
"Jim's lungs are not looking too good at 4000m and we have to head back to the hospital in Manali"
Cass offered a semi rest day with a short optional ride up to the lake for a walk and a swim if anyone wanted it. Good job too, as Jim was looking a bit crook and had woken up with ‘funny gurgling noises in my chest’. Now I used to work as high altitude mountain guide, and when someone says that to you, it generally only means one thing – Pulmonary Oedema, a very serious form of altitude sickness. Jim wasn’t showing any other of the usual symptoms though, so we decided to see how he was with the opportunity to rest and acclimatise some more.
Whilst Jim rested, the rest of the team of Cass and Cara, Dan the Aussie traveller and Andy, part time Iron Man and full time chicken farmer, headed off to the Lake. Half an hour later, happy that Jim was OK for the time being; I decided to catch up with the others for some of the sublime singletrack on offer at the lake. Cutting the corners on the road, I rode steeply up dusty singletrack to arrive at one of the bluest lakes ever seen. By the time I got there everyone was chilled out in the sun soaking up the ambience. The ride back was as promised, sublime. Kicking up dust from our wheels, you either had to ride just about blind or drop back far enough to be able to see the ground through the dust again. Under the dust, hard packed earth offered fast playful riding with any number of line choices.
We rolled the last steep section into camp and arrived laughing like children after such an effortlessly fun descent. By the early hours of the morning it was obvious Jim wasn’t getting any better. I could hear the ‘funny gurgling noises’ without even putting my ear to his chest, his pulse was over 100, a sure sign of respiratory distress and he was feeling just ‘crap’. I woke Cass and Cara up at 5am and suggested that we go back with the jeep to the hospital in Manali whilst the others go on. The next six hours were almost the most worrying of my life, checking Jim every few minutes to make sure he was still conscious, with him improving as we dropped down from Chandra Tal back into the valley and then deteriorating again as we had to re-ascend to 4000 m to cross the Rothang Pass.
By the time we got to Manali and the oxygen rich environs of Manali, Jim was up and walking about again. At the hospital they took x-rays of his lungs, checked his blood oxygen levels and gave him a variety of tests. The outcome of all this just confirmed what we already knew, he was very sick, his blood oxygen levels were at 60%, dangerously far below the normal 95% for that altitude, and his right lung was full of fluid. It was obvious that Jim was not going to be getting out on his bike again on this trip. Pumped full of drugs and hooked up to oxygen, we booked into a private room for the night so that I could stay with him. In the morning all the doctors at the mission hospital including three British medical students came to see him, so fascinated were they all to see real pulmonary oedema in the flesh.

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