Episode 33: Sunday February 07

Drs. Sam Jejurikar @samjejurikar, Salvatore Pacella @sandiegoplasticsurgeon, and Sam Rhee present the last part of our special solo multi-part interview. Drs. Sam Jejurikar, Salvatore Pacella, and Sam Rhee welcome special guest Dr. Ramin Behmand MD. Dr. Behmand is the only board-certified plastic surgeon to have successfully summited Mount Everest.

We talk to Dr. Behmand about his unique experience climbing Mt. Everest. In the two years previous to Dr. Ramin's successful summit, nearly 40 people died in serious avalanches, the highest death rate on Everest to date. Over 300 climbers have died attempting to reach the top. Only about 5000 people have successfully reached Everest's summit since Sir Edmund Hillary and Tenzing Norgay first made it to the top in 1953. This singularly unique experience is riveting to hear.

Dr. Ramin Behmand began his esteemed career in cosmetic surgery at the Case Western Reserve University School of Medicine in Cleveland, Ohio where he was a member of the Alpha Omega Alpha (AOA) Medical Honor Society. Dr. Behmand completed his plastic surgery trainig at the University of Michigan. Certified by the American Society for Aesthetic Plastic Surgery (ASAPS), the American Board of Plastic Surgery (ABPS), the American Society of Bariatric Surgeons (ASBPS), and The Rhinoplasty Society, Dr. Behmand’s expertise spans many procedures and treatments, including breast augmentation and breast lift, liposuction assisted body contouring, and facial rejuvenation. He also maintains active membership in the American Society of Plastic Surgeons (ASPS) and the Alpha Omega Alpha Medical Society.

Full Transcript (download PDF here)
2021.02.07 PART 1 
Dr. Salvatore Pacella: [00:00:00] Good morning, everybody. We're back in 2020 21 with our podcast. Here we are. And Dr. Sal Pacella in San Diego, California. My Instagram handles@sandiegoplasticsurgeon.com. Or at San Diego plastic surgeon. We've got Dr. Sam Jejurikar from Dallas. His Instagram handle is at Sam Jejurikar. We've got Dr. Sam Rhee from Paramus New Jersey.
He's at Bergen cosmetic. Thank you everybody. How you doing? 
Dr. Ramin Behmand: [00:00:30] Very well. 
Dr. Salvatore Pacella: [00:00:31] Fantastic. All right. We've got us very special guests today. Our good friend remained bemoaned. He was, he's a plastic surgeon and he's got some interesting things that are not plastic surgery to talk to us about today. But before we get into that, I just want to read our disclaimer.
This show is not a substitute for professional medical advice. Diagnosis or treatment. The show is for informational purposes, only treatment and results may vary based upon the circumstances, situation and medical judgment after appropriate discussion, always seek the advice of your surgeon or other fight or other qualified health provider.
With any questions you have made regarding medical care or climbing say above 10,000 feet, never disregard professional medical advice or delay seeking advice because of something in the show.  I'm going to hand it over to either of these two guys that take over Sam from New Jersey. You want to take it over.
Thanks. 
Dr. Sam Rhee: [00:01:25] So we knew Rameen because he was our senior resident when we were junior residents at university of Michigan. So we trained with romaine quite a bit. And w how many years above us, where you actually 
Dr. Ramin Behmand: [00:01:37] remain. I finished in 2001. 
Dr. Sam Rhee: [00:01:41] And so what was I 2000? And I don't even remember. I think you were like three, maybe a three years above.
Dr. Ramin Behmand: [00:01:47] Yeah. 2004. Yeah. And all of you were in the same? 
Dr. Sam Rhee: [00:01:54] No, I was one year out. I was one year up from Sam and I guess two for cell. Wow. It didn't seem like that, but I guess so, 
Dr. Salvatore Pacella: [00:02:02] Remain, you were When I came to visit for my recruiting trip to Michigan and that spectacular plastic surgeon, Joe Fodera.
