{"id":2962,"date":"2026-04-03T15:30:27","date_gmt":"2026-04-03T15:30:27","guid":{"rendered":"https:\/\/americanvoiceofhealth.com\/index.php\/2026\/04\/03\/no-way-to-go-but-up\/"},"modified":"2026-04-03T15:30:27","modified_gmt":"2026-04-03T15:30:27","slug":"no-way-to-go-but-up","status":"publish","type":"post","link":"https:\/\/americanvoiceofhealth.com\/index.php\/2026\/04\/03\/no-way-to-go-but-up\/","title":{"rendered":"\u2018No way to go but up\u2019"},"content":{"rendered":"
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\n\t\t\tHealth\t\t<\/a><\/p>\n

\n\t\t\u2018No way to go but up\u2019\t<\/h1>\n<\/p><\/div>\n
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\n\t\tSy Boles\t<\/p>\n

\n\t\t\tHarvard Staff Writer\t\t<\/p>\n<\/p><\/address>\n<\/p><\/div>\n

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\n\t\t\t6 min read\t\t<\/span>\n\t<\/div>\n

\n\t\t\tFrom the ER to the highest mountains, sometimes riskier route is right, says wilderness doctor\t\t<\/h2>\n<\/header>\n
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\t\t\t\t\t<\/a><\/p>\n<\/h2>\n

\n\t\t\t\tA series exploring how risk shapes our decisions.\n\t\t\t<\/p>\n<\/p><\/div>\n

N. Stuart Harris was 14,000 feet up Mount McKinley, and the conditions weren\u2019t looking good. His patient, a veteran who was hiking as part of a Wounded Warriors program, had entered his medical tent complaining of chest pains and shortness of breath. Was it an altitude-related illness? A pulmonary edema? Maybe a heart attack? <\/p>\n

\u201cThere was a limited amount of material \u2014 oxygen and diagnostic EKG and other things,\u201d said Harris, who at the time in 2011 was working for the National Park Service in Alaska. \u201cWe had just a little nylon cot that he was on, resting in a tent, with 8,000 feet of ice underneath us up on the glacier.\u201d <\/p>\n

The weather was too bad for a helicopter, so with evacuation off the table, Harris<\/a> \u2014 who is now the founder and chief of the Division of Wilderness Medicine at Massachusetts General Hospital and associate professor of emergency medicine at Harvard Medical School \u2014 did what he always strives to do: He told the truth. <\/p>\n

\u201cI told him, \u2018These are the things I\u2019m concerned about; these are the risks if we run out of medications, or if we run out of oxygen, or if we\u2019re not able to get you off the mountain in two or three days.\u2019 I would like to think that we, whether it\u2019s as physicians or patients, should be able to talk about risk in a little bit more of a realistic, humane way.\u201d<\/p>\n

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“I would like to think that we, whether it\u2019s as physicians or patients, should be able to talk about risk in a little bit more of a realistic, humane way.\u201d<\/p>\n<\/blockquote>\n<\/div>\n

The veteran eventually made it down to Anchorage and recovered, Harris said. It was likely high-altitude pulmonary edema, a life-threatening form of altitude sickness. But Harris doesn\u2019t know for sure. In his line of work, he has to be OK with not knowing sometimes. <\/p>\n

Risky decisions are a daily reality in the emergency room. A common example: whether to intubate. Putting a tube into someone\u2019s trachea is not risk-free, especially if there\u2019s been trauma to the area and blood and teeth are in the way. But if you wait too long, you lose your chance. Patients might be intoxicated or unresponsive; the details of their condition are unknown. Those urgent decisions are drilled into medical students\u2019 brains: Act fast, with whatever information you have. <\/p>\n

\u201cIt isn\u2019t like if something bad happened, it was inevitably a bad decision \u2014 no. Given the confines, maybe you did what needed to be done. Sometimes what might seem a little bit more risky is exactly the right choice because it overall reduces risk,\u201d Harris said. <\/p>\n

\u2018My fear level has really plummeted\u2019<\/h4>\n

Harris isn\u2019t one to shy away from risk in his personal or professional life. He remembers rock-climbing as a teen near where he grew up in the mountains of southern Virginia. \u201cI was well on my way up when I recognized, \u2018Yowza.\u2019 There was a sense, even in that adolescent male brain, which is pretty devoid of accurate risk assessment, that there was no way to go but up.\u201d <\/p>\n

He continued to embrace risky situations. He became a whitewater rafter. In college, he worked as a firefighter. He practiced emergency and wilderness medicine in the Himalayas, in Japan after the 2011 tsunami, and at the remote base camp on Mount McKinley. He has also served as board chair of the National Outdoor Leadership School and is the co-creator of the monthlong senior medical student course, Medicine in the Wild, with NOLS Wilderness Medicine. He founded the MGH SPEAR (SPace, Ecological, Arctic, and Resource-limited) MED Division, which provides expert medical care in extreme environments.<\/p>\n

