Surviving The Extremes by Kenneth Kalmer

Knapsack Treks Book Review by Chan Joon Yee

Surviving The Extremes by Kenneth Kalmer

For those unfamiliar with the author, Kenneth Kalmer was the only doctor on Mt Everest during the 1996 tragedy. This book touches on human physiology and how we adapt to and tolerate extremes in environmental conditions. It contains valuable information with which every adventurer should be acquainted. Though it is written for the layman, this is certainly not the kind of book you can read just before going to sleep. It’s pretty heavy on scientific principles.
Dr Kalmer begins with the jungle environment, namely the Amazon forest and swamps. Though heat exhaustion can be a problem here, most of the hazards of this environment seem to come from the denizens of the jungle. Survivors in this environment need to keep a constant lookout for the anopheles mosquito (malaria), black caiman, anaconda, venomous snakes, poisonous frogs and caterpillars, schisto worm (liver parasite), stingray, electric eel and a most interesting creature called the candiru. This is actually a very tiny catfish which has a great affinity for salt. When an animal urinates under water, this tiny creature will follow the stream of urine and lodge itself in the animal’s urethra. Surgery is required to remove it.

Ironically, the jungle is also a natural pharmacy that provides medicines to heal the sick as well as poisons for blowdart hunting. No wonder people still live there.

The next hostile environment is the open sea – endless stretches of water, not a drop of which can keep the castaway’s body hydrated. Dr Kalmer gives many examples of how castaways survive. The world record is held by Chinese sailor Poon Lim, who drifted on a raft for 130 days without supplies. He collected rain water and used a spring in his torch to catch fish. Methods thought up by other survivors include using improvised solar-powered stoves to distill seawater. The physiology of salt intake, dehydration and starvation are presented along with some coverage on cannibalism at sea.

The scorching desert is an even more hostile environment that causes heat exhaustion, dehydration and starvation to set in even more rapidly. Dr Kalmer explains in detail how the body regulates temperature and maintains a constant internal environment. He also explains how this system can break down under extreme external temperature and dehydration. Death occurs with the loss of 15-20 litres of body fluids. However, defying the limits of human physiology, is one Mauro Prosperi, who claimed to have survived for 9 days in the desert without any water.

Diving medicine is a very big topic by itself, but Dr Kalmer gives us the essentials on what happens to the body during free diving, the mechanics of SCUBA as well as the causes of decompression sickness. As with the other environments, many examples of diving accidents along with a microscopic view of what went on inside the victims’ bodies are presented.

High altitude medicine is one area where Dr Kalmer has the most firsthand experience. Bringing out actual situations he encountered on Himalayan expeditions, the author presents a flowing account of Himalayan expeditions alongside an “insiders’” view of the characters’ bodies. The mechanics of AMS (acute mountain sickness), HAPE (high altitude pulmonary edema), HACE (high altitude cerebral edema) and frostbite are neatly woven into the story. Dr Kalmer even proposes a somewhat controversial evolutionary advantage that the Sherpas may have over other people. Even more surprising but factually indisputable, is his mention of the “miraculous” survival of Beck Weathers and Pasang Sherpa.

The final chapter is really out of this world – space adventure. Space is the ultimate hostile environment combining extreme cold, extreme heat, vacuum and cosmic radiation from which the human body must be almost completely insulated. Topics covered include the physiological effects of G force and zero gravity. Also mentioned are research projects into building self-sufficient spacecrafts for interplanetary exploration. Interesting hypothetical situations are presented and Dr Kalmer manages not to bore the reader with his wit and humour.