Back from Base Camp

This is a short post to let you all know that I'm back from base camp. 2 days just wasn't enough. I'll post more later when I have time, but now I have to unpack and then repack for Island Peak. I'm leaving for Chukkung this afternoon to meet the guide and my hope is that it is only the two of us climbing. We'll see.
When I get back I'll report on the climb as well as the sushi, Oreos, dark chocolate, and french toast to which I was treated at the bottom of Everest.

7 Days on the Road

Saturday April 23, 2011

6:33PM

After 7 days out and about, Ed and I got back this afternoon, and we had a great, but exhausting, time. 2 major mountain passes with some side hikes led up to a couple of well-needed rest days before coming back to Pheriche. The scenery was beautiful and traveling for a few days really made me realize why so many people fall in love with Nepal.

We started out with a relatively easy hike up to Zhungla, which entailed a gradual climb up to the valley below the Cho La Pass. The weather was sunny and windy, but by the time we arrived at our destination the clouds had rolled in, and by the next morning an inch of fresh snow covered the ground around our lodge as well as the surrounding hills. We both wondered how much had fallen at the higher elevations we were aiming to cross later in the day. As it turned out, the light snow was helpful. There was not enough to obscure the path and by leaving slightly later than other groups we were able to follow footsteps in the snow.

The trail gradually ascended a long valley up to what appeared from a distance to be a vertical rock wall. As we got closer to the steeper terrain ahead, we realized that there was a blocky trail that led up the rock face. After climbing a few thousand feet up the difficult trail we again found ourselves at the bottom of long valley, only this time one covered in snow. A short distance later the snow turned to ice, thankfully covered with a thin coating of snow which aided traction, and the valley became a glacier. To our right large crevasses and glacial tarns littered the landscape. Soon the horizon opened before us giving us wonderful views of the surrounding mountains, especially Ama Dablam and Cholatse among others.

It only took 3 hours or so to get to the top of the pass, but because of our late start we had to share the view with at least 25 of our closest friends. Ed and I shared a Mars bar I had saved for the occasion, took a few pictures and then made our way down the west side toward Thaknak. A short while later the clouds obscured the mountain tops making us realize that we had just barely made it in time to really see what makes the climb so worthwhile.

The remainder of the day was relatively uneventful, just the standard snow storm to make the last hour a little less pleasant. The thunder accompanying the snow, a rare phenomenon in the eastern US,  made things a little more interesting. In contrast to my last attempt to cross the glacier separating Gokyo and Thaknak, the way was straightforward and easy to follow. After the difficulties of last time, I kept waiting for the path to fall off into the lakes below or to suddenly end at a deep river crossing. Luckily, that didn’t occur and as we climbed over the final hill into Gokyo, I couldn’t help but feel a bit satisfied to have finally completed this route.

The Namaste Lodge in Gokyo is one of my favorites thus far in Nepal. The food is good, the dining room is warm and the sleeping areas are clean. It has also proven to be a nice place to whether a snow storm, which is what we did. 

The following day a few inches of snow had fallen and Ed and I decided to stay in Gokyo another night and do a hike in the area for the day. There is a string of 6 glacial lakes leading up to Gokyo and then onward to just below Cho Oyu. We left the banks of the third lake, on which the village lies and  aimed upward, as usual. The sun was shining and the winds calm all the way to the fifth lake. From there we had great views of Cho Oyu, Everest and many of the other smaller mountains in the range. We continued on to the final lake but by the time we arrived an icy breeze was blowing and the clouds had arrived. There was nothing to do but hunker down behind a rock, out of the wind, and enjoy a Twix and a Clif Bar. As per my usual arrival in Gokyo, we puts our heads down through the blowing snow that greeted us, thus making 4 entries into the village in a snow storm.

The day’s efforts hadn’t been overly difficult, but when added to the effort required to cross the pass on the previous day, we were starting to feel a little tired. When we set out across the Rhenjo La Pass the next day, our legs were not quite as energetic as they had been at the start of the journey. We plodded out of Gokyo for the final time and crossed the base of the Gokyo Ri which lies opposite the village on the banks of the third lake. Excellent weather was upon us and persisted for the entirety of the day, an experience that I believe I had not yet had in Nepal.

