“People thought I was crazy”

When Lea Dümpelmann set out for Everest Base Camp in May 2026, she was carrying more than just medical equipment in her luggage. She was also bringing two years of preparation, permits, study materials, and an idea that has never left her mind. The internal medicine physician and researcher at Eurac Research’s Institute for Alpine Emergency Medicine had repeatedly encountered people with severe frostbite during her previous stages at Nepalese hospitals. Mountaineers and Sherpas often had to wait hours or even days for treatment. Yet with frostbite in particular, every hour determines whether fingers or toes can be saved. This observation gave rise to an ambitious project: Could drug infusion therapy for severe frostbite begin directly on the mountain – even before the affected are taken to a hospital?

 At first, the idea seemed almost impossible to put into practice. But Dümpelmann refused to let it go. Two years later, she found herself at Everest Base Camp, nearly 5,500 metres above sea level, pursuing the project on her own. Conditions were far from ideal: temperatures regularly fell well below freezing, medications were vulnerable to the cold, and the improvised treatment station bore little resemblance to a hospital. Yet despite these challenges, she succeeded in launching the study. The results surpassed all expectations…

You’ve just returned from the Everest region. How are you feeling?

Lea Dümpelmann: To be honest, very tired. I was traveling in Nepal for a total of one month and spent most of that time at altitudes above 3,000 meters. I was at base camp itself for a week and worked practically around the clock there. The altitude, the physical strain, and the conditions up there are very challenging indeed.

What is Everest Base Camp like today?

Dümpelmann: Many people might imagine it’s just a few tents. In reality, it’s actually a huge tent city; it takes about an hour to walk from one end to the other. At times this season, there were around 2,500 people there. That’s really impressive. What was unique this year was that summit attempts were concentrated into just a few days due to difficult conditions on the glacier route and poor weather. This led to the long lines on the mountain that were also shown in the media. At night, you could see the headlamps from base camp – a single string of lights winding its way up the mountain.

But you weren’t there as a mountaineer were you?

Dümpelmann: I wanted to find out whether iloprost, a medication used to treat severe frostbite, could be administered directly on the mountain. The drug has long been used to treat circulatory disorders and rheumatic diseases and, more recently, frostbite. But until now, it had only been administered outside a hospital in a single reported case involving two patients during a helicopter evacuation. It had never been used at high altitude on a mountain. That was completely new. The idea itself was straightforward: when it comes to frostbite, every hour counts. The sooner treatment begins, the better the chances of saving damaged tissue. I wanted to see whether we could bring the therapy closer to the patients instead of waiting until they reached a hospital.

A makeshift clinic at nearly 5,500 meters: at Everest Base Camp, Lea Dümpelmann treated patients and conducted her research in a tent.

Credit: Lea Dümpelmann | All rights reserved

Where did the idea come from?

Dümpelmann: I’ve worked at a hospital in Lukla on several occasions. The hospital’s in a town in the Khumbu region where many trekkers and climbers begin and end their journey into the Everest area. We regularly saw patients with severe frostbite who had to wait hours or even days for treatment because evacuation was delayed. The consequences could be devastating: lost tissue leading to fingers or toes sometimes having to be amputated. Over time, I kept asking myself the same question: wouldn’t it be possible to begin treatment much earlier?

What does the current treatment for frostbite on the mountain look like?

Dümpelmann: First, the affected fingers or feet are placed in a warm water bath to thaw the tissue. This can already be done at base camp. Afterward, the patients are transported to a hospital, where medication-based treatment can begin.

How common is frostbite on Everest?

Dümpelmann: That varies from year to year. Weather conditions play a major role, particularly temperature and wind. Long waiting times on the mountain also increase the risk of frostbite. This season, several factors came together. At a time when the first climbers would normally already be heading for the summit, the route had not yet been completed. Unlike in alpine mountaineering, where climbers determine their route as they go, Everest relies on fixed ropes and ladders installed along the route. This year, clearing and preparing the route took an unusually long time. As a result, summit attempts by a large number of climbers were compressed into just a few days. Long queues formed on the mountain, which likely contributed to the rather high number of severe frostbite cases we saw. Based on previous experience, Everest typically sees around four to fifteen severe frostbite cases per season that require specialized treatment. And, of course, Everest is not the only high mountain where these injuries occur.

 How does an idea turn into a research project on Everest?

Dümpelmann: With a lot of work. (laughs) I first shared the idea about two years ago at an international conference, where I discussed it with several experts, including Peter Hackett and Hermann Brugger, two leading specialists in alpine medicine. They were very supportive from the start. After that, I developed the study design, wrote the ethics application, and organized the logistics. At first, I did all of this alongside my work at the clinic. Later, when I joined Eurac Research, I was able to focus on the project full-time. It was really special to see an idea gradually take shape and become something real, step by step.

You ended up being alone at base camp. Was that the plan from the start?

