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'The situation up here as far as we know it,

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'two have fallen, one of them fell about 1,000 metres

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'and did not get up and is believed to be dead. Over.

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'We originally had reports that two people fell 1,000 metres...

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-'can you confirm, over?

-'Not sure, there could be.'

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'But we simply don't know at the moment, over.'

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In the most hostile environment on earth,

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8,500 metres above sea level, a team of climbers are

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about to embark on the final push to the top of the world.

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Going to extreme altitude is like being a hundred years old.

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You are breathless all the time - even at rest.

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But this is no ordinary climbing team.

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Oxygen saturation is 62 percent figure six-two, over.

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They are doctors and they are here to rewrite our understanding of the human body.

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Experimenting on themselves as they attempt to climb to the summit.

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This is really pushing the boundaries of what is possible.

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This team will turn Everest into the highest laboratory on Earth.

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Why do it?

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My answer to that would be to be part of one of the most exciting scientific experiments

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that's existed in the last 20 or 30 years.

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But nothing can prepare them for the life and death decisions they'll face.

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In the last half-hour I've seen a complete disregard for human life.

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With respect to your doctor... he will die.

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The guys on the mountain who are continuing to go up in bad shape,

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I wouldn't give them a cat's chance of living.

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This is the story of an expedition unlike any Everest has seen before,

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the story of a team of men and women willing to risk everything in the pursuit of knowledge.

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I'm here to do a job and I want to get it done and go home.

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I'm looking forward to getting home.

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This is the story of Doctors in the Death Zone.

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'Mike, this is Denny, over.'

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'Mike, this is Denny, do you copy, over?'

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It's the 24th of March, 2007.

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A group of 60 doctors and scientists are flying to the Himalayas.

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They're here to climb the world's highest mountain,

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Mount Everest.

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Lukla airport in northern Nepal is perched on a cliff 2,800m above sea level,

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it is as far as mechanical transport can take them.

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250 people will pass through this airport over the next three months.

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They will form the Caudwell Xtreme Everest Expedition -

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the largest research team ever to come to the Himalayas.

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I don't like that at all.

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-Not at all.

-I absolutely love it.

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But from here it is a two-week trek to base camp.

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Doctors Roger McMorrow and Nigel Hart have been climbing together

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for 12 years but coming to Everest will fulfil a lifelong dream.

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Everest is the undisputed highest mountain in the world.

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It is probably the first mountain that I ever knew the name of. As a boy you hear stories about Everest

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and climbing Everest and the adventures people have here.

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It goes back to the first time you get into mountaineering.

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The beauty of it, the isolation of it and also the physical challenge.

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I can't say that I ever ever ever thought that

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I could be contemplating trying to get to its summit.

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But Everest is a killer.

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For every 15 people that summit, one dies trying.

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They are remembered in a memorial three days from base camp.

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I've been to Everest twice before and on my first trip I ended up burying somebody up there.

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Sundeep Dhillon is a military doctor and the only member of the team to have climbed on Everest before.

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I think of all the people in the summit party I am probably

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the most scared and wary of the challenges we're about to face.

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14 of the world's highest mountains are in the Himalayas.

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But the biggest challenge climbing them is nothing to do with technical ability.

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Climbing high up on the mountain when there is so little oxygen is almost a dream-like state.

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You feel like you're drunk, you feel sort of soporific.

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Every footstep is an effort of will and physically pushing the body.

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It's not uncommon to have to take 15...huge breaths like that

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between each pace and despite that you just want to collapse down into the snow.

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These doctors haven't come just to climb Everest...

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..they're here to make a discovery.

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They are hoping

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to find something that will transform lives back home.

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Many of the team are intensive care specialists

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and they are risking their lives to save patients like this.

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One in seven of us will be treated in intensive care...

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..after a major accident,

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traumatic surgery

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or during an extreme illness.

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But for intensive care consultant, Mike Grocott,

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the fight to save a life almost always boils down to one thing.

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What kills his patients is a lack of oxygen in their blood, or what doctors call hypoxia.

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All the people that we see that are sick have hypoxia, in some form or another.

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So they have low oxygen levels either because their heart

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heart isn't working so well, isn't pumping the blood around the body,

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their lungs aren't working so well that the oxygen isn't getting into the body.

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And we see this all the time.

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It's hard to think of a sick patient

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who doesn't have problems with hypoxia.

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And yet it's extraordinarily difficult to study them.

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In intensive care survival often appears random,

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some patients can endure extreme levels of hypoxia whilst others simply die.

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It is a mystery that Mike Grocott and his team believe can only be

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answered by putting their own bodies into an identical situation.

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On Everest these doctors will become the guinea pigs.

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They want to see how their bodies adapt to the lack of oxygen at extreme altitude.

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We're taking a number of healthy, almost identical individuals

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and then we are making them critically hypoxic for about three months.

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How can they do it,

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when our patients are dying with the same levels of oxygen in intensive care?

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The further up the mountain they go,

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the less oxygen they will have to breathe

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and the closer they will push their bodies into intensive care.

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It may be the things that predict how people do at high altitude will

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be the same things that predict whether they'd survive a critical illness.

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Just doing the research, without trying to climb

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the highest mountain in the world, is a challenge in itself.

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I'll be happy when we come back all in one piece.

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If they can reach the summit they will have less oxygen in their blood than people who are critically ill.

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A level of oxygen so low

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they should be dead.

