Episode 35: Sunday February 21

Drs. Sam Jejurikar @samjejurikar, Salvatore Pacella @sandiegoplasticsurgeon, 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. In a thrilling finale, Dr. Behmand describes in words and photographs how he was able to conquer 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)
2021.02.21 RAMIN PART 3
Dr. Ramin Behmand: [00:00:00] So now this is camp two and, uh, it says 21, 300 depends on where your campus. It can be all the way to 22,000 feet. Uh, you definitely feel the altitude here being there one hour is not a big deal being there. Two hours is not a big deal. You stay a few hours and. Everything starts changing people, get nauseous, they start throwing up.
You have massive headaches. A lot of people wake up the next day and they, they know they can't go on and they need to go down. Uh, so what you don't want to do in mountain climbing is completely exhaust yourself to your. To the point that you want to be stopping. Uh, if you do that, you're going to have a very rough next day and you may not recover so slow and steady is much better than being a Jack rabbit and leading the team to the next camp that it never works out well for most people that people upfront on these high altitude climbs, usually by the end of the climb.
They're not doing as well. The typical person, I'm not talking about the very gifted at V stirs or somebody, uh, who has, uh, natural 
Dr. Sam Rhee: [00:01:18] gifts to do well. 
Dr. Ramin Behmand: [00:01:20] Uh, most people going slow 
Dr. Sam Rhee: [00:01:22] do better. This is the 
Dr. Ramin Behmand: [00:01:25] base of Lhotse face again. You can probably see the scale. This, this is a person. This is a person and yeah, this is an extremely steep beginning to the 5,000 foot climb.
Once you go up the Lhotse face in the middle of it at around 24 and a half, somewhere between 23 to 24 and a half thousand feet, you're going to carve a platform amount of ice, uh, for yourself to put your tent there. Some of the climbing is pretty steep. Like you see here. And you kick, uh, footsteps and other people have gone ahead.
So you're climbing with cramps, Hans, and this is me. This is the middle of Lhotse face at 24,000 feet. And now I'm going to show you the angle from the side, because again, this picture doesn't do it. Justice. You cannot get a sense for how steep it is. 
Dr. Sam Rhee: [00:02:30] This is our camp 
Dr. Ramin Behmand: [00:02:33] that we've chiseled out over here.
And this is the steepness of the Lhotse face. 
Dr. Sam Rhee: [00:02:40] The South call is here 
Dr. Ramin Behmand: [00:02:43] at 26,000 feet. So once you wake up. And you get your gear back on. 
Dr. Sam Rhee: [00:02:49] You're going to come across here. Uh, this is a yellow band, 
Dr. Ramin Behmand: [00:02:54] uh, and then you have the Geneva spur up here and then you're a South call. It is, this is another place that in 2016 had kind of a traumatic experience.
Um, we had just gotten there. We had set up our tents. I. Suddenly hear a whole lot of excitement and chatter. And I jumped out of the tent. You know, you, you obviously don't want to step anywhere you, and if you're not tied down, you're going to go straight down. So I stood right here by our tent on the path and.
Everybody was pointing to this dot that was coming down. Somebody had radioed from above that something's coming down and it was a climber. He had not, we don't know exactly what happened, but he had not, uh, double clipped into a rope. And, uh, his, uh, one clip failed and he was coming down and he went down the entire 5,000 feet.
Uh, it was, it was. So sobering to see someone going past yet that high rate of speed, they're doing everything they can to stop themselves climbing at the ice, trying to stop anything they can. And that look of horror on their face, that you catch just a glimpse off because they're going so fast and we all on the way down.
And we all saw where this person landed. It. You know, the ground is white and there's a patch of red or this person smashed into it. So you, you see these things and we all just, nobody's said a word. We all just sat down first waiting for this person to make it to the bottom because you're looking at the whole thing happening.
And then everybody realizes this could be me. So it was very, very tough night over there. Um, on, in camp three, having just seen that and knowing that you're going to be doing what that person was trying to do, uh, the next morning.
