After losing his son, Doug Julian’s father, also named Doug, is now mightily determined to educate and spread awareness about altitude sickness. Julian desperately wants to prevent further heartbreak and loss from anyone else at risk who may experience the same symptoms as his son did.
“It was nearly 1:30 pm on a beautiful warm summer day in August in Salem, Utah…“
Doug Julian was spending his Saturday doing yard work when he heard his dogs intensely barking. The thought of unexpected visitors made Julian think something terrible must have happened to a loved one. Dread filled his mind as he immediately thought of his 17 year-old son who was on a Scout trip.
His fears were met with two cop cars outside his house, the sight making him silently curse. Living in a small town, Julian recognized Chief James, who quickly walked up to him and firmly placed his hands on his shoulders and frankly stated, “Doug, your son has passed away.”
At first, a strange thought ran through his head and he almost smiled, He’s pulling my leg, he thought. “Are you kidding me?” Julian stated.
“Doug, that is not something I would joke about!” Chief James insisted, after Julian asked several times.
“All at once the realization hit me… I became weak in the knees…”
Following Chief James and his fellow Officer Marbery’s order, Julian called his wife and told her to come immediately home from lunch with her niece. “What has happened to Doug?” she questioned, automatically surmising that Doug was in trouble. She arrived home quickly after, just sitting in the car not wanting to face the bad news— until neighbor Todd Harris helped her out and led her to her husband. Not knowing exactly what to say, Julian slowly told his wife “I guess… Doug has passed away.” She immediately sank to her knees and fell into his chest and began weeping bitterly, repeating,“Not my boy, not my boy, not my boy!…”
“It felt as if someone had taken a large drill bit and bored a hole in my chest,” writes Julian. “It has been just over two months since my son has passed away and that pain from that metaphoric hole in my heart is still present; I suppose I will have to try and get used to it… I don’t think it will be leaving any time soon…”
“Doug began to feel congestion and had a headache…”
Sunday, the day after Doug’s passing—which would have been his 18th birthday—two of the leaders from the Scout trip sat with the Julians in their living room to recount the unfolding of that weekend.
Chad Balls and Cory Walker explained that on the second day of the hike, Doug began to feel chest congestion and had a headache—the first signs of altitude sickness. However, leaders attributed these symptoms to Doug catching a cold— after all, another boy had brought a cold with him onto the trip. Balls also recalled that Doug had brought along a few packs of Rolaids because it was common for him to get nauseated when camping at higher elevations.
“I didn’t think anything of it, except that I was grateful he’d come prepared,” Balls recalled— perhaps another reason why Doug’s serious symptoms were misinterpreted.
The leaders on Doug’s hike aren’t the only ones to misdiagnose the first signs of acute mountain sickness (AMS);
Doug began to feel congestion and had a headache—the first signs of altitude sickness.
hikers commonly think congestion or headaches are simply caused by cold weather, or from not being in perfect shape. Not wanting to stop, slow down or have to backtrack, many hikers think they can just “push through” their symptoms. What they don’t know is that continuing to hike with altitude sickness can cause hikers to acerbate, or irritate the symptoms, causing the hiker to become violently ill, pass out, go into a coma, or can even be fatal if not immediately treated.
Understanding and being able to distinguish between serious and not serious symptoms will save lives. Experts say that if a headache is the only symptom, you should stop climbing and take a mild pain reliever. Symptoms such as rapid (but still comfortable) breathing, shortness of breath while strenuously exercising, short pauses in breathing while sleeping, and frequent urination are mild symptoms and not cause for immediate concern.
However, if the headache persists and is accompanied by one or more symptoms associated with AMS, assume it is AMS and get down to a lower elevation immediately.
Nevertheless, the Scouts went along with their day and enjoyed the time in the mountains fishing and spending time as a group. Doug’s symptoms, however, only worsened. He went to bed that night feeling nauseated and still suffered from congestion. One day later he was so sick that he stayed back from going fishing.
“As his father, I would have realized that this was not normal for Doug…he rarely missed a chance to fish, as he has a passion for fishing,” said Julian.
“As his father, I would have realized that this was not normal for Doug……he rarely missed a chance to fish.”
When Ryan Larsen, one of the boys on the trip and a friend of Doug’s, learned that Doug had even thrown up, he thought it was just the flu.”I didn’t think Doug’s illness was life threatening. I just thought that if we got him down to a lower altitude and to a doctor he’d recover.”
At this point, Doug had shown many of the signs of AMS; chest congestion, extreme fatigue, lethargy coughing, a worsening headache, and nausea. Although no diagnosis was determined, Doug’s symptoms were becoming worrisome. “I agreed with all the boys that we would get up early, pack all of Doug’s stuff in their packs, and head out as quickly as we could,” recounted Balls.
The next morning, Doug tried to stand up and immediately fell to his knees. Now understanding that the situation was life and death, Balls desperately ran 9.4 miles down the mountain to get cellphone service and call for help.
Leaders tried to help Doug down the mountain, but after taking nearly an hour to get 200 yards, with Doug collapsing repeatedly, Walker realized that they weren’t going to be able to get Doug down on their own. He managed to get Doug off to the side of the trail, sat him down, and propped him against a log to rest. He had just turned away to discuss something with his son, when Doug slumped over to his side and passed out. Walker moved Doug to a lying position and found that his pulse was fading fast.
