“I was scared to death.” Freezing, out of food and lost near the top of one of the world’s highest mountains, type 1 Colby Smith has to decide. Should he save himself and head down the mountain to safety and leave his friend behind to die, or stay with his friend, which could kill them both.
Smith and his friend, Mike Heiser, lost their way on one of the coldest and windiest climbs on earth, and could not find a shelter to sleep in. After 23 hours of exposure and no sleep, they were out of food. Smith was surviving on glucose tablets; he ate 70 to stay alive.
With or without diabetes, humans cannot take these extremes—lack of food and oxygen, getting tossed by the wind and cold—for too long. Heiser began showing signs of exhaustion, literally falling asleep standing up. For a while, Smith carried him. But after some time, pushing and jolting him just could not keep him awake.
Heiser collapsed and Smith sat down beside him, facing the possibility that they would die there on the mountain.
How does a person with type 1 diabetes find himself in this situation?
Smith, a type 1 for 20 years, has climbed three of the world’s famous seven summits, the highest peaks in each of the seven continents. And he’s not done yet.
From where does his perseverance and sense of adventure come? Smith would probably begin back in his childhood in Macon, Georgia, his Southern accent getting stronger with each memory.
“I’ve been fortunate with my control,” says Smith. “The only times I’ve actually gone into a diabetic coma were the first years I was diagnosed, when I had two. Aside from that, I’ve never had another one. I’ve never had ketoacidosis.”
Smith was diagnosed at age 7. That was 20 years ago, and Macon had no endocrinologist. His father, an orthopedic surgeon, decided that his family would have to educate themselves.
“I think I was reading medical journals concerning diabetes by the age of 8. That was very influential, because I always knew what was going on. I think that’s the key, to understand diabetes and know how to manage it,” says Smith. That knowledge took him to great places.
Making a Mountain out of a Medical Journal
Smith went to law school, where he began making a list of places he wanted to visit.
“My first place was Africa,” he recalls, “so I applied for a summer job there after my first year of law school, in 1994. I got a job with the United Nations, working in the legal division for their environmental program.”
Stationed in Kenya, he befriended other U.N. workers, who asked him to join their climb to Mount Kilamanjaro’s peak, the highest in Africa. Smith said yes, without giving his diabetes much consideration.
“I had always grown up with my parents’ philosophy that as long as I maintain and control my diabetes, there’s absolutely no reason in the world why I should be limited in doing anything.”
He didn’t consider that his insulin would freeze in the cold air near the top, which it did, in his backpack. He had just enough that didn’t freeze (stored closer to his body heat, in his shorts and socks) to keep him alive.
“The nearest hospital was about eight days away. I knew I had just enough to get me back to Nairobi, where I had some more stuff, so I finished the climb.”
This near-miss did not scare him away, but encouraged him to learn more and better prepare for future climbs.
The List Goes On
Back at law school in the United States, Smith again took out his list and Alaska caught his eye. Guess what? He made it there, clerking for the federal judge in Ketchikan right after law school.
“After I finished my job in Ketchikan, I met two attorneys who were big climbers,” Smith says, recalling their first discussion of climbing Russia’s Mount Elbrus, the tallest peak in Europe. “So we all just decided to do that one, see some of Eastern Europe and climb Elbrus.”
For Elbrus, Smith says, “I was a lot more prepared for things.” He knew he had to take enough supplies to last through any emergency.
“Since that first mishap on Kilamanjaro, I take double supplies of insulin, and each of my climbing partners carries a double supply, in case someone falls and it breaks or freezes. Everyone in the group has enough supplies to get me through it all.”
One other lesson he learned on Kilamanjaro is that glucose monitors don’t work in extreme cold. Their liquid crystal displays freeze.
“That time around, I took the old, visual read test strips and I didn’t have any problems on Elbrus.”
Well, maybe one problem.
“We ran out of food.”
During their trek, a storm blew in and left them stranded in one spot for seven days.
“The trip was only supposed to take five days so we spaced the food out into thin rations,” he says. “We had soup for breakfast, soup and piece of bread for dinner. I had tons of glucose tablets, and that was my staple. We had one day when we were just out [of food]. But on that day the weather had calmed, so we went down the mountain and bought some more food. We decided, we had come all that way, we might as well give it another try.”
And they headed for the top again.
What keeps Smith climbing despite some close calls? The answer lies in his body, inflicted with diabetes, and in his soul, which loves the climb.
