The risk of altitude illness on the PCT, in memory of Maddie

The PCT is above 13,000 feet only at Forester Pass for about a half-mile. It’s above 12,000 feet at Forester, Mather, and Pinchot passes in the High Sierra, accounting for about 4.3 miles of PCT. The trail is above 8,000 feet for 435 miles. Research from Colorado shows that 25% of visitors sleeping at elevations above 8,000 feet are affected by acute mountain sickness.

We write to raise awareness about the risk of altitude illness on the PCT. We write in memory of Maddie Magee, a thru-hiker who died of high-altitude pulmonary edema on Forester Pass in 2022.

Altitude illness is divided into 3 syndromes: acute mountain sickness (AMS), high-altitude cerebral edema (HACE), and high-altitude pulmonary edema (HAPE).

The risk is real, and you’ll be smart to manage it. Take a wilderness first aid class. Learn the signs, symptoms, treatment, and prevention of altitude illness.

Maddie’s tragedy on Forester Pass

Maddie “Riddles” Magee loved to dance and had an infectious love for friends and family. She graduated with a bachelor’s degree in Mechanical Engineering and Applied Mechanics and a master’s degree in Bioengineering in 2021 and worked for the Philadelphia Phillies developing the next generation of baseball players by analyzing biomechanics data. She thrived walking the southern PCT. She made quick friends, sharing riddles and puzzles while they walked. Her family came to visit for Cinco De Mayo.

Normally a strong hiker, the signs of trouble seem to have started while climbing Mount Whitney. On top, her friends heard there was a woman struggling with the ascent. By the time she summited, her lips were blue, she was quiet, didn’t have an appetite and was not recovering well.

Hikers are often a stoic bunch. We can hide our symptoms, wanting to keep up. Her friends say that Maddie wouldn’t have wanted to be a burden.

About fourteen miles into the next day, on the final climb to Forester Pass, she collapsed. Friends ran to her and found her with no pulse and unresponsive. CPR started. Emergency services were called. By happenstance, fellow hikers included a former-EMT, a retired doctor and a former police officer. Despite heroic efforts, those who responded were unable to save Maddie’s life. The universe shattered for her friends and family and her death affected the entire PCT Class of 2022.

Maddie did not exhibit symptoms such as vomiting or severe dizziness. Some people have a genetic likeliness of suffering HAPE or HACE. Altitude can be a silent killer with mysterious risk.

In her memory, take the risk of high altitude seriously.

Altitude illness education

Reading a few paragraphs online isn’t enough. Prepare diligently before any wilderness adventure. Take a wilderness first aid class. Still, the Center for Disease Control and Prevention’s Yellow Book for travelers is a good place to start.

High elevations bring the risk of hypoxia due to the decreased partial pressure of oxygen. There’s less oxygen in your blood up high.

How susceptible you are to altitude illness is at least in part genetically determined. Being physically fit doesn’t affect risk.

Prevention: acclimatization

Gaining elevation slowly and strategically is one of your best lines of defense. Ascend slowly, and sleep at lower elevations. Avoid going “too high too fast.”

The goal isn’t necessarily to avoid all symptoms of mild altitude illness, but you should be sure to avoid the more serious symptoms.

CDC’s three rules for preventing severe altitude illness or death

Travelers can adhere to 3 rules to help prevent death or serious consequences from altitude illness:

• Know the early symptoms of altitude illness and be willing to acknowledge when symptoms are present.
• Never ascend to sleep at a higher elevation when experiencing symptoms of altitude illness, no matter how minor the symptoms seem.
• Descend if the symptoms become worse while resting at the same elevation.

Please read the CDC’s Yellow Book to learn more about altitude illness.

Learn more about Maddie Magee

Maddie’s hiking partner, Chris Rigas, has published a book about his hike and Maddie. Titled “The Next Step”, all proceeds are being donated to the Pacific Crest Trail Association.

In her memory, the Madison ‘Maddie’ Magee Award for Undergraduate Excellence was created at the University of Pennsylvania. Recipients will be Penn Engineering seniors who “exemplify the energy, enthusiasm, and excellence that was Maddie.”