When Vail Health internist Tracee Metcalfe summited Mt. Everest in May 2016, she didn’t pause long to savor the view. Instead, with her oxygen mask only partially working and fatigue setting in, she took one good look, then turned around and started to descend—for her own sake and her team’s. “When I’m climbing, I don’t want to be so tired I can’t be a doctor,” Metcalfe says. That medic-first mentality explains why Metcalfe has spent five seasons as an expedition doctor in the Himalayas, most recently as the mountain medic for expedition outfitter Himalayan Experience, led by legendary guide Russell Brice. As Everest summit season reaches its peak this month, we talked with Metcalfe about what it takes to practice medicine above 20,000 feet.

Name: Tracee Metcalfe
Age: 44
Occupation: Internist at Vail Health and Himalayan expedition doctor

5280: When did your career as a doctor merge with your passion for climbing?
Tracee Metcalfe: I’d been hiking fourteeners in Colorado for a few years, but in 2012 I took a monthlong trip to Denali, volunteering with the National Park Service as a climbing ranger/doctor. I did that for two summers and I really liked it, so I started looking into mountain medicine. In 2013, a good friend of mine put me in touch with Russell Brice, who hired me.

What makes you a good fit for a team like Brice’s?
Internal medicine is actually really good preparation for the kinds of issues we see while climbing. I see chest pain all the time. I know the top 20 causes of it and whether I need to be scared or not. I’d say 70 percent of the problems I see—like coughs, acute mountain sickness, and high-altitude pulmonary edema—are more suited to internal medicine as opposed to trauma or other types of medicine.

How does your job at Vail Health prepare you to treat mountain medical issues?
Vail’s at 8,000 feet, and we see high-altitude illness frequently here, so I feel really comfortable managing it. Working here also allows me to brush up on skills more suited to the emergency room, like suturing and starting IVs. It’s also taught me how to triage things better and understand how hard it can be to evacuate someone. A lot of times, we can’t fly someone down to Denver because the weather in Vail just won’t cooperate.

Have you ever had to evacuate someone during an expedition?
I have. When I was on Everest, at Camp 2 [around 21,000 feet], I evacuated a person with high-altitude pulmonary edema. On Denali and Everest, I’ve also treated people with butt boils [perirectal abscesses]—basically infected pimples where the backpack rubs, at the top of your butt crease. It can actually be really serious, because you need to open it up and administer antibiotics. I had to have someone evacuated once because it was so severe.

Any plans to return to the Himalayas?
Definitely. This fall, I’m hoping to work as the expedition doctor on a trip to Cho Oyu, which is a less technical 8,000-meter peak on the Nepal-China border. But I’ve also slowly been trying to climb all the peaks in Colorado’s Gore Range. I think after being away so much, you realize how satisfying it is to live in Colorado and have the Gore Range right here.