SAN FRANCISCO -- As Alison Levine watched climbers head back down Mount Everest when the weather turned, she contemplated the possibility that she might again come up just short of reaching the world's highest point.
She thought back to 2002, when she captained the first American women's Everest expedition and made it within 200 feet of the summit before deteriorating conditions forced her to descend. Now, eight years later, she was facing the same decision: risk a push for the top or turn around and see all the hard work and painstaking preparations go for naught. She forged ahead.
By doing so, the 44-year-old Levine became the first American woman to complete the "Adventure Grand Slam," which entails reaching the highest peak on every continent and skiing to both the North and South poles. It's estimated fewer than 30 people have accomplished the feat.
"It looked like it was going to be a good day," Levine said. "(But) by 10:30 p.m., there was a foot of snow and high winds for our summit push. We just kept going."
All this despite being born with a life-threatening heart defect that kept her from even going up stairs. Diagnosed at age 17, she had two cardiac procedures to correct the problem and only began climbing when she was 32.
Bad weather and all, she pushed on in the wee hours of May 24, carefully placing every single step she took to avoid an accident.
"We actually didn't know if we were going to be able to do it, weren't sure if we'd be able to continue, but we were absolutely going to put our heads down and keep climbing into the wind and blowing snow until we absolutely couldn't keep going," she recalled. "As we continued to push, getting pelted in the face with ice and snow, we realized that, yes, it was (bad), but we just kept putting one foot in front of the other until we eventually got there."
Levine is well aware of the dangers of high-altitude mountaineering, taking the approach that the summit is only the halfway point and that she must save enough energy to get back down.
"For me the goal always has to be coming back down alive," she said. "The way down is when most deaths on Mount Everest occur. It's about using good judgment."
At 5-foot-4 and just more than 100 pounds, Levine regularly lugs backpacks equal to half her body weight during the two-month trips. She trains on Mount Shasta or at San Francisco's Ocean Beach, where she drags up to three tires behind her through the sand for several hours to prepare for a grueling polar expedition.
Levine has learned by trial and error along the way.
"A lot of it is learning from failure," she said, noting she knows exactly what to bring and what to leave behind.
Any problem, minor or major, can mean the end of an expedition. She has turned around because she just didn't eat enough.
Levine often loses more than 10 pounds during an expedition. Over the years, she has learned to take a break every half-hour to consume 200 calories -- forcing herself, even when she doesn't feel hungry. In addition, when she's out Levine eats an entire stick of butter each day, spooning it right into her mouth or dropping some into her hot cocoa.
Another key is always having duct tape.
In fact, she has pink duct tape wrapped around one ice ax. That way all she has to do is tear off a piece when she needs it. The tape once came in handy to repair a boot liner.
"Duct tape is the miracle item," she said.
Levine has to be prepared for anything to go wrong: from an oxygen tank malfunction to her tent being destroyed by wind or dropping a piece of equipment that can't be retrieved. Any of those things can end a climb. That's why she's careful about picking her team, making sure she has levelheaded partners when she's in the most extreme conditions.
"You think you know people well at sea level," she said, "but altitude brings out the best and worst in people."
She completed her latest Everest trek in memory of good friend and fellow athlete Meg Berte Owen, who died last October at age 37 from a lung infection and complications of the H1N1 flu. Levine engraved Owen's name on her ice ax and planted it at the summit.
"Fewer than 300 people have succeeded in climbing to the summit of the highest peak of every continent. Very few of those people have also reached the two poles, completing the Adventure Grand Slam," said Harry Kikstra, director of 7summits.com. "Alison's achievement is even more impressive since she not only skied the last degree to the North Pole, but also skied the entire 600-mile Messner Route to the South Pole, becoming the first American to do so."
Levine is an adjunct instructor in the Department of Behavioral Science and Leadership at the U.S. Military Academy at West Point, teaching cadets about making life-and-death decisions in extreme environments.
She also serves as a keynote speaker at about 100 conferences a year across the country through her company, Daredevil Strategies. That means she typically sleeps in her San Francisco apartment about three days a month. She just returned from a nine-day climb in Peru and is enjoying a brief respite in her Marina neighborhood before attending a reunion of her Everest team in Idaho later this month.
"When I'm out on a two-month expedition, it's more continuity than I have in my life," Levine said.
She recently rented a storage unit for her gear, though one closet in her home is packed with everything from ice axes to a down bodysuit and a 40-below sleeping bag. Those training tires are in the back of her car.
It was in 1998 at the start of graduate school at Duke that Levine's adventures began. She was on six-week terms with nine days off in between and had frequent-flier miles from 11 years working in the pharmaceutical and medical device industry.
Two girlfriends canceled last minute on Levine two weeks before they were to climb Mount Kilimanjaro, but she went anyway and found a local guide to take her up the mountain.
"That sort of started the ball rolling," she said.
People ask her all the time what's next. She's not sure. Perhaps becoming the first person to ascend an unclimbed peak in Nepal.
"That would be my pick. I tend to plan things very last minute," she said. "I just keep thinking there's so much I want to fit into this lifetime. I won't have time for everything, but I want to take advantage of every opportunity I have to see every corner, every inch of the planet."