High-Altitude Doctor

He wouldn’t have time to concern himself with her or her reasons for being on Everest. And she certainly wouldn’t have time to concern herself with him.

Sally closed in behind her, still eager to talk. ‘I can’t believe I’m really here. In the Himalayas. It’s been my dream for so long.’

Grateful for the distraction, Juliet encouraged her to chat and learned that she and the other trekkers were all medical students.

They were an enthusiastic and lively bunch and Juliet hoped that they weren’t underestimating the effects that altitude would have as they climbed further down the valley. Many people who had never been exposed to the effects of high altitude were taken by surprise.

Just as she’d predicted, as soon as the sun vanished behind the clouds, the temperature dropped dramatically. Juliet stopped to pull a jumper out of her pack. ‘The air doesn’t hold much heat up here,’ she told Sally. ‘Once the sun goes, it’s freezing.’

Sally also added another layer and Juliet noticed that she was slightly out of breath.

Lack of fitness, excitement or the sudden increase in altitude? Juliet wondered at the cause and made a mental note to keep an eye on Sally.

They continued down the trail to the river, crossed a wood and cable suspension bridge and arrived in the tiny hamlet that would be their home for the night.

A group of climbers was sitting outside a lodge with their feet up, drinking Coke, and Juliet exchanged a few words of greeting and then took Sally up a set of steps to a top-floor room that was full of wooden bunks.

‘We’ll bag a space now,’ she told Sally, ‘ready for when our duffel bags arrive. Make sure you keep your day pack as light as you can. Only carry the things you really need. Everything else—spare film, sleeping bags—put in your duffel.’

All items not needed during the day and which were to be carried by the Sherpas were packed into duffel bags, leaving the climbers and trekkers to carry the bare minimum as they negotiated the trail through the foothills.

Sally glanced around her, her gaze sharp and interested. ‘How do they build these things in the middle of nowhere?’

‘Hard work.’ Juliet rummaged in her pack for another jumper. ‘You see Sherpas and yaks transporting impossible loads up and down the valley. Teahouses and lodges are springing up all over the trail now to accommodate trekkers and climbers, some of them more sanitary than others, to be honest. When we get higher up we’ll be moving into tents. Come on—let’s join the others and get something to eat. Then I’m going to brief you all so that you’re prepared for what’s ahead.’

CHAPTER TWO

THEY ate sardines and French fries and afterwards, she and Neil gathered the trekkers together in the small, smoky room of the teahouse that served as a dining area when it was too cold to sit outside. In one corner a fire burned and at a table in the corner sat two climbers. One of them was Finn McEwan.

The moment Juliet entered the room their eyes met and held. Then she forced herself to give a nod of acknowledgement and turned her attention to her own party. She would have preferred that he wasn’t sitting in the corner while she talked, but there was nothing she could do about it. So she set about ignoring him.

‘Tomorrow we’ve got a five-hour, three-thousand-metre climb to the village of Namche Bazaar.’ She spread out the map so that she could show them the route. ‘You could call it the last outpost of civilisation. It may not seem far but it’s really important that you walk slowly. At this altitude you can get tired very quickly and if you exhaust yourselves early on, you won’t be finishing the trek. Remember the story of the hare and the tortoise? Well, up here, it’s the tortoise that wins every time.’

One of the men settled back in his chair, his arms hooked behind his head, gym-developed muscles bunched. ‘We’re all pretty fit and well prepared.’ His gaze was slightly mocking, as if it should have been obvious from a glance that he was more than up to the job. ‘I can’t see any of us having a problem.’

Cocky.

Juliet studied him for a moment, looked at the muscles and the man and wondered whether to cut him down to size now or let him fall down by himself later. His name was Simon and she’d met his sort before on treks. Macho. Determined to stride out and prove himself, not understanding the effects of altitude on human physiology. By the next day he’d probably be gasping for breath by the side of the trail, unwilling to admit that he was in trouble.

In the interests of team harmony, she decided to watch and wait. But she delivered a polite warning. After all, that was her job and if she didn’t watch him, she’d be the one clearing up the mess.