Dr. Ramin Behmand: [00:02:11] Yeah.
We took Sam style under our wing and took him to the seafood place and had a pie and gave him a lot of life advice. And ironically, the only person that's gotten it right. Is Sal.
I just 
Dr. Salvatore Pacella: [00:02:28] remember. 
Dr. Sam Rhee: [00:02:31] Always being comparable and collected under pressure. So that was what I remember the most about residency with romaine. 
Dr. Salvatore Pacella: [00:02:40] Yeah. 
Dr. Sam Jejurikar: [00:02:40] I remember my, one of my favorite remains glories. I was gonna say one of my favorite stories though, had to do with time where Sam and we're making shared a hotel in Los Angeles 
Dr. Ramin Behmand: [00:02:51] where now 
Dr. Sam Jejurikar: [00:02:53] you're like, remember, Oh yeah.
If I remember correctly, didn't you invite a homeless guy to spend the night in your room. We'll take a 
Dr. Ramin Behmand: [00:03:00] shower. It changes every time it gets better. A shower. Yes. 
Dr. Sam Rhee: [00:03:08] Romaine has a big heart. He's a very kind gentleman and he always has been for 
Dr. Salvatore Pacella: [00:03:13] sure. Yeah. Yeah. 
Dr. Sam Jejurikar: [00:03:16] That the reason why we asked Rameen to be on the show is remained is probably one of the most interesting plastic surgeons.
Any of us had ever met with a lot of. Hobbies outside of plastic surgery that that make him unique. In fact yeah, only plastic surgeon to successfully have climbed Mount Everest. How did you develop this passion for climbing mountains remain and tell us the mountains that you've actually 
Dr. Ramin Behmand: [00:03:38] climbed?
I was on a trip with a group of friends in to Tennessee, ironically, where I live now and we had a cabin in the mountains and one of them, it was raining and one of them handed me this book. This was back in 1998, had me this book into thin air. He said, this is great. You got to read this thing.
And I finished the book in two days that we were there and I put it down. I was like, wow, I just have to do this. I had no idea what I was talking about or what it entail. It just sounded great. So from there on, I was reading about mountains and it really was not till about the mid two thousands that I genuinely started climbing mountains.
To answer your questions. I started small, climb Kilimanjaro was the main major, tall mountain that I climbed, but that's more of a hike and it was. It seemed hard at the time and then went to more technical mountains like Mount Rainier and then to Denali in Alaska. So Rainier is about 14,000 feet, but it's got some serious climbing involved in it.
Can be very technical depending on the time of the year. Especially the late winter time early spring is particularly tough and an alley. Punishes you with the coldest weather you've ever experienced. We used to joke that it's all about how quickly you drop your pants when you got to go in nature and pull it back up and get into the tent before.
Everything gets frostbit and it happens in seconds. So it is a rough place. Anyway, after that, I took a little bit of a time off. I'm done headed to Russia, to climb to the year after to climb Mount Elbrus, which is a tallest mountain in Europe. And That's about 18,000 feet following that there is a mountain in South America called Aconcagua it's tallest mountain outside of the Himalayas 23,000 feet or 22, 900 something.
And it's about the highest you're going to go comfortably without oxygen. You can go higher without oxygen, but studies have shown that you get brain plaques and there's definitely some injuries to your brain that it's hard to know what it will do down the line as you get older.  Climb Aconcagua that year and the year after twice.
Yeah.
food and to the city of Mendoza, it's like a fantastic place to hang out. It's it was very great to go there. After that things got a little more serious I spent a month in In Antarctica more for heavy pack climbing and more technical sort of by their climbing. And I would say Antartica wallets cold.
It's a, maybe a miniature version of what you doing Denali. So it wasn't as difficult from that perspective. As Donnelley had been a couple of years back. But it's such a beautiful serene space. There's nothing there. If the wind doesn't blow, it's the only place I've ever been, where you hear nothing.
