The title says it all. This is a book about all that can go wrong with the human body when it’s exposed to the most extreme conditions possible—including places where no human can survive without the benefit of modern technology. The medical science provides plenty of tidbits of fascinating food for thought, but it’s the stories of survival (or, sometimes, the lack thereof)—many of which the author, Kenneth Kamler, M.D., was present for—that make this a gripping non-fiction read.
There are only six chapters, addressing survival in the jungle, on the high seas, in the desert, underwater (diving), high in the mountains, and in space. There’s also a prologue that sets up the book with examples from Dr. Kamler’s experiences at high elevation (specifically Mount Everest.) Each chapter is full of illuminating stories about the threats to human life that exist in all of the aforementioned environments. The author is a hand surgeon who made a secondary specialization through expeditions to extreme environments to deal with the maladies that are largely unknown to the average person’s day-to-day existence—from pulmonary edema to exotic Amazonian parasites. A few of the chapters feature mostly stories of Kamler’s own experiences. These include the chapters on the jungle, deep-sea diving, and high altitude climbing. For other chapters Dr. Kamler draws together fascinating cases of survival and perishment in extreme environments such as living in a life raft on the high seas.
Besides considering what might kill you in extreme places, this book also reflects upon a couple of other interesting tangential questions. First, what adaptations (cultural or physical/genetic) do the locals have who live at or near these extremes that allow them to live? A fascinating example of this seen in the explanation of how Sherpas of the Himalayas differ from the Andean Indians who live at high elevations in terms of their biological adaptations to elevation. These two peoples living under similar conditions share some common adaptations, but other adaptations are quite different. On a related subject, Kamler also looks at what adaptations other species have developed to allow them to be so much more successful in some extreme environments (e.g. seals in water.)
Second, the role that x-factors like belief and will to survive play are never shunted aside as irrelevant anomalies by the author. Kamler devotes an epilogue to the subject of will to survive. Dr. Kamler was at one of the camps above base camp on the day of the 1996 Everest tragedy in which 12 perished. Kamler saw and advised on the treatments of Beck Wethers and other severely frostbitten climbers. Wethers’s story is particularly fascinating as he lay freezing in the snow overnight in a blizzard, apparently snow blind—though it later turned out to be an altitude related problem with an eye surgery (radial keratotomy)—before climbing to his feet and shambling into the wind (his only guide to where the camp might be.) Kamler considers the science of how Wethers neurons might have fired to get him to his feet against what seems like impossible odds, but concedes there’s much we don’t understand about what separates survivors from those who succumb.
I found this book to be fascinating and would recommend it to anyone interested questions of what a human is ultimately capable of. If you’re interested in medicine, biology, or survival, you’ll likely find this book engaging.