Dümpelmann: Maybe not the plan, but that’s how it turned out. Of course, I would have liked to have had some support with me. But that wasn’t possible for financial and organizational reasons. In Kathmandu, some people thought I was crazy when they heard what I was planning to do. I always joked and said, “This is my one-woman show.” But I want to emphasize that I received an incredible amount of support both on-site from the Everest ER team and remotely from colleagues who were always available.

What was your daily work routine like?

Dümpelmann: I had to improvise a lot. Of course, there was no traditional hospital setting at base camp. I attached the IV bags to climbing carabiners and hung them from ropes on the tent ceiling. The IV pump I’d brought with me wasn’t designed for temperatures of minus twenty degrees. To keep it working, it had to be kept warm. For that, I had brought a small electric heating pad, which is supposed to be used for growing plant seedlings. When the power went out, I placed hot water bags on top of it. And of course, there was no monitor. That meant “old-school” blood pressure measurements had to be taken - with a stethoscope - under the sleeping bag. And the medication, which was in liquid form, couldn’t be allowed to freeze. So, I coordinated with the Everest ER doctors who were willing to help me. We divided the medications among ourselves at night and kept them close to our bodies in our sleeping bags.

When every piece of gear has a second purpose: a climbing carabiner serves as an IV stand.

Credit: Lea Dümpelmann | All rights reserved

The study ended up going better than expected anyway...

Dümpelmann: Much better than I expected. I had hoped I would be able to treat perhaps four to six patients max. per season, which is why the study is designed to run for two years. Yet within just a few days on Everest, I had already treated seven people. That came as a surprise. In fact, nine people wanted to be treated, but in two cases it wasn’t possible because of logistical or insurance-related issues. I was also surprised by how smoothly the treatment could be administered under such extreme conditions. The medication can have serious side effects, so it must be given very slowly. I had expected that at an altitude of around 5,500 meters we would need to reduce the dose-rate even further and that the treatment would take much longer. But that wasn’t the case with the seven patients I treated. What surprised me most was how well the therapy was tolerated at that altitude.

Necessity drives innovation: a simple hot water bottle helps keep the infusion pump running in extreme cold.

Credit: Lea Dümpelmann | All rights reserved

How long does this type of treatment take?

Dümpelmann: A single infusion takes about seven hours. The treatment itself spans several days and involves at least five consecutive doses of the medication. Of course, you don’t expect miracles after a first infusion: severe frostbite doesn’t disappear overnight. It was all the more encouraging to see how well the therapy was tolerated and how positively some of the more severe cases progressed in the days that followed. My initial impressions therefore make me very optimistic. I feel that we can build on something truly promising here.

What’s next?

Dümpelmann: For the study, we need a minimum of ten cases, and with the seven patients treated on Everest, we’ve already come very close to reaching that goal. The target number is based on the fact that the most common side effects of the drug occur in more than one in ten patients. With at least ten cases, we can assess whether the treatment is tolerated just as well – or just as poorly – under these conditions as it is elsewhere. That means we still need at least three more cases. In a few weeks, I’ll be traveling to Lenin Peak in Kyrgyzstan. The base camp there is at an altitude of about 3,600 meters – considerably lower than Everest Base Camp, but still high enough to continue the study. After that, I’ll analyze the data and prepare the results for publication in a scientific journal.

You also treated Sherpas...

Dümpelmann: Yes, you see many Sherpas or Nepalis in general on Everest who are missing fingers or toes. And it really struck me how different the conditions can sometimes be. Many tourists are flown off the mountain by helicopter when they encounter problems. What struck me was that, despite severe frostbite, many Nepalis still had to hike down the mountain for hours, often carrying additional loads. Yet these men and women are the backbone of the expedition industry... For many of them, working on the mountain is their livelihood. If we can help ensure that fewer people lose fingers or toes, that would be a great success.

What do you personally take away from this experience?

Dümpelmann: Above all, I feel grateful – and exhausted. Two years of work culminated in a single week on Everest, so when I returned, the exhaustion hit first. At the same time, I was overwhelmed by how well the project had gone and how positively it had been received. What impressed me most was the support I received on the ground. It wasn’t my first time in Nepal, but I continue to be amazed by what people there accomplish with the resources available to them. I was welcomed by the local team immediately. I never felt the need to explain or justify the study. Instead, everyone focused on how they could help – introducing me to expedition agencies, connecting me with key contacts, and supporting the project in countless ways. The team at Everest ER was equally invaluable. Although I conducted the study independently, I was rarely on my own. My colleagues helped with initial patient care, took blood pressure readings, and stepped in during the seven-hour infusions so I could grab a meal or get some fresh air. During the long, cold night shifts in particular, it made a real difference not to be alone. Having someone to share a cup of coffee with or exchange a few words with meant a great deal to me.

About the Interviewed

Lea Dümpelmann is a physician who specializes in internal medicine and a researcher at the Institute for Alpine Emergency Medicine at Eurac Research. Originally from Germany and now based in Switzerland, she has additional training in mountain and expedition medicine, tropical medicine, and diving medicine, and holds an additional master’s degree in global health. An avid traveler both professionally and personally, she is particularly interested in the intersection of medicine, research, and extreme environments.