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You see people breathe more, cardiac output, so the amount the heart pumps increases

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so there's more oxygen pumped round the body

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so the number of very small blood vessels increase as well.

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So many people have died trying to get up to the summit.

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The nervousness of impending disaster, it might not turn out OK.

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You're gasping, as if someone's strangling you.

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You go first, Mike.

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Just go forwards.

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Place it on there, then I'll go.

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Right, two, three, lift.

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This expedition started life five years ago and 4,500 miles away from Everest.

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we had this idea of doing a research expedition to Everest.

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About four years ago, we realised that really we either should

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shut up and stop talking about it or get on and do it.

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It was something that for at least a year and a half that we discussed in the pub over a pint

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and weren't sure that it was translatable into reality.

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I think that's, that's it.

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We spent a lot of time sitting outside Parisian street cafes

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discussing what we might do, and we started putting together

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a group of people who were likely to be involved.

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Me as the expedition leader...

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and we kind of gathered the team as we went along.

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They're all very experienced high altitude mountaineers.

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This is a historical record of my least fit moment.

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Mike's wife Dr Denny Levitt is one of the project's research leaders.

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She's designed many of the experiments they'll carry out on Everest.

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It'd would have been very difficult for him to have been

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involved and me not involved because it's been very much a life-consuming project for the last year or so.

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It's a challenge your husband being the boss because he's always right at work,

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so we have a system where I'm always right at home, that makes up for it!

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We're not fantastic climbers, we're not going to break any records

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for climbing, but it's by a long way the largest high altitude research project

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that's ever occurred, and I'm not sure that anything like this will be repeated for a very long time.

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OK, go!

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Right, to the end of the garden and back!

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After two weeks of walking the trek is over.

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Everest Base Camp is set on a glacier at the foot of the mountain.

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At an altitude of over 5,000m this tent city is higher than any peak in the Alps.

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-Brilliant job.

-Have a look around, see what you think.

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What are you looking forward to?

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-My bed.

-A cup of tea would be good.

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And then my bed.

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Now we're up near 5,000 metres, and we're starting to get that shortness of breath, the dry cough.

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And so, the sense of what's ahead really is starting to build.

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It's amazing to think really that at 5,000 metres we're just halfway up, and we're already finding it hard,

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walking, and starting to think "Oh, my goodness, this is a very big mountain."

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We've a long way to go.

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Base Camp is so high there is 50 percent less oxygen than at sea level.

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And this makes it a perfect natural laboratory to study the effects of hypoxia

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or low oxygen.

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We're here with a goal that we believe in

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and that we think is valuable and at the same time have the opportunity to

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live in this environment and potentially to climb to the summit and that is a unique opportunity.

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I'm most looking forward to getting back to base camp, with everybody else absolutely fine,

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and knowing that we've done what we came to achieve

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without causing any harm to anyone.

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Our priorities are very clear in terms of safety first, and then the science and then the summit.

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It's amazing. It'll be a great place to live.

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Over the next few months 213 people will be studied here

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on this constantly moving world of ice and rock.

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These tents house hundreds of thousands of pounds of advanced research equipment.

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The doctors will conduct over 40 different experiments,

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looking at every aspect of how the body copes with low oxygen.

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They will measure every breath

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and every heart beat.

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The tests range from simply stepping on a box,

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to biopsies that look at individual cells.

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To look at cellular mechanism you need a bit of tissue

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and the muscle is actually relatively easy to get to.

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Easier than your brain, or heart or lungs.

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Many of the results won't be known until they can analyse them back in the UK.

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We have about 17,000 samples from the expedition as a whole.

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The combination of these tests will create the most detailed picture

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ever assembled of the human body at altitude.

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We've got a lovely picture of all the tiny red blood cells

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zooming through the small blood vessels, under his tongue.

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Some of the experiments are so invasive

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that they are only conducted on a small group of volunteers.

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The one everyone is dreading is tonometry.

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Behind me is the lab tent, and they're torturing people in there.

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So this is lignocaine jelly.

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It's a local anaesthetic jelly and it's a water-based jelly

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so it will make the tube slide easily down through the back of Nigel's nose, into his throat.

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Then he's got to swallow it down and it's got to go all the way down to sit in his stomach over there.

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It wouldn't be in my top five things I want to do on this trip or any other trip.

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But anyway, it's all for the good of science.

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Belfast GP Nigel Hart has practised this test in London, he knows how unpleasant it can be.

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I'm really not looking forward to this.

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-Are you ready for this Nigel?

-Yes.

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The experiment is designed to study one of the most common complications in intensive care.

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NIGEL CHOKES

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OK, swallow, chin forward, chin on your chest...

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As the body becomes more and more hypoxic,

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it attempts to protect the vital organs from the lack of oxygen by cutting the blood supply to the gut.

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The gut is a relatively non-vital organ in the short term, so the body will draw oxygen away from that

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to perfuse vital organs like the brain, the lungs.

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This test will measure how Nigel's gut is reacting to the low levels

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of oxygen on Everest.

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This goes into one of the arteries in Nigel's wrist.

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This sort of stuff people have to tolerate all day, every day

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in hospital. It's quite a good, er,

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learning opportunity for those of us who are on the other side.

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Not that I'd want to do it too often.

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Andre Vercueil is a liver specialist and well practised at performing this technique in intensive care.

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There you go.

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You can see that pulsing with each beat of Nigel's heart.

