Apa's 21st summit

May 11.  At 10:30 last night Tenzing sent me a text message with the exciting news that Apa reached the summit for the 21^st time— 9:15 AM Wednesday May 11^th in Nepal.  Everyone at Diamond Mold is thrilled with the news, and extremely proud of Apa.  We are now holding our breath waiting to hear he’s safely back to base camp.  Tenzing thinks Apa will stop at camp 2 for the night, so it may still be another 24 hours before he’s back to base camp.

Brett Prettyman wrote a great article for the Salt Lake Tribune regarding Apa’s success: http://www.sltrib.com/sltrib/news/51789082-78/apa-sherpa-everest-pool.html.csp

May 12.  Tenzing came in to work this morning and confirmed that his mom, Yangjin, talked with Apa around 5:00 AM and he’s at base camp.  This is a huge relief.  Apa has made it back down, he’s through the ice fall, and has 21 summits safely behind him.  Congratulations Apa!

In Dingbouche Again

April 17.  I’m up early. It’s another crystal clear dawn in Dingbouche. The weather pattern so far has been clear mornings, wind rising later on toward noon, then clouds moving in around 1:00 or 2:00 pm, followed by precipitation, possibly--or just cloud and wind. The peaks generally become obscured in the later afternoon. But today’s dawn promises another stellar morning and I am feeling, I’m not sure, it’s an odd feeling as I consider it, looking out the window at Ama Dablam’s northwest side with the sun coming up gradually. I sit up further, pull myself together a bit, and work on convincing myself that I feel just fine, that coming down to Dinbouche was just the right thing, that the Snow Lion lodge is just the place to work off altitude sickness. I climb out of the sleeping bag and head to the dining room for tea. My thought’s are that we need to get ready to go back up to Loboche soon, that I’ve already delayed Apa enough. He’s definitely going to miss the Puja ceremony at base camp now. At breakfast I tell him I am sorry about this, and again he tells me it’s OK, not to worry, that he’s had so many Pujas already that he is full of good luck.  Having no choice I accept this, but I am concerned that I’ve become a greater liability for him than the original plan called for.

Philip, the French Canadian from Montreal comments on my improvement. “You look a lot better than last night,” he says, “there’s color in your face,” and Apa agrees. They both remark how last night my face looked pale and ashen, “Not good.” Apa says. “Your eyes didn’t look good,” he says this pointing at the outer edges of his own eyes, “Here,” he says, “your eyes looked no good right here,” and he taps the sides of his temples. I’m not exactly sure what he means by this but am encouraged nonetheless. Today I look better than yesterday and feel better too, This is a good sign. After breakfast I bring out the laptop and hammer away. This is also a good sign; I can write again. Mingma is watching, “No wonder you have headache. You think too much. Too much laga up here,” she says pointing to her own head meaning my head. We all laugh, and especially Philip who is busy writing in his own journal; a small black note book. He has tight, crisp handwriting, very small letters. Philip is old-school, writing by hand, but then so are almost everyone I see. They all keep journals by hand, have tiny, legible penmanship. It must be a European thing, the ability to write by hand. We discuss this and no one agrees with my theory. It’s the weight, they say, why would you carry a heavy laptop? The battery weighs too much. I argue back that my laptop weighs less than most of the big-lens SLR cameras the serious trekkers are carrying. Jums’s camera comes to mind. Justin’s, the Outside Magazine editor, his camera was huge. The Austrian trekkers who came down from the Tashi Lhasa pass and stayed at Apa’s lodge. Their SLR cameras were enormous--weighed pounds. And this is a good sign too. Last night I didn’t have energy for discussion. Today it’s no big deal.

Apa tells me the good news: Mingma has invited me to help after breakfast with a Puja at the stupa built on the hillside several hundred feet above her lodge. The work detail will be five of us: Mingma’s two cooks, Jetta, Mingma, and me, and we’ll string new prayer flags. She is carrying five rolls of the blue, white, yellow, red and green connected flags.  These are large long rolls of flags, not the small shorter tourist-size rolls, but hundreds of flags, and when I look up at the stupa above us I can see why she is carrying so many. The stupa is large and its old worn wind-torn prayer flags that we’ll be replacing are numerous. Hiking up is steep, the same hike Apa and I did a couple days ago looking for a cell phone signal. I’m following Mingma, and when we get to the top, actually just a level spot on the slope, the cooks are already climbing the sides of the stupa. On the steepest section mid-way up they haul up a wooden ladder that’s heavy and awkward, but it works.