Maybe we had built up the Cho La’s potential difficulty in our head due the reports from other trekkers, but it didn’t really seem too bad. In comparison the Rhenjo La was, plain and simply, hard. The ascent was long, stair-stepping up steep sections which led to large glacial cirques ringed by mountains higher than those we had already crossed. The route finding was also more difficult and it wasn’t until we were a few feet from the last steep section that I saw where the path led and that it was possible without technical equipment.

The 3 hour slog was well worth the effort as the views were the best I have encountered in Nepal and, for a change, the weather cooperated long enough for us to take in the dramatic vista in the distance. I snapped a few pictures, took a rest and enjoyed one of the best Snickers bars I have ever had before we packed up and ventured down the western side of the pass. Of course, we expected to find similar difficult terrain down the opposite side but instead there was a beautiful staircase extending several thousand feet down the side of the mountain. Why one side was so rugged and the other so polished I have no idea. Maybe the king of the Nepal came to the area and found the terrain too difficult and so mandated that stairs be built? Regardless, it made the way down quite easy in comparison to the ascent.

Ed had talked with a guide in Gokyo who recommended that we stop our descent in either the village of Lungden or, if we were fast, Thame further down the valley. He went on to say that it just wasn’t possible to get all the way to Namche in one day after coming over the pass from Gokyo. That was, apparently, the wrong thing to say to Ed who was now bound and determined to make it all the down. The challenge intrigued me, but I have to admit I was even more motivated by the potential for chicken dahl-bat, warm weather and the two German bakeries in town.

Once we got down into the less steep terrain we turned up the pace significantly. Lungden, Maralung, some other village I can’t remember and then Thame came and went without even a short break. Once you’re down a few thousand feet it is much easier to maintain a good pace but the lack of food and water started to slow us down. Ed is part camel and only drank 1.5 liters for the whole day and I managed only 1 liter more. The difference was that he didn’t finish what he had and I ran out 3 hours before we arrived. We also only consumed a couple of bars and a snickers before arriving in Namche, so the lack of calories didn’t help us out either. The last hill leading up to the Panorama Lodge nearly broke us, but we made it. The dahl-bat was exceptionally delicious that night as was the popcorn, hot chocolate, lemon Tang, chocolate cake .....

After spending 10 hours in mountaineering boots the day before, neither of us was up for walking anywhere, and Namche is an excellent place to pass a leisurely day or two. We started the day with a very large breakfast at the lodge before establishing camp on a local coffee shop’s sun-drenched deck. That is where we spent the next 4 hours drinking cappuccino. Once the breeze picked up a little we made the long walk across the street to the bakery to have a salami, cheese, cole slaw and fried egg sandwich on homemade brown bread. It was the strangest sounding club sandwich I had ever seen but it was excellent. The remainder of the day was spent wandering the streets checking out the shops. Ed bought a pair of down pants to take to Denali in a couple of weeks and I tried to haggle with a shopkeeper over a grossly overpriced Camelbak. The shopkeeper tried to argue that the extra cost was due to the expense of a porter carrying the bag up to Namche but I feel quite certain that no porter has ever gotten paid $50 for carrying anything, much less a 2 pound backpack. Despite all the effort all I came away with was a few pieces of chocolate to take back to Pheriche.

The most interesting event of the day came in a small bar which housed the only pool table in town. We decided to treat ourselves to a beer which was a great idea. The bartender had a great musical selection on his Ipod which he plugged into the stereo and blasted. When I asked to hear Pink Floyd, he got really excited. As it turned out, he learned to speak English by listening to Pink Floyd, and knew much more about the band than I ever did. With good music and a pool table (not so good but useable), we definitely stayed for a second round but then went back to the lodge to gorge ourselves again.

Through the course of the evening I felt a cold coming on, so the next morning we used that as our excuse to lounge and eat for another day. I debated getting a haircut at “The World’s Highest Hair Salon” but better judgement steered me away. Day 2 was essentially a repeat of day 1, minus the beer and pool, and it was equally as good as the previous. The one downside was getting a sunburn on my ankles when I took my socks off. 