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Ordinarily if we were doing this at sea level, the blood coming out

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of here would be a bright orange red colour, but because there's less oxygen carried by the blood

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it's this fetching blue colour.

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But Dr Dan Martin knows that the low oxygen on Everest

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is not enough to exactly mimic intensive care.

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They need to push Nigel even further.

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The other component we can simulate if you like is the increased oxygen consumption that sick patients have.

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They require a lot more oxygen to get over the disease that they're suffering from.

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And we can increase Nigel's oxygen consumption by getting him to exercise.

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So although it wouldn't be quite right

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to make him ill and study him, we can exercise him which increases the amount of oxygen demand on his body.

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So we want to find the point at which

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Nigel's gut becomes ischemic or lacks oxygen.

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In critically ill patients it may do that to such an extent that the gut may die.

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I think what you, what you sometimes forget is you're sitting here and it almost looks like

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a laboratory, then you look outside the door and there's the ice fall.

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It makes it all a bit difficult.

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The studies at base camp are just the beginning of the team's work.

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15 of the doctors are planning to take their experiments to the highest place on Earth.

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It just looks like a maze...

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..like a broken maze.

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It looks really hard.

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The first obstacle they face is the Khumbu Ice Fall.

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Everest has so much history associated with it, so many books written about it,

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and the Khumbu Ice Fall is one of the notorious obstacles,

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that anyone who wants to climb Everest from this side has to get over.

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It's basically a continuously moving river of ice

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with the ever-present risk that part of it will fall down.

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You can see those big blocks, some of them the size of houses

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and they are coming down from time to time.

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It has been impossible to ignore how unstable the mountain can be.

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If a large serac or chunk of ice decides it's time to fall down

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when one of our team is walking underneath,

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there's very little you can do about that. The only thing you can do is minimise exposure by getting

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people through as fast as possible and as few times as possible.

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Behind the ice fall, and hidden behind the ridge of Nuptse,

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is the Western Cwm, this broad, relatively flat valley that goes up towards the Lhotse Face.

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As they climb to the summit the doctors will stay at Camp 2 for seven days.

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The route meanders up to Camp 3 which is about halfway up and then across to the South Col.

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Then up at the South Col we're into the area colloquially known as the Death Zone.

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Above the South Col you can see the South East Ridge

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heading up into the cloud and Everest summit.

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And that's the other main area of risk for us because of the critical lack of oxygen.

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Only at this extreme altitude, where there is one third of the oxygen

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there is at sea level, can they find the answer to the mystery that brought them to Everest.

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How does the human body survive with such low levels of oxygen?

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As they begin their ascent the ice fall poses a challenge most of the climbers have never seen before.

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The glacier is 450m deep and sliding down the mountain at over metre a day.

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It is riddled with crevasses that can open and close without warning.

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Sundeep is the climbing leader and the only person to have tackled the ladders before.

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Everest is a very dangerous place.

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If you asked me at this stage how many people would get to the top

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I'd probably say somewhere between six to eight.

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That's not really making an assessment on individuals...

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-Nice work!

-Good job.

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..that's just the toll the mountain takes on people and it would be

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difficult to say who would or wouldn't be in the summit team.

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It's quite a long way, isn't it?

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If you fell here, you'd load these points here

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far more than, than is probably safe for then.

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You really, really don't want to fall here.

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LABOURED BREATHING

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-Hi, pixie.

-Hi.

-Three ladders is just here, it looks all right...

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It is truly stunning though, isn't it?

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Despite the danger, the ice fall is one of most extraordinary places on earth.

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A vertical kilometre of shifting ice, breaking and cracking as it flows.

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Every day in this jumbled world is unique.

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Wow, it's hot.

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It's kind of messy over to our left.

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You can see where all these blocks come tumbling down.

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This looks horrible.

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It's tough-going, isn't it?

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Woah, crazy.

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Breathe, breathe.

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To climb through the ice fall will be a gruelling experience for Mike and the team.

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Let's go.

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Not a place to pause.

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What slows them down is not their fitness or strength but the lack of oxygen.

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At this altitude, the thin air is so suffocating, they can never climb fast enough to exhaust their legs.

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The body reacts by attempting to get more blood to the oxygen-starved muscles.

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The lungs breathe harder, sucking in more air.

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The blood is thicker with extra cells to carry oxygen.

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And the heart beats faster.

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But this traditional understanding of how the body copes isn't enough to explain one thing.

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Why do some people,

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no matter how fit, struggle to perform at high altitude?

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Mike was an absolute star. As you can see, he's carrying

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a lot of my gear, cos I was struggling a bit earlier on.

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Particularly when we started cos it was really cold.

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Ah, I don't think I'd had got up here if he hadn't helped.

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But we're here in one piece at last which is excellent news.

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I'll go and have a cup of tea.

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Mike and the team believe what causes this difference is not how much oxygen is

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pumped around the body, but how well the body uses that oxygen.

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Understanding this is the major goal of the expedition.

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Here at Camp 2 they will set up a new lab, repeating the tests they've done all the way from sea level.

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But now the conditions are much tougher.

0:26:070:26:10

Here temperatures will drop to below minus-20

0:26:110:26:15

and then soar in the heat of the sun to over 40 degrees.

0:26:150:26:20

Living here will be more like camping in a desert than on a glacier.

0:26:220:26:26

And yet they are about to perform experiments that require all their skills as scientists.

0:26:280:26:34

Dan, you're going to feel a scratch.

