RS: On April 25, everything changed. We were having a conversation in our living room in the clinic. All of a sudden, everything started shaking. To be honest, an earthquake didn’t cross my mind for the first five to 10 seconds because we were supposed to start construction on the clinic. Once we realized what was happening, we ran outside. Inevitably, every building except for two within the village of Pheriche was affected. When we ran outside, people were screaming; you could hear buildings collapsing and see dust clouds. We did quick surveys to see if anyone was injured. Thankfully, this happened during the day because the casualty rate would have been much higher if it happened at night. Unfortunately, there was a lot of uncertainty because we had limited communication. Even the satellite phone wasn’t working.

Critical patients evacuated from Mount Everest base camp in the Himalayan Rescue Association sunroom in Pheriche.

Nepal’s last major earthquake was about 80 years ago, and every 80 years or so, Nepal tends to have a large earthquake. It was due.

KK: If you’re planning on taking a trip internationally to hike or mountain climb, probably one of the safest places for the next 80 years is going to be Nepal. It finally hits you that this is an earthquake. What was your first emotion?

RS: My first feeling was concern about whether there was anyone who needed medical care because that’s part of my expertise.

KK: The uncertainty—tell me about that.

RS: Our concern immediately went to the Himalayan Rescue Association team up at Everest Base Camp. We had a radio system between our two medical posts, but we found out later that the radio had been blown by the avalanche wave into the Khumbu ice field. One of the physicians at the Everest emergency department, Rachel Tullet, an emergency physician in New Zealand, estimated it was probably about 200 miles per hour.

KK: When did you have the realization of, “Wait a minute, we are going to be receiving all kinds of patients with varying degrees of injury and trauma”?

RS: The earthquake occurred around noon, and at 8:30 or 9 p.m. we saw three headlights coming down the valley from the Everest Base Camp region. We got the first two patients. One was evacuated out on a horse and the second one by foot, and then there was a third one who was uninjured, who was leading the other two. One of them we were concerned probably had potential internal solid organ injuries as well as a pneumothorax and some fractured ribs. He was admitted overnight in our clinic. The other one we were able to treat and discharge. We were woken up at 5:30 in the morning hearing helicopter traffic heading up the valley. The first helicopter pilot said, “Here’s four patients. I have about 60 more that I’m bringing you.” There were three physicians at the post, two clinic managers who were Nepali, and a cook. We ended up getting 73 patients in total.