You're actually here. Nothing. There's no people around. During the busiest time of the year, the entire continent might have four and a half thousand people on it. And when we're climbing, there's just not that many people there, the Russian dilution plane drops you off on the ice pad on is gone, comes back four weeks later to pick you up.
Ideally three weeks hours got delayed because weather was bad and couldn't get it. It's a gorgeous place. Anyway. So by that point I had tried a bunch of different things and then it became time to start looking at much higher altitude things in the Himalayas. 
Dr. Sam Rhee: [00:08:02] Now, did you need all this training with all these different?
Yeah. Climbs in order to be ready for Everest, because I've read some articles now where it's almost like some sort of guided tour experience where all these inexperienced climbers are climbing Everest all the time. So how do you feel about that and how do you feel all of these amazing experiences prepped you 
Dr. Ramin Behmand: [00:08:26] for Everest?
Yeah. While I was very excited about climbing Everest. Honestly, it was not a goal like each one of these places I was climbing was really fun. Met great people, saw a great country, cultural experiences, new friends, a lot of times with the same friends it was And wrote that end ended up where I was sure that I wanted to climb Everest, but it didn't start out that way.
I think mountain climbing is like anything. Alice is the mortgage experience you have, the less likely you are to get into trouble. There is a lot of very fit athletic people who might do well. If nothing comes along to cause trouble for them. And there is people that have a lot of experience and a ceramic Trop on their head and they'll die.
So there is a lot of chance involved and chances are inexperienced people doing yet may get away with it. 
Dr. Sam Jejurikar: [00:09:41] When you climb Everest, there's a whole period of Of acclimating to the altitude before you get there. Talk about the time commitment. If you decide I'm going to climb Mount Everest and you simultaneously have a very busy plastic surgery practice, what kind of time commitment are you looking at to go undertake this venture?
Dr. Ramin Behmand: [00:10:02] The actual climb. I think you're looking at seven to eight weeks, so two months, but realistically, you can't be operating until the last day and then take off for two months. So you will. Need to stop operating a couple of weeks ahead, depending on the kinds of surgery, surgeries that you're doing to make sure your patients are okay, and to feel comfortable, turning them over to whoever is going to cover for you so that you're not just taking off.
And there is a huge amount of training involved. You need time to be able to train, but as it goes,  plastic surgeons, we have a hard time taking time off. Practices are busy. And so it's not like you slow it down. You still go to work when you usually do and come back when you usually did, except now you may wake up at say four 30 and go train till six 30 and then go hit the operating room or clinic, whatever you're doing.
And then later in the evening you might do things. So training, I think goes in. Three categories. One, you already touched on, you got to gain experience. The more experience, the better. There's just no question about it. What seemed difficult before and decision-making was hard at the beginning of when I started climbing becomes much easier decision-making which means that in certain situations you're less likely to get in trouble.
The second thing is you've got to be in. Really excellent physical shape for doing what you're going to do. And that means something different to each person. You really want to figure out if you're a person that can deal with altitude or not. Because fitness as sea level does not translate into doing well in high altitude.
And the third part is being mentally prepared. So much of this as mental you question. So many things for the many hours that you spend in rough spots and misery and loneliness that whether you're doing the right thing and you start questioning it because you just see people get hurt, people die and you're away from people you care about.
It can't be a mental challenge. 
Dr. Salvatore Pacella: [00:12:20] Rhee Rameen I have a little bit of a logistical question for you. So you mentioned about climbing Denali and the bitter cold. And so w what kind of cold are we talking about? Temperature wise here? 
Dr. Ramin Behmand: [00:12:35] So the Nalley is a particularly windy mountain and To have in may, which is a colder part of the climbing season there rather than June in may.
When I was there, the temperatures are regularly minus 20, but the wind is what makes it miserable. And at nights it regularly could drop into minus 30, minus 40 in the high camps. 
Dr. Salvatore Pacella: [00:12:59] So how much warmer could attend possibly be like, when I go camping with my kids, I'm like, wow. This tent is doing nothing.
