Charles Houston Remembered
Medicine for the Outdoors
Medicine for the Outdoors

Dr. Paul Auerbach is the world's leading outdoor health expert. His blog offers tips on outdoor safety and advice on how to handle wilderness emergencies.

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Charles Houston Remembered

In the field of wilderness medicine, I have had many mentors. One of the first, and in many ways the most important to me, was Dr. Charles Houston, who died on Sunday, September 27, 2009 in Burlington, Vermont at the age of 96.

Many of us are indebted to this icon of mountain medicine, for he was a true friend, inspirational leader, and like other remarkable physician adventurers of his era, such as Herb Hultgren, MD, allowed us young folks to bask in his experience, expertise and wisdom. We will be writing briefly in tribute to him in an upcoming issue of the journal Wilderness & Environmental Medicine, but for those of you who are not familiar with his amazing life and contributions, here is an obituary written in the U.K. by Stephen Goodwin for the Independent Newspaper:

"Charles Houston's territory was the 'thinne aire' of big mountains. He almost gasped his last of it in 1953 during an epic retreat on K2, the world's second highest mountain, and later immersed himself in the study of why we get sick at high altitude, and sometimes die there.

The archaic quote was a favourite of Houston's, from Father Jose Acosta, a Jesuit missionary who vividly described his symptoms on crossing the Andes in the late 16th century. Acosta attributed his retching and vomiting to air so 'delicate as it is not proportionable with the breathing of man'. The priest was on the right track, but it was not until the publication of Houston's Going Higher: Oxygen, Man, and Mountains in 1980 that climbers and medics were offered a clear understanding of the cause and effect of the main types of altitude sickness, together with sound advice on staying healthy.

The critical juncture in Charlie Houston's long and multifaceted life came on 10 August 1953 as he lay unconscious on a narrow shelf high on K2's Abruzzi Spur. He and most of the team hard hurtled down a steep slope in an horrific accident. In the freezing maelstrom of wind-blasted snow, death was the likely outcome.

Houston, however, was coaxed back to the land of the living by his friend Bob Bates, who awakened him and ordered him to climb 50 metres to the shelter of a camp. Bates, who died in 2007, recalled it thus: 'Charlie,' I said with the greatest of intensity, looking directly into his eyes, 'if you ever want to see Dorcas and Penny [his wife and daughter] again climb up there right now'. Somehow this demand penetrated to his brain, for with a frightened look and without a word, he turned... and fairly swarmed up the snowy rocks of the cliff.

Houston never gambled with his life on a high mountain again. (Anyway, his dreams of K2 were crushed a year later when an Italian expedition made the first ascent.) Houston stopped climbing and devoted himself to his family, medicine and human good. It is unusual for top-flight mountaineers to kick the habit while still in their climbing prime, but read Houston and Bates's account of the Third American Karakoram Expedition, K2, the Savage Mountain, and you appreciate why he would not want to overdose on risk, drama and tragedy at such intensity ever again. He could, in any event, already look back on an impressive mountain record in the Himalaya and Alaska.

Born in New York in 1913, cosseted in East Coast privilege, Houston was introduced to the hills by his parents and at the age of 12 had walked with them from Geneva to Chamonix. There, in the heart of the Alps, he read Geoffrey Winthrop Young's classic On High Hills, perhaps acquiring in the process his fondness for English gentleman adventurers. While a medical student, he joined the Harvard Mountaineering Club, teaming up with four other putative big names in American climbing – Bates, Bradford Washburn, H. Adams Carter and Terris Moore – to form the so-called "Harvard Five". In 1933, he was invited by the more experienced Washburn to climb on Mount Crillon, Alaska, (a near-miss) and a year later he returned to the chilly north on an expedition led by his father, Oscar Houston, to make the first ascent of Mount Foraker. Also on Foraker was the British mountaineer T. Graham Brown, with whom Houston climbed in the Alps and, in 1936, co-led an expedition to Nanda Devi in northern India.

The Nanda Devi party was an intriguing mix – four cocky Americans, all members of the fledgling Harvard MC – and four veteran Brits, including two university professors and the notoriously spartan Bill Tilman. Tilman and Noel Odell, an old Everest hand, reached the 7,816 m summit on 29 July. It was the highest peak on Earth so far climbed. The happy trip was also revealing of Houston's character, his plain human decency and belief, in his own words, that 'the game is more than the players'. Houston seemed set for the first ascent himself, but at the last camp fell ill with food poisoning – a treacherous tin of meat – and descended to enable Tilman to take his place alongside Odell. Tilman recalled: 'Bad as he [Houston] was, his generous determination to go down was of a piece with the rest of his actions.'