Today’s hike back to Pheriche was a little long but not too bad. After leaving the sun in Namche, I can’t say I was particularly excited to come over Pheriche Pass and walk down into the usual icy wind-tunnel that we call home. Whenever we ask Ang Rita about the weather his standard response since early March has been “It’s not usually this cold, I think warmer next week”. I don’t believe him anymore.

As for the remainder of my time here, I have been making a list of things I want to do before returning to Kathmandu. The first couple of things will be accomplished within the next week, but the others are going to be tough with only 28 days remaining. Tomorrow I’ll be staffing the clinic alone again while Alun and Lauren go for a hike. The following day I’m walking up to Lobuche before continuing on to Everest base camp to spend 3 days in the clinic there. Ed’s wife Jen is swapping with me so they can see each other before he departs for Denali. From base camp it’s back here for one day to do a bunch of laundry and then back up to Chukkung on the opposite side of the ridge. There I’m meeting a few people to climb Imja Tse (Island Peak but I prefer the local name) which should take 2-3 days. By that time there will be less than 3 weeks left here. The list of things to do in that remaining 3 weeks is long but I should be able to work something out with Alun and Lauren. 

At the top of the list is to leave Pheriche, cross the Cho La Pass to Gokyo and descend Gokyo valley before returning up through Phortse and Pangboche to Pheriche all within 24 hr. After crossing the pass this week, I think it is very doable, but will be a hard day. The second on the list is to do the Kongma La Pass and likely spend one night up there to climb Pokalde. Lastly I would like to climb up to the base of Tabuche and scope out some of the routes. I have not intention of climbing high but the mountain is beautiful and close by, so it seems a shame to not take a closer look. I suspect that if I can get one or two of those done in my remaining time it will be a success.

Lastly, a few days on the road has allowed me to do some good reading. The book total is up to 12. I never thought I would get into the Harry Potter series but the first four were here in the clinic and since I have run out of most everything else with the exception of the last book in the Twilight series (I saw the first two movies), it seemed like the next most viable option. I knocked those out and now don’t have the fifth book. I checked on Amazon and was amazed that Harry Potter is not available electronically. I guess I’ll have to wait until June to find out what happens next, unless I happen to find a trekker who has and is willing to trade for something else......Twilight. 

Happy New Year

Thursday April 14, 2011

4:38PM

Happy New Year! That’s right. It’s the Nepali New Year today. Why they have a different calender, I have no idea, and I can’t seem to find a Nepali that can explain it to me either. It doesn’t seem to be quite the festive holiday we celebrate back home. Regardless, Ed and I are going to celebrate over a bottle Nepal’s finest - Kukuri Rum. Before you get all excited that we’re about to get ripped you have to realize that a bottle of rum is all of 4 ounces, and at the local prices (and taste) you typically don’t go for a second serving.

After today, I think that a night out on the town is in order. Ed and I were supposed to set out for our two-mountain-pass journey yesterday, but the weather has been decidedly poor the past two days and we decided to wait for improvement. I’m actually glad that the clouds, snow and fog arrived before we departed, so that this time I might avoid multiple hours hiking in the blowing snow. 

Lauren, however, was not happy about our delay and continued to voice her opinion that we should just go. It became pretty apparent that she really wanted to get out of the clinic, so I set she and Alun free to hike down to Namche for a short holiday. I’m more than happy for them to get away, especially while the weather is bad, if it means she comes back less grumpy. The downside is that I now spend the day with three guys who only talk to each other in a language I don’t understand, and I see all of the patients. Much of life is about compromise, right?

The plan now is to leave on Sunday or Monday after my colleagues return, and I’m looking forward to the break. We hit the half-way point on Sunday and as much as I’m enjoying my time here, I am also starting to look forward to being back home. Last night we had the painful discussion regarding all of the foods we would love to be eating instead of the pasta with carrots and ketchup. A couple of other things that will be really great: Geary’s, dessert, running without feeling like vomiting, ratz, warm fingers and toes, and of course being back with Charlotte, the Ratz and our friends.