0:26:370:26:40

At every stage of the climb the team will be taking a blood sample straight from an artery.

0:26:410:26:47

Measuring the level of oxygen in blood is a test Mike would do every day in intensive care.

0:26:500:26:55

-You all right there?

-Just about.

0:26:550:26:58

Arterial blood is the blood that is pumped out of the heart

0:26:580:27:01

having been through the lungs, so is the most oxygenated.

0:27:010:27:04

So it gives us a measure of how much oxygen the tissues are seeing.

0:27:040:27:08

At sea level a healthy person will have 10 to 14

0:27:100:27:14

units of oxygen in their blood, someone who is critically ill, around eight.

0:27:140:27:19

We've just analysed Dan's arterial gas sample and it, it's just astonishingly low.

0:27:210:27:26

I've never ever seen a sample, a content of oxygen in the blood as low in somebody who's still alive.

0:27:260:27:34

It's, er, 4.47 partial pressure of oxygen

0:27:340:27:39

in kilopascals which is a third of what it is at sea level.

0:27:390:27:43

I, I've just never seen, even on somebody on an intensive care unit,

0:27:430:27:46

critically ill with terrible lung damage, I've never seen a level this low, ever.

0:27:460:27:52

You should be worried.

0:27:520:27:55

Still alive.

0:27:560:27:58

It's a beautiful morning and this is my incredibly beautiful and historic temporary home.

0:28:140:28:21

Behind me here is Everest itself,

0:28:220:28:25

the highest mountain in the world and as you can see, it's cloudy

0:28:250:28:29

a little bit, it's windy and cold up there this morning.

0:28:290:28:32

So we're certainly not going anywhere today.

0:28:320:28:35

Over there is Lhotse...

0:28:350:28:36

another 8,000m peak which is the fourth highest mountain in the world.

0:28:360:28:40

And this tent here is, as far as we know, currently the highest laboratory in the world.

0:28:450:28:51

Until we put one up there next week.

0:28:510:28:53

Having established that all the team have levels of oxygen in their blood

0:28:530:28:58

that mean they should be dead, their next test

0:28:580:29:01

is designed to reveal why they are still alive.

0:29:010:29:05

To do this they have brought an exercise bike nearly 6,500m up the mountain.

0:29:090:29:16

That's perfect.

0:29:160:29:18

This is the most important experiment for the Xtreme Everest team.

0:29:180:29:22

It is the foundation of the whole expedition.

0:29:220:29:25

You've just got to go as hard and as long as you can.

0:29:270:29:32

The machine knows when you are fibbing.

0:29:320:29:34

By exercising on this bike Sundeep will push his body to the very limit.

0:29:340:29:39

It's a test he first performed in London three months ago.

0:29:410:29:45

It's one of our key hypotheses on the whole trip is whether actually

0:29:450:29:49

the way your cells use the oxygen changes when you're at altitude

0:29:490:29:53

when there is not much oxygen around.

0:29:530:29:56

They believe that Sundeep's muscles are using less oxygen up here

0:29:560:30:00

to do the same amount of exercise he did at sea level.

0:30:000:30:04

Really good, Sundeep.

0:30:040:30:06

Excellent. Doing really well, drive those legs.

0:30:060:30:09

What we think happens is that your cells basically tune up, a bit like a car engine.

0:30:090:30:14

So you can get more miles to the buck really, you can do more work for the same amount of oxygen.

0:30:140:30:21

And that would help explain why people with very low levels of oxygen in the blood

0:30:250:30:31

are still able to perform amazing feats like climbing Everest.

0:30:310:30:36

Denny thinks that Sundeep's cells have

0:30:360:30:38

adapted over the last few months and some how become more efficient.

0:30:380:30:43

They think that this happens in intensive care as well.

0:30:470:30:51

Some patients respond to treatment better than others

0:30:530:30:57

because their cells might be more efficient at using oxygen.

0:30:570:31:01

We can clearly see that some people have exactly the same number of red blood cells

0:31:010:31:06

and their heartbeat is the same and their breathing is the same.

0:31:060:31:09

But one performs far better than the other.

0:31:090:31:12

It's a revolutionary new theory.

0:31:120:31:15

If we could tune their cells into a more efficient state we may

0:31:150:31:21

be able to, in the future, improve their outcome in intensive care.

0:31:210:31:25

And that's why I'm here on Everest putting myself through this

0:31:250:31:29

so that I can hopefully improve their outcome in the future.

0:31:290:31:33

I think in our wildest dreams what we would love to see is that some people have certain genes

0:31:330:31:38

that allow them to use oxygen more efficiently than others.

0:31:380:31:43

So what we are really really hoping from this trip is

0:31:430:31:47

that we could target treatment to poor oxygen users.

0:31:470:31:52

It's quite a wild and big thing,

0:31:520:31:55

but we may go some stages towards identifying those mechanisms.

0:31:550:31:59

Really good, Denny. Keep pushing those legs round.

0:32:010:32:04

But to get the clearest picture of what is going on in their bodies they need to take

0:32:040:32:09

the exercise bike to the most extreme environment possible.

0:32:090:32:13

They will set up their final lab on the South Col.

0:32:190:32:24

The climbers will spend two days at 8,000m testing themselves to exhaustion.

0:32:250:32:31

If these experiments prove that their cells are more efficient

0:32:330:32:37

they may be able to develop a treatment that would save thousands of lives.

