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“Why would you want to go there? It’s cold, you can’t breathe, and you sit around burning yak dung every night...not to mention it’s dangerous.” The call of the mountains is not something everyone understands, but I had caught the fever, and there was no cure but to trek deep into those snow capped giants and experience every detail.  

Arriving in Kathmandu, the aroma of overpopulation and pollution filled my nostrils, however once I saw the kind faces greeting me with the frequent "namaste”, I remembered why I came back. I had traveled to Nepal in 2014 to research the prevention of AMS, and had vowed to come back, this time with my father, my life-long hiking partner. 

I was a Fellow of Wilderness Medicine at Virginia Tech Carilion in Roanoke, Va, and this trip was part of our Nepali Exchange program, in which we hosted young Nepali doctors hoping to match into a U.S. residency program. In turn, I was given the opportunity to teach a few workshops and lectures for the Mountain Medical Society of Nepal and Tribhuvan University Institute of Medicine, and would shadow at several of the rural clinics and hospitals along the way.     

Lukla, the portal to Everest, is touted as being the most dangerous airport in the world, with its short runway, poor weather, and and even poorer visibility. The runway looked like it was 100 ft. long, and the plane touched down as the stone wall ahead of us came closer and closer in the front window. We came to a screeching halt just in time, my heart racing from the altitude and adrenaline  

The entire trek is 77 miles to EBC and back, a journey which typically takes 10-12 days to complete (including acclimatizationdays). There are no motorized vehicles past Lukla, which is incredibly refreshing, however it makes resources scarce and expensive, as all goods are packed in by yak or porter, or flown in.         

The trek to Namche Bazaar is brutal, with an elevation gain of 807 m (2,648 ft). My legs and lungs screamed for oxygen. We crossed the river on a very mobile swinging bridge with the milk river (Dudh Kosi) hundreds of feet below flowing aquamarine from the glaciers beyond. My pride would be further crushed as a porter would pass me, sometimes with two fully loaded packs on their back. Such amazing athletes, methodically rolling up the mountain with a smile and a "namaste" as they passed. 

I was ecstatic to finally see Namche Bazaar, a city built in the style of a giant amphitheater on the mountainside. This was the last place where supplies could be reliably purchased and where we would take our first acclimatization day.   
       
The next day we ascended to Khunde (elevation 3,840 m, 12,598 ft) where I was lucky enough to shadow Dr. Kami Sherpa at Khunde Hospital. Started by Sir Edmund Hillary in 1966, this hospital is a small, but highly functional facility which serves the remote Khumbu valley, giving patients access to X-ray, ultrasound, ECG, and an obstetrical delivery room. As there is no motor traffic in this region, access to this hospital often requires that patients travel several hours by foot, pack animal, or be carried on a stretcher. After four days with Dr. Kami and his staff, I was sad to leave; they practiced real wilderness medicine here, brilliant and resourceful. 

We headed toward Tengboche, the site of one of the world’s highest Buddhist monasteries. For a one dollar donation, trekkers are allowed to camp on the lawn adjacent to the monastery, so we set up camp in time for the nightly service where we sat cross- legged in the divinely ornate monastery listening to the chanting and the drums of the monks.

As we ascended to Dingboche (4,410 m, 14,469 ft), we departed from the forest, to low lying shrubs, and tiny flowers, better suited for the harsh environment above treeline. While I loved the comfort of the guest houses, I appreciated our tent, away from the burning yak dung and commotion of climbers. I watched the moon rise over Ama Dablam with billions of stars twinkling in the frigid night, before retiring to my -20 degrees F sleeping bag, nothing exposed but my mouth and nose which would be surrounded by an icy crust when I awoke.
    
Rejuvenated, we ascended to Lobuche via a steep pass known as “Khagan chorten”, where it is rumored that the climbers are cleansed of evil spirits as they arrive at a gathering of monuments to climbers who lost their lives on Everest. 
      
Six hours after arrival in Lobuche, my father was feeling the symptoms of altitude sickness and we noticed our lips were blue. Acute mountain sickness is uncomfortable, but if it escalates to high altitude pulmonary edema or cerebral edema it can become a deadly condition which mandates descent. Thankfully, by morning he was feeling better, and grateful for the extra acclimatization day. 
     
