The importance of altitude sickness: or how to survive in a dangerous world.

CEO, Ajay Khandelwal, tells of the unexpected life lessons he’d learnt from a ski trip in Italy.


I recently fulfilled an ambition to go skiing in the Italian Alps. In my enthusiasm, I crept off from my group in the first 10 minutes as to avoid being on the baby slopes doing boring exercises. As a seasoned runner and cyclist I reckoned that skiing couldn’t be that difficult. You just point yourself down the slope and go – easy. No fevered pedalling or lung busting leg action required, I was convinced I could do it asleep. Within 15 minutes of being on my first ever ski slope, I had ditched my instructor (sorry Massimo) and found myself on a red run. It looked steep, and everyone seemed to know what they were doing; everyone except me.
Now I was up there I couldn’t see anyway down except by skiing so I decided to give it a go. I got to the bottom but was it pretty? No, no it was not. Did I spend most of it crashing and lying forlornly in the snow trying to get my skis on and off? Yes. Did I lose any semblance of grace and dignity? I sure did. Still, through a series of “controlled” crashes, I managed to get safely to the bottom.
The next day, with my tail between my legs, I made the decision to join the group. Maybe – I grudgingly conceded – I did have something to learn. As a therapist maybe I should know better? Yes, sometimes you need a guide, especially on unfamiliar territory to show you the way.
Although I knew this intellectually, some over inflated part of me thought I could work it on my own. I’m sure you’ll be glad to know us therapists have our blind spots too! I had to get literally knocked down to the ground, repeatedly, in order to learn my lesson. As therapists we say this day in day out.

Our patients come in and tell us the ego, the “I”, can master every situation. Yet, the “I” always bumps into more powerful forces – inner and outer-  and usually gets a beating. The conscious mind generally gets too big for its boots. We usually need to listen to and enlist the unconscious to really grapple with the difficulties and risks of life.

Later in the day – when I’d completed my lessons and was practising on my own – I found myself in the wrong lift again. The wrong lift once I could cover as an accident, but twice? This is what Freud might have called “repetition compulsion”, when we keep recreating a situation again and again, hoping that we can figure it out this time round. Usually, we don’t. And then we do it all again. This process happens without our knowledge, driven by the unconscious. I knew something wasn’t quite right when I got on this lift. I had a gut feeling but couldn’t quite figure out why. ! was about to bail, but ended up getting on and overriding my instincts.
To confirm my worst fears, the lift just kept going up and up. I felt a knot in my stomach and the guy next to me was looking very intense. I had ended up on another red run and just to let those of you who don’t know, not all red runs are the same – this red run was really red! Skiers were jumping off the lift and fluttering down like birds, turning and twisting straight down the slope.
This time I knew I was out of my league; I took off my skis, found a small valley to the side of the piste and carefully slid myself back to the flatter slopes. Various skiers stopped by to check I was okay, to which I repeatedly answered, “I’m not injured, just embarrassed…” Half an hour later, I was back on more comfortable ground and I was able to put my skiis back on. Although this was humiliation to my ego, I had surrendered and accepted defeat. A lucky escape.
Interestingly, I’d found myself attracted to the higher slopes. I’d been drawn to areas where I didn’t have the skills for and somehow managed to “accidentally” repeat this. The second time, humbled and a little frightened, I’d chosen to make a safe descent. On the last day I took the ski lift (without skis) up to the glacier and was only able to go part way as I had missed the final lift cut off time. I was secretly relieved as I really didn’t want to go any higher. For some reason I felt nervous about going up to 3000 metres, even though I wasn’t skiing.
On returning to the hotel I remember feeling a little nauseous and unwell. I knew the signs of mild altitude sickness, which I seem to suffer from. It’s a useful warning signal from the body, telling me I needed to get down from the mountains. So, every day, I had become more and more cautious. The unforgiving terrain had educated me.
Still, our culture often makes feel that we can do anything and that we shouldn’t back down. In the last few days I read about a French woman and Polish man who ascended the very dangerous K2 mountain without oxygen. The Polish man died, and the French woman took her shoes off after hallucinating brought on by altitude sickness. Shes been told by doctors that her hands and feet may have to be amputated due to frost bite. Even so, she said “I’ll back in the mountains because I need this.”
The climber Beck Weathers, a very driven American doctor, said he used to climb to deal with a deep depression. The total dedication and obsession required to climb, combined with the physical exhaustion, seemed to cure him of his depression. One in six people who climb Everest don’t make it down alive. Nevertheless, he was a man possessed. It was only due to a near death experience, resulting in him losing his hands, that forced him to give up climbing which led to him being reunited with his family.