0:32:370:32:41

To get there they must first tackle the Lhotse Face.

0:32:430:32:46

This 1,000m sheer wall of ice towers above the Western Cwm.

0:32:510:32:58

It takes two days to climb the nearly vertical slopes with a constant threat of avalanche.

0:32:580:33:04

Yesterday we had an extraordinarily sad event.

0:33:100:33:15

We were in camp doing studies but the radio traffic gradually revealed that unfortunately one of the Sherpas

0:33:160:33:25

working with a different team had been hit by an ice avalanche

0:33:250:33:28

and as best we understand it had been killed instantly.

0:33:280:33:31

And that, that obviously upsets our Sherpas greatly and all the members of our group.

0:33:310:33:37

It's just a bit shocking at how easily a life can be snuffed out

0:33:370:33:43

in an environment where we're planning to walk exactly the same path in a few days' time.

0:33:430:33:50

And that's what I think is playing on all our minds.

0:33:500:33:55

I mean we're going on with our experiments this morning and you almost feel like saying "Oh,

0:33:570:34:03

"just close the door and you know I'll not bother this morning."

0:34:030:34:06

It's very difficult to justify any reason for putting yourself

0:34:090:34:13

at any extra risk, when you have a wife and two small children.

0:34:130:34:19

This morning's really focused our mind an awful lot on what we're doing here.

0:34:190:34:24

We came here to do a job, a lot of effort's been put into it

0:34:250:34:29

and, I want to do that job.

0:34:290:34:33

But at the same time, keen to get home.

0:34:330:34:36

The weather is changing high on Everest,

0:34:450:34:49

the threat of snow will make the mountain much more unstable.

0:34:490:34:53

With the science completed at Camp 2 Mike chooses to return to base camp

0:34:580:35:04

rather than continuing to climb with the increased risk of avalanche.

0:35:040:35:09

We came down on the advice of our Sherpas because there was

0:35:110:35:14

a warning of snow, which increases the avalanche risk.

0:35:140:35:17

It didn't snow, but while we were

0:35:170:35:19

walking through the Western Cwm there was a big serac collapse

0:35:190:35:24

which caused...

0:35:240:35:26

hundreds of tonnes of ice come rushing down the slope towards us.

0:35:260:35:32

Fortunately it stopped before it got to us but good thing to be down.

0:35:320:35:37

Living at high altitude has proved much harder than they had expected.

0:35:370:35:42

It's been a great week

0:35:440:35:47

but hard work. We've got everything we wanted to do scientifically done which is brilliant.

0:35:470:35:51

It's nice to be warm again and to be able to breathe again.

0:35:510:35:55

Virtually everything we did has not been done before.

0:35:550:35:58

A few things that have have not been done with the same degree of fidelity so we're delighted.

0:35:580:36:04

The appetite affects you quite a lot.

0:36:040:36:06

So you might notice we've all lost quite a lot more weight,

0:36:060:36:09

I think the record is 11kgs so far.

0:36:090:36:12

To climb Everest the team need to be as strong and healthy as possible, even a simple cold could stop them.

0:36:140:36:21

They will wait here at base camp trying to regain their strength

0:36:210:36:25

until the weather on the summit clears.

0:36:250:36:29

Entertainment is thin on the ground at base camp,

0:36:310:36:33

the climbers have had to find their own ways of keeping busy.

0:36:350:36:40

You can control it very well at home, at sea level but here it's not so easy! Steady...

0:36:470:36:52

This is the highest-flying model helicopter in the universe.

0:36:550:37:01

Do you know why he's in here? To get his hard drive to work.

0:37:150:37:20

We put it out here.

0:37:200:37:22

The disk drive is working!

0:37:220:37:24

-Is it working?

-Absolutely perfect.

0:37:240:37:27

Who did that? I bet that was Grocott.

0:37:270:37:32

WHISTLING SOUND

0:37:320:37:35

Are you ready? Let's go get them!

0:37:430:37:46

The climbers have been waiting for

0:37:520:37:54

the weather to clear on the summit for nearly three weeks.

0:37:540:37:59

It's pretty good in that humidity is pretty well zero,

0:37:590:38:03

precipitation is zero, right up to the 1st or 2nd June.

0:38:030:38:07

So, that's very good. The only thing we've got is the jet stream

0:38:070:38:11

and that is tracking from a north-westerly down to a south-easterly direction

0:38:110:38:16

so it's getting closer and closer towards Nepal.

0:38:160:38:19

Wind speed will be the thing that stops them. I don't think there'll be any snow for the next ten days

0:38:190:38:26

so it's just the wind.

0:38:260:38:28

It's 6am. 15 of the climbers are getting ready to leave Base Camp for the last time.

0:38:370:38:44

Five years of planning has brought them to this point.

0:38:460:38:49

They will have one chance to climb to the summit,

0:38:520:38:55

the smallest problem could mean abandoning their science for good.

0:38:550:39:00

I can't find my gloves!

0:39:040:39:07

Building ourselves up, it's all in the mind.

0:39:080:39:12

As intensive care specialists all the doctors are aware of the dangers they face climbing at altitude.

0:39:120:39:19

I think everybody's feeling pretty strong.

0:39:230:39:26

It looks like we've got between seven and ten days of good weather

0:39:260:39:30

without high winds.

0:39:300:39:32

Looking at the top of the mountain today, it looks really calm.