‘The only thing that can prepare you for altitude is altitude itself.’ She spoke the words quietly, directly to him, hoping that he’d take heed. Then she addressed the group as a whole. ‘As we get higher up we’ll be sleeping two to a tent, and as soon as you arrive in the camp the Sherpas will serve tea. Make sure you drink it. It’s important to drink plenty of liquid at high altitudes and in hot weather to prevent dehydration. Due to the polluted water supplies it is necessary to boil all water, so hot tea is the best available drink. Having said that…’ Juliet gave a wry smile ‘…heartburn is a common complaint around here and it’s largely due to the tannin in the black tea. It’s abrasive and irritating to the stomach. If you find you have problems, you might want to switch to herbal.’

The two guys exchanged appalled looks that clearly stated their opinion of herbal tea.

Juliet chose to ignore them, knowing that once their stomachs started protesting they’d switch soon enough. Instead, she ran a finger over the map, showing them the route. ‘The first half of tomorrow’s trail follows the river and crosses it a few times. Then we gain some height and that’s when you’ll start to feel the effects of altitude. I’ve said it before but I’m going to say it again because it’s important.’ She lifted her head and looked directly at Simon, determined to get the message across. ‘You need to keep your pace slow and steady.’

He gave a suggestive smile. ‘I can do slow and steady when the occasion demands it. Any time you want a demonstration, Doc, you only have to ask.’

‘You’re totally disgusting, Si.’ Sally gave him a friendly thump on the shoulder and leaned forward to look at the map more closely, her expression interested. ‘Can you really develop altitude sickness at that elevation? I thought you’d need to be higher up to feel the effects.’

Juliet chose to ignore Simon’s comment but the look in his eyes was making her increasingly uneasy about the forthcoming trip. ‘Certain normal physiological changes occur in every person who goes to altitude. At night you wake more frequently and you might notice a difference in your breathing pattern. During the day you’ll find that you become short of breath on exertion and you need to pass urine more often.’

‘All the more reason to cut down on that herbal tea,’ Simon drawled, and Juliet gritted her teeth and reflected on the fact that before the trip was over she might well have stabbed the guy with the business end of her ice axe.

She didn’t like his arrogance and she didn’t like the way he was looking at her.

Something made her glance across at Finn and she was surprised to find him staring at Simon, his gaze cold and hard.

Juliet bit her lip, wondering exactly what had angered him. Perhaps she wasn’t the only person to find the guy objectionable.

Sally sipped her drink, apparently oblivious to the undercurrents of tension around the table. Or maybe she was just used to Simon. ‘And that’s all OK? All those changes are normal?’

‘As long as the shortness of breath resolves rapidly once you take some rest. The increase in breathing is an essential part of adapting to the altitude. You have to work harder to obtain oxygen and you do it by breathing more deeply and more quickly.’

‘Because there is less oxygen in the air?’

‘Precisely.’

The other male trekker, Gary, was enjoying a drink of chang, the local brew, and Juliet gave him a pointed look. ‘That can be a pretty alcoholic drink and by tomorrow you might be regretting that decision. It’s a good idea to avoid alcohol and certain drugs, anything that might decrease breathing—that’s if you want to finish the trek. Remember, you need those extra breaths to give your body the oxygen it needs to function. And even when you’re breathing faster you still won’t gain normal blood levels of oxygen.’

Simon stared at the glass. ‘No alcohol and plenty of herbal tea. Who the hell talked me into this trip?’

Sally frowned at him. ‘For goodness sake, shut up, Si.’

Silently thanking Sally for the timely intervention, Juliet continued with her talk, aware that Neil had joined Finn and was watching and listening from the edge of the room.

An oldtimer at altitude, Neil had seen it all before. And heard it all before.

Juliet carried on talking, made the points she wanted to make, answered the girls’ many questions and then called a halt to the evening.

She needed some space and time by herself.

And she needed to get away from Simon.

Leaving the group of trekkers to enjoy themselves, she dragged on her jacket and left the teahouse, braving the freezing air outside.

Juliet stood for a moment with her eyes closed, feeling the sting of the cold bite her cheeks and listening to the rush of the river just below the lodge. She breathed in the smell of smoke and outdoors and instantly felt more relaxed. Apart from the muffled laughter that came from within the lodge, the night was silent and she huddled deeper inside her jacket and opened her eyes, letting her vision adjust to the semi-darkness.

She walked a short distance, sat down on a boulder and hugged her knees, enjoying the night sounds.

‘That trekker of yours is going to give you a problem. You need to watch him.’

The deep, masculine voice came from right next to her and she gave a soft gasp, wondering how she could have not noticed the powerful figure leaning against the tree.

It was Finn McEwan.

He was obviously escaping the crowds, too.