Okay. When you get to camp three, again, even though you're, you're wanting to just go here and get it over with you. Can't so you climb back down to camp two, you climb to camp one and you got to base camp. This is what you're called your last acclimatization, uh, rotation. After this you're down in base camp, anywhere from three days to a week recovery and letting your body strengthen up in a place of higher oxygen.
Um, and then you're going to go for your summit bid. So I'm going to just start from going from, uh, Champ three here, not show you going back down again. So this is a look up Lhotse face in the morning from camp three. You can see, uh, the rope it's 
Dr. Sam Rhee: [00:06:06] right here. This is what they call the fixed rope. 
Dr. Ramin Behmand: [00:06:10] That is, um, that is fixed, uh, by Sherpas, uh, w uh, sharp from each team.
They form a group and they fixed the rope in the steep sections. 
Dr. Sam Rhee: [00:06:29] They're very 
Dr. Ramin Behmand: [00:06:29] different. If you had to do it, they're difficult. They're, they're difficult. And here's a picture looking back. Uh, so let me tell you what you're looking at. This is, um, camp two down here. Cam three is around here on the steep slope.
And this is above camp. Three base camp is down in this scorch and this mountain here is Calla. PATAR where you get the most beautiful views of Everest by climbing this, uh, the best pictures of Everest are from up here. Uh, it's about eight, 15, 19,000 feet. I think.
So you can see that, uh, you do some climbing in, on rock with your crampons, completely counterintuitive, but there's nothing you can do. You're going from ice to rock ice, to rock and on rock. It's the worst thing you could climb with. You're using way too much upper body strength, uh, when going over rocks, but you don't have a choice.
Uh, this is the yellow band that we're crossing 
Dr. Sam Rhee: [00:07:40] here. 
Dr. Ramin Behmand: [00:07:43] So this is South call, uh, at 26,000 feet. It is the saddle between Lhotse, which is right here and Everest, which is, uh, going to be, uh, to the right over here. The stuff you see here is not garbage. There was a storm. Um, the, the, um, The week before. And majority of this is not even from the storm.
It's from the earthquake the year before everybody abandoned the stuff they had and they left. And so it's a lot of frozen gear from the past year. It's kind of surreal up there. It feels like you're on the moon. Um, yeah. I spent the whole day going around, you know, there's all these different spots on South call with the I've read about.
And I knew who can't wear in 1960s or which area they were in 1970s. And if you know these things, then you spend time going round. You're going to find what I consider artifacts of, of that they may have left behind whether it's an ice screw from the sixties or. Something that's frozen in the ice. It's pretty impressive.
But I spent the whole afternoon doing this. We got there. I want to say around 11 in the morning and you rest up here till about eight at night, and then you go for your summit. Instead of going in a tent, I spent the whole day looking at stuff and most of the time without oxygen, cause I didn't want to use, use up my oxygen.
And suddenly around six in the afternoon, I was like spent, I hadn't rested. I was pretty nervous when I realized what I'd done. So I'm going, my tent for a couple hours, ate a low something, had a massive headache and was very lethargic. Okay. So. South call is down here. You see these little yellow dots. I don't know if it can see it on your screen, but that's South call.
Yeah. And here is your toughest 3000 foot climb. You're going, it's very steep. You're going this beginning part is not bad. You're going here and here it's it gets steep and you're climbing, uh, Pretty tough angles. This is the shoulder that I was telling you about the balcony and Scott Fisher is right here.
Um, on that night that we were climbing, I watched a group of Indian climbers go that way from the Indian army and. I didn't figure it out at the time. I didn't know what they were doing, but they actually had walked off the mountain, uh, is what I found out later. They, I don't know what they're trying to do, but there isn't, there isn't a pad here.
So several of them died that year. And, uh, there were not found. In fact, New York times wrote an article about them. Uh, uh, it's a long, yeah, the lengthy article about the written a couple of years later, but what happened here? Who would they try to recover? What happened to the families and all that. So then from here you go up, uh, this is a very narrow Ridge that you're going up on, on this side.