0:39:320:39:36

Fingers crossed that the weather holds and we can get up and get down safely.

0:39:360:39:41

I'm looking forward to bringing everyone back down in a week's time.

0:39:440:39:47

I'm quite excited, ready to go,

0:39:510:39:54

it's a big day today and a big week ahead of us.

0:39:540:39:58

I think for everyone it's a mixture of excitement and nervousness really to be honest.

0:39:580:40:04

-Terrified.

-Terrified.

0:40:040:40:06

-Did you bring the guide book?

-No, I left it in the tent.

0:40:080:40:13

'Graham, this is Mac, go ahead.'

0:40:130:40:17

What terrifies the climbers the most is not avalanches or frostbite...

0:40:210:40:26

Six to eight hours of misery coming up!

0:40:260:40:29

..it's the effects the low oxygen will have on their brains.

0:40:310:40:36

Protecting the brain is Mike's top priority in intensive care.

0:40:430:40:48

Without oxygen, cells die in minutes,

0:40:480:40:51

leaving a patient permanently brain-damaged or even dead. When the brain suffers a major trauma,

0:40:510:40:59

like in car accident, it swells and pushes against the inside of the skull.

0:40:590:41:04

As the pressure builds less oxygen gets to the brain causing a spiralling effect.

0:41:040:41:10

The same thing can happen on the mountain.

0:41:100:41:15

The low levels of oxygen are enough to trigger the same kind

0:41:150:41:19

of brain swelling. It's called High Altitude Cerebral Edema

0:41:190:41:22

or HACE.

0:41:220:41:24

It is the most serious effect of climbing at altitude

0:41:260:41:29

and nowhere on Earth is the threat greater than on the summit of Everest.

0:41:290:41:34

At nearly 30,000 feet, it's the cruising altitude of a jumbo jet.

0:41:380:41:43

If a climber were to be dropped straight onto the summit

0:41:470:41:51

their brain would shut down, stopping them breathing and they'd suffocate in minutes.

0:41:510:41:56

To counter these effects the Xtreme Everest climbers

0:42:020:42:06

have been training their bodies to cope with the low oxygen.

0:42:060:42:10

Over the last six weeks they've been climbing the mountain in stages,

0:42:100:42:14

with each trip they go a little higher.

0:42:140:42:16

But despite this cautious assent some of the team have found climbing beyond Camp 2 difficult.

0:42:180:42:23

First off my heart started going a terrible pace

0:42:360:42:41

and then I just started to feel very woozy.

0:42:410:42:44

Not so much woozy, but as though I was going to black out.

0:42:440:42:49

And, er, I thought "Wow, the altitude kicks in quickly."

0:42:500:42:57

I thought I was stuffed.

0:42:570:42:58

And I was breathing really fast.

0:42:580:43:01

Honestly everything was just going "Woo, black, black can't see, woo, I've gonna pass out here."

0:43:010:43:07

I was thinking "Shoot!"

0:43:070:43:09

YOU were thinking shoot!

0:43:090:43:11

Yeah, you were thinking "Darn, I've got to go down as well."

0:43:110:43:14

Nigel Hart is lucky.

0:43:160:43:18

The effects of the low oxygen have turned out to be mild.

0:43:180:43:21

But climbing at this extreme altitude is a game of Russian roulette.

0:43:230:43:27

The most important thing for us to understand is whether he'll be walking wounded or stretcher case.

0:43:270:43:32

I'd feel happier with Andre short-roping him all the way down.

0:43:320:43:38

For one of the team the worst has happened.

0:43:380:43:41

There should be about 30 cylinders up there, just keep on using it.

0:43:410:43:46

Did you give him 8mg?

0:43:460:43:49

Whilst climbing on the Lhotse Face anaesthetist Patrick Doyle has

0:43:500:43:54

become confused and disorientated, these are classic symptoms of HACE.

0:43:540:43:59

The bizarre thing is you know I feel 1,000 percent better and I think "Well, what's all the fuss about?"

0:44:030:44:09

You think, "I'm sure I could go back up there" but it's just...

0:44:090:44:14

How do you feel about not going back up?

0:44:140:44:17

Er...

0:44:170:44:18

a bit emotional not, not being able to do it but,

0:44:200:44:24

er, I always said I'm gonna be totally sensible and, er.

0:44:240:44:29

It's good to have you back down safe, Pat.

0:44:290:44:34

But we're all gutted for you as well.

0:44:340:44:37

I didn't think it would be me!

0:44:390:44:43

Staying at Camp 2 should allow Pat to recover but he can't climb any higher.

0:44:440:44:50

You look better than we could have hoped.

0:44:500:44:52

After two months of preparation, his summit dreams are over.

0:44:520:44:58

Pat was one of the strongest climbers and the effect

0:44:590:45:03

of the altitude on him has shocked the whole team.

0:45:030:45:06

He's sensible, he wouldn't have gone up if he was feeling super crook.

0:45:220:45:27

-It sounds very much like HACE.

-Yeah.

0:45:270:45:30

It's difficult to deal with in hospital even.

0:45:300:45:33

Caudwell Base Camp, this is Mike, over.

0:45:330:45:36

He's in the right place with the right people.

0:45:360:45:39

They all know that above 8,000m, the critically low levels of oxygen

0:45:390:45:44

mean they will run the risk of suffering permanent brain damage.

0:45:440:45:49

We've got at the moment an uncertain medical situation up here.

