Walking Well: Heat

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Beware of heat! J. Philip Crowe, 58, of Wilmington, Delaware, died on the AT on Wawayanda Mountain in New Jersey during a 16-mile hike on July 15, 1995. The temperature was 103 degrees F with high humidity (nearly 100 percent relative humidity), the hottest day of the year in that area.

He and his companion, Tom Tandy, were experienced section hikers, each having done about 500 miles on the AT. They set out from Wilmington at 4 a.m. and started on the trail at 8 a.m. from NY 17A (north of Greenwood Lake) heading south toward NJ 94 at Vernon. They had planned to complete the hike in less than six hours by 2 p.m., before peak daytime temperature. However, the rocks on top of the ridge were slippery from the humidity and rougher than they expected from the profile and the hikers were exposed to direct and reflected sunlight for many hours.

Tandy and Crowe each carried three quarts of water and one quart of Gatorade. They both drank a considerable amount of water at a number of breaks. Crowe (6'3", 230 pounds) considered himself a power hiker but had been on a cruise a week or two previously and was not in optimal hiking shape.

Tandy usually walked in front of Crowe up hills, and, around 2 p.m. noted that Crowe's skin was red and hot and that he began to lag behind. He suggested a rest and water break. They went on and the same thing recurred, only more severely. Crowe lagged considerably, and by 2:30 p.m., he was breathing heavily and almost fell twice. Another 15-minute break yielded a slower start. Tandy was concerned about Crowe's condition at each of these periods and urged food and drink along with rest. At this time they were a little over a mile from their car. Crowe had finished his Gatorade and still had some water left by the time they had gone 14 miles and reached Wawayanda Mountain.

After passing the crest of the mountain Crowe remarked, "I'll be all right when we get back to the cabin." Tandy reminded him that they were going to their car, not a cabin and Crowe agreed. As they started down Crowe was swaying and said, "It would be easier if we stayed on the trail." Tandy pointed to a blaze immediately next to Crowe.

"Are you all right?"

"I don't know."

"Would it help if I got you a stick?"

Tandy cut Crowe a five-foot stick. Crowe was very pale and sitting on a rock. When he stood up he was disoriented, uncoordinated, and he swayed and almost fell. Tandy insisted that he sit down and rest. Realizing that the situation was serious he decided to hurry down the mountain alone to get medical help.

In about ten minutes he met two hikers who volunteered to help and arrived in about 15 minutes to find Crowe with no respiration or pulse. They administered CPR for about 15 minutes with no effect. Tandy continued down and recruited another group. Paramedic teams responded and with difficulty brought the dead patient down the very steep south slope of the mountain. When Tandy revisited the site later he noted crossed sticks on the ground, which he interpreted as indicating the spot where the body was found. This suggested that the patient had collapsed and fallen about 10 feet off the rock where he was last seen alive.

Autopsy revealed cardiac enlargement and evidence of chronic myocardial damage from an earlier silent heart attack. The pathologist thought that heat exhaustion combined with the earlier heart damage to cause death. He suggested that the episode was an extreme stress test that drove a previously injured heart beyond its functional limit. The paramedics who talked with Tandy indicated that he had done the right thing in seeking help and that the severe condition of Crowe could probably only have been treated by ice packs (of course unavailable on the mountain). Even this treatment might have failed.