You can see what you're looking at. You're looking at, not just this drop-off, but it actually goes 8,000 feet down. Um, It's pretty unnerving. If you are able to see during the daylight at night, which you do most of this climbing at night, you don't see it. So when we started, um, climbing, it was eight at night.
And by the time we came out of our tent, that it took me like a half hour to put on my boots. It's amazing how inefficient you've become and, uh, Got all the gear ready. There was a good 90 to a hundred lamps lights, headlights that we could already see up here. People going up up ahead of us. It was very disconcerting and I was pretty upset with myself for letting that happen because you don't want to get caught behind people.
But the Sherpa that I was climbing with, um, he actually. On the way to camp three, um, Got altitude sickness and he had to be evacuated. He went down to camp two on a helicopter, picked him up from there and, uh, took him to Katmandu. So I had actually climbed with his son who was a teenager at the time until, Oh, you before.
And I knew him and they radioed me from base camp and said, Hey, do you mind. If, uh, his son who's here comes up. He's never claimed Everest before, but you know him, you've climbed, Chael you with him. I was like, no, there's a great guy. Uh, send him up. And I waited for him. He came to camp three and we met up there and he did, it was his, this energetic, positive guy was really awesome.
So when he came at him, he saw these headlights. Hi, I turned around to him and I'm like, let's, let's try and pass him. Let's just try and pass them before we get to the higher altitude. We're never going to get past these guys. And he took it to heart. We passed every single person except for like three or four.
By the time we got to the balcony and we were making great time, we passed the other ones. Uh, Around this area where there is some rock climbing, uh, it was pretty unnerving actually trying to pass people, uh, in certain areas down here is not so bad because there's no drop-off on either side, but on this Ridge, it's very unnerving to pass people.
What 
Dr. Salvatore Pacella: [00:13:58] remain w what are people, how are people reacting when you're trying to pass them? Is there like some, some hubris involved, did they say. You're not passing me or like, are they safe? Are they encouraging? Go ahead. You know, no problem. 
Dr. Ramin Behmand: [00:14:13] Uh, well you can't talk to each other so that there's, um, there's no conversation, uh, because you have your oxygen mask on, on, you're pretty bundled up.
Uh, but the, I say universally people hate being passed. Uh, because you're struggling, you're doing something extremely difficult and suddenly somebody is trying to pass you and they make your difficult tasks, even more difficult, breaking your rhythm, getting in front of you. So there are groups that actually make sure you can't pass them.
So if it's narrow enough, they'll. They'll just not let you pass. 
Dr. Sam Rhee: [00:14:59] And how do they do that? 
Dr. Ramin Behmand: [00:15:03] They tend to, they, they S cup with each other. So like two or three people will be two or three feet apart from each other. There's no space in between. And the, there is no path to go past them. And, uh, the other way is to just not let you physically not let you, like people may elbow you back.
So one thing sorta like Samira 
Dr. Sam Rhee: [00:15:30] and, uh, 
Dr. Salvatore Pacella: [00:15:31] the Vegas craps tables.
Dr. Sam Jejurikar: [00:15:43] But one of the rules of mountain climbing was to not try to be the fastest guy. Why, why did you want to pass everybody? Like that seems to 
Dr. Sam Rhee: [00:15:52] contradict what you said before. 
Dr. Ramin Behmand: [00:15:54] Absolutely. Correct. And what you're saying, so, 
Dr. Sam Rhee: [00:15:57] uh, the last day is your last day. 
Dr. Ramin Behmand: [00:16:01] You don't have any climbing to do after this day. And what I learned in, on the other 8,000 foot.
Uh, our 8,000 meter peak that I climbed in 2014, was that all the slowness of the beginning of the climb had put me in the position to be much stronger on the last day than pretty much everybody. And I knew that about myself, that when it gets to be very high, if I've really taken my time and gone slow, I'm going to do well.