0:45:490:45:54

It's Pat and he's probably got a touch of cerebral edema.

0:45:540:45:57

He's hopefully going to get better pretty soon.

0:45:570:46:01

I'd have thought if he's well here, he'll want to stay here.

0:46:080:46:13

He's pretty sensible and wouldn't want to go back up.

0:46:130:46:17

With Pat ill Mike has to reorganise the team.

0:46:170:46:21

If they are to reach the summit they can't afford any more delays.

0:46:210:46:25

-Then at least you two are together.

-We can send the first group up

0:46:250:46:29

which would only delay us by a day.

0:46:290:46:32

We'll go and have a look at that weather again.

0:46:320:46:35

The team has split in two. Sundeep is leading an advanced party

0:46:460:46:51

to Camp 3. Mike and the main climbers will follow a day behind.

0:46:510:46:57

But getting to Camp 3 means climbing the Lhotse Face.

0:46:590:47:05

Doing this is a monotonous exercise.

0:47:080:47:11

Hour after hour of hauling yourself up a sheer wall of ice.

0:47:110:47:16

Clipping off and on ropes every few metres.

0:47:160:47:19

As the oxygen drops the effects on the brain become more profound.

0:47:210:47:27

Even the simplest of tasks becomes challenging.

0:47:270:47:33

The history of deaths on Everest

0:47:370:47:40

is littered with stories of terrible simple mistakes.

0:47:400:47:44

There are people who won't do up their harnesses properly,

0:47:440:47:48

there are people who when it comes to clipping in and out of a rope,

0:47:480:47:52

they simply can't be bothered, the effort of leaning down, unclipping

0:47:520:47:56

and clipping on to the top rope is too much for a lot of people.

0:47:560:47:59

And they start to think that they'll move quicker if they don't do those things.

0:47:590:48:04

The climb to Camp 3 is only 700m

0:48:090:48:13

but it has taken over five hours.

0:48:130:48:16

Dan, Maryam and Vijay are first to arrive.

0:48:210:48:24

Chris follows behind and Sundeep comes last to make sure nobody gets left on the Lhotse Face.

0:48:270:48:33

It has been a hard day and the team need rest before continuing tomorrow.

0:48:330:48:40

This small cluster of tents

0:48:440:48:46

is a stop-off for all the teams on Everest.

0:48:460:48:49

From here the final camp before the summit is just a few hours' climb away.

0:48:540:49:00

-Have you got a headache?

-I had a bit of one, my first one.

0:49:090:49:14

I think I'm dehydrated. We should get the stove on and get going.

0:49:140:49:20

A climber from another team is struggling to make the last few metres before camp.

0:49:270:49:33

He could barely move.

0:49:380:49:40

All the time, he's breathing as hard and as fast as he can

0:49:400:49:45

but having complete air hunger and feeling that nothing's going on.

0:49:450:49:49

If you combine that with somebody who's got this single thought in his mind that if he continues

0:49:490:49:56

to follow this rope he's one step nearer reaching the summit of Everest.

0:49:560:50:01

Actually all he was doing was climbing closer and closer to death.

0:50:010:50:05

And at that point I just thought, if we're going to be stood here, we might as well go down and help.

0:50:060:50:11

Vijay, don't go down there without being clipped on.

0:50:110:50:15

Just clip on and stay safe.

0:50:150:50:18

'It's very treacherous ground round there and if you take a fall,

0:50:180:50:21

'you're not clipped into anything and you're just going to keep on going to the bottom of the Lhotse Face.'

0:50:210:50:26

He was really in bad shape when I arrived at him.

0:50:300:50:33

He was completely incoherent, just making gargling noises.

0:50:330:50:38

Can you take his pack, Vijay?

0:50:380:50:40

'Er, I tried to give him some water but he couldn't swallow -'

0:50:400:50:44

the classical signs of HACE really.

0:50:440:50:47

-We'll get the oxygen down here as well.

-He needs to be up here, Vijay.

0:50:480:50:53

The doctors realise that this is a potentially fatal situation.

0:50:540:50:59

But the sick climber's team seem reluctant to help.

0:51:000:51:03

They call their own doctor at base camp for advice.

0:51:030:51:06

In the last half-hour, we've seen a complete disregard for human life.

0:51:080:51:14

We've seen a bunch of guys sitting in their tents

0:51:140:51:17

while they watch their team member struggle like hell up those ropes.

0:51:170:51:22

They just looked on, took photos, took out the video camera.

0:51:220:51:26

They came to us guys to step in and drag him up. They thanked us

0:51:260:51:30

for it but what were they doing?

0:51:300:51:32

That's everything that is wrong with people.

0:51:340:51:39

With light failing there is very little time to act.

0:52:020:52:05

If the climber is to be carried down the Lhotse Face they must leave immediately.

0:52:050:52:12

My name is Daniel, I'm a British doctor.

0:52:120:52:15

The man here is very unwell...

0:52:150:52:17

With the other team reluctant to take advice Dan calls the doctor directly

0:52:170:52:22

to try and persuade him the situation is extremely serious.

0:52:220:52:26

I think his life is in danger.

0:52:260:52:28

If he comes to Camp 2, our doctors there may be able to look after him.

0:52:280:52:32

We have a lot of doctors at Camp 2.

0:52:320:52:35

VOICE CRACKLES OVER RADIO

0:52:350:52:37

Yeah, we need a stretcher right away.

0:52:420:52:45

We've just seen another guy who's unconscious on the ropes...

