Well versed in the hazards of altitude sickness, the dreaded “soroche” as it is called in Bolivia, we had taken the necessary precautions.  Coming from the sea level of Orlando Florida, we had acclimatized over a few days. Use of Diamox was a little controversial and though three of us took the medicine ahead of time, the fourth member of our party was somewhat reluctant since he was already on a diuretic for hypertension, We had fortified ourselves with quarts of the ubiquitous coca tea and faithfully avoided alcoholic beverages.

We were after all a group of four physicians, with more than 25 years of medical practice under our belts. What could possibly go wrong?

Traveling through the pristine, cobalt blue waters of Lake Titicaca, in the company of flying fish and soaring condors we arrived at the shores of Sun Island. We were met by an excited bunch of teenage locals who quickly grabbed our suitcases and proceeded along the steep Inca steps. Our route would be a three to four mile hike over a hilly ridge offering us majestic views of the lake and the towering snow clad Andes, to our hotel, the Posada del Incas. The terrain was moderately rough, at an altitude of about 13000 feet. We were met by a local guide with a mule that was to take one of the members of our party who had slightly sprained her ankle. Another person accompanying us was a small wizened person with an ageless weather lined Inca face, his barrel chest reflecting the compensatory lung capacity of the dwellers of this high altitude. He carried a flask of coca tea and much to our reassurance a small tank of oxygen in a satchel. .

So we set out at moderate pace. The mule trotted off and soon our friend became a small speck in the distance,

Halfway up the hill, our friend who had avoided Diamox, started feeling nauseous and complained of a headache. We slowed down our pace while he took several swigs of coca tea and we tried to admire the view. Few more paces and he complained of faintness and shortness of breath. His face had taken on a grayish hue.  Slightly alarmed but trying not to appear over concerned we nonchalantly felt his pulse.We tried to phone the hotel on our cell phones but there was no reception. The mule had disappeared into the horizon.

Suddenly our friend threw up. The little man began gesticulating towards his first aid bag. Of course, we had a portable oxygen canister! Why did we not think of it before? What a relief! He came over and attached a facemask to a clear tubing.  With infinite care he wiped the mask with an alcohol swab. Then with a flourish he attached it to the oxygen tank and with a practiced twist of his wrist opened the oxygen valve and carefully placed the mask over our friend’s face.  A minute passed and we waited with bated breath for our friend to respond. But what was this? Our friend tore off the mask, coughed and glared at the man, sputtering in rage. The oxygen tank was EMPTY. We four doctors with a combined 100 years of experience, veterans of travel into third world countries, had failed to do an elementary check of our equipment. Our guide was furious and roundly berated the attendant.

Somehow our friend got up and staggered the rest of the way, which wais now thankfully downhill and reached the hotel A tank of oxygen awaited him and after a half hour inhalation of the life sustaining gas he emerged as good as new.

Over dinner we rued the fact that we could never get too complacent or let our guard down. “Time out” pause whether in the operating room or in the realm of adventure remains of critical importance.

Rest of the trip passed without any untoward happening. The spirit of Viracocha smiled once again.