A Feeling Like No Other
“Had I not been a diabetic, I probably would not have pushed myself so hard to do all these things. I think it’s always been a factor not just to be normal, but go beyond that,” Smith says.
Smith yearns for the feel of the climb and the exhilaration of making it to the summit. “It’s not like anything else. I can’t describe it. It’s an accomplishment that’s different from any of my other accomplishments, like work. You’re physically pushing yourself to a limit, battling against Mother Nature.”
Still, he realizes his own limitations in the battle, not from diabetes, but just from humanity.
“I don’t want to sound like someone who is an adrenaline junkie and would spit in the face of danger,” he insists. “I don’t feel like I have to get to the top. I just take my time with it and do it carefully.”
Smith got enough of an adrenaline rush from Elbrus to plan his next climb, up Argentina’s Mount Aconcagua, the highest mountain in South America, and the Western Hemisphere, where he faced a decision no one should have to face.
Back to Aconcagua
Along with the same friends from Elbrus, Mike Heiser and Vern Kellor, plus one more, Julie Rowe, Smith began his toughest climb yet.
The wind and cold were much more severe on 22,850-foot Aconcagua, so cold that when he put his blood on the visual read test strip, the blood froze. And testing at altitudes like these becomes much more crucial, as it is hard to distinguish if you are feeling bad because of your blood sugars or the normal, physical effects of high altitudes. Smith couldn’t tell the difference.
“I tested up to 17 times a day.”
Kellor and Rowe decided against pushing to the summit after a storm set them back, leaving Heiser and Smith to summit alone. Having made the decision to push on, they were inspired by that unforgettable feeling they knew awaited them at the top. But Aconcagua gave them another shock.
Greeting them at the summit was the frozen corpse of a climber they had met earlier on the journey.
“It’s supposed to be your best day. This was the worst day, by far,” Smith says.
They didn’t stay long, beginning the journey down in very low spirits.
Mental and Physical Challenges
Smith was climbing on a mountain where everyone is in danger and diabetes only makes the hazards worse. Other challenges of high altitudes are loss of appetite and bad circulation.
“At high altitudes there’s no oxygen, so you already don’t have very much circulation going on, and if you add a high blood sugar in there, it really creates a very high risk for frostbite.
Smith did lose part of a toe on Aconcagua. “It was my second toe, which was longer than the rest, so it evened them all out,” he jokes, that Southern drawl getting strong again.
The toe is nothing compared to what he almost lost.
It was on the way down from Aconcagua, already drained from seeing the dead climber at the top, where Smith held Heiser’s cold, sleeping body, wondering if they, too, would die on that mountain.
“I had made my decision,” Smith says. “I knew that I wasn’t gonna leave him. I knew that I couldn’t live with it. I didn’t know what was gonna happen after I did that. I was hoping that he would wake up, but I was just sitting there in the dark, waiting.”
For fifteen minutes, they just lay there in the pitch dark.
Miraculously, Heiser did get up.
At that moment, the clouds broke, revealing the full moon which would light their way to safe, warm shelter. Without that moon, Smith shudders to think what would have happened.
On To Better Days
Did this scare Smith away from climbing? It talked him out of Mount Everest, but his spirit is far from dimmed. As terrifying as it was, this incident has not scared him away from climbing. Rather, it has affirmed his love of safe, reasonable climbing.
“Instead of spending two months doing Everest, I think I’d rather go do some different stuff.”
That stuff will be another continent’s highest peak, Mount Kosciusko of Australia. Actually, nearby Carstens Pyramid in New Guinea is much higher, just not on the mainland, so there is some debate. Smith and his friends plan to avoid the dispute and climb both. After these two will come North America’s Mount McKinley, closer to home but no less challenging. From there, who knows where his list will take him.
Day To Day
Even in the periods of time between peaks, Mr. Smith’s life is far from boring. He continues to practice law and works as a guide in ice fields near his current home, Juneau, Alaska. He also stays fit by running.
Obviously, to survive these climbs, his diabetes control must be good. Besides exercise, he tests frequently, injecting Humalog according to a base rate and a carbohydrate count at every meal.
“I never cheat,” Smith insists. “I was fortunate in getting diabetes at a young age, when I didn’t have any habits. Mine all became diabetic habits because that was all I knew.”
Is beating diabetes on his list?
“I don’t feel a reason to beat it. With just keeping control of it, look what I can do. I’m standing on top of one of the highest mountains in the world, and folks who aren’t diabetic have a hard time getting there, so there’s no reason to beat it. You just control it.”