Those experiences made him an evangelist for the idea that a little bit of risk can be good for you. It helps build resilience and comfort with failure, he said. Plus, it makes life more interesting.<\/p>\n

\u201cWe\u2019ve become so risk-averse in some aspects of our civilization and culture, and with our children, that I think we\u2019re creating tremendously larger risks and we\u2019re just not recognizing them,\u201d he said. <\/p>\n

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Harris flying to Denali in 2025.<\/p>\n

Photos courtesy of N. Stuart Harris<\/p>\n<\/figcaption><\/figure>\n<\/div>\n

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 <\/strong>The disaster response in Japan in 2011. <\/figcaption><\/figure>\n<\/div>\n<\/div>\n

It\u2019s not an argument for recklessness. Proper risk assessment, Harris said, is about balancing likelihood with downside. His metaphor, naturally, is of rock-climbing: An amateur climber bouldering indoors, 6 feet off the ground, with a mat underneath and a friend spotting, might have a high likelihood of falling but the downside risk is pretty low. On the other hand, a highly skilled athlete lead climbing in Yosemite might have a low risk of falling, but the downside could be permanent and fatal. <\/p>\n

What\u2019s the secret sauce, the personality trait that comes out when decisions need to be made? Acceptance. <\/p>\n

\u201cMy fear level has really plummeted,\u201d he said. \u201cPart of it is that I\u2019m just old enough. I\u2019ve seen enough patient presentations and human nature and other things. I have an idea of what I can control in those things I work very hard to alter for the better. But I also have seen enough to know that I\u2019m a wee little person, and even as good as I am, or not, I\u2019m not going to change some outcomes.\u201d <\/p>\n

It might sound like fatalism, but Harris situates his philosophy squarely in the camp of Stoicism: Focus on what can be controlled and be humble in the face of what can\u2019t. His favorite people are the ones who have gotten \u201ckicked in the teeth\u201d a few times. Asked if he ever feels frustrated with people who come into the ER because they\u2019ve done something risky and gotten hurt, he doesn\u2019t hesitate: Never. <\/p>\n

\u201cI\u2019ve done so many dumb things in my life, I just happened to get lucky,\u201d he said. \u201cYou can\u2019t be in this job and not realize that.\u201d He added, \u201cIt\u2019s not very interesting to hang out with people who haven\u2019t seen the ugly downsides and experienced them personally. It makes us who we are.\u201d<\/p>\n<\/div>\n\n","protected":false},"excerpt":{"rendered":"

Health \u2018No way to go but up\u2019 Sy Boles Harvard Staff Writer March 23, 2026 6 min read From the ER to the highest mountains, sometimes riskier route is right, says wilderness doctor A series exploring how risk shapes our decisions. N. Stuart Harris was 14,000 feet up Mount McKinley, and the conditions weren\u2019t looking …<\/p>\n","protected":false},"author":1,"featured_media":2963,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"loftocean_post_primary_category":0,"loftocean_post_format_gallery":"","loftocean_post_format_gallery_ids":"","loftocean_post_format_gallery_urls":"","loftocean_post_format_video_id":0,"loftocean_post_format_video_url":"","loftocean_post_format_video_type":"","loftocean_post_format_video":"","loftocean_post_format_audio_type":"","loftocean_post_format_audio_url":"","loftocean_post_format_audio_id":0,"loftocean_post_format_audio":"","loftocean-featured-post":"","loftocean-like-count":0,"loftocean-view-count":16,"tinysalt_single_post_intro_label":"","tinysalt_single_post_intro_description":"","tinysalt_hide_post_featured_image":"","tinysalt_post_featured_media_position":"","tinysalt_single_site_header_source":"","tinysalt_single_custom_site_header":"0","tinysalt_single_custom_sticky_site_header":"0","tinysalt_single_custom_sticky_site_header_style":"sticky-scroll-up","tinysalt_single_site_footer_source":"","tinysalt_single_custom_site_footer":"0","footnotes":""},"categories":[37],"tags":[],"class_list":["post-2962","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-staying-healthy"],"_links":{"self":[{"href":"https:\/\/americanvoiceofhealth.com\/index.php\/wp-json\/wp\/v2\/posts\/2962","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/americanvoiceofhealth.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/americanvoiceofhealth.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/americanvoiceofhealth.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/americanvoiceofhealth.com\/index.php\/wp-json\/wp\/v2\/comments?post=2962"}],"version-history":[{"count":0,"href":"https:\/\/americanvoiceofhealth.com\/index.php\/wp-json\/wp\/v2\/posts\/2962\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/americanvoiceofhealth.com\/index.php\/wp-json\/wp\/v2\/media\/2963"}],"wp:attachment":[{"href":"https:\/\/americanvoiceofhealth.com\/index.php\/wp-json\/wp\/v2\/media?parent=2962"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/americanvoiceofhealth.com\/index.php\/wp-json\/wp\/v2\/categories?post=2962"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/americanvoiceofhealth.com\/index.php\/wp-json\/wp\/v2\/tags?post=2962"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}