And. Both of us had had the same experience on the last mountain, the Choi from 2000, uh, 14. So are, it's much more important that you can get to the summit in seven or eight hours before you run out of oxygen than to be stuck behind people and have it take 12 or 13 hours, which is a real problem. You're going to end up having to turn around and come down.
So this is where experience came in handy. We could do it and we did it. Um, this is your last day. So you can go fast if you don't know your limits and you go too fast, you're going to get stuck. You're going to turn around. But if you have experienced that before and you know that it's going to work for you, then it makes a lot of sense not to get stuck behind people, especially that now you're in.
Minus 40 degree temperature and no significant oxygen. Everything is freezing. Like it could be 60 degrees up there and you're going to get frostbite it's you're just not your body's unable to warm up because of the lack of oxygen. So 
Dr. Sam Rhee: [00:17:45] yeah, even with yourself, 
Dr. Sam Jejurikar: [00:17:47] Jen, Um, do you ever have a pulse oximeter?
Like, do you know what your oxygen 
Dr. Ramin Behmand: [00:17:51] saturation? Yeah, I can. I forgot to mention that. So down here, uh, before going, starting the summit climb, I was on oxygen. I was 73 74.
Dr. Sam Rhee: [00:18:09] Oh, wow. So you're hypoxic even on 
Dr. Ramin Behmand: [00:18:11] oxygen. Yeah, you're not really, you have a very low flow of oxygen, uh, you know, a leader at most, and there's, that's, it's not enough. 
Dr. Sam Rhee: [00:18:24] 73%. Yeah. Wow. Yeah. 
Dr. Sam Jejurikar: [00:18:30] So just for, uh, just for our viewers, that, that would get them in the hospital here.
Dr. Sam Rhee: [00:18:41] yeah. 
Dr. Salvatore Pacella: [00:18:41] Right. Suck it on 
Dr. Sam Rhee: [00:18:43] plastic too. Well, yeah, so 
Dr. Ramin Behmand: [00:18:47] exactly this is, you know, at the advantage of the weeks and weeks of being on high altitude, what your body is able to tolerate on the oxygen is able to carry at this low saturation is enough. But beyond this point beyond South call, what were the deaths and starts you no longer have the ability to adapt.
You've already maximized your ability to adapt. So definitely oxygen from this point on and, um, on the summit I had the, I had the oxygen off for a while up there and I was in the fifties. I mean, yeah, you're a 
Dr. Sam Rhee: [00:19:30] very curious, so, I 
Dr. Ramin Behmand: [00:19:31] mean, I was very curious what it would be and I was saturating the fifties. I felt fine.
Wow. Wow. Yeah. But you're not fine. And you suddenly realize that everything is extremely difficult to accomplish, uh, the simple task of like putting a mask back on may take you, uh, 10 minutes. 
Dr. Sam Rhee: [00:19:53] So, wow. 
Dr. Ramin Behmand: [00:19:55] So. By here, we then made it to the South summit. We stopped and had a little drink. We were the first ones there and it's nighttime, you know, usually like to get to the summit when the sun's coming up.
And we were at South summit sometime around three o'clock in the morning and there's no one in front of us. So there is no pathway. And this, I got to show you guys. This, you see this one, this is the Chinese route. This is a North side that you see they're coming this way. And we could see lights of a couple of climbers coming up simultaneously while we were going up this way.
So then the cross this, I made it to the summit. Unfortunately it's still, while it was dark. I'm showing you the Hillary step here. So this is what Hillary step looks like. Um, this is not my picture, uh, but. It's about a 40 foot rock climb. That looks a little different than this now after the earthquake, but it's a cold place.
There's a lot of ropes from old years and previous years that you can get tangled in and you're spent, you have nothing to give and you're doing a rock climb right before this. Oh, 
Dr. Sam Rhee: [00:21:23] wow. 
Dr. Ramin Behmand: [00:21:25] So this picture I took from the South summit. On the way down, I'm already up on down and you can see the people here and here and there, and that's the summit right there.