CPR was begun and fluids began to flush out of Doug’s lungs. Two times over a 25 minute period, Walker was able to revive him; however, Doug finally took one last big breath and then passed away. CPR was stopped and Walker moved Doug to a shady spot, covered him up with a tarp, and waited for the medical helicopter to come.
It had taken Balls two and a half hours to get to an area where cellphone coverage was available. Three and a half hours after Balls had ran for help, the medical helicopter arrived.
When Larsen saw the life flight helicopter overhead he was completely shocked and broke down and cried. “It was pretty traumatic to see my friend gone in a tarp when I had seen him two hours before that alive.”
Those that remained with Doug, including Larsen, built a large Ebenezer to mark the location of his last moments here on earth. “I built the Ebenezer to remember him by, and when I go back there for years to come I’m going to add a rock to remember him,” shared Larsen.
There was no way we could rewind, fast forward, or pause the series of events that had just transpired over the past few hours.
“We all experienced much needed love and overwhelming support from our neighborhood, ward, stake, and friends,” Balls expressed. “We are all now much more aware of altitude sickness; the symptoms, and the need to quickly respond to those symptoms. Because of this awareness we’ll be more prepared for future outings to these same mountains with other groups of young men.”
“This was frankly one of the hardest meetings I have ever been involved with and I am sure it will be for the rest of my natural life,” Julian said about discussing what had happened with Walker and Balls.
From this tragic loss, Doug’s loving father’s plea to every single outdoors-lover out there is to make sure that we all educate ourselves and everyone we are associated about the seriousness of understanding AMS. By becoming better equipped with education and awareness, we can prevent the suffering of future families like Doug’s.
Steps You Can Take to Prevent Altitude Sickness
When traveling to areas of no communication, have a satellite communication device to summon help quickly. When going to elevations above 8,000 ft: have a pulse oximeter to check oxygen levels and supplemental oxygen, if possible. Ascend in stages to allow time for your body to acclimate to the change in pressure and oxygen content in the air.
Please read and become educated about altitude sickness by going to the following links:
- BSA Safety Moment: Acute Mountain Sickness Recognition and Prevention (see below)
Are you getting ready for your Philmont Trek and a summit of Baldy Mountain? Perhaps you live close to sea level and plan to hike the John Muir Trail in the Sierra Nevada range, Kings Peak in the Uinta range, or some 14ers in Colorado. These trips might result in symptoms or effects of acute mountain sickness (AMS), high-altitude pulmonary edema (HAPE), or high-altitude cerebral edema (HACE), which if untreated could result in death. As altitude is gained, air grows “thinner,” and less oxygen is inhaled with each breath.
Acute Mountain Sickness
- Have you recently arrived at an altitude of 6,000 feet or higher? Look for signs of AMS, such as headaches, loss of normal appetite, nausea (with or without vomiting), insomnia, and an unusual weariness and exhaustion.
- The treatment is to descend or to stop ascending and wait for improvement before going higher. Continuing to ascend in the presence of symptoms is not recommended. If the illness progresses, descent is needed.
High-Altitude Cerebral Edema
- Be watchful for loss of coordination (e.g., an inability to walk a straight line or stand straight with feet together and eyes closed).
- Signs and symptoms often include a severe headache unrelieved by rest and medication, bizarre changes in personality, seizures, and coma.
High-Altitude Pulmonary Edema
- HAPE symptoms often appear initially as a dry cough, soon followed by shortness of breath, even at rest. Shortness of breath becomes more pronounced, with chest pain as fluid collects in the lungs.
- The cough may become productive and with frothy sputum early on that may turn reddish.
Preparation: Discuss your planned climb with your health care provider while undergoing a pre-participation exam (Part C of the Annual Health and Medical Record). Improve your fitness with regular hikes while carrying a load in anticipation of your climb.
Staged ascent: If possible, your first camp should be no higher than 8,000 feet. Increase no more than 1,000 to 1,500 feet per day. When starting out higher than 9,000 feet, spend two nights acclimating to that altitude before proceeding higher. Proceed higher during the day, but return to a lower elevation to sleep (climb high, sleep low).
Appropriate exercise level: Until acclimated, exercise moderately, avoid intensity, and be alert to shortness of breath and fatigue.
Hydration: To offset increased fluid losses at high altitudes, stay well-hydrated.
Evacuation: Stop ascending until AMS symptoms resolve. If you suspect the onset of HACE or HAPE, evacuate rapidly to a lower altitude (descending at least 1,000 to 1,500 feet) and get evaluated by a physician as soon as possible.
- Annual Health and Medical Record
- Wilderness First Aid Curriculum and Doctrine Guidelines, BSA 2017
- Boys’ Life, “How to Avoid Altitude Sickness” by Buck Tilton
- Fieldbook, Fifth Edition: Altitude Illnesses (page 188), HACE and HAPE (page 189), and Adjusting to Altitude (page 225)
To read more about what happened here are some links from news articles about Doug’s story.
Author: Katelyn Kenedy | Marketing Associate, Utah National Parks Council