Houston and Tilman teamed up again in 1950 when Oscar Houston unexpectedly obtained permission to explore the Khumbu valley towards the southern flank of Everest in Nepal. The Himalayan kingdom had kept its doors closed to foreigners and expeditions to Everest had always approached from the north, in Tibet. Enthralled, the party hiked into the Sherpa village of Namche Bazar – now a trekker honeypot – and on up the Imja Khola river valley to Thyangboche monastery. Houston and Tilman prospected further, camping on the Khumbu glacier and viewing the fiercesome icefall that cascades from the Western Cwm, first seen from the Tibet side by Mallory in 1921. Both thought the icefall too hazardous for laden porters and doubted that Everest could be climbed by this route. History, in the form of Hillary and Tenzing, proved them wrong.

Charlie Houston, however, is most famously associated with K2, giant of the Karakoram and arguably the toughest of all 14 of the world's 8,000-metre peaks. A classic pyramid in glacial isolation at the junction of Pakistan, China and India, it is raked by storms and has a sobering mortality rate. Among mountaineers, climbing K2 carries far more kudos than an ascent of Everest by standard routes. Houston led two expeditions to K2, the first, in 1938, an acclaimed reconnaissance when he and Paul Petzoldt became the first to reach 'The Shoulder' at 8,000 metres on the Abruzzi Spur. It had required a supreme effort, wading in deep powder snow. 'I felt that all my previous life had reached a climax in these last hours of intense struggle,' Houston wrote. This paved the way for another American attempt on K2 a year later, a messy affair that gained another 400 metres but ended with the death of its sponsor, Dudley Wolfe, and three Sherpas.

War service over, Houston returned to K2 in 1953 with a strong team, including his close friend and companion from the 1939 trip, Bob Bates. Storm and struggle accompanied the team up the Abruzzi Spur; even so, by the beginning of August they were encamped just below the Shoulder and optimistic that the summit was within grasping distance. Just three good days were needed. But foul weather again confined them to battered tents – the flimsy nylon shelter occupied by Houston and George Bell was torn away completely. In retrospect, Houston was philosophical about their 10-day battering at Camp VIII. 'Perhaps it is this conquest, conquest of one's self through survival of such an ordeal, that brings a man back to frontiers again and again.'

On 7 August, as the cloud lifted and the climbers crawled out of their tents, the young geologist Art Gilkey collapsed unconscious in the snow. He had developed phlebitis, with blood clots in his left leg. As both a doctor and a climber Houston knew there was really no chance of getting Gilkey back to Base Camp alive, but there was no question the team would not try to save him. Avalanche risk and pitiless weather delayed them for three days, until, as Gilkey's condition worsened with clots carried to his lungs, descent became imperative.

With Gilkey wrapped in a sleeping bag and the smashed tent, the team began inching him down the mountain in a raging blizzard. All were exhaust-ed and encrusted in ice. The sick man had just been lowered over a cliff when George Bell, who had frostbitten feet, slipped, dragging his rope mate, the English army officer Tony Streather, with him, and dislodging others. Bates thought his end had come. Once off the ice slope they would drop through hundreds of metres of space to the glacier below. 'It was like falling off a slanting Empire State Building six times as high as the real one.'

Amazingly, the five hurtling climbers were halted on the lip of the abyss by the strength and superb belaying technique of Pete Schoening, who also held the weight of the suspended Gilkey. How they had survived was doubly a mystery to Houston who, even after being urged back to life by Bates, had little idea where he was. 'What are we doing here?' he kept repeating. Battered and bleeding, the party struggled to the nearby Camp VII, then three of them went to fetch Gilkey, who had been left anchored by two ice axes. He had vanished, swept to certain death by an avalanche. The close team was shocked by the loss of their friend, but as Kenneth Mason observed in his history of Himalayan exploration Abode of Snow, perhaps the mountain had been merciful. Gilkey's seven companions would never have abandoned him, nor in their exhausted state could they have brought him down alive.

It was another four days of nightmare descent before the team stumbled gaunt and hollow-eyed into the embrace of their tearfully relieved Hunza porters. Houston was at times delirious. At a reunion 25 years later he revealed how close he had come to ending it all above a technically difficult 'chimney' pitch. He feared he would knock his friends off the mountain if he fell. 'Better jump off to one side and get it over with,' he'd thought. 'I knelt in the snow and said the Lord's Prayer. Next thing I can remember is being grasped by strong arms and helped into Camp IV.'

