Kenneth Kamler, 56, a leading New York hand surgeon, has spent nearly 30 years travelling the world to study ‘how the body adapts to environments.
That expertise has led him to operate on the machete in the Amazon basin, treat 5 in the Arctic, and consult for NASA on a variety of medical topics. The 1996 Mount Everest tragedy(article) [Video] on which the book Into Thin Air was based would have been even worse had Kamler — a fellow climber and the expedition’s attending doctor — not been there to treat the victims.
In his book, Surviving the Extremes, Kamler examines the physiological changes that humans experience in strange and dangerous environments. His ﬁnal diagnosis is that, given half a chance, the human body can adapt to almost anything.
In the following Q&A, Kamler explains the life-saving adjustments that the body makes in reaction to overwhelming heat, cold, starvation and altitude, among other extremes.
Survival Guide Q&A
As a doctor, what one medical emergency Worries you the most when you’re in the middle of nowhere?
A head is the worst injury in any environment. Brain tissue is mostly nerve. If you cut a nerve, even with the best repair job ever it’s never going to be the same again. Plus, the diagnostics are tough. You don’t have CT scans and MRIs [magnetic resonance imaging] on a mountain.
You say that being lost at sea is the best test of someone’s innate survival Skills. Why?
Survival journey – Shipwreck survivors didn’t set out looking for adventure. Most are families on holiday. or a guy who thinks he’s on a 30-minute jaunt between islands — and all of a sudden they ﬁnd themselves on a 150-day survival journey.
Worst-case Scenario: my boat just hit a whale and sank. I’m stuck in a two-metre life raft with no provisions. What’s my biggest worry? Sharks? Starvation? Sunburn?
Thirst. A lot of people who are shipwrecked start drinking seawater. It eventually kills them.
Why isn’t it OK to drink seawater?
Your blood is maybe one per cent salt. Seawater is about three per cent salt. If you’re making soup, and you add too much salt, the only way to make it taste good again is to add more water. But it won’t help if that water has even more salt in it. The body is the same way. A person without fresh water will lose consciousness in three to four days.
Could you cut your freshwater with seawater?
A friend, Norman Baker, was the second in command on Thor Heyerdahl’s Ra expeditions across the Atlantic. Their raft was sinking, and to lighten it, they threw out a lot of the water. They made up for it by diluting seawater with the water they had, to bring it down to less than one per cent. So if you dilute it to a low enough level, it can work.
How long can you live without food?
At least six weeks. It depends on your level of activity, how cold it is, and a lot of variables that burn up energy. If you’re not fat, you can lose a third of your body weight without too much trouble. Between a third and a half is when you start shutting down. And more than half is considered fataL
Is it worth burning the energy to pry off and eat the barnacles stuck to the bottom of your boat?
People who survive have discipline and control — the idea that they get themselves out of the situation. Even though it might take more energy to unstick a barnacle, you’re acting to save yourself.
Survivors have discipline and control – they want to get out of the situation
Does someone know you’re there?
The ﬁrst thing is not to move if you think there’s a chance of rescue. You do not want to burn more energy than you have to, though it might be worth the effort to dig a hole. It’s extremely hot down to about two metres. Below that, you’re in much better shape.
What if no one knows where I am? How does my body defend itself?
In the Arizona desert, it’s 46 degrees at times. Proteins, whether contained inside eggshells or skulls, congeal at 44 degrees. Your body can adjust for a while. It will divert blood towards the skin but if the air outside is hotter than the blood it will warm you up rather than cool you down.
Sweating, the body’s sprinkler system, works only if you have the water to feed it. If not, the temperature in the hypothalamus — the “control centre” located in the core of the brain that regulates body heat and temperature — starts to go up and it sends out crazy signals. Your temperature control systems collapse and your brain will cook.
Is it possible to tell in advance who will do well under pressure?
If you are a disciplined person who can wait for secondary gain instead of immediate gratiﬁcation, or get satisfaction from accomplishing something as opposed to telling everyone about it, or do something because it’s right and not because you are looking for approval, then you have the same qualities as a survivor.
Take Poon Lim. He was a steward in the British merchant navy in World War II when his boat was torpedoed. To survive, he pulled nails out of his life raft with his teeth and used them as ﬁsh hooks. However, if you complain and use your energy to talk about what a heavy load you’re carrying when things get rough, you’ll fold.
Are there limits to the extreme conditions that humans can endure on Earth?
Well, there are limits. Like where they have migrated. Very few people live above two kilometres in altitude. No one lives under the sea. You can’t live naturally in Antarctica.
