Back in Namche Bazaar

We started our last morning in Thame with a leisurely breakfast and then hiked up the northern ridge to a monastery overlooking the town. There is an old Stupa nearly the entryway to the monastery, as well as a very long Mani stone wall. We saw student monks, perhaps elementary school age, on the monastery grounds and also found a tea house up there. This would probably be a cool place to stay in the future. We returned to Thame for lunch to the sound of several monks chanting and praying in our tea house. They were using drums and other instruments, and we caught a glimpse of them on our way up to our room. They were wearing traditional red and orange robes, 10-15 of them, huddled in a room just below ours. They were still chanting and praying a couple of hours later when we left Thame to make way for Namche.

The path from Thame to Namche Bazaar is pleasant, rolling, and relatively short. Just outside of Thame we crossed the river on a steel suspension bridge, overlooking a narrow chute in the rock worn smooth by the rushing white water. Shortly thereafter we ran into an "introverted" trekker from the states. He joined us for a few miles and despite considering himself introverted, was quite chatty, and in fact was a biomedical engineer. He had studied at University of Washington and will matriculate in the graduate BME program at Columbia in the fall. Small world. He had taken a non-traditional career path having started a small company around a novel electrooptical diagnostic technology before heading back to school. Interesting dude.

The approach to Namche was quite beautiful...we had overwhelming views of the valley below us and became fully immersed in a tree-dense forest. We descended upon Namche from the Northwest and passed by the town's helipad and a field of newly-painted Mani stones. Upon returning to Namche, we found the Khumbu lodge - where we had agreed to meet Chris & Penny - set down our things (in another place occupied, at one time, by Jimmy Carter), and found the pizza joint and bakery for some snacks and a beer. We no sooner started digging into our lunch when Hillary heard Chris and Penny's voices passing by the patio. We flagged them down and made our plans for dinner at the Lodge. We spent some time shopping for gifts and souvenirs and reorienting ourselves with Namche before re-uniting with the Hills for dinner.

The reunion dinner was superb...we splurged on a couple bottles of red wine and partook in the Yak steaks that were available. Perhaps most striking, though, was the tomato salad. We ended up ordering 3 of these appetizers which were incredibly simple yet so welcome to the taste buds. Fresh fruit/veggies! The tomatoes were simply sliced, salted and doused with vinagarette. We proceeded to order several of these plates the following night as well. All around us in the Lodge dining room were Everest climbers recounting their experiences on the mountain and celebrating their summits.

Later that night we visited Namche's Irish Pub, complete with snooker and foosball tables. Sadly, they were out of Guinness, so the Chris's opted for a "local whiskey" that just could've substituted for airplane fuel. Somehow over the course of conversation we arrived at a proposal to compete as couples in a fancy dress (re: costumes) contest. The losers would be buying dinner and a round of drinks. Game on! The competition was tentatively scheduled for our arrival in Lukla in a few days. Given the previous days' treks and the 10pm curfew at the Lodge (they lock the front doors at that point) we retired relatively early and sleep found us quickly. Nevertheless, we were all awoken by the sounds of drunken climbers pounding on the front doors sometime after midnight. A healthy monsoon rain had set in so they were certainly anxious for shelter. Drunk and wet, they were rowdy for over an hour, keeping us up, until someone mercifully opened the doors for them.

View of Thame from the ridge leading to the Monastery:

River crossing just outside of Thame, with beautiful paintings on the water-worn walls of rock:

Another Jimmy Carter favorite...the Khumbu Lodge in Namche Bazaar:

Gokyo Ri

Despite the recommendations of other trekkers and our best intentions, we got up a bit late for our ascent of Gokyo Ri, a high point above Gokyo and the lake that offers tremendous views down-valley and also of Everest (on clear days). The recommendation was to get up and out such that we reach Gokyo Ri by 6 or 6:30am to get the best views...which means we'd have to start the hike by 5 at the latest. Well, given our long day the previous day, we slept in a bit and finished breakfast around 7:30. We decided to make an attempt on Gokyo Ri anyway, and leisurely hiked up the steep, dusty path over the course of about 2 hours. We were pleasantly surprised to find that the weather held out (i.e., the clouds rolled in later that day) and gave us stunning views of the glacial lakes, the glacier to the west, and the peaks to the north. We encountered beautiful, almost iridescent, blue birds on the way, as well as numerous people really struggling with the hike. Although there were lots of people up there when we arrived and some clouds had emerged, we were gratified by the hike and views. We descended easily to Gokyo to relax, take some lunch, and plan our trip over the Renjo La.

After lunch we were itching for some cleanliness. Wearing the same socks for day after day on these hikes had taken its toll on our feet and we decided to wash our feet in the lake. It was incredibly refreshing and soothing to clean up a bit, although the water certainly chilled to the bone. After washing, we lazed in the sun on a hillside taking in the view of the lake, Gokyo Ri, and examining the route up to Renjo La. We later retreated to the Lodge for more Yak steak and beers with the Hills.

Blue bird on the approach to Gokyo Ri:

Looking down-valley at the glacier and glacial lakes from Gokyo Ri:

 View looking west from Gokyo Ri...looking for Everest but the clouds prevented us.

Cleaning up in Gokyo Lake...

Cho La and Yak Burgers

Today we began the trek across Cho La. "La" is a Tibetan term for mountain pass. It proved to be a long day and challenging ascent and descent, but the experience of walking across two glaciers in a single day was absolutely incredible. We left Dzongla early in the morning after a breakfast of toast, baked beans, eggs, and coffee, and we headed further up the valley below Cho La. There were several other trekkers crossing the pass with us that day so the trail was somewhat busy. The first leg was along a green valley floor and although the sky was clouded, the weather was warm and pleasant. As we began to climb and scramble up towards Cho La we had to shed layers. A few hours later we arrived at the pass (elev: 5350m) to find that the clouds had cleared and we could see Ama Dablam, Taboche, and some of the other major peaks around the valley. The top of the pass also afforded us our last view of Pheriche. On top of the pass was the Cho La glacier: a vast ice flow several tens of meters deep. After taking some pictures and finishing off our supply of jerky, we traversed the glacier (literally walking on top of the ice) until the Gokyo valley opened up beneath us. The descent into this valley was hairy just below the pass - at several points we just slid on our butts to get down because the path was either loose scree or icy/wet stone and über-steep. Eventually we made it down and found steady sun in our "new" valley.

We spent a couple of hours on rolling trails and moraines to our planned lunch spot, a village called Dragnag. Crossing the Cho La took a lot out of us, and we lingered at the first teahouse we found for hearty pasta lunches and a large pot of milk tea. Despite our inertia, we pushed on towards Gokyo, our planned stopping point for the next couple of nights. The weather had turned grey again and the path to Gokyo led us across yet another glacier. Rather than a snowy surface, however, this broad ice flow was covered with grey stone. Only below the surface, and in a few small lakes, was the ice to be found. The combination of the grey sky and the grey earth gave the impression of walking on the moon or another planet. It was an eery environment to be sure, as throughout our passage across the glacier we also heard the sound of ice and rock falling into pools and lakes...the glacier is very much "alive" in that it is continually moving and changing shape. The time scale over which this happens is shorter than you would think though!

Rain started to fall as we approached Gokyo and the daylight began to dwindle. It was a great relief to arrive at our lodge (Namaste Lodge; recommended by the teahouse owner in Dragnag). The dining room was warm with a yak dung fire and busy with the chatter of several groups of trekkers. The owners even greeted us with "welcome juice" (hot mango). Chris and Chris spotted yak burgers on someone else's plate across the dining room and decided to order the same for themselves. They were not disappointed! After finally reaching our destination and fueling up we retired early, looking forward to the next day of relaxation and exploration.

Last view of Pheriche, from Cho La. The clouds only got worse the longer we stayed.

 Crossing the Cho La glacier. Those specs in the middle of the snow field are people.

Striking a pose midway across the glacier. Pic taken by a Sherpa guide who had brought a patient to the clinic earlier in the season.

 Crossing the Khumbu glacier...had a "lunar" feel to it.

 Gokyo and Gokyo lake...our destination for the next two nights. A sight for sore legs...

Closing Time

Today is the closing of the HRA Aid-Post. We finalized all of the inventories, counted the final bank, and covered the equipment with plastic and sheets. We closed up and locked the pharmacy closet after placing the TV, DVD player, ultrasound, EKG machine, oxygen tanks, and oxygen concentrators inside. After lunch we took down the signs and put up a closed sign with phone numbers to the nearest medical facilities in Namche and Khunde, both nearly a day's walk away. After no one showed up for the final lecture, we brought in the cushions and chairs from the sunroom, then closed and locked the door. In an effort to leave the clinic in a better state than we found it, we picked up the common areas, shook all the mattresses, and swept the floors.

This morning we tried out Pembadiki's porter basket for carrying yak dung, then she invited us in for tea made on a stove built by her father, Ang Rita who worked for the HRA for many years. Her home is a single room, simple but cozy. She has vegetables and onion growing in the windowsill and a butter churner in the corner. She is the exception to the rule that everyone descends for the summer. She will follow her yaks up to the Kongma La in search of green grass for several weeks before returning to visit her family in Pangboche.

Dr. Luanne Freer, who was key in starting the Everest ER Base Camp Tent, arrived this afternoon in Pheriche with her team bound for base camp. Already several climbing teams have summited, slightly earlier than usual this year. There have been several injuries and a few fatalities, but it sounds like some great rescues as well. (By the way, no sign of Tom Cruise.)

Chris Hill and Penny left a day early to see the Italian Pyramid after finally contacting hem on Skype. They will meet us in Zhongla tomorrow where we will stay the night. Arjun was planning to go over the mountain passes with us, but he was informed of some last minute training in Kathmandu on May 24. He and Jeet will leave at 6am tomorrow with the goal of making it to Lukla tomorrow before dark. Jeet will continue to his hometown another few days walk. Arjun will fly back to Kathmandu.

The four of us will spend the next week taking the scenic route down. We will spend the night in Zhongla before getting up early Tuesday to cross Cho La into the Gokyo valley. We hope to make it to Gokyo that night, then go up Gokyo Ri the next morning if the weather behaves for some good views. Then we will cross Renjo La and begin our descent to Thame, which was a part of the Tibetan trading route in the past. Finally, we will come back below the tree line into Namche Baazar on Saturday and Lukla on Sunday with the goal to fly back to Kathmandu next Monday. We will be offline for several days, so we will catch up on our stories on the flip side!

This is the Spring 2013 Pheriche HRA team... Signing off.

Altitude Illness Lectures

Every day at 3pm we give a lecture on altitude illness and prevention. These lectures discuss how the lower atmospheric pressure causes air to expand and resulting hypoxia (low oxygen in the blood). We highlight acute physiological changes at altitude including tachypnea (fast breathing), tachycardia (fast heart rate), and increased urination. Over longer weeks to months the. Body also increases red blood cells, metabolism, and some structural changes particularly in muscles. We also discuss the main types of altitude illness ranging from the benign high altitude headache and acute mountain sickness to the emergency conditions of High Altitude Cerebral Edema (HACE) and High Altitude Pulmonary Edema (HAPE). We also discuss warning signs as well as treatment (mainly descent although we do use some stabilizing and temporizing measures). These lectures are usually well-received and we get many good questions. Sometimes we demonstrate the Gamov Bag (a oblong bag which we can pressurize with a foot pump to simulate descent.)

March 20 (delayed upload)

Photo 1: Hillary gives the lecture in Pheriche while Chris holds the lecture cards.

Photo 2: Chris gives the lecture in Dingboche. During the busiest part of the season, we gave lectures on Monday, Wednesday, and Fridays also at 3pm at the Alpine Conservation Center.

Final Days and Unrelenting Haze

The final days in Pheriche are upon us. We are have already begun packing, cleaning, organizing, and making our final preparations for our trek out over the passes. Chris and I had planned to spend our last couple of days on top of the Kongma La and enjoying the outdoors, but a storm moved in from Bangladesh and brought a thick cloud that got stuck in the valley obscuring everything. Of our three day window, we had no reasonable days in which to attempt this pass, and so we spent the days going somewhat stir-crazy in the clinic.

We have all come down with Pheriche Lassitude. There have only been a few patients to occupy our time and even fewer in the lectures. Chris got so bored he gave a second lecture to only three people. Penny finished the medication inventory and took a three-hour nap. In between games of Solitaire, Hillary re-folded all the t-shirts, scarves, and hats, then blew up the Gamow bag for fun. Chris Hill researched homebrewing equipment inspired by our brew planning and searched for jobs in Canada. Arjun spent hours on Facebook and attempting to Skype. Pumo (the clinic dog) found a girlfriend and the other dogs have all been curled up in balls in our front yard all day. The yaks are all covered in frost. Even Utom (the main employee in the Himalayan Hotel) came by several times to chat and hang out. We watched old Will Smith and Tom Cruise movies. We considered starting the 3000 piece puzzle. While we don't wish ill health on anyone, we desperately wished for something to happen. We have rarely been so bored.

Photos: From inside the Gamow Bag.

Everest Memorial

Outside of the aid-post is a memorial constructed of rock and stainless steel for the climbers and Sherpas that have lost their lives on Mt. Everest (aka Safamartha, or Mother of the Universe, in Nepali). There have been at least 3 Sherpas and 1 Russian climber who have died on Everest this year, and a Japanese trekker perished on the Kongma La early in the season as well. The monument always draws a lot of attention for visitors to Pheriche. The polished stainless is meant to reflect the beauty of the surrounding mountains (rather than compete with it) and the names of the fallen are placed on the opposing faces in the gap between the peaks such that you must insert your body to read them...it's meant to make for a more intimate experience. It's quite the landmark and a powerful symbol of both the risks taken and the ambition of those who brave Everest.

An unsubstantiated rumor

Tom Cruise will be passing through Pheriche on his way to Everest Base Camp in a few days, accompanied by an HRA veteran. Last night we watched Top Gun in his honor and also because we are running low on new movies.

Note: This rumor has been circulating for years. Stay tuned.

Pea soup

So much for crossing the Kongma La. We awoke to exceptionally foggy conditions that persisted throughout the day. Even if we made it up to the pass, it is likely that we would've seen nothing but fog and clouds. It is eerie and strange to basically be within a cloud for two days.

Some porters passing by the mani stones in Pheriche gradually emerge from the fog. Visibility was limited to maybe 15m.

Yarsagumba

Traditional Tibetan medicine often involves herbs and medicinal plants. However, there is a special type of fungus which is a caterpillar parasite which is worth it's weight in gold - literally. Known as yarsagumba and described as half-animal, half-plant, this is a truly unique organism and not well-understood. The fungus "sprouts" from the ass end of the caterpillar during a late stage of larvae development and grows up to 15cm. In the process, the caterpillar is mummified and kind of forms a root for the fungus. Pretty nasty looking. Anyway, 1 kg (2.2lbs) of these things is worth ~300k rupies ($3500)...and since these grow well here in the Himalayas the locals spend quite a bit of time seeking them out. The claimed medicinal effects range from anti-depressive to aphrodisiac to generally protective of bone marrow (in irradiated mice anyway). Fascinating...

We bring this up because our counterparts at the Manang clinic have encountered many cases of snowblindness in locals harvesting yarsagumba near the snowline in the Annapurna region. Apparently it's that time of year.

Snapshot of a website describing the yarsagumba. These things don't grow near us in the Everest region.