The stupa looks like it was built a hundred years ago, I have no way of knowing—but it’s very old. It is in the condition of so many stupas we’ve seen, decayed by the elements, the wind and rain, the freezing and thawing. The outer layer of white-washed cement is cracked, entire sections have peeled off, missing. The rock underneath looks stable, but vulnerable. I estimate this stupa to be 25 feet wide each side at the bottom of its square rock base. The traditional dome starts about four feet above the ground and rises perhaps another 20 feet to the upper section with painted eyes, and finally a gold-painted wooden spire is at the top. I notice a foot long piece of the gold-painted spire has broken loose and is stuck on a ledge about five feet above me. I hand this up to one of the cooks thinking he might be able to wedge it back into the space it has broken away from.  The whole stupa needs repair, the characteristic blue eyes need repainting, one eye seems to be partially missing so it looks like it’s squinting, blinking perhaps, but in the obvious order of priorities in the Khumbu, this stupa is just fine as it is.  Today’s priority is to string the new prayer flags, and fitting the loose piece of spire back into its space can wait.

Mingma assigns me to a station halfway up the side of the stupa. “Terrell, laga,” she says amid huge amounts of laughter. We are all getting a kick out of the pampered westerner actually doing something constructive. It is our new joke, “laga,” which I know means work, and the joke is, that no matter how much laga I do, it will never equate to a fraction of the work going on around me in the Khumbu.

It is my job to unroll the prayer flags and feed them to the cook above me who in turn feeds them to the cook who’s clinging at the very top of the stupa by pinching with his feet. This aerial artist is tying the end of the prayer flag’s cord to the spire.  It occurs to me that a fall from this height could possibly be his last, but in Nepal I’ve learned that my American sense of what is acceptable risk would, if implemented as a threshold for action, limit about 30% of all activity, primarily construction. Life around me is being carried out in precarious fashion, and walking the fine line between seeing the next sunset and not is the status quo. Take chances or certain things wouldn’t get done in the Khumbu. It’s just the way it is.

Jetta and another of the kitchen crew are busy taking the four steel flag poles out of the ground. These poles are set about ten feet off each corner of the stupa so that, between each flag pole, there is a span of about 45 or 50 feet. That’s the distance the flags will be strung between poles on each of four sides. Then from the top of each pole to the spire on the stupa another string of flags will be run, these diagonally. In all there will be 8 strings of flags, and I quickly learn that the five flag rolls Mingma has brought are ultimately tied end to end so that when one roll runs out another is attached and the stringing continues.  The flag pole raising process is not clear at first, but as soon as one pole is up I understand. First, the end the string of flags is tied to the top of the flag pole which is now laying on the ground. Then four people raise the pole by sticking one end into a foot-deep hole in the ground and doing an Iwo Jima type of flag raise. I am taking lots of photographs in hopes of catching a similar image, but from what I remember of the shutter clicks there will be no such defining digital moment. I’m not quick enough with the camera plus the default auto setting has a half a second focusing delay before the shutter actually opens, or clicks, or whatever it is that digital cameras do to take photos. While the pole raising is gong on I spend quite a bit of time thinking about the similarity between raising these prayer flags and the iconic photo of the US flag being raised on Mt. Suribachi. Both are acts of hope, but in this case no bullets are flying. The wishes connected with this Puja might not be for success in a life and death pitched battle that 66 years ago was being waged on the island of Iwo Jima, but here today in Dingbouche Mingma has timed her Puja to be a send-off for Apa, to bring him good luck and protection in the face of uncertainty and impending risk. She knows he would be at the Puja at base camp, and isn’t, and this Puja is a fine consolation.

“Look,” Mingma says, “Apa laga.” She points down the hill and I can see Apa collecting fresh juniper branches. He collects a bundle the size of a grocery bag and carries this to the entry of the Snow Lion where there is an outdoor fire pedestal. It’s kind of an elevated rock fire place, a column 12” square, scooped out on top, with small rock sides and a semi-lid, also rock. This is the designated incense burner.  The wet juniper is lit, burns slowly, and smoke billows through the courtyard just like at Apa’s lodge and all the lodges and monastery’s in the Khumbu. The exact significance of burning the green juniper is something I haven’t learned yet, but Apa has told me it’s a good thing. “We need to burn the juniper,” he has said, and that explanation suffices. Being part of this flag raising Puja and seeing Apa far below doing his part makes me feel a little better for the main Puja he is missing--the one going on at base camp at this very minute.

The flag pole raising and flag stringing continues. As each pole is raised its base is further supported by a rock-pile pyramid, a surround about 3 feet in diameter that the cooks are building. They select rocks and jam and pound them together to hold the flag poles upright. I watch their fingers as they work in unison. Those rocks could crush easily. I ask Mingma if the flag poles ever blow over in the wind. Frequently, she tells me.

We start on the next run of flags. The trick is to have the two converging strings the proper length. Both the diagonal string from the stupa’s spire to the flag pole and the string from the adjacent (previously erected) flag pole need to be the right length. Both need the right amount of sag. Not too tight, not too loose. There is a lot of pole lowering, flag untying and retying, and re-raising to get this balance right. A tape measure would be how we