So yeah. So tell me how you stay. Like w obviously you have a sleeping bag or something like that, but like what, how much warmer could it possibly be in the tent to rest, 
Dr. Ramin Behmand: [00:13:23] but you're really rely on your outfit. You have to have, you have to make sure your clothes are dry. If you've been climbing on your sweaty, you gotta somehow get rid of some of that wetness, then your sleeping bag and whatever cover you have on the ground that separates moisture from you.
There isn't a whole lot of moisture in that kind of cold environment. But when you go camping South there's moisture and the moisture will within a few hours, you're a miserable in the tent. And when you're camping with your son. So it's all about the barrier between you, the ground and your sleeping bag.
The mountain climbing is sleeping bags for a cold place like that. It's. Start with enough feather that it can withstand a minus 40 degree temperature, but more importantly, the wind is what kills you as well. So the tent does make a difference, huge difference up there. And these are, these are tents that in 70, 8,000 mile an hour, winds will actually come on, lay down on you, but they won't blow away because you've anchored them into the ice.
Dr. Salvatore Pacella: [00:14:35] And how much sleep so obviously you can only climb during the daytime. So let's say you're doing it in may. Denali's in Alaska, correct? Yeah. Yeah. So 
Dr. Ramin Behmand: [00:14:45] there's not a ton also known as Mount McKinley. They recently made the permanent name change to Denali. 
Dr. Salvatore Pacella: [00:14:52] And  there is so that's in may so that there is just a few.
There's very minimal darkness at that time. That's right, yeah. And so how much, tell me a little bit about your day there. Like how much, how many hours are you climbing? How many hours are you resting? What's the end of the day? What do you do for food? Walk us through a day on a 
expedition 
Dr. Ramin Behmand: [00:15:11] like that.
So Donnelley is unique in that you carry everything for your client, everything at one time, When you set off from base camp to get to base camp, you'll take a Bush plane from around somewhere around Anchorage to to the Bay, to the base camp. And then from there, you pack everything into your bag and you start going.
These are extremely heavy packs. They can be 60 pounds. You start, the early part was snowshoeing, and then you set up your first camp and the way mountain climbing goes is that it's a lot of up and down like S. Sam was asking how do you acclimatize? And it's by going up a little too much and coming back down the same day.
So getting your body a little used to it, and then coming back down on the same day and each time you go up halfway or the full way you drop by Bunch of supplies. And in on dental, you dig a really deep hole and you bury it. And then you come back to the lower ground. You're buried in snow.
So the days look like this, the day start early the sun tends to start showing itself that time of the year around four o'clock in the morning. And It really doesn't hit the slopes till sometime around six 37. So it's on the horizon. It's light, but you don't have sun on you. It doesn't come up very far in the sky.
It's it's always sorta coming up a little and going down, up and down on going down. The difference of a climbing in the sun or climbing in the shadows is massive. Massive. It's like very miserable and the sun's not out on Denali. So by six o'clock everybody's ready and you're, you've had a hot tea or something that you've made on the stove and snack and you hit the slope and you could climb somewhere around seven to eight hours a day.
And every hour you take breaks, put sunscreen on drink, a Lois, something keep moving. Donnelley is also unique in that you're roped. To your fellow climbers because of risk of crevasses breaking open. So if, imagine force four people attached to each other by rope, maybe 30 feet apart each, when one of them suddenly punches through a snow bridge and falls in.
The other people have a chance to immediately do what we call a self arresting, try and stop their break their fall and stop them from basically getting swallowed into the hole because it's very hard to get somebody out of a crevasse alive. Anyway. So you're you go as fast as the slowest person on the team and you go to where you want to drop your stash off and you come back to the lower camp, you sleep there the next day, you do the same thing, but this time you pack up your tent and everything and you take it up.
And that becomes your new camp at a higher ground than you do. Repeat this to a higher ground and come back and then. The next day you woke up. How do you does 
Dr. Salvatore Pacella: [00:18:38] that explain a dry, how do you dry your wet clothes or your underlayer at night? 
