Possible explanations to the death of Per Lyhne

By Henrik Jessen Hansen

Henrik Jessen Hansen is a doctor and has four times participated in mountaineering expeditions in the Himalayas.

When you have to acclimatize for the greater heights, then it is to avoid altitude sickness and the serious and potential deathly sequelas cerebral and/or pulmonary edema (water accumulation in brain or lungs). A safe plan of acclimatizing is only ascending 1.000 ft. in sleeping height a day, and having one or two rest days a week. One may climb to higher altitudes during the day, but it is the sleeping heights that is crucial, as the symptoms only arise after six to twelve hours in the new altitude (new examinations have shown, that simply lying down increases the pressure in the pulmonary circulation and the risk of high altitude pulmonary edema).

Once you have felt well at a given altitude on a mountain climb, it will normally be at no risk being at that altitude later on the same climb. However acclimatization will disappear after a while, so you have to start acclimatizing all over again, having been in the lowlands for only a few weeks.

On the Makalu expedition Per Lyhne had already been at 23.000 ft. before, and thus been sleeping several nights above 20.000 ft. He was doing fine, although a little troubled by his cough and there is no sign of insufficient acclimatization. When I'm reading Jan Elleby's account of the dramatic night in the tent, where Per dies (and where Jan evidently made a big and correct effort) my first thought is, that the cause of death is high altitude pulmonary edema. But as Per a few days before had been at higher altitudes and the fact that the death took place late in the course of the expedition following a sensible acclimatization, it cannot be altitude sickness alone causing his tragic death.

More likely is, that he got ill by some other reason. An illness causing the altitude to affect him even though he would have been fully adapted. A pneumonia, for instance, would reduce the oxygen supply so the body reacts as if one was at much higher altitude. Many climbers develop bronchitis with heavy fits of coughing and perhaps formation of mucus because of the large quantity dry and cold air inhaled (On the Danish Mount Everest Expedition in 1996 I was coughing so much that I ended up with a broken rib!).

Another possible explanation could be a thrombosis in the brain, heart or lungs, as this would give similar symptoms and again result in poor respiration and problems with the lungs. The causes of an eventual blood clot are dehydration and the blood becoming thick and slow-flowing because of the increased formation of erythrocytes at altitude (the same thing that happens by overdosing the "epo" doping, which for the time being is very debated in especially cycling).

Most of these diseases can develop very fast, and there is no reason to reproach the members of the expedition or their doctor with anything. Going on a Himalayan expedition is dangerous with a risk of death at 2 % for each participant and a risk, one obviously has to do everything to reduce, but also has to be ready to run for sake of the fabulous adventures. By now so many Danes has been to the Himalayas so often, that statistically a death regrettably had to happen.

It is hard luck on Per and the other participants in the Makalu expedition, as they are very rational and more cautious than other people, that plunge more or less headlong into climbing the world's highest mountains.

Clipped from Adventure World no. 15/1998.