Not that you need a name like Tenzing or Pemba to excel at mountaineering. In 1978, Peter Habeler and Reinhold Messner became the first humans to climb Everest without supplemental oxygen–an achievement previously considered a physiological impossibility. So incredible was their accomplishment, in fact, that researchers assumed the two must enjoy a freakishly well-tuned hypoxic ventilatory response: As oxygen decreases in the bloodstream, we unconsciously begin inflating our lungs more deeply and more often–an enhanced huffing and puffing that extracts more oxygen from thinner air. "But when Habeler and Messner were measured for this, it turns out they were just normal," says Allen Cymerman, a physiologist at the U.S. Army Research Institute of Environmental Medicine (UARIEM) in Natick, Massachusetts. What Cymerman and other high-altitude researchers have subsequently shown is that hypoxia triggers a host of short-term and long-term changes that together allow us to make the best of a less than ideal situation (see "You, At Altitude").
"Up high, there’s a whole cascade of events taking place from the lungs to the blood to the mitochondria in our cells," says Robert B. Schoene, a pulmonary specialist at the University of California San Diego and former president of the Wilderness Medical Society. After years of exercising in low-oxygen conditions, Habeler and Messner appear to have optimized their capacity for high-altitude performance at every step along this physiological cascade.
A lifelong climber himself, Schoene has bronchoscoped elite climbers suffering high-altitude pulmonary edema (HAPE) on 20,320-foot Mt. McKinley and studied acute mountain sickness (AMS) in average people at much more moderate altitudes. Though we’re not all cut out for the extremes, Schoene believes most reasonably fit people can do fine at heights like Mt. Elbert’s–provided we give ourselves time to acclimatize. Unfortunately, few recreational athletes traveling to altitude from sea level have the luxury of full acclimatization, which can take a month or longer. But going for the gusto too soon can often prove a recipe for misery. In a study published in the Annals of Internal Medicine, researchers looked at 3,158 tourists traveling to ski resorts located from 6,300 to 9,700 feet in the Colorado Rockies. Even at these modest heights, fully 25 percent developed full-blown AMS. And those whose permanent residence was below 3,000 feet proved 3.5 times more likely to get sick than those who lived above 3,000 feet.
The conventional wisdom holds that deadly disorders like HAPE and high-altitude cerebral edema (HACE) only occur at much loftier altitudes. Not true, says Schoene. Early in his medical career, he took a sabbatical at Colorado’s Keystone ski resort, elevation 9,400 feet, to study athletic performance and altitude illness. "At the height of ski season, we were averaging five cases of HAPE per week," Schoene recalls. "The victims were almost always people who flew in from either coast and immediately started exercising hard."
Folks, in other words, like me: an alpine rookie with scant time off who must begin his assault on Mt. Elbert as soon after de-planing as we possibly can.
After combing the research literature, it became clear what I had to do: grow myself some cojones–hemoglobin ones, at least–before even departing Pittsburgh. If not, I had no doubt, it would be Mt. Elbert assaulting me.