0:52:450:52:50

On the ropes passing the camp another crisis is unfolding.

0:52:500:52:54

A climber returning from the summit is in trouble.

0:52:570:53:01

Your emotions are torn between concern for those you're trying to help,

0:53:070:53:13

you're concerned about the, er the health and morale

0:53:130:53:16

of your team that are now running around expending energy

0:53:160:53:20

and potentially making themselves sick when they should be resting.

0:53:200:53:24

But actually you realise you're fairly helpless.

0:53:240:53:27

Vijay, what's the score?

0:53:310:53:33

It's not our decision, we can only help.

0:53:370:53:39

Vijay, they can still get this guy down.

0:53:410:53:44

And that is the right treatment.

0:53:440:53:47

-Vijay!

-Vijay!

0:53:470:53:50

They'll get him down!

0:53:500:53:52

-Vijay!

-Vijay!

0:53:520:53:55

Dealing with two casualties will leave the team dangerously stretched.

0:53:570:54:01

Vijay should come back really. Vijay!

0:54:020:54:05

-Vijay!

-Come back!

0:54:050:54:07

Leave it!

0:54:070:54:08

It's awful to say this - we have to look after ourselves rather than endanger ourselves.

0:54:080:54:14

Vijay!

0:54:140:54:15

I've never ever been in this position.

0:54:150:54:17

We have to look after ourselves.

0:54:170:54:19

We really have got ourselves into a right pickle.

0:54:190:54:24

Drugs and oxygen can help, but the only guaranteed treatment is to descend to a lower altitude.

0:54:250:54:33

Taking the climber down will save his life.

0:54:330:54:38

Vijay, you're a good man.

0:54:380:54:40

But time is running out for the other climber. His team are still making no attempt to leave.

0:54:400:54:45

Sundeep radios for support.

0:54:490:54:53

OK, I'll see what I can do. I doubt it'll help but we'll see.

0:54:550:55:01

He wants to get everyone mobilised

0:55:010:55:03

to put maximum pressure on this team to bring their climber down.

0:55:030:55:07

'He's going to die and they're aware of that.

0:55:070:55:11

'They've decided to keep in the area.'

0:55:110:55:14

OK, I'll go into the camp and discuss it with the doctor,

0:55:140:55:19

It's unclear whether they're unconcerned or don't understand

0:55:220:55:27

or don't want to pay their Sherpas for an extra carrier.

0:55:270:55:31

The motivation is confusing.

0:55:310:55:34

I can't imagine anybody I climb with saying, "Oh, it'll be OK."

0:55:340:55:40

I've spoken to the doctor in the team and the leader

0:55:400:55:45

and they don't feel any great degree of urgency unfortunately.

0:55:450:55:50

-It's very frustrating being down here.

-It is, yes.

0:55:500:55:55

You now wait and see if he lives or dies.

0:55:550:55:58

If they're not going to accept any help, then...

0:55:580:56:02

OK, thanks very much.

0:56:020:56:05

I'll read this guy the riot act one more time.

0:56:050:56:10

We are all doctors with a lot of experience

0:56:100:56:13

in England in high altitude medicine.

0:56:130:56:16

We believe that if he stays the night here, he has a very high chance of dying.

0:56:160:56:21

Our advice to you is that you get him down immediately.

0:56:210:56:28

The summit is not important, he is important.

0:56:280:56:31

He should have been turned around a long time ago.

0:56:310:56:34

I don't...this is my doctor down here...

0:56:360:56:41

With respect to your doctor, he will die.

0:56:430:56:47

Is your doctor here or down there?

0:56:470:56:51

OK, well, we are doctors here who've seen your friend

0:56:510:56:55

and we don't think that he will survive.

0:56:550:56:59

VOICE CRACKLES OVER RADIO

0:56:590:57:03

They have finally agreed to take their climber down, but it is too late.

0:57:090:57:16

Night is falling and it is

0:57:170:57:20

too dangerous to descend the Lhotse face.

0:57:200:57:23

Dan in particular spent a lot of that evening treating this guy.

0:57:260:57:31

The impression that we had was that they were prepared to allow one of their team members

0:57:310:57:35

to potentially die, so that they wouldn't have to sacrifice their high position on the mountain,

0:57:350:57:43

and therefore their summit attempt.

0:57:430:57:45

It has been an exhausting experience and they've only just prevented a death.

0:57:450:57:51

Despite being physically drained,

0:57:510:57:53

early tomorrow the doctors will push on to Camp 4.

0:57:530:57:56

When they get there

0:57:560:57:58

they will set up the highest laboratory the world has ever seen.

0:57:580:58:01

There's a lot of drama going on on the mountain.

0:58:010:58:04

Over the next two days they will be tested as scientists, stretched as doctors

0:58:040:58:10

and pushed beyond their limits as climbers.

0:58:100:58:13

No hand orders. Not hand orders.

0:58:130:58:16

We're just going to turn around and go back down

0:58:160:58:19

because it's the right thing to do, you know?

0:58:190:58:21

If one person is up there, close to death and nobody's rescuing them,

0:58:210:58:25

there's nothing we can do.

0:58:250:58:27

But nothing can prepare them for life in the Death Zone.

0:58:270:58:30

-I don't like working off luck.

-'Mike, this is Denny, over?

0:58:300:58:33

'Mike, this is Denny. Do you copy?'

0:58:330:58:37

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