SIR EDMUND HILLARY (full story)
On a Thursday evening Dr. Alistair called me from the Emergency Room.
"I've some bad news." "What's up, Al?" "Well, Sir Edmund has come in with chest pain and shortness of breath. Looks like he's in Pulmonary edema."
The helicopter took him out to his project at 8000 feet, where he began to get short of breath, and later chest pressure. After 3 days, he couldn't stand it and was flown in. His cardiogram is abnormal."
Sir Edmund Hillary had written to me three months before asking if we could take a certain intern doctor on the staff of Patan Hospital. We did that, and we also arranged for Sir Ed, when he came to Nepal later in the year, to come and inaugurate our new Children's Ward. The Hillary's had gone out to the hills by helicopter, in order to view the projects that his Himalayan Trust had set up over the years. Now one week before the inauguration, he was a patient in our Emergency Room.
He was an aging bear of a man, with a tangle of white hair, and a large jaw that fell easily into a smile. He wanted to reassure his doctors that he wasn't really sick. As we moved him about to examine him, he tried gamely to exercise his latent athletic energy. But there was no bounce left: he was laboring under too many pounds, he was over 80 years old, and his lungs were soggy with fluid. He looked very tired.
The usual tests took some time to complete. We gave him a diuretic and discussed the need for him to be admitted to the hospital. Dr. Kami Sherpa, a nurse, and I took Sir Ed up the elevator on a stretcher and wheeled him into the ICU. Several of us half-hoisted, half-directed him across into his bed. He looked about, taking a moment to focus on his new surroundings. Finding my face in the crowd, he beamed as if he was meeting an old friend after a long time away. "Ah!! So it's you again!!"
He listened to his report-irregular heart beat, possible heart attack, fluid in the lungs causing low oxygenation. He was in a mission hospital that cared for 300,000 patients visits a year, almost all local people and quite poor. The equipment that surrounded him in our ICU was a grab bag of used items donated from all over the world. Our nurses spoke barely passable English. His wife June would not be able to come in from the hills for another two days.
"Well, I'm sure that it will all work out. It always does. I have been through a few tough times before, and I can see that I am in quite capable hands. You have put me completely at ease." His wide smile revealed haphazard teeth of an adventurer.
He slept poorly. The lady admitted to the next cubicle in the ICU was confused and combative, and made noise all night. The next night, another patient died in a nearby bed. Nevertheless, morning rounds found him better. Every day he invariably had something amusing to say, and then he'd add a few words about what a fine hospital he felt this was. Examining him, I tried to concentrate on medicine and banish the inner voice that whispered to me, "Hey! This is the guy who climbed Everest. This is Hillary!" With the stethoscope I noted that the fine crackles in this chest had come down to just the bases of the lungs. The heart, though still irregular, had slowed to a more healthy rate. His large hands lay peacefully in his lap.
"Your heart has been weakened, Ed. Do you exercise much?"
"Well, yes, I do. In fact, over the years I have been quite an active walker."
He seemed to be doing better. The lab tests and repeat cardiogram and chest X-ray were reassuring. I gave him the latest reports and then let curiosity get the best of me.
"Ed, if I may ask: That day in 1953, who actually made it to the top of Everest first?"
"Well, with my axe, I cut the path up through the ice and snow on the approach to the top. Tenzing was just 5 yards behind me the whole way. But, you see, this is a question that mountaineers never ask. It was a team effort. We did it together. Unfortunately, after we came down into the real world, politics entered the picture. Cartoons were printed showing the Nepali carrying the Westerner up to the summit on his back..."
June arrived on the second morning. Ed was better. His steady help-mate and friend, she asked appropriate questions to learn more about his diagnosis. They were both very trusting of our care. Dr. David Murdoch, a New Zealand colleague of mine and friend of the Hillary's, was able to track down Sir Ed's last cardiogram and 'fax' it out to us. Comparing this to the most recent one, we could determine that the abnormality on the cardiogram was old, thus lessening the likelihood that he'd had a heart attack.
