Feeling Headless: A Case of Active Suicidal Ideation at 4300 Meters

At the Himalayan Rescue Association's Pheriche Aid Post, located at 4300 m (14,100 ft) along the Everest Base Camp trek in Nepal, a 40-year-old Nepali female with a past history of unspecified psychiatric illness presented with her husband, reporting suicidal ideation with a specific plan. She also described one day of headache, bilateral hand numbness, and a resolved episode of dizziness. On examination, her vital signs were stable, and she appeared calm, cooperative, and without focal neurological findings. Given the limited local resources, she was discharged under the supervision of her husband and referred to Kathmandu on horseback for definitive psychiatric care.