Dr. Ramin Behmand: [00:18:44] It's 
Dr. Salvatore Pacella: [00:18:45] obvious. 
Dr. Ramin Behmand: [00:18:46] These are all 
Dr. Salvatore Pacella: [00:18:49] the things I've always wondered, so like it's. If I'm out skiing in the snow and I'm wet, that I got to wait till I get back to my cushy fire hotel room, like in the middle of 
Dr. Ramin Behmand: [00:19:03] the four seasons fireplace over there. 
Dr. Salvatore Pacella: [00:19:08] All right. So how do you drive this 
Dr. Ramin Behmand: [00:19:09] stuff? It's just a simple. So the main thing to dry is your socks because your socks on gloves, your feet will get frostbitten.
If you go in the tent and try to sleep with wet socks. So as soon as you're going inside your tent and you're situated for the evening, you pull off your socks and you put new socks on. You travel with three pairs of socks. So you put a new dry pair of socks on you. Take the wet ones. You do not hang them in the tent to dry because they will freeze within minutes.
So it is actually below freezing in the tents, but it feels a lot warmer than being outside. And then you take the socks. And you lay them on your skin of your stomach and you cover it with your shirt. Anything that you have that sweat socks, gloves, it all goes on your skin and it gets covered by your shirt.
You sleep with the wet socks by morning. They'll be dry. It's a. It's what as kids, we hated having wet clothes on. Whenever we did things or socks that are not comfortable or the seam was in the wrong place. So all night, do you feel like that there's a bunch of wet stuff on you? The more wet stuff you have, the more wet things are on your skin for the night.
So you're using your 
Dr. Salvatore Pacella: [00:20:27] body heat to dry your clothes. That seems absolutely counterintuitive to me. 
Dr. Ramin Behmand: [00:20:33] Like your it's your only way, right? Yeah. Wow. Unless you're a tent made, we'll let you put them on that, on their skin. 
Dr. Salvatore Pacella: [00:20:41] But at nights when you're done,  you can't have a fire, right?
It's too high to, to light a fire. 
Dr. Ramin Behmand: [00:20:47] No. Oh yeah no. It's, you're carrying every bit of supplies, so you're not even going to be taking wood or anything with you. You can't have a, yeah, go ahead. Go ahead. That's what I was 
Dr. Sam Jejurikar: [00:21:01] gonna no, I'm sorry. I'm 
Dr. Ramin Behmand: [00:21:05] go ahead please. 
Dr. Sam Jejurikar: [00:21:08] Okay. I wanted to ask you about why it's all right.
So the U you successfully summited Mount Everest, but the first time you went to Mount Everest, you ran into some challenges. Yes. And you had just earlier told us how you had spent all this time training. You spent, eight weeks. Getting to the point where you could potentially summit. So tell us what happened then what prevented you from somebody and just what that.
The emotional rollercoaster that must've been 
Dr. Ramin Behmand: [00:21:38] well, you put your finger right on it. Simir it. That third aspect of what I said in getting ready for the mountains was not right for me at that time. And that was the mental aspect of it. I just had a son. It was my first child that was born and I left our house at four in the morning with.
Everybody in the house, huddled around them crying. It was not like a go get it, send off. It was like, Oh, you're probably gonna die. We'll never see you again. And it had a profound effect on me the whole two days that I was traveling to Katmandu or Nepal, I was down in the dumps. I wasn't thinking about about the climb.
I was thinking about what. What I was doing and how I may never see my kid again and that kind of stuff. Once I got there, it got better. I got there climb to base camp. I wasn't a problem. Came back and climbed Lobo shape peak, which is a training peak of a little over 20,000 feet. That was great. Went back to base camp climb through the ice falls.
On the first day I was climbing through the ice falls. The guy in front of me falls into crevasse and dice. And it was very graphic. He was, he literally had just passed me to cross a crevasse before me, because he was going faster and it was a scene of massive amounts of blood. And. Yeah, it left an impression that this stuff happens.
