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Praise for Last Breath:

"Un-put-downable," says Ian Frazier, author of On The Rez. Ira Byock, who himself explores all things morbid in his book Dying Well, has this to say: "Death comes to us all. Last Breath introduces us to the people who tempt fate and experience their final expiration. We witness their intimate encounters with death from multiple angles. Stark's craft as a storyteller blends physiology, ecology, physics, psychology, and metaphysics into a compelling read. Last Breath is a page-turner!"


The Washington Post
October 21, 2001

Physical challenge and exploration of remote corners of the universe have been human passions throughout history, but in recent decades easy access to transportation and information, sophisticated sporting gear and a culture of physical fitness have propelled vast numbers of people into outdoor activities in far-flung locations. Cellular phones, Goretex and Polypro lull casual adventurers into thinking that help is but a phone call and short, warm wait away. And more and more of us who live in cities and work at deskbound jobs tend to seek out what remains of the world's wild places.

These are among the elements that set the stage for Last Breath, a curious mix of fact and fiction that examines what happens when the human body goes beyond the brink of survival. In a series of set pieces, Peter Stark -- an outdoor sports and travel writer for Outside magazine and himself a backcountry adventurer -- illustrates how the body responds to extreme heat or cold, altitude or depth, drowning, burial by avalanche, a fall from great height, malaria, jellyfish toxin and scurvy. The medical details are scrupulously accurate. The stories created to display these facts are fictional or loosely based on events as they might have occurred.

Last Breath does not attempt to provide practical first aid or preventative advice. It describes scenarios in which generally well-prepared individuals (or those who thought they were) ignored obvious warning signs, or slipped into danger when unforeseen conditions or accident conspired against them. The intention, as the subtitle says, is cautionary. Only a narrow range of conditions is conducive to human life. Under certain circumstances, activities such as mountain climbing, scuba diving, snowboarding, desert trekking and mountain bike racing can push the body into a condition from which recovery is difficult or impossible. The point of Last Breath is not to say "Don't go" or "Don't do this" but to say "Be aware; these things can happen..."

The Missoula Independent
October 4, 2001

Nothing is as bound up in the human psyche as death, not even love. Sooner or later, everyone wakes up to the staggering realization that our bodies are only dirt on loan, wrapped into attractive packages by collagen and connective tissues cranked out by miniature manufacturing concerns inherited from our parents. We grow, we branch out, we merge to form subsidiaries, the moving parts wear out and eventually the bank forecloses-all this barring any sudden instances of fire, flood or catastrophe...

Last Breath: Cautionary Tales from the Limits of Human Endurance isn't so much about death as it is about dying. It comprises eleven chapters of individuals overstepping, as the subtitle would imply, the various environmental and physiological lines in the sand -- caloric, barometric, atmospheric, thermal, altitudinal -- between which the human body can live and where it starts to die. Packed with scientific detail, historical anecdote, medical suspense and baited with a monster narrative hook, it reads from cover to cover like an enchanting, freely roaming malarial dream.

Author Stark generally introduces each of these eleven ways to die with what seems on the face of it like almost horror-movie simplicity: by establishing fictional characters with varying degrees of sympathy and attachment to the reader, and then having them stumble into the inexorable pull of physics and physiology through their own hubris, determination or poor judgment. Or simply by accident. He accomplishes this by employing a nicely heterogeneous mix of tenses and persons; in the closing chapter on dehydration, the person is a squarely second-person you who's running out of water and stumbling around the sun-blistered ergs of the Sahara.

In many case -- dehydration and hyperthermia, for example -- there's plenty of room for these factors to collude and conspire toward a death from multiple injuries, ruptures, leaks and failures. In their most discrete stretches, however, all these faces of death, as it were, assume a kind of purity of form that's strangely peaceful even as the narrative plunges us into holes under river boulders, stuffs us into claustrophobic snow caves in the Himalayas, and drags us bouncing over exposed rock faces.

Within each chapter, Stark also strikes a sublime balance between narrative and character development and an incredible wealth of medical and scientific data, historical background and metaphysics. In Reader's Digest terms, it's "I Am Joe's Body" times "Drama in Real Life," with much more picturesque speech...

To get the most out of a book as viscerally engaging as Last Breath, it probably pays to be susceptible to a certain degree of altitude sickness or hypoxia of the mind while reading -- to be a traveler from temperate regions in an equatorial ferment of yaws and flukes and schistosomes. It makes you graphically aware of everything that can go wrong; it makes you reconsider your own breathing. Having finished about half of the book, I came home to the smell of cooking chiles rellenos and, in that pleasantly acrid cloud of Anaheim fumes, I imagined knots of capsicum molecules like garden rakes scraping at the receptors that ring this message to the brain and back: "Brother, let's eat."
October 26, 2001

What I loved about the book is that you do not need to be a doctor, a scientist, or a forensic specialist to understand Stark's writing. It is very appealing to the average layperson. There is a superb blend of science, personal anecdote, cautionary advice, and even cure possibilities woven into each story: If he gets a drink right now, he can live. And not every victim dies. As the book progressed I found myself trying to figure out early on who would make it -- and who would not.

I read this book in an afternoon while I was at the beach, and by the end of the day I was beginning to feel like a hypochondriac. As I lay in the sun reading, was I suffering from hyperthermia as the sweat poured from my body onto the concrete around the pool? As I rode my bike and got cottonmouth I wondered if this was the beginning of the second of the six stages of thirst.

My children asked for lunch as I finished the chapter on scurvy. I quickly cut up a peach for each of them. (They found it amusing that I told them we could have lunch after I finished reading about scurvy and we could bike after I finished dehydration.)

If you already have enjoyed The Perfect Storm, The Hungry Ocean, and Into Thin Air, this book is the perfect next read. You will never complete any physical task quite the same way again.

The Seattle Times
October 17, 2001

This grim and uneven -- but morbidly fascinating -- volume examines in intimate detail what happens to the human body when its physical limits are pushed beyond the breaking point. Through 11 fictional "scenarios," magazine writer Peter Stark depicts lethal or near-lethal encounters with pulmonary edema, hyperthermia, avalanche, drowning, malaria, scurvy, dehydration and other dangers encountered by adventurers in remote locales and extreme situations.

The collection's strength is in Stark's graphic and often expressive accounts of the physiological processes associated with the body's breakdown under extremes -- one's blood "thickening like crankcase oil in a cold engine" during hypothermia, how malaria parasites invade a host's red blood cells to "feast on a groaning banquet of cytoplasm and hemoglobin."

Also compelling are Stark's digressions into natural history (such as the life cycle of the box jellyfish, "perhaps the most venomous creature to humans on the face of the earth").

Generally less effective are Stark's "composite" characters and contrived fictional scenes -- understandable, perhaps, that this journalist's facts would be more compelling than his fiction.

But the two best chapters approach the level of good short stories. "As Freezing Persons Recollect the Snow," about a man out alone in subzero weather, begins on an ominous note: "When your Jeep spins lazily off the mountain road and slams backward into a snowbank, you don't worry immediately about the cold."

The story then moves inexorably -- with engrossing technical digressions about the process of freezing to death -- to its conclusion. "In a Land Beyond the Shade," the final chapter, melds history, physiology and Sufi mysticism with a tale of a magazine writer dying of thirst in the Sahara.

Last Breath is probably not the thing to read while tent-bound in a storm on Mount Everest; but safe at home in a warm and comfortable armchair, it's an absorbing (although macabre) excursion.

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