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May-June 1999

Volume 87, Number 3

High Life: A History of High Altitude Physiology and Medicine. John B. West. xv + 493 pp. Oxford University Press, 1998. $79.50.


When I first started trekking in the Himalayas, my constant backpack companion was a very dog-eared paperback called Going Higher by Charlie Houston. Several times while paging through my copy in some picturesque tea house in Nepal, I would spot, across the room, another trekker paging through his or her copy of Going Higher. There is, of course, no lack of mountaineering books, many being of the coffee-table type with gorgeous photographs often accompanied by terrifying climbing stories. But to my knowledge, Houston's book was the first to combine the sheer love for the high mountains with a love of high-altitude physiology past and present. Many of us in the mountaineering community were saddened when Houston's book went out of print, but that made us cherish our copies all the more. (After I started writing this review, I discovered to my great joy that Going Higher was just reissued. Wonderful!)

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Going Higher and this new book, John West's High Life, are both very similar but at the same time very different—similar because both authors are giants in high-altitude physiology as well as passionate mountaineers, different because both attempt in different ways to present a comprehensive story of our understanding of high-altitude physiology from its early beginning in Greece, Asia and South America to our quite sophisticated understanding of it today.

I suspect that the audience for West's book is thoroughly familiar with his background and his many accomplishments, but for those who are not, it would be difficult to better the book jacket's own description of the author: West, professor of medicine and physiology at the University of California, San Diego, "was a member of the 1960-1961 Silver Hut expedition led by Sir Edmund Hillary and he led the 1981 American Medical Research Expedition to Everest. He is the author or editor of 17 previous books, including several on high-altitude physiology."

In High Life we learn that although the vast majority of the world's population (more than 6 billion) live below 8,000 feet above sea level, a full 2 percent live above this altitude. That's a significant number of people. That number not only comprises those whose recreations include skiing, climbing and trekking but also those who live year round at altitude or who work for extended periods at elevations higher than 15,000 feet. This last group includes miners and astronomers. We learn that oxygen-enriching equipment where these people work or sleep is becoming as popular as air conditioners in South Florida. We also learn that for these people only a 1 percent increase in oxygen (from 21 percent to 22 percent) is the physiological equivalent of a 1,000-foot drop in elevation.

West also retells the stories of the three perhaps most famous high altitude studies done to date: the Silver Hut expedition, the American Medical Research Expedition to Everest and Charlie Houston's classic hyperbaric chamber experiment, Operation Everest II. West was a major participant in the first two of these studies.

All the material in this quite extensive book is timely and interesting, although some readers may not be as enchanted as West is, or as I am, with the question of whether Aristotle really understood the concept of thin air. My reading of High Life suggests that he did not. As one might expect from a medical-school professor, the book is voluminous and very thorough, but I suspect it will not find its way into many backpacks journeying to altitude. For that we still have Charlie Houston's Going Higher.—R. Igor Gamow, Chemical Engineering, University of Colorado, Boulder

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