|ALUMNI FEATURES Winter 2000|
Medical teaching and research and mountain climbing have been intertwined in the life of Thomas Hornbein. He credits a "pivotal" moment when his parents sent him to summer camp in Colorado.
When Tom Hornbein was a youngster growing up at 6955 Waterman in University City, Missouri, he used to climb to the roof of his house. On May 22, 1963, he climbed to the top of the world.
Just after 6 that spring evening, Hornbein and his climbing partner, the late Willi Unsoeld, reached the summit of Mt. Everest. They had pioneered a new route up Everest's West Ridge, still considered one of climbing's greatest achievements. In his book Everest: The West Ridge (Sierra Club, 1965), Hornbein describes that approach to the summit:
"Just rock, a dome of snow, the deep blue sky, and a hunk of orange-painted metal from which a shredded American flag cracked in the wind. Nothing more. Except two tiny figures walking together those last few feet to the top of the earth."
Unsoeld and Hornbein spent about 20 minutes on the summit. Then they began the perilous descent via the South Col route, the first traverse of a major Himalayan peak, rejoining other members of the first successful American expedition to Everest.
In the nearly four decades since those moments at the highest spot on Earth, mountains have been a powerful metaphor for ways in which Tom Hornbein has approached his life and career.
He has had a distinguished career as an anesthesiologist, including serving as chairman of the Department of Anesthesiology at the University of Washington School of Medicine in Seattle from 1978 to 1993. And it was the mountains that brought him to medicine.
As an undergraduate studying geology at the University of Colorado, Hornbein says, "I spent a lot of my time climbingcutting labs and things to do that. I got involved with mountain rescue and teaching first aid." At the end of his junior year, he decided to follow his interests and study medicine, intending to return to live in the mountains as a family practitioner. He applied to medical school, and, he says, "Washington University was willing to consider someone off the beaten premed path" and accepted him. He earned his M.D. in 1956.
Mountains and Medicine
From the melding of mountains and medicine, Hornbein became interested in how people acclimatize to high altitudes. This led to a lifelong research interest in the physiology of breathing and altitude adaptation. In particular, he has focused on the stimuli that prompt an animal to breathe, especially the effect of hypoxia on carotid body sensors and the regulation of brain extracellular fluid acid/base balance. He had begun to think about specializing in surgery, he says, when his surgery professor, Carl Moyer, "suggested anesthesiology to me, which was something I would have never thought of." Hornbein decided that anesthesiology would allow him to combine his research interests with taking care of patients.
Having received his medical degree, Hornbein interned at King County Hospital in Seattle, then returned to St. Louis for a residency in anesthesiology at Barnes Hospital, followed by a two-year fellowship in the laboratory of Professor Albert Roos, supported by the National Institutes of Health.
Horbein's passion for mountains did not take a back seat to his passion for science and research.
"Thinking back to Washington University," he says, "the individual who impacted most powerfully on my life is Albert Roos. He taught me a lot about science and the passion of being a scientist. In many ways, he was the most influential individual both in my life and science."
But Hornbein's passion for mountains did not take a back seat to his passion for science and research. In 1960, he had his first experience of high-altitude climbing in the Karakorum Himalayas when he joined an expedition that climbed Masherbrum. Among the members of that group were Willi Unsoeld and Dick Emerson, who later participated in the Everest expedition.
The climbers on Masherbrum had difficulty with their Swiss-made oxygen masks, and Hornbein became interested in trying to solve the problem. "We found it was very difficult to breathe through them, although we didn't train or get accustomed to them ahead of time," he says. "We decided it was easier to climb Masherbrum without oxygen.
"When I came back, I set out to design a simpler maskone that has a lower resistance to breathing. I came up with the concept of a mask that has only one valve to prevent breathing back into the rubber bladder into which oxygen flows from the tank. When you breathe in, you pull oxygen out of the bag.
"One evening in Wohl auditorium I gave a talk to the medical staff on my Masherbrum trip. One of the surgeons, Gene Bricker, brought up a patient he had operated on a few days beforea massive surgical procedure. Gene told me of his patient's interest, so I went up and met him. I spent many afternoons visiting with him; his name was Fred Maytag, head of the Maytag Company. He lit up when I told him about this mask. He got his R&D department to work on turning my concept into a mask that would be molded from a single piece of rubber. So they made the masks for the [Everest] expedition."
During his fellowship in Roos' laboratory, Hornbein was invited by Norman Dyhrenfurth to join the American Everest expedition, an invitation he readily accepted. "I said that I had some ideas about oxygen masks," Hornbein recalls. "He said, 'OK, would you mind being in charge of the oxygen?'"
With his fellowship over in 1961, "The Navy nabbed me," as Hornbein puts it. While his fellow climbers prepared for the Everest expedition, Hornbein asked the Navy's permission to be able to join them. "My commanding officer, the admiral in San Diego, was enthusiastic, but back in Washington they said they couldn't spare anyone, and I was turned down. Then they shipped me off to Thailand because things got a little unsettled along the Mekong River.
"The second request to be permitted to go to Everest, just before I was sent off there, went all the way up to the secretary of the Navy. That was also turned down."
During the summer of 1962 as the other team members gathered on Mt. Rainier, Hornbein joined them with the oxygen equipment. "I perceived myself as not really being a member of the team," he says.
Willi Unsoeld, who had been on the 1960 Masherbrum climb, was heading off to become the associate director of the Peace Corps program just beginning in Nepal. He told his boss that Hornbein was not being released by the Navy. "As it turned out," Hornbein says, "Sargent Shriver (head of the Peace Corps) called his brother-in-law, (President) John Kennedy, who called Bob MacNamara (the secretary of defense).
"The next Monday morning when I was in the operating room in San Diego, I got this phone call from some admiral who said, 'I understand you want to go climb Mt. Everest.' I said, 'Yes,' and he said, 'I've been instructed that you may do so, but you're going to have to leave the Navy.'
"On February 3, 1963, I was discharged from the Navy."
Tom Hornbein returned from the Everest expedition to a position as assistant professor of anesthesiology and of physiology and biophysics at the University of Washington School of Medicine in Seattle.
"I was just starting my academic career," he says. "I was worried that I would be forever known as 'the doc who had climbed Everest'; I needed to establish my credentials as a scientist.
"It was almost like a schizophrenic existence. People would ask me to give a talk about Everest, and I was doing that partly to pay off the debt and partly because it's fun. I certainly got to meet a lot of interesting people this way.
"But I kept it a separate piece of my life until I hit about 50. I realized, or maybe figured out, it didn't much matter any more."
He also discovered, he says, "that, ultimately, mountains are the spiritual as well as the professional and social foundation of my life. Everything else has grown from that passion, including my choice of medicine, my choice of specialty, and my research directions."
His medical career has led to publication of more than 100 journal articles and book chapters, as well as honors ranging from a Distinguished Teaching Award from the University of Washington in 1982 to membership on the prestigious Institute of Medicine.
He retired from clinical practice three years ago but continues to teach. And he continues to climb. Though slowed a bit by age (70 in November) and an artificial hip, "I'm still able to climb pretty actively," he says. "I can climb rock at a standard higher than those pioneering first ascents decades ago, thanks mainly to the footwear" and other advances in technology.
As he looks back to those ascents of his University City home, he says, "I've gotten interested in recent years in the pivotal events in lifethe moments that change your life. There are many of them, of course. The one at the top of my list is when my parents made a decision to send me to a camp in Colorado instead of, say, Michigan."
"Ultimately, mountains are the spiritual as well as the professional and social foundation of my life. Everything else has grown from that passion, including my choice of medicine, my choice of specialty, and my research directions."