Many psychoanalysts say it’s very important to accept our limits. In a culture that pushes us to extremes, it is very important to accept our vulnerabilities.

It’s a lesson Beck Weathers has taken to heart: he no longer climbs, but is happier than he has ever been.
On the penultimate day in the hotel I got talking to a man who was a very experienced skier; he enjoyed going off-piste and outside the prepared ski areas. I was impressed, but on the last day him and his twelve year old daughter went missing. We feared the worst. The last ski pass had been at 10.30 am at 3000 metres at the top of a glacier – the one I’d turned back from because I’d missed the cut off time. He hadn’t been seen or heard from since and as night fell, the helicopters and search parties returned to base.
No sign of him. No phone, no signal, no flares. Nothing at all. Everyone in the hotel was in total shock; no one could sleep. The next day he had still not been sighted. In the morning, just as I was leaving, there was news they’d been found. Even with all that experience, he’d managed to get lost on the top of the glacier. They had then walked non stop for 16 hours through the night in order to stay warm and stave off sleep. They eventually found shelter, and were picked up at 9:30am.
It was an incredible ending to what could have been a terrible misadventure. I wondered, what is it about getting “high”? It’s easy enough to get up there, but it’s hard to get down.
Marie Louise Von Franz, the Jungian analyst, worked with a lot of such cases. In her book, the Puer Aeternus, she recalls the case of young men who had trained themselves to sleep on mountains without any camping gear. The idea being that they didn’t want anything to weigh them down, either kit wise or psychologically. But mountains are extremely dangerous – they cut us down to size. The top of Everest, with its thin, lifeless air, is known as the death zone. People get up mountains, but sometimes they don’t get down. On a very minute scale, I experienced this over-inflation.
Oblivious to the people being carted off the slopes in ski ambulances, I ended up on slopes that were beyond my ability. Similarly, my fellow guest – despite his decades of experience – had become disoriented off-piste and without any back up plan. He was able to draw on inner resources, but it was very risky. Luckily, we avoided injury or worse, but both felt somewhat chastised in our different ways.

The body’s physical and psychological warning systems, such as altitude sickness, have an important role to play.

Even though you can get medicine to rid yourself of altitude sickness, perhaps that is not always so wise?  Watching the winter Olympics its easy to get carried away. However, if you watch an interview with any of those athletes, you’ll find that they are riddled with injuries; metal rods run through bodies; their bodies are broken and battered and they have spent months in hospitals and rehabs. Still, something keeps them going back.
This knife-edge existence is extremely precarious. That is why the gods can live in Mount Olympus, but not humans. We can spend a few days at altitude, but then we need to come down to sea level. When we go up, we need to carry emergency supplies – whistles, flares, and plenty of humility – or we risk being thrown down the mountain.

Addictions work in a similar way. It is maybe easy to get “high”; it seems like you can live up there forever; but then one wrong step; or just bad luck, and you find yourself caught up in avalanche.

Von Franz warned of the dangers of over-inflation; it is very depressing to have to face our limitations and vulnerability, and so the Puer Aeturnus wants to deny these limits. This works for a while and can even be very heroic, but in the end, the hero usually meets a grisly fate. A life with no challenge or risk is dry and dull, but when a person only feels a alive when dicing with danger, that is another matter. 
My initiation to mountain sports has given me plenty of food for thought. The deeper I got into the skiing, the more aware of my limits I became.
Also, my fellow hotel guest Gary and his daughter appeared in an article in The Sun – and were grateful to have survived a very harrowing ordeal!

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