Safety first: Decision before expedition

I'm in bed banging out the Zzz's when I hear an excited shout to tell me someone is looking for a medic to join an Everest summit attempt. 

I spring out of bed, alarmed, dazed, looking for an intruder, clueless as to where I am, am I dreaming? 

I look at my phone: 'Medic required for an all-expenses-paid trip to support an Everest summit attempt, leaving in 3 weeks' BOOM! This is it! The dream job for any mountain-obsessed medic. 

This is a job I've been dreaming of for a decade, so to say I'm excited is an understatement. How many paramedics can say they've worked on an Everest attempt?

How cool is it going to be to experience Nepalese culture? To meet the Sherpas and porters, learn about their way of life, and do some cool mountaineering with the opportunity to go up to camp 2. Those who know me know I don't get excited often, and I show it even less. 

I reply as fast as my blurry eyes and fat fingers allow: Yes! I'm in! I get the OK and am provided with the Expedition Manager's contact details. 

I know this is a huge job, further complicated by the short notice. Medical cover preparation for an Everest attempt ideally takes around six months. 

No way I can turn it down though, I'm like a child on Christmas Eve, this is my dream and besides - there's no cuff too tough - I've learned over the years. I'll make it work. 

***

I start preparing not only logistically but physically and mentally for this 10-week Nepal trip, looking after a large team. A list of questions is sent to the Expedition Manager - about my role and the team's expectations of me. My experience informs me that a defined role is crucial. 

Two weeks later: I have been told I am going but why I haven't had an answer to my initial questions? A few alarm bells start to sound. I only have one week left to prepare for a trip of unprecedented magnitude in terms of my career. I plan medically and personally to the best of my ability and uncertainly await my flight details. 

As communication is at best questionable, my mind turns to: Is this safe for me to do? Is it professional? Will I be able to keep the team medically safe?

***

Am I getting carried away by excitement? How many times have I rescued people from a situation where their egos were writing cheques their bodies couldn't cash? Is this my ego writing a cheque right now? Am I going to disregard safety and professionalism? Two of the key tenets of my career. 

Fortunately, I know some very experienced expedition medics and high-altitude doctors, so I seek their advice - secretly hoping at least one would say "Yeah, just go for it".

However, the opposite consensus comes back, backing up my gut feeling. This is a trip that - despite being a lifelong dream - I must withdraw from. 

And so, with a heavy heart and a great deal of frustration, I email the Expedition Manager, and do exactly that. 

***

Having had time to cool off and reflect objectively, of course I made the right decision. Safety First is a key principle in my work, and before we can even get to the safety during an expedition, we must always first consider if the controllable risks have been mitigated as best as can be before even leaving. Remember you must have your own back first, to ensure you can look after others. 

Expedition medicine is tough decisions top to bottom and tolerance of uncertainty and mental resilience are vital. As you have previously heard me say before, we must always be prepared for the dislocation of expectation. 

The good news for me personally and professionally is that I have other upcoming expeditions planned and so this learning will not go to waste.

What I have taken away:

• Safety first - the decision before the expedition. Obviously expeditions have an element of risk, thats what attracts me to this line of work in the first place. But what I have to remember is it's my neck on the chopping board when things go wrong. 

• Seek advice from experienced people and mentors.

• Don't allow excitement to derail your professional principles. Remembering not to write those cheques your body can't cash.

"Conduct yourself in life as if at a banquet. As something being passed around comes to you, reach out your hand and take a moderate helping. Does it pass you by? Don't stop it. It hasn't yet come? Don't burn in desire for it, but wait until it arrives in front of you. Act this way with children, a spouse, towards position, with wealth - one day it will make you worthy of a banquet with the gods"

-Epictetus