Can you train your body to adapt to extreme cold?
Yes. Arctic explorers used to prepare for their expeditions by taking cold showers. And each day they’d make it a little colder and stay in the shower a little longer. It seemed to work.
How does the body react to subzero temperatures?
Our bodies are designed for the tropics. However, there are ways the body can combat cold. Number one, your body will send blood where it needs to go — under the fat, instead of over it, fat is a good insulator. Two, you shiver, which ﬁres your muscles, stoking your internal ﬁre. The only other mechanism we have is pathetic: goosebumps, left over from when we had lots of body hair. An animal will fluff up its fur to protect itself from the cold.
Is shivering the best thing you can do to stay warm?
Shivering produces only about as much heat as walking You’re much better off using that muscle energy to get yourself out of the cold.
Is it better to walk on frozen feet or newly thawed ones?
When you thaw out, you are left with broken blood vessels. When you pound on them, more will break and there will be less blood ﬂow, making them less able to tolerate whatever cold is around them. So frozen ones are better to walk on. You won’t have any sensation — they’re blocks of ice. But they’re fairly resistant.
Perception plays a key role in survival. Why are some people in agonising situations able simply to shut off their pain?
Pain is like an alarm. Sometimes you get huge amounts of pain for relatively minor things. If somebody bends your ﬁngernail back, it’s torture. Your body is saying, “Take care of this. I don’t care if you didn’t ﬁnish your sandwich.” If you don’t have pain, you’ll think, maybe I’ll ﬁnish my sandwich. That’s not good for survival.
Should a major injury result in major pain?
I saw someone walk into the emergency room with an axe in his forearm and say, calmly, “Doc, can you help me?” The body is so smart in this kind of situation. You know you’re in trouble. And you’re going to do whatever you can to save yourself. You don’t need a loud pain alarm. If you were in screaming pain, it would be very hard to use reason to get help.
Is Everest — at 8850 metres — the highest point a human could climb to without supplemental oxygen?
No—one really knows because you can’t get any higher to ﬁnd out. In 1999 the famous climber Babu Chiri Sherpa proposed to go to the summit and sleepover. That had never been done before. I was half sure he was going to die up there. He went to the summit, and he slept there, staying for 21 hours. He came down the next day. We sat and had tea. There was nothing wrong with him. So who knows what the real limit is?
People often seem to get sick on climbing expeditions. Why is that?
On a mountain there’s less oxygen, so your body tries to conserve energy by slowing down according to priority function. Your immune system will soon begin to slow down. At 6400 metres cuts don’t even heal. So if you get a cold at that altitude, you just have to deal with it. It’s not going to go away until you go down.
How does the body struggle to hang on in those last moments?
When you’re really at the minimum physically — a breath every two minutes, a heartbeat every 30 seconds — your higher mental capacities begin to close down.
The body starts shutting down system by system, in reverse order of priority — your reproductive system, your digestive system, your immune system. Then the circulation to your hands and feet. The blood goes away from those places to feed your most vital areas, your brain, your heart, and your lungs. When those shutdown, that’s the end.
Why do people who survive a brush with death always say the same things: I saw my life flash before my eyes, I was floating above my body, I saw a white light?
It’s amazing how common that is. The brain is always on — when you’re sleeping, you hear a loud noise and you wake up. You dream. If you’re in a sensory—deprivation chamber, you won’t see or feel anything, but your brain will generate hallucinations or wild thoughts.
When you are near death, the brain shuts down its less vital parts and you have the ultimate disconnect between the thinking part and the maintenance part of your brain. Therefore, you have intense hallucinations. You see things: the hovering above the scene, the white light. The lucky ones come back and tell us about it.
When you were the doctor on Everest in 1996, it was during the Into Thin Air disaster in which eight climbers died during a blizzard. What do you think happened to Beck Weathers after he was left for dead but got up and walked to camp?
It’s hard to explain. It’s like a miracle. Every structure has a natural harmonic — a frequency at which it vibrates. That’s what makes music. When Beck was dying, his brain was shutting down. But he still had some electrical impulses ﬁring here and there.
Beck said that when he was lying in the snow, he had visions of his family. Those are powerful signals he was generating. My idea, which is not original, is that all these ﬁring electrical impulses somehow come together in a harmonic that generates the energy to get up.
Is this conﬂuence of impulses something innate to the brain cells? Or is it a signal sent from God? It is something we can never know.
Isn’t there, something kleptomaniacs can take to help them?