So once portion was done, I climbed through the ice falls to a camp one and I came back down, as I said, we go up by me, calm down. So I came back through the ice falls down to base camp, and the next rotation was going to be in a couple of days. And. I w I was not having any altitude issues and I was feeling great.
So I went back through the ice falls and went to camp. One, stayed there the night, the next day I was going to climb to camp two. And as we were climbed to camp two, there was an avalanche and a guy 200 yards in front of me. Got buried and died. So now I'm like mentally seeing this whole thing as different because I was being safe.
I was doing everything right. And there's just this deaf stuff was happening a little too easily. So I climbed back. I asked that eventually I went to camp to spent the night there and that's not 22,000 feet. At the base of Lhotse face where everything gets to be extremely steep. And again, you go all the way back to base camp as part of the training.
So I. Climb back down to camp one and I climbed through the ice falls and back to base camp. So you see that the most dangerous part of this is the ice falls, but you climb back and forth through it. You don't just climb through it. I never go. In it again. So there's all this repetition of the very dangerous areas.
The ice falls, it's just basically a river up ice. It's too steep for the glacier to be smooth and chunks are breaking off and dropping down. And that's what the ice falls are. It's the blocks of ice can be size of. Eight 10 story buildings. And if one of 'em tips over and you're in the wrong place, you don't really have either the room or the ability to get out of the zone.
How far 
Dr. Salvatore Pacella: [00:25:40] is the zone? How far is the ice falls? Like 
Dr. Ramin Behmand: [00:25:43] the distance? That's a good question. I don't know the distance style two to be precise. If you climb through it fast, you can be through in four hours. Majority of people take six to seven hours. Now you 
Dr. Sam Rhee: [00:25:57] have some pictures remain of your, was this the first time on Everest or second?
Dr. Ramin Behmand: [00:26:03] The pictures are mixed from different things I can share with you guys. But so I'll finish this story of what Sam asked and that is that so when it came time for me to climb back up, I decided it didn't make sense by that point. This was, I was going to go to camp three and then back down to camp two.
And by, at that point of the trip, eight people had died and. It just was enough. I wasn't mentally prepared for that much. And I left before even attempting to go to the summit and I came back home. I regretted it very soon after, because I'd made such close friends on the climb and I really want it to have been a part of it and I regretted it, there's no changing your mind once you think of it, you're gone.
In the end that year 12 people died. It just was a hun unusually high death rate for that year. 
Dr. Sam Jejurikar: [00:27:02] So w was that 
Dr. Ramin Behmand: [00:27:03] 2014? That was 2012. I was wondering 14 was a bad year there. They had the avalanche that killed over 20 people at base camp. And nobody climbed at that year. And 2015, there was the earthquake that killed a whole bunch of people on Everest and nobody climbed the mountain that year either.
So then the next year that was available, it was 2016. 
Dr. Sam Jejurikar: [00:27:34] So talk to me about the family dynamic involved, where in 2012, you have witnessed all of this death and destruction, 2014, 2015, highly publicized deaths. And then you How do you tell your wife? Now you have a second child at this point. How do you tell your wife?
I want to go and climb Mount Everest. When I stopped, when I was literally staring at the mountain before, because it was too dangerous. How do you convince your wife that this is a good decision?
 Dr. Ramin Behmand: [00:28:05] I think my mood did the convincing. I came back and I was completely miserable that I hadn't done it. I came back and I recognized that it was mental weakness and there was no other reason that I didn't finish it. And it's it feels bad. It feels bad on it stayed with me for quite some time. And so in 2014, I actually.
Was not thinking of going on climbing Everest. It was my wife who suggested, why don't you go climb another humiliation peak that's more than 26,000 feet to just do their routine without feeling like you're climbing Everest, then it was a good suggestion. She's a mountain climb too.