Do you, 
Dr. Sam Rhee: [00:21:42] how, how much room is there out of 
Dr. Ramin Behmand: [00:21:45] the summit that looks very small, very small. Uh, you can have six or eight people up there. Uh, anything more than that. And you're probably encroaching on a cornice like this. With unstable sites. 
Dr. Sam Rhee: [00:22:01] So you see the path 
Dr. Ramin Behmand: [00:22:02] here, right? You're going on the edge of the stone, but you gotta be careful not to step here.
You have an 11,000 foot drop on this side, into Tibet. This side is Nepal. So you come here and then. Right around here, where 
Dr. Sam Rhee: [00:22:22] the path 
Dr. Ramin Behmand: [00:22:23] goes, you go to Tibet, you drop down and you remerge up here. So there's a drop-in here and you reemerge. And, uh, that is the Hillary step up there. So the reason I took this on the way down was because when I was going up, it was pitch dark still.
So couldn't see this. And this is on the summit. Uh, this is. Me and the climbing Sherpa I was with. And it's cool because we have the same picture on troll you together from being on the summit there. This is the prayer 
Dr. Sam Rhee: [00:23:02] flags. 
Dr. Ramin Behmand: [00:23:03] That's where the sun's coming up. Uh, guys, these are leather gloves I bought at home Depot.
Uh, but uh, I thought I was going to need him somehow. I didn't need him. This that is bulging. Here is my water bottle. I got, we got up there. I went to drink and it was frozen, solid, well, rock solid. And I tried to take pictures with my camera. Both of my cameras were frozen and non-functional ironically one of the, uh, the guy 
Dr. Sam Rhee: [00:23:40] who took the picture, 
Dr. Ramin Behmand: [00:23:42] um, had he had an iPhone and had a deepened as clothing and he gave it to the next person that came up after us.
And he took this 
Dr. Sam Rhee: [00:23:51] picture for us. 
Dr. Sam Jejurikar: [00:23:55] That would be amazing if you couldn't get a picture of her, 
Dr. Ramin Behmand: [00:23:59] I would have to, I would have 
to 
Dr. Sam Rhee: [00:24:01] just like, I'd have to stay till someone
Dr. Sam Jejurikar: [00:24:07] or you'd have to make yet another trip this time with a working camera. 
Dr. Ramin Behmand: [00:24:11] But the truth is if you don't have photographic evidence, they will not even issue you the summit permit. Or the summit, uh, confirmation, which Nepal government issues you, but there's been enough fraud attempts that now they require multiple photos from different stages, including the summit.
So that's me on the summit. I'm like getting something out of my pocket. This is the oxygen canister. It's like the buoy bag type thing. This is a non Rhee breather and I'm Oh yeah. Um, I think I'm trying to get my, um, my pulse ox out to take my gloves off and check to see what the, uh, pulse pulse oximetry reading is.
And it was the worst thing I ever did was take my gloves off. It took a good three, four hours before I could feel my fingertips. Again, it just was not warming up on the way down. So, yeah, that's, that's the summit. And up there, when the Chinese group got up there, it was kind of like the cold war. We came from one side and they came from the other side and we shook hands and we couldn't talk to each other, but we did some, uh, respect showing respect type maneuvers.
Yeah. And they did their thing and they went down. 
Dr. Sam Rhee: [00:25:38] These are, this 
Dr. Ramin Behmand: [00:25:39] is the cloud cover probably somewhere around 23, 24,000 feet. And this is from, uh, camp, I'm sorry. From, uh, South summit. The sun is not, so I've come down a couple of hours. Uh, No, it hasn't take a couple of hours, takes like 45 minutes on the way down.
I've come down about 45 minutes to the South summit and now the sun is coming up and you can see the pyramid of Everest that you you see with the sunrise and guys, this is Lhotse remember how he looked like. It was the same size as Everest. This is a fourth highest mountain in the world and it looks tiny down there.