It had, as Mason said, been an 'Homeric struggle'. Houston was deeply affected by the loss of Gilkey and also, quite unreasonably, by a sense of failure. Though he gave up climbing almost completely, the conversion was not quite so Pauline as often presented. His first thought was to have another shot at K2 a year later but he was stunned to find it already booked by the Italian explorer-geographer, Ardito Desio. The news, when two Italians reached the summit, came as a heavy blow to his spirit. However on the dictum that 'style is everything' Houston's men win hands down in the story of K2. Theirs had been a bold, lightish-weight push to within an ace of the summit – in a manner still regarded as the finest of mountaineering styles. Desio, on the other hand, laid siege to K2, employing military tactics, 500 porters, and bottled oxygen for his top climbers.

Houston had permission for an attempt on K2 in 1955 but did not take it up. A growing family and rural medical practice increasingly filled his time. Five years – 1957-62 – were spent in Aspen, Colorado, working at the Aspen Institute and walking and fishing in the surrounding mountain country. Then came a big change as director of the US Peace Corps for India, an ideal post for someone so devoted to the well-being of his fellow human beings. Houston loved it, visiting almost every corner of India, plus Nepal and Afghanistan. He was called to Washington to develop the worldwide doctor Peace Corps but his internationalist dreams were snuffed out by the Vietnam War and the doctor draft.

In his last decade, Houston's liberalism reasserted itself publicly and he would stand on a soap box in Burlington city park railing against the warmongering of George W. Bush and the shameful absence of universal medicare in the United States. He was a man of complex emotions, as revealed in a fine biography by Bernadette McDonald, Brotherhood of the Rope (Bâton Wicks, 2007), with an abrasive, critical streak that caused difficulty in his professional life. He suffered periods of depression and, in his self-criticism, unjustifiably under-rated his achievements.

Houston may have quit serious climbing early, but he did not turn his back on one of the great perils of the Himalaya and other ranges. In the second half of his life, settled into teaching medicine at the University of Vermont, he became one of the great authorities on altitude sickness. He had made earlier studies of 'thin air' during the Second World War. Entering the Navy as lieutenant in 1941, after interning at the Presbyterian Hospital in New York, he trained pilots in the effects of hypoxia at combat altitudes; pilots had died as a lack of oxygen caused them to black out or make fatal errors.

Immediately after the war Houston persuaded the Navy to let him do further research on volunteers in a decompression chamber. Called Operation Everest, the tests were ostensibly about gaining air combat superiority, though more interestingly to mountaineers they showed that, with acclimatisation, humans would be able to survive briefly at the top of the world. Twenty years later, Houston returned to the subject, directing physiology studies at a laboratory at 5,300m on Mount Logan, in the Canadian Yukon, each year from 1967 to 1975 and rerunning a more ambitious version of Operation Everest in 1985.

Most relevant to the growing numbers of climbers and trekkers heading for the greater ranges, however, was the publication in 1980 of Going Higher: Oxygen, Man and Mountains, most recently updated in 2005. The majority of trekkers going to places like Nepal experience some degree of Acute Mountain Sickness above the 4,000-metre contour, though for all its scary title this is usually only a couple of days of mild headache. Houston explained why this was so, and detailed the more serious forms of the sickness, notably High Altitude Cerebral Edema (HACE), a swelling of the brain, and High Altitude Pulmonary Edema (HAPE) a build-up of fluid in the lungs. Each year these sicknesses continue to kill those who rush to altitude or do not acknowledge the symptoms, but after Houston there is not much excuse for ignorance. Going Higher is no dry tome.

The 1996 tragedy on Everest, when 12 people perished, nine of them in one furious storm, aroused differing emotions in Houston. The loss of lives appalled him yet the victims were on the kind of big-money peak-bagging trips he deplored. Commercialism wasn't evil, he said, 'but somehow it is unseemly for mountaineering. He also believed that on Everest and elsewhere hypoxia had eroded not only climbers' judgement but their ethics and morality. Erstwhile strangers on a commercial trip did not have the sense of brotherhood essential to pull through in extreme situations.

Houston, then, was a moral mountaineer. The fellowship of the rope in its most decent manifestation was at the core of his philosophy. And while he had not been able to save Art Gilkey on K2, Houston's own survival and subsequent work on mountain sickness surely saved the lives of many more.

Dr Charles Snead Houston, physician, mountaineer, university professor and author: born New York City 24 August 1913; co-author of 'Five Miles High' (1939) and 'K2 The Savage Mountain' (1954), author of 'Going Higher' (1980) and numerous medical articles; married 1941 Dorcas Tiemeyer (deceased; one daughter, two sons); died Burlington, Vermont 27 September 2009."
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About the Author

Dr. Paul S. Auerbach is the world’s leading authority on wilderness medicine.