So I went on climb a chill, Oh, you which is about 27,000 feet. And It's very much the same routine. You go to Katmandu and actually for troll you go then take a bus to the Chinese side and through friendship hype, the way of the most dangerous road I've ever been on, I'd rather climb Everest than have a bus.
Take me on a friendship highway to China, but then you go to Tibet on your climb that, and. That gave me a huge amount of experience in high altitude. What I realized is that I do very well in high and high altitude. When other people slow down or have some difficulty
Dr. Salvatore Pacella: [00:29:32] well remain remain. What is what is base camp at Everest? Are you, can you, do you have to Can you be dropped off there or drive there, or you have to climb up to base camp and tell us a little bit about the culture at base camp. How many people are there at any given time?
Like what's going on at base camp? 
Dr. Ramin Behmand: [00:29:52] Great question. Great question. There's two base camps. There's the North side and there's the South side. The South side is a Nepal and you approach it from Katmandu. There is no road going there. So from Katmandu, you fly to a high ground at 8,000 feet. And from there you do a 50 mile hike to base camp at 17,000 feet.
So you're doing a climb over. A couple of weeks to get to base camp. On the North side, the Chinese have built a rope to base camp and it's a higher base camp at 20 some thousand feet. I think it's 21, almost 21. Okay. So you just take the bus there and I've been to both on the North side, it makes you realize how much time you save by just taking the bus there and it's easy.
And on the South side, it feels like a real climb. It's actually more exciting to do that. Walking approach. The culture at base camp is initially very fun. When the climbing season starts, there is not only the climbers there, but there is a lot of trekkers there. People who decided to get to base camp. A few days and get experience, and these are hikers and they're going to go back.
They're not technical climbers. They never approached the base of the mountain or go through the ice palace. So it has a funner, more relaxed culture. The first month that you're around there, then the climbing starts in earnest and. The fun people go away. The people who are not worried who are not spending their nights strategizing and being worried about what's going to happen or what they saw that day or what they try to doing the training hours during the day that didn't work for them.
So things started getting tired and and sometimes the people who seem to be best off. Start dropping off of the team and the announcements come down like a hammer. You're having dinner suddenly somebody's in the mess tent. And somebody stands up and says, Hey, I got to tell you guys, this has been my dream.
I've been saving for this for years. I love you guys, but I'm gone. I'm out. Or somebody gets injured. One day, the friend I was climbing Wescos the back of my knee hurts. Can you take a look? And I took a look and it's like a clot this big in the back of his knee. Like so many things can happen on come up.
People break legs, somebody slipped, them, broke ribs, anything that happens. So people start dropping off and it definitely plays on people's nerves. And then there's some of the professional climbers,  who feel like things should be done a certain way. They don't want anybody on the mountain.
They think, Hey we're the best 10, 12 climbers in the world. Everybody else should not be here. There is a lot of back-and-forth talk there that it makes a tense for people who, there's going to be as many as. Is as many as maybe a thousand people in base camp at this point, some are climbers.
Some are support staff, such as cooks yak, herders Tran people who carry things. And then there is a small number of Sherpa as well. And the Sherpa are. The cream of the crop, the top of everything they're very experienced. They were physically gifted in the high altitude. And they're super nice ice people, always kind people.
I always climbed with the same person every time I've been to the Himalayas. And you develop a friendship even now, after all these years, we are in touch and. Email all the time. So that's the culture in base camp is you can't think of it as ratcheting up tension. And by the time you're going for your third round up the ice fall, people are tense.
You, you joke and you laugh in spurts, but the tension is palpable. People can sit. Four hours in their tents. They don't want to see anyone. It's you're going to take a test on the smart tit goes, Oh you had to study for this. I didn't study at all. And this stuff that can make you nervous and they talk about the technical aspects.
When most of the stuff you don't really need to be talking about all the time. So people get tense. So it's a tense environment. Especially the first time around. I didn't find it to be quite as tense the second time around, but I could see how it was tense for a lot of people.