Back on My Feet

Wednesday March 23, 2011

8:32AM

This morning has started far better than most of the previous days. Health-wise, things seem to be functioning normally, which is uplifting from both a physical and emotional standpoint. Now it’s time to get out and explore the country a little more before the thick of the trekking season arrives and the clinic gets really busy. 

Yesterday, I got up early and made for the top of the ridge between Dengboche and Pheriche. On the way up I felt reasonably good and found myself approaching the summit after only about 2 hours of climbing. A little acclimatization must have occurred since my last jaunt up the hill, because I didn’t lose the rhythm of climbing and breathing at 16,000 ft as I did the other day. Instead, I maintained the 2 steps for each breath beyond my previous high-point. It occurred to me that my normal breathing rate while maintaining a good running pace at home is 4 steps per breath. The ratio has been gradually declining as we have gone higher, and at some point in the near future, I suspect will actually invert so that there are more breaths than steps. 

As I approached the boulder strewn summit, I anticipated a fantastic view down into the Kong Ma La pass below but instead was greeted by yet more ground to cover. Where I was standing was a false summit at ~16,700ft. The apex of the ridge I was ascending tapered down to a rock path about 3 feet wide that lead around a vertical walled cirque toward the summit of Pokalde. I briefly contemplated going onward, as my goal had been to reach the top, but seeing the thousand foot vertical drop on either side of the off-camber “sidewalk” quickly changed my mind. Had I actually spent some time looking at my topographic map I would have clearly seen the futility of my route choice.

Hiking back down, I passed ~40 people coming up the hill. Of course, they were all staying in Dengboche, but nonetheless I did some advertising for the HRA and our daily altitude illness lecture. Unfortunately, the most recent edition of the Lonely Planet Guide to Trekking in Nepal describes Pheriche as “a cold, windy, inhospitable place”, and apparently this is diverting many groups to the other side of the hill. My hope is that as more groups pass through either the lodges in Dengboche will fill up forcing people to come here or as the weather warms up people may ignore the guidebooks recommendation. I say I hope, because I passed more people on my hike yesterday than I have seen in Pheriche all week. Govi and the lodge owners don’t seem very concerned, so I’ll defer to experience. 

When I arrived back at the aid post one of “my” patients was waiting for me. I say she is mine because I don’t think anyone else wants to deal with her injury. She’s a 15 yo local who burned her right index and middle finger in a stove fire 3 days ago. She waited 24 hours to come see us and by that time the skin was bubbling and peeling. I was able to remove much of the damaged skin and fortunately found good tissue underneath indicating an injury that will likely heal with significant time and care. (For the medical folks - 2nd degree partial thickness). Now we’re on a schedule where she comes back every 48 hours for a dressing change and usually removal of a little more dead skin. I think the thick calluses on her hands saved the underlying tissue. This will be labor intensive on my part in a clinic with few supplies so it’s no wonder the others don’t seem too interested in dealing with it. The most difficult part of it all is getting her to stop working and to keep the dressings clean. These people are tough to say the least and not much short of death prevents them from attending to their daily labors. Deep inside I wish there was somewhere else to send her, maybe the tertiary burn center, since dealing with the long term care of significant burns isn’t really at the top of my skill set. The problem is that I am the burn center here, so I should probably look at my discomfort as a good motivator to learn.

Today Lauren and Alun are heading out to hike to Mocherma and around the Cho La Pass. It will take about three or four days and is supposed to be an excellent route with fantastic views of the high mountains. We have a group similar to our own working for the International Porter Protection Group in Mocherma, so we’ll be paying them a visit soon. After my colleagues return I’ll be setting off to do the same route and should get back just in time for the “Everest ER” team to arrive in Pheriche. I hear we throw down for a couple of nights with them before they proceed up-valley, but I can’t imagine getting too rowdy up here. 

Finally, my daily observation of Ang Rita: He appears to enjoy the bluegrass mixes I play on the computer while blogging or typing emails. He seems to particularly enjoy Dolly Parton which has him dancing around the kitchen, humming the tune 4 seconds behind the actual song all while eating soup from the pot in which he cooked it.