Attitudes on Altitude: Pioneers of Medical Research in Colorado's High Mountains (review)

In describing scientific achievements spanning the fifty years from 1910 to 1960, Jack Reeves and Bob Grover have taken a wonderful approach to the history of altitude science in the Colorado Rockies: presenting the stories through the words of those who were responsible (or, in the case of those already departed, via the words of their relatives or coworkers). This is unusual in this field, where data and their interpretation are what count most. It has brought a value, an intimacy, and an insight that are hard to achieve when past events are traditionally described from the distantly written word. Within this seven-chapter effort, one senses much more of this in the final chapter than in earlier chapters relying on the words of relatives and coworkers—because the principals, Charles Houston (the doctor) and Alex Drummond (the patient), are still here to tell the tale themselves. The chapter leads us through Houston's efforts to understand the malady (to become known as high altitude pulmonary edema) that befell Alex Drummond high in the Rockies on New Year's Eve in 1958. Houston gives a whimsical account of his becoming involved. One then gets the insight into Houston's "attitude"—he puzzled over this case for months. He obtained medical consultations from several luminaries, finally published his findings in 1960, and appears in the text photographed with his arm around Drummond's shoulders thirty-five years later.

The book's title may suggest a confrontation among the early pioneers, but that is really not the way in which the term "attitudes" has been used. Rather, it signals the editors' intent to uncover the thought processes that led the early workers to come to Colorado, and the ways in which they worked through and solved the scientific and practical problems they faced. Both scientific instruments and living arrangements were far less well developed than today, demanding unusual creativity that Reeves and Grover present well. While each chapter details a different story with a different cast of players, one message seems to come from them all: So much in science happens by chance, followed by perseverance and logic when something "established" just does not feel right. This is clearly the case with Houston's account of Drummond's illness. This book will give the nonscientist and scientist alike much insight into how people make discoveries.

There is a carefully engineered similarity in the structure of each chapter, which, despite large differences in subject matter, makes the book comfortable to read. However, the text is a bit dense; it is certainly not consumable in a single setting if the luxurious but interesting details are to be absorbed. More challenging is trying to understand to whom the book is addressed: there is a curious admixture of lay terminology and science, especially in some of the charts, that defies a clear image of the target audience and may lightly trouble both lay and scientific readers alike. However, the key scientific references are provided to allow more detailed follow-up for those interested. These are minor irritations that do not diminish the book's value. The only criticism of substance is the glaring absence of a chapter by Reeves and Grover detailing their own contributions to altitude research in Colorado! We who know them recognize their major accomplishments—reflecting efforts that go back many decades and that link closely to many of the topics covered in the book. Maybe they do not yet wish to think of themselves as history, or maybe they were just too modest.