Friday April 15, 2011

8:25PM

Yesterday’s entry came to an abrupt close in part due to the arrival of a patient requiring evaluation but also because we ran out of power. With the prolonged bad weather of the past week our power supplies have been slowly dwindling, unable to regenerate through the solar panels. We finally hit rock bottom yesterday in time for two emergencies which killed any hopes of New Year celebrations

The first was an infection of the hand that I thought would be treatable but progressed rapidly and did not respond to our limited antibiotic supply. The second was another case of AMS and HAPE that required overnight treatment. With my colleagues on holiday that meant that I was up all night administering medications and monitoring for effect. 

Today started busy from the beginning with patients arriving at 7 AM and not letting up until the most recent five minutes ago. The damage consisted of 22 total patients (our busiest day yet), 1 ground evacuation and 3 helicopter evacuations. I now realize why last fall’s team recommended that 2 physicians be in the clinic during the middle and busiest part of the season. I actually prefer being busy in the clinic, but Gobi and I are hoping for a little sleep tonight.

Theme of the Week: Heli-evac

Monday April 11, 2011

7:05PM

The theme as of late has been heli-evacuation. We’ve had at least two per day over the last 3 or 4 days, and I have to say, they have all been legitimate. Not that we would call or approve a helicopter transport for someone who didn’t deserve it, but most of these people have been pretty sick. Even the ones who didn’t look all that bad at first glance turned out to have horrible vital signs.

The streak started with the woman I previously mentioned with the bizarre sudden vision loss and since then there have been two Brazilian men with HAPE, a man from the Czech Republic with HACE and HAPE, a nervous camerman with a heart condition, and, at least, a few others that I can’t currently recall the specifics. There would have been two others, but they chose not to heed our advice and walked down. 

The first of these two was a middle-aged man from the US who while working hard to get up a steep hill began to feel heart palpitations and subsequently passed out. In the medical world, red flags go up over a situation such as this, but despite our warnings he decided to walk down. The second of the two refusals was even more dramatic. A young woman, again American, happened to notice her very rapid heart rate while resting in her room. As it turned out, she has likely had a thyroid condition for years, which is being treated back in NY by her “Oriental Healer” with ginger and some other herbal supplement. Judging by the goiter in her neck, the twigs and berries haven’t been working. We don’t have the ability here to prove the thyroid as the cause and there were several other more serious diagnoses in consideration so we recommended that she fly down to Kathmandu for a more formal evaluation. The trouble came when she refused to go and insisted that she continue up to base camp with her group. After multiple meetings with her and her guides she was ultimately escorted down to Lukkla and onto a plane by one the group’s guides who missed out on his first opportunity to guide a Himalayan ascent on Lobuche.

Tonight we have an Aussie woman with some mild AMS who really just needs someone to hold her hand for a little while. Too bad we’re all going next door to the Panorama Lodge for a night on the town. Five minutes after she arrived her companions asked whether the “heli” would arrive tonight or tomorrow morning. Fortunately, Alun was feeling kind hearted and provided both the TLC as well as the well thought explanation of why she would likely be heading down-valley under her own power tomorrow after spending the night in her own lodge tonight. One of the benefits of eating out is siting around the lodge’s wood stove, so it’s going to take a really sick patient to keep us away from that.


I'm now off for another backpacking trip, and I'm really looking forward to some time away. The plan is to head up to Zhungla today and over the Cho La Pass from the east to Gokyo tomorrow. From there we'll head up to Cho Oyu base camp before crossing another high pass, the Rhenjo La, to Thame. Then it's a long two days of walking down to Namche and back to Pheriche. I should be sufficiently tired by the time I get back. Hopefully, I'll have some new adventures to report in a week or so. Pictures, as I'm sure you can tell, haven't been loading into the blog well on the slow connection, so I'll try to put something new on Facebook when I get back.

Increasing Business, Decreasing Temperature

Thursday April 7, 2011

4:23PM

In the past week business has started to pick up, especially in the last 2 or 3 days. The large climbing expeditions have started to roll through town, which, for the most time, make the village seem a little more alive. I expect the expedition traffic to continue for another 1 to 2 weeks before tapering back down to trekker traffic, which has also increased.

With the large expeditions comes a lot of “personalities”. I’ll leave it there as I don’t want to pass judgement. Just to give you an idea, the questions during our altitude lecture have transitioned from curiosity regarding side effects of altitude medications to wanting to know how many liters of oxygen a face mask should be delivering above 8000 meters in order to achieve adequate oxygen saturations for summit success. Hmmmm....... not sure anyone has that one worked out quite yet. My thought was give yourself enough to stay awake and give the rest to your Sherpa, so he has plenty of energy to carry you to the top. Not all have been quite so aggressive, and it has been nice talking to the guides as well as many of the climbers. I’m looking forward to going up to basecamp where I can get to know them a little better.

With increased traffic comes increased patients and we’ve had a few more in the recent days. We flew out two patients today, one of whom had strange vision loss in her left eye along with AMS, so I suspect that it was mainly due to the elevation and perhaps some variant of cerebral edema. She didn’t really cooperate with examination and there wasn’t a lot we could do for her anyway, so the answer was to fly her down. I gave my card to her guide so he could send information back to us when her condition had been treated. The other was a trekker with mild pulmonary edema who could have been treated here, but I think he had had enough of the Nepal highlands. Otherwise, I feel sure that I have now seen every person in the villages of Dingboche and Pheriche and several have been seen twice. At one point today, I thought about hanging a box of tylenol and cough drops out front next to a sign with the definition of a cold that instructs the local population to take each of the medications for at least three days before coming to the doctor. I have seen one patient three times in the last 2 days: once because he wanted his blood pressure checked, once because his left ear felt full and again today because his ear still feels full a whopping 18 hours after I told him it would get better with some time. 

The nice thing about having patients, even when they aren’t really all that sick, is that it breaks up the day. We’ve started taking them out to the “sunroom” to be seen as you can’t see more than two in a row in the clinic before your hands don’t function from the cold, not to mention that I feel terrible asking people to take off their 4 layers of clothes for an examination when it’s 25 degrees INSIDE.

In regards to the temperature, I’m tired of being cold but at the same time I've grown pretty used to it. My hands and feet stay cold most of the day with the exception of the morning in my nice warm sleeping bag. The hot water has also now gone from broken to fixed to broken to fixed and, we believe, now permanently broken. It’s a painful experience coming back from a run in the snow to bathe inside a freezer with a small pitcher of hot water. Actually, it’s even more painful if there is no preceding exercise as you start off even colder. Thus far, I’m the only one to attempt bathing since the water broke and I’m pretty sure my blue lips and intense shivering deterred the others. Eventually, though, they’ll break down too.

I might be tired of being cold, but Lauren is on a completely different level. We have a gas heater that, if one sits a few inches away from its front, can warm you reasonably well. Last night it ran out and we have to conserve our remaining gas for cooking. That must have been the final straw, because a short time later she came in the kitchen and very sternly asked, “Is there a solution?”. Her question received the silent response of confused looks from our Nepali counterparts, but Alun and I both knew what she was thinking. She continued with “If we can’t get wood or dung for the stove heater, gas for the other heater, or working hot water, I’m going on holiday to Namche until something gets done.” Obviously, nothing got fixed today and Lauren has yet to emerge from her sleeping bag.

In the next few days. I’m going to head out again to reattempt the Cho La Pass. The husband of one of the basecamp team is spending the next few weeks wandering Nepal after his expedition insurance lapsed thus canceling his plans to climb Ama Dablam. I think both of us are happy to have some companionship while trekking through the mountains. The plan this time is to go over directly from this side and then to spend a couple of days hiking up Gokyo Ri and to Cho Oyu basecamp before coming back across the pass. Things will surely go better this time, and I’ll definitely carry a little more gear to assure staying warm and dry.

Unfortunately, I’ll have to stop this entry here. I have more to say, but my fingers aren’t working too well and I can’t feel my toes, so it’s time to add a few more layers.

First Month Done

Friday April 1, 2011

4:23PM

After the adventure earlier this week, there hasn’t been much exciting to report. The HRA Basecamp team, led by Luanne Freer, has been in town for the last 2 days and it has been nice to have some new faces with whom to socialize. Luanne has been running the basecamp operation for the past 7 or 8 years since she first worked in Pheriche back in 2002. This year there will be 3 doctors there as well, excluding herself, but she plans on staying only long enough to get things up and running smoothly. I’ll be trading for a couple of weeks with the Nepali doctor and suspect that Alun and Lauren will also go up for a few days of something different.

Two nights ago the two teams and the duo of Sandy Scott and John Knowles from the Everest Memorial Trust sat down to a tasty dinner and a few drinks at the Himalayan Lodge. It’s amazing how well one sleeps after 1 glass of red wine - far and away my best night yet. I think I could make it a nightly habit, but red wine, even the cheap stuff, runs about $35 per bottle. 

John and Sandy have an interesting relationship with the HRA. The HRA has been running this facility since 1973, but sometime in the ‘80’s the EMT began remodeling the post. This has lead to the EMT managing the post from a structural standpoint and the HRA handling the administrative and medical side. I understand that, occasionally, there may be some tension between the two groups on how things should be done, but from my observation it appears that everyone gets along pretty well. Through the years the EMT has installed the running water, solar power, and a glycol heating system, all of which I’m more than happy to use. However, Nepal can be a difficult place for advanced technology to take hold and the heating system has never really worked. It would be nice to be warm at some point during the day, especially inside, but I suppose I can be content with the occasional hot shower. 

That brings up the downside of the last 48 hours. The day Sandy and John left, and the day the plumber was supposed to arrive to fix the pipes, the hot water pump mysteriously quit. Once that news got around to everyone, spirits dipped slightly, to say the least. It didn’t help that the plumber, who was supposed to bring 15 ft of replacement pipe, arrived with 12 in of pipe, no tools, and after taking one look at the system stated that he really didn’t think he could do much. Awesome!

I’m certainly no plumber but it made sense to take a systematic approach to figuring out the issue rather than giving up on account of overall complexity. Coincidentally, or perhaps through some divine intervention, Alun and I both had dreams during the night about fixing the system. Over breakfast this morning we put our heads together and started at the breaker box moving down the line toward the pump. Ultimately, the problem was lack of power to the pump which was easily remedied by splicing a broken wire back into the circuit. Voila! The hot shower was back up and running and spirits recharged. Now the plumber could go back to eating and watching Forest Gump.

Since we now had water again, it was time to get out and work up a little sweat. I put off running yesterday in hopes of getting the water fixed, so I set out on the route I had planned previously. Thinking back to my previous running experiences here, I started out downhill for a few minutes in hopes of getting the system a little warm before trashing myself up a hill. That almost worked, but the hill started a little before I was ideally warm. To be honest, I’m not sure that being ideally warm would have made much of a difference in my ability to get up and over Pheriche Pass. Surprisingly, I managed to get within about 20 ft of the top before I started to get lightheaded from the effort. After coming down the opposite side of the pass I took a hard left at the junction with the trail to Dingboche. There were a few steep sections leading up to the neighboring village that I had to walk and then a couple more when crossing up and over the ridge from Dingboche back to Pheriche. All in all, I had to walk less than I realistically expected but more than I hoped. I guess it really wasn’t bad for 50 minutes and close to 1000 ft of elevation gain. If I manage to run the whole thing before I leave, I’ll be pretty psyched. Of course no recent venture would be complete without running into my Parisian friend, Christine, who made it to Basecamp and was returning down the ridge from Dingboche.

Upon getting back to the post I kicked the plumber out of the bathroom (He had decided to do some work) and took advantage of our efforts from this morning. Since my I had been wearing my last clean shirt and socks for the last 3 days, I also took the opportunity to do some laundry, which reminds me of a question I have been pondering for the past few days. When washing  clothes by hand in a basin of soapy water, do the clothes really get much cleaner, or is the dirt just redistributed? I’m leaning toward the latter. Perhaps the icy, subfreezing fog in which the clothes are now hanging to “dry” will contribute positively to the cleaning effect.

On a final note for the day, if you’re reading this Friday morning in Portland, don’t wimp out because of the forecasted weather. Go to the Boys and Girls Clubs Auction tonight! Anything on which Charlotte works this hard is guaranteed to be good and you can go home with a warm fuzzy feeling inside for supporting a great local organization. Happy April Fools Day!