don't speak much Spanish and couldn't understand). I understood, through staticky and unclear transmissions, that the group was making very slow progress and were still far from the pass, but that Piter was over the pass and heading to the nearest village.

A while later, I heard something that made me cringe: Piter was trying to use his cell phone to call Juan in La Paz, but his phone was out of credit... One of the porters, who had another cell phone, was sent to race ahead of the group so he could give his phone to Piter.

Not wanting to throw fuel on the fire, I told Ro, Jeff and Judy that Piter couldn't get reception and was therefore unable to call Juan at that time. This still prompted outraged cries of, "Well! Where's the sat phone?!  It's just irresponsible to be out here without a sat phone!"  For the record, while a satellite phone is most definitely advisable for group trekking, it is by no means a guarantee of successful communication, and should not be relied on as the exclusive means of saving someone. Yes, KE should have ensured there was a sat phone and a Gamow Bag on the trip -- but hearing Jeff go on and on about the sat phone was not helping get Bo out of trouble.

During the long wait, I moved my gear into Bo's and William's deserted tent, in an attempt to spare Catrina from catching my cold, and allow her to sleep without my constant coughing. I lay down in the tent and fell asleep for a while.

I woke up to Catrina's and Tully's voices, who had just returned to camp with Marcus around 4pm. They updated us on the news, relating that the porters were effectively carrying Bo, who was "sitting" cross-legged in a kind of sling made of blankets. The porters were rotating, 6 at a time, to carry him upwards towards the pass, walking in very difficult conditions, but making steady progress. They had just recently reached the pass...

Walking passed Jeff, Judy, and Ro, who were huddled outside and whispering, I overheard Ro, in her best outraged-lawyer tone,  "...and who's in charge of this thing anyway...? How is it that a PORTER gets to make *executive* decisions anyway?!?"  Wrong time, wrong place, wrong approach to question the leadership and management of the expedition.

Kate soon followed them into camp, reporting that "all should be fine now" and they should "soon be in the village". She did however confirm that at this time, there was no vehicle on its way yet. Talks of getting a helicopter, or at least a 4X4 from La Paz, were still speculative, as communication with La Paz had still not occurred due to technical difficulties, and missing cell phone credit.

With the sun going down, and no longer able to communicate via radio with Piter or the group (once they were over the pass, radio waves could not reach us), the remaining members of our group -- Jeff, Judy, Ro, Catrina, Tully, Marcus, me, and Kate -- met for tea and snacks. The rest of the whiskey that Catrina and I had brought from La Paz was finished off, and we contemplated various scenarios, listening to Catrina, Tully and Marcus retelling the events of the day several times. It turns out that each of them had played an important role by going up with the group -- Tully's medical training was instrumental, as he gave Bo drugs and medication along the way that no doubt kept him from getting worse, and Catrina and Marcus had water and food with them that they shared with the group.

I found it amusing that Catrina, Tully and Marcus all told me they felt bad for leaving ME behind with Jeff, Judy and Ro... Compared to the day they had had, my little frustrations had been nothing. What did become clear that evening, however, was that the group was split: the Brits and the Canadian on one side, the other three, who happened to be Americans, on the other side. It wasn't explicitly said, of course, but it was obvious. As for Kate, she didn't have much to say, and she certainly did nothing to assert any leadership or demonstrate that she was in control of the expedition.

We went to bed after deciding that the plans for the next day would be left to the porters: depending at what time they returned to camp (we had no clue when to expect them), they would decide whether they felt fit enough to head out, or whether they would take a rest day. The itinerary would be adjusted appropriately.

We hoped that Bo was safe and sound.
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