"IF YOU LIVE IN SEATTLE," writes Litsa Dremousis in her new book, Altitude Sickness, "you either know a climber or are a climber." Out now on Portland's Future Tense Books' brand-new ebook imprint, Instant Future, Altitude Sickness contains multitudes in roughly 10,000 words: references to Courtney Love, the politics of climbing Mount Everest, the particular sadness of seeing your dead best friend's favorite candy, and a list of every friend-of-a-friend Dremousis can name "off the top of my head" who has died climbing. There are falls and broken ropes, loose rocks and bodies never found. But the most devastating loss for Dremousis was the disappearance of her best friend and sometimes lover, Neal, who "fell 1,000 feet when the rock beneath him gave way" on Mount Rainier.

If you live in Seattle, or Portland, or anywhere mountain-adjacent in the Pacific Northwest, you probably at least know of someone who has died in a climbing accident. Dremousis wants to know how that became normal. So while Altitude Sickness is an elegy for her friend, it's also much more. Throughout, she interrogates the distinctly Pacific Northwest obsession with scaling peaks. She seeks to catalog exactly what is lost in the process, even when climbers make it home: Even occasional climbers, she reports, experience subtle yet irreparable damage that "impairs the brain in important ways."

Altitude Sickness traces our regional obsession to a singular personality type, associated with rock climbers and drug addicts, here called "sensation seekers." Sensation seekers, reports Dremousis, paraphrasing psychology professor and director of the Center for Drug Abuse Research Translation Michael Bardo, are "more likely to partake in high-risk activities," and their "brain function reinforces risky behavior." You probably know a sensation seeker. Maybe you are one. Here, then, is Dremousis' portrait of loving one: Again and again, she watches her friend seek out new and more terrifying adventures, and again and again she worries that he's going to die.

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Kevin Sampsell, editor and publisher of Future Tense, says the new ebook imprint will have a similar aesthetic to Future Tense's printed books, but adds, "I think we might take more chances with Instant Future"—and Altitude Sickness does feel slightly risky. At its best, it's associative and freewheeling, with Dremousis hooking her personal narrative onto a macro level. In one particularly incisive section, Dremousis discusses the usefulness—or lack thereof—of trigger warnings in online articles. "I find the persistent online debate surrounding 'trigger warnings' grimly bemusing," she writes. "What do you do when your entire city is a trigger? One of the first things visitors to Seattle say is, 'You can see the mountains from everywhere here! It's beautiful!'"

Dremousis' pragmatic, far-reaching, surprising approach to highly personal territory elevates Altitude Sickness from a straightforward account of loss to an honest examination of the desire for danger, catalyzed by proximity to an awe-inspiring natural environment. That quote about Mount Rainier as an emotional trigger? There's more to it: "It is beautiful. Or it was," she writes, before subverting all expectations to add, "I guess it's beautiful again."