We moved him to a room on the Private Ward. He came off the oxygen and began to walk the halls. Only then did he admit that he had found it frightening being alone in the ICU.
Sir Ed brought up the issue of the Children's Ward inauguration, something I'd been avoiding. In an off-hand way, after I examined him one day, he mentioned getting his speech ready for the program. I found myself in a quandary. An old man, just coming out of heart failure, with an irregular heartbeat, needs rest-the doctor in me said so. The medical director in me replied-everyone is counting on him and all the announcements and invitations have already gone out. I shared my dilemma with colleagues in the hospital. They said they were supportive of whatever I decided to do, which wasn't much help. I spoke to June about possibly substituting for Ed at the inauguration. She said she would be more nervous about that than about Ed doing it himself. Even before he came into the hospital, I'd had a funny premonition that something would go wrong. Now I pictured the scene of Sir Edmund Hillary collapsing and breathing his last on the Patan Hospital stage.
Events took their own course. Each day he became stronger. When I walked with him in the hall, I had to step quickly to keep up. We talked of the plans for the inauguration. We could bring him in early through the back gate, get a wheelchair to meet him, get him up on the roof before the crowds came; he could leave early and skip lunch. June asked if we didn't have an elevator to get to the roof where the tents would be set up. We didn't. He was discharged from the hospital two days before the inauguration.
On the day of the inauguration, Sir Ed and Lady June returned through the front door. Supported by a cane, he walked the length of the new ward, viewing the rooms, saying "What a fine place for the children! Just lovely, isn't it, June?!" Compliant with my request, he rested on the landing half way up the flight of stairs to the roof. When two of our petite nurses tried to hoist his ample frame up onto the stage, he turned to the crowd, raised his eyebrows and cried, "They're carrying me!"
Colourful circus tents had been erected across the roof of the new ward. It was a hot day in April with almost no breeze, so as the hour proceded the air under the big top grew stifling. Sir Ed's speech was half about children and half about how thoroughly he had "enjoyed" his time as a patient in Patan Hospital, "and one is not supposed to enjoy being in a hospital."
"One week in this hospital, including two days in the ICU, and look at me..." -he raised his arms widely from his ample frame; his face as red and moist- "the very picture of health!"
At the prescribed time, he pulled the curtain on the brass inaugural plate. The festivities ended with politicians making speeches about how much better Patan Hospital would be if we would help them in one way or another. We escorted Sir Ed out past the crowds, with a number of stops for introductions, handshakes, and photos. Right up to the time they got into their car, they stopped again and again to give another stranger a smile of appreciation and a few words of chat. The day was a success.
On the previous Saturday night, Sir Ed's third day in the hospital, he had been moved to a single room up on the Private Ward. I stopped by in the evening to see how he was doing. At the nurses' station, the senior nurse said "Hari Maya has some children in to see him just now". Hari, our nurse anesthetist, had asked me earlier if she could bring her kids in to meet him. I'd said OK reluctantly, for we had been trying to limit his visitors.
The room was lit by the dying light from its balcony window and a dim fluorescent bulb overhead. He had a circle of about 10 Nepalese children, with Hari behind them. They'd just sung him a song and were in the process of handing him small clusters of flowers. He sat on the edge of the bed, stooped forward, hands resting on his huge thighs, and an oxygen cannula in his nose. As usual, his hair appeared hurricane-blown.
At my arrival, Hari began to shoo the children out. He shook a hand, saluted another, and smiled wearily to the last one. Then it was just the two of us. A sheet of paper lay on his bedside table. It was a letter written in the careful hand of a child. At the top of the page was a crayon drawing of two men on top of a mountain, one planting a Nepalese flag, the other a New Zealand flag. The letter began "Dear Brave Heart of Mt. Everest 1953".
He picked up the letter and looked at it again, then handed it over to me. "It's really something, isn't it?"
Dr. Mark Zimmerman
(Used with permission of Sir Edmund Hillary)