Right? I mean, we're at. 29,000 feet. And this thing is, I think 26, almost 27. 
Dr. Sam Rhee: [00:26:36] I know. Oh, 
Dr. Ramin Behmand: [00:26:37] this is the moon. By the way, this is not a spec. This is the moon. It was a full moon night. 
Dr. Sam Rhee: [00:26:43] This Rameen, 
Dr. Salvatore Pacella: [00:26:44] this reminds me of a photo of, um, Samir that I knew he climbed. I know he didn't climb ever Everest, but I think he climbed another.
Another 
Dr. Sam Rhee: [00:26:53] mountain,
Dr. Ramin Behmand: [00:27:02] what mountain? 
Dr. Sam Jejurikar: [00:27:04] They're not, not quite the same, but yeah. Thank you for that. That was amazing. 
Dr. Salvatore Pacella: [00:27:11] Absolutely amazing. Spectacular. I mean, I, I, um, I ju I'm just, um, Really impressed with the mental toughness that one has to have, and you have to have to, to climb this. I mean, I S I S I didn't quite understand what you meant by that until you, you articulated it very well with bodies flying past you, and just, what am I doing?
Type of, you know, questions. I mean, that's, that's really impressive. 
Dr. Sam Rhee: [00:27:41] So what, so what 
Dr. Sam Jejurikar: [00:27:41] do you want once you've accomplished something of this magnitude? That you spend years of preparation for, um, it's such a big goal. What do you, what do you do afterwards when you come down from this? Like, what's the next best goal?
The next goal after that, 
Dr. Ramin Behmand: [00:27:56] you know, uh, one question people always asking me is how much time did you spend up there? And just before I made it to the summit, I actually took a fall and it was hanging off my rope. I was the first guy up. So, um, my climbing partner was. Good a hundred feet behind me. And I took a fall.
I was dangling the 8,000 feet and I didn't know how it was going to get up. I like really did not have any idea whether I was going to get up and I did, but from that point on until 15 minutes later, when I made it to the summit, I just cursed myself the hallway. Say, why did you need to do this? Because for sure, I was sure that I was not going to see my.
Kids again, or, uh, that was the end. So I enjoy the summit, but not as much as I would have if that hadn't happened and on the way down and my future the whole time, I was like, if I get Don alive, I'm not going to do this again. I don't need to do this again. It doesn't doesn't need to be this dangerous. So I decided to just be a good parent when I got back.
Uh, mostly have succeeded, not always. 
Dr. Sam Rhee: [00:29:16] Now your next, 
Dr. Salvatore Pacella: [00:29:17] your next, uh, your next Trek is to the bottom of the ocean, the lowest portion of the ocean, right? That's 
Dr. Sam Rhee: [00:29:23] right. That's right. Actually, 
Dr. Ramin Behmand: [00:29:25] I, my son was just teaching me hover boarding the other day, and I did a bunch of hover boarding on man. I took a nasty spill.
I don't know if he can see, uh, I got a Shiner over 
Dr. Sam Rhee: [00:29:35] here. I got one of 
Dr. Salvatore Pacella: [00:29:36] those two rounds on the other day. Yeah. My kids love that thing. 
Dr. Ramin Behmand: [00:29:40] Yeah, they really do, but 
Dr. Sam Rhee: [00:29:41] it's kind of hard to get used to it. That's truly inspirational romaine that's that's amazing stuff. Thanks. That's great. 
Dr. Salvatore Pacella: [00:29:53] All right. Well, I, uh, I think we, you know, remain, we just want to, on behalf of, uh, Dr.
Rhee in New Jersey and Dr. Jejurikar in Dallas, we just want to thank you so much for joining us. It's always a pleasure to catch up with you at a meeting or. Or a phone or conference it's been too long, my friends. So we'll have 
Dr. Sam Rhee: [00:30:11] to catch up again, 
Dr. Ramin Behmand: [00:30:12] guys. Thank you so much for having me. This has been fun. I look forward to seeing all of you soon, very soon.