Author:
Erik Monasterio, MBChB, FRANZCP and Sr. Clin Lecturer.
Erik Monasterio is a Bolivian/New
Zealand medical doctor and mountaineer. He specializes in Forensic
Psychiatry and also has a research background as a Senior Clinical
Lecturer with the University of Otago, Medical School. Erik has been
mountaineering for over 17 years and has climbed in the Andes,
Himalayas, NZ, Alaska, and Tibet. He has prospectively studied a
group of mountaineers, over four years, to determine the risks
involved in mountaineering and also exploring the personality
characteristics of climbers and base jumpers.
Adventure and risk-taking sports
such as mountaineering, kayaking, rock climbing, downhill mountain
biking and base jumping have increased in popularity in recent
years. These activities court significant dangers and attract
individuals who are prepared to gamble their personal safety, and at
times their life in search of a rush of excitement or an unusual
accomplishment. Public attention in these sports generally focuses
on tragedies and as such are highly emotive and sensationalized.
Dramatic accounts of accidents and hardships often lead to fierce
debates on the merits and ethics of these sports. Take as an example
the controversial events surrounding double-amputee, Mark Inglis'
successful climb of Everest in 2006. Over forty ascending climbers,
most with significant team back-up and radio contact to base camp,
walked past a dying English mountaineer, David Sharp. Recent
accounts reveal that film footage of the unfortunate climber was
gratuitously taken and despite David's poor health he was able to
speak to the climbers. Tragically and incredulously despite the
teams being well equipped with modern equipment, oxygen and medicine
no rescue attempts were made. Ambitious mountaineers walked around
David and left him to die, choosing instead to direct their energy
to the climb. They gave more value to the summit than to the life of
a fellow mountaineer! The climbers once again stumbled past the
moribund David on their way down, and still offered no help. The
self-serving justifications that he was beyond help and that rescues
at such high altitudes are impossible are not convincing, as ten
days later another very sick mountaineer, Australian Lincoln Hall,
was rescued from a position higher up the mountain. Himalayan
climbers, and the leader of the Inglis team, Russel Brice, know very
well that many successful rescues have occurred beyond the “Death
Zone” (over 8000m) and that it is notoriously difficult to predict
who will die from mountain sickness. In 1996 on the same mountain,
Texan pathologist Beck Weathers walked to safety despite twice
having been deemed “essentially dead”. Over time 245 mountaineers
have died in their quest to climb New Zealand's highest mountain,
Aoraki/ Mt Cook and more than one thousand in their quest for
Europe's highest peak, Mt Blanc. Australian sea kayaker Andrew
McCauley tragically died attempting the first solo-crossing from
Australia to New Zealand. Base jumping is probably the most
dangerous sport in the world and involves parachute jumping from
either tall natural features or man-made structures. The parachute
is initially closed and is opened after a (short) free fall. A
comprehensive data base of base jumping fatalities reveals that 175
jumpers have died since the sport began (approximately 30 years
ago). The surprising finding is that only 123 of those deaths were
directly related to base jumping, the other deaths were related to
other accidents, drug overdoses and suicides. Taking these reports
into consideration the understandable public perception is that
adventure sport participants are an unusual, highly selfish or odd
breed of people. Why else would they willfully choose to court
danger and gamble with their lives? At times to the detriment of
others.
Sensationalized reports, although
very good at capturing public attention, are seldom balanced or
objective and therefore unhelpful in providing an understanding of
the risks and motivations behind risk-taking sports. Given that New
Zealand currently promotes itself as an adventure destination, where
risk-taking sports and activities are popular and traded
commercially, it is an important and timely subject. As a
mountaineer and psychiatrist I have been involved in scientific
research to try to determine the rate of accidents in adventure
sports. I am also interested in finding out whether people who
engage in these activities have “unusual” or unique personalities,
and whether there are any biological or genetic reasons to explain
why people take up these sports.
In a New Zealand based study of
experienced and committed mountaineers, I found that almost half of
them had suffered at least one climbing related injury. Two thirds
of those injured were hospitalized and 20% required more than 3
months to recover or were left with long-term health problems. Four
years after starting the study there was a 10% death rate (five
deaths), four due to climbing accidents. Other studies of
mountaineers have found similar results. For example Murray Malcolm,
from the University of Otago found that the death rate from climbing
in the Mount Cook National Park was 5000 times greater than from
work-related injuries. The death rates from climbing on the highest
peaks in the Park where similar to those of climbers to peaks over
7000m, approximately 4%. I also found that the personality of
climbers was quite different to that of average people. Climbers
scored higher in the areas of Novelty-Seeking and Self-Directedness
and lower on Harm-Avoidance. What this suggests is that climbers
generally enjoy exploring unfamiliar places and situations. They are
easily bored, try to avoid monotony and so tend to be
quick-tempered, excitable and impulsive. They enjoy new experiences
and seek out thrills and adventures, even if other people think that
they are a waste of time. Climbers therefore also participate in
other adventure sports, such as mountain biking. When confronted
with uncertainty and risk climbers tend to be confident and relaxed.
Difficult situations are often seen by climbers as a challenge or an
opportunity. They are less responsive to danger and this can lead to
foolhardy optimism. Climbers also have good self-esteem and
self-reliance and therefore tend to be high-achievers. I am
completing a similar study of base jumpers and the initial results
are sobering as they show that almost two-thirds have suffered at
least one base jumping accident. Almost all of those injured
required hospital treatment and two-thirds needed more than 3 months
to recover or were left with long-term health problems. All base
jumpers estimated that they had had “near-misses” and all of them
had friends die from the sport. Overall the personality of the base
jumpers appears to be very similar to those of mountaineers. These
findings are similar to those of other personality studies of
risk-taking sports people, which have found high scores on the
measure of Sensation Seeking (essentially the same as
Novelty-Seeking). What these findings suggest is that biology and
genetics play at least a moderate role in determining who will take
up these sports. We know that the amount of Harm-Avoidance,
Novelty-Seeking and Sensation-Seeking are inherited from our parents
and are determined by the levels of a number of brain
neurotransmitters, called monoamines. These monoamines (Dopamine and
Serotonin) are chemicals that pass information between lower and
higher brain regions. High Novelty-Seeking and Sensation-Seeking are
both associated with low levels of Dopamine and the current theory
is that involvement in risk-taking activities helps to boost the
levels of this brain neurotransmitter. High Harm-Avoidance, which
confers a propensity to become anxious or scared in the face of risk
or uncertainty is related to high levels of Serotonin. In my studies
risk-taking sports people had low levels of Harm-Avoidance and this
may explain why they are able to tolerate risk and uncertainty
without becoming overwhelmed by fear and anxiety. In fact the low
levels of Harm-Avoidance may contribute to a tendency to
underestimate danger and therefore may partially account for the
high rates of accidents.
An interesting observation of
serious risk-taking sports people is that despite frequent “near
misses” and accidents, they continue to participate in adventure
sports. This persistence in the face of trauma is in my view quite
unique. Average people who experience or witness trauma to the
levels found in my studies would be expected to develop
psychological complications, such as Post Traumatic Stress Disorder,
and other mood or anxiety problems. In the studies however
participants appeared to be immune to these reactions. Researchers
in Switzerland who studied a large number of professional mountain
guides also found that they had unusually low levels of
trauma-related psychological complications. The researchers
commented that the level of trauma experienced by the mountaineers
was similar to that experienced by fire-fighter and army personnel,
yet they had only 10-20% the rate of psychological disturbance. Only
3% of mountaineers developed Post Traumatic Stress Disorder, whereas
rates in firefighters are up to 20%. The mountaineers in that study
were also found to have low levels of Harm-Avoidance. What emerges
as an interesting possibility is that risk-taking sports people may
be protected from the psychological complications that generally
accompany serious trauma. This could explain why accidents don't put
them off adventure sports and low Harm-Avoidance may account for
this immunity. At a community level, psychological complications
from trauma are relatively common and it is estimated that at least
5% of the population will suffer from these debilitating problems at
some point in their lives. A major difficulty for health workers
following traumatic events such as natural disasters or terror
attacks is identifying which people are at risk or are protected
from these conditions. If a link between Harm-Avoidance and a lower
incidence in these conditions is established, then it may eventually
help to identify vulnerable individuals and offer early
interventions. Further studies of risk-taking sports people could
therefore have important public health benefits.
The study of risk-taking sports
people yields interesting results. Not surprisingly sports such as
mountaineering and base jumping are associated with significant risk
of accidents and fatalities. People who choose to take up these
sports appear to have a biological make-up which is different to
that of average people in the community and these differences in
brain chemistry help to explain why they put themselves in perilous
situations. Biological correlations however must not be taken too
far. In my view adventure sports are rewarding and exhilarating for
reasons that go beyond the explanation of biology. A very
significant number of participants in these studies pointed out that
their involvement in risk-taking sports were richly rewarding for
reasons far more profound than the simple thrill of risk-taking.
They often described a connectedness to nature and respect for the
natural environment. Others spoke of the special relationships that
eventuates from trusting partners in challenging times. Ultimately
however, whatever the reasons behind risk-taking sports,
participants will be judged not so much by their achievements, but
by their response to the needs of others at times of crisis and
need. The risk that personal ambitions and economic pressures erode
acceptable standards of behavior and moral values are sadly as
present in adventure sports as in any other human endeavor.
References
- The research on Base Jumping
is undertaken in collaboration with Dr. O. Mei-Dan (orthopaedic
surgeon, Israel).
- Malcolm M. Mountaineering
fatalities in Mt Cook National Park. N Z Med J. 2001; 114:78–80.
- Pollard A, Clarke C. Deaths
during mountaineering at extreme altitude. Lancet. 1988; 1:1277.
- Monasterio E. The Climber.
Christchurch: Saxon Print; 2003: Issue 43/Autumn:p31–2.
- Cloninger C, Przybeck T,
Svrakic D, Wetzel R. The Temperament and Character Inventory: a
guide to its development and use. Center for Psychobiology of
Personality. St. Louis, Missouri: Washington University; 1994.
- Monasterio E. Accident and
fatality characteristics in a population of mountain climbers in
New Zealand. N Z Med J. 2005; 118.
