High Altitude Medicine and Physiology

Three wonderful physicians and high altitude medicine and physiology experts, with whom I just completed a delightful week in Scotland teaching and studying wilderness and mountain medicine, Drs. John B. West, Robert B. Schoene, and James S. Milledge, have recently published the 4th edition of High Altitude Medicine and Physiology (Hodder Arnold, 2007), which is a definitive text on the subject. Given the increasing rate at which persons are attaining summits, including, of course, Mt. Everest, and the popularity of high altitude recreation, such as skiing and trekking, the more we can learn about the medical concerns of high altitude, the better.

The authors of this book are not merely doctors. Each has been a mountaineer and explorer, so they write from first-hand experience. These are the world's experts, and I admit, my role models in so many ways. Therefore, it is an honor to review (and recommend) this book. It is not a volume written for laypeople, but I believe it would be of great interest to anyone with an interest in the technical aspects of how the human body adapts and responds to high altitude.

Attaining the fourth edition of a book is no mean feat. Compared to the previous edition, this book contains major updates to scientific content, increased coverage of genetics and advances in molecular biology and medicine, and additional tables summarizing features and treatments of important high-altitude diseases. The authors point out that they have also worked diligently to update coverage on women and children at high altitude, neurological disorders at high altitude, athletic training using high altitude, recent work on high altitude pulmonary edema, and the problems of persons with existing diseases who plan to go to high altitude. To make space for all of the improvements with creating a significantly larger book, they trimmed certain discussions, such as cold injury. The book is very appropriately dedicated to Michael Ward, who for many years was a pillar of the mountain medicine community, and who served as the lead author of the previous three editions of this book.

As Editor of a larger volume entitled Wilderness Medicine, I rely upon the expertise and wisdom that emanates from books such as High Altitude Medicine and Physiology. The coverage in this volume is extensive and, for a wilderness medicine enthusiast such as me, quite fascinating. I am particularly appreciative for the innovative discussions of such topics as "History," "Commuting to high altitude for commercial and other activities," "Athletes and altitude," and "Practicalities of field studies." The book is adequately illustrated and well organized. The litmus test question is whether it is sufficiently improved over the previous edition to warrant its purchase. In my opinion, the answer is a resounding, "Yes!"

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