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One thing I gots to say for it, boy, is it Goth. Way and creepy Goth, ICD-10, brought to us by all the chumps and chumpettes who are touting its internationality and useability.

Tsewang Pajor

Mr. Tsewang Pajor, Green Boots Cave, North Col, Mt. Everest

Green Boots” by Maxwelljo40Own work. Licensed under CC BY-SA 3.0 via Commons.

-This poor fellow, apparently Mr. Pajor, climbed Mount Everest from the North, and made it vanishingly close to the summit when he expired.

DYING ON EVEREST

Dying on Everest used to be a somewhat private consequence of climbing, experienced by about ¼ of all climbers, and the corpses were passed by respectfully by one’s followers up the mountain. Climbing Everest 20 years ago was a hard enough experience; lugging even a few pounds of silver film equipment was an exhausting burden. You, too, were fighting the mountain. The body you pass by today may resemble your own dead and frozen body whom the next climbers may pass by tomorrow. A colleague in fate. A place on the North approach is called Rainbow Valley – a pretty name for an open graveyard fluttering with the Day-Glo coverings wrapping the remains of other dead who had dressed up one day long ago to struggle with the Great Mountain. They pre-wrapped their shrouds, how kind of them. And in these wrappings they lie – and will until the mountain takes them down.

Some just sat and died; some pitched down a crevasse or off a high place; some were fearfully wounded in a way that might have been remedied downhill, but was inevitably fatal for one so high up. Rescue and aid is nearly impossible. There is no handy 911. Helicopters can beat the air so far up; they cannot carry weight, as the air is so thin.

Death comes silently atop the great mountains, especially above 8Km. The bodies freeze-dry in the sparse environs, and bringing them down the mountain was often a lethal enterprise. Let the mountain have them! Some fall, some simply freeze, or expire from the body’s inability to tolerate the vicious conditions of 28,000 feet.
I ask the spirit of Mr. Pajor for its forgiveness, in showing the picture of his corpse.

At one time, the only way to pass by and see his remains was a privilege of other hikers to the top of Everest. Upon the manufacture of light and durable digital equipment, his corpse became a showpiece to those of us who had not risked what he risked. Thankfully, his body has been moved beyond its spectacle, to elsewhere.

For a few years he had a room-mate; David Sharp, who sat for a brief rest under the overhang of Green Boots Cave. He sat there on the afternoon of the fifteenth of May, 2006, and sat there the next day. Could his life have been spared with help? Yea, probably. It’s a busy world. He sat there when the Fall Climbers came up in 2006, and again when the Spring Climbers came in 2007. For some reason, his cadaver was dragged out, and a rocky cenotaph erected with his name memorializing it. A few years later, his roommate, Green Boots fitfully turned over onto his right side for a season; the next year, he was gone.

In the manner of those who routinely risk death, the corpses were named, sardonically – Mr. Pajor was “GREEN BOOTS” for obvious reasons; another woman, whose long tresses blew in the wind for years until her cadaver was dumped down the mountainside, was “SLEEPING BEAUTY.” Not sleeping, indead, and likely no longer beautiful; the weather is merciful, but the ravens and corvids can get up that high, and eyeballs are notable treats to high-altitude scavengers.

But why ICD-10?

What does ICD-10 have to do with this?

Any of my fellow users of ICD-10 note that it has a very odd distribution of diagnoses. Many clinical diagnoses are quite weak; others are queerly detailed.
Many of the “diagnoses” describe un-survivable events and conditions. Many of the ICD-10 details are written not for the living, but for the dead.

Mr. Pajor, and again apologies, died alone; the end of his life is not recorded for our peering scrutiny. There are more pictures, interesting to those with clinical or morbid curiosity, or taphonomy. But T70.20X Unspecified effects of high altitude, for sure. There is a last letter, added for fig-leaf pretense – A, D or S, to discuss whether the treatment is for an initial, subsequent, or sequela encounter. A shotgun blast to the head is dutifully named if this is the first time it has happened, or a subsequent time. It is rare indeed for such events to be survived. There are ICD-10 listings, such as nuclear blast injuries, which are not likely to occur more than once. It is a grim sarcasm to enumerate them.

Bizarrely enough, the actual medical conditions appearing at altitude – HAPE (high altitude pulmonary edema) HACE (high altitude cerebral edema) and AMS (acute mountain sickness, the prodrome of the first two) do not even merit their own diagnostic descriptions! To treat living persons with these three conditions, one has to write them out – no specifics noted beyond the cerebral edema/pulmonary edema, which are broadly generic diagnoses from 100 years ago.

The ICD-10 is not designed for the living. It is, however, designed for YOU, you vanishingly temporary animate prequel to a return to the soil whence you came. Your medical chart has the chronic conditions – the toe-tag entries that will appear on your death certificate. The summit entry, of course, has not been entered, the one that ends your existence. Gunshot? Pulmonary Embolus? never mind, we’ll get it entered.

DYING TO GET YOU SOON

Soon, when we are all RFID-chipped, a drop of body temperature to 20°C or less will prompt your chip to seek a Final Diagnosis, and then be ready to spit out your Electronic Medical Epitaph for statistical value to the e-reader when you are on the cooling table (or under the overhang of Green Boots Cave.)

If you consider ICD-10 to somehow be for the good of YOUR health, please explain. All I see it is a liturgical data sequence that closes out your file. Sayonara.

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