Over 2.7 miles of rocky, icy moraine, we trekked to the highest city in the world, Gorak Shep (5,181 m, 17,000ft). Trekkers typically take one day to climb the nearby peak, Kalapathar, for a spectacular view of Everest, and then proceed up the path of the Khumbu Glacier to EBC. To our surprise, every guest house was full, so we wasted no time setting up camp at the edge of town. I was thankful we had all of our gear, otherwise we might have found ourselves trekking back to Lobuche in the dark. There was a dusting of snow accumulating on the boulders as we settled into our cozy down bags, our water containers with us so we wouldn’t awake to a block of ice.

"Sleep was fragmented as snow pelted our tent, causing the sides to sag inward. We would wake periodically to beat the snow from the sides, and clear away the drift from the door"

Sleep was fragmented as snow pelted our tent, causing the sides to sag inward. We would wake periodically to beat the snow from the sides, and clear away the drift from the door. When the sun finally rose, we could see the accumulation from last night’s storm. A party of climbers, roped together, could be seen traversing the path that led to EBC, though I don’t know how they were able to navigate the loose, slippery snow on such dangerous terrain. For two days the sun never came, more snow accumulated, and conditions remained dangerous, until a break in the clouds gave us an opportunity to attempt a sunset climb of Kalapathar, a 5,643 m (18,514 ft) vantage point on the side of Pumori, allowing for one of the most beautiful views of Everest, and the neighboring 8,000 m+ peaks in the area. Sunset is breathtaking as Everest turns bright orange in the alpenglow. The wind was wicked, and would have blown us to the ground if not for our trekking poles. We descended by headlamp following the trail which snow had drifted over in the high winds. Back at our tent we fell into the deepest sleep. If all went well, tomorrow we would arrive at the pinnacle of our trek, the basecamp of all basecamps, at the foot of the highest mountain on our planet. 

The next day, the winds were still dangerously high, but the sun was out, so we headed toward EBC. Yak trains, porters, and countless trekkers crowded the narrow path, loose rock and ice on either side dropping into glacial ponds amidst the Khumbu glacier. The yaks had stomped down the snow enough that there was a visible path, and at last we caught the first sight of the magnificent tent city, which hosts a population of approximately 1,000 souls during climbing season. 

 

EBC is nothing more than a pile of rocks littered with 30 foot tall ice blue spires, but extensive work by expedition crews make the area livable by setting up cooking, sleeping, and toilet tents. At the base of the Khumbu Ice Fall sits the highest ER in the world: the Everest Base Camp Medical Clinic. This barrack style tent is staffed by three doctors and funded by the Himalayan Rescue Association. By May 6th of the 2017 climbing season, these doctors evaluated over 365 patients, with 58 percent of these being Nepali. I was lucky enough to get to visit with my friend Dr. Sanjeeb Bhandari and his colleagues Dr. Walmsey and Dr. Nemethy, and thank them for their service in this harsh environment. 

 

On our descent, euphoric from the increased oxygen and our renewed appetite, we toured the HRA clinic and listened to a lecture given by the volunteer doctors outlining the symptoms of AMS and when it was necessary to descend. Many lives have been saved through their education, and medical care can be delivered to the tourists and locals as a result of their service. Tomorrow we would descend back into the land of vegetation and oxygen, and though my body would appreciate it, I would miss the rugged, austere beauty of above treeline. 
      
Tears filled my eyes as the plane took off from Lukla (a day late, due to dense fog), and carried me back down to the haze of pollution and the smell of overpopulation in Kathmandu, but my heart stayed full, and I marveled at all we had seen and experienced. Soon I would be back in my sterile, comfortable Western world and this would all be a distant dream. 

The ability to ascend to this altitude is a gift that not all get to experience. Altitude sickness does not discriminate. Men, women, old, young, even professional athletes succumb to the symptoms and have to descend, never realizing their dream of seeing the top of the world. Trekking to EBC is far less risky than attempting a summit, but still many have lost their lives. Is it worth it? In my opinion, absolutely. Never have I seen such beauty, encountered such wonderful people, or felt as close to God as I did in this gorgeous and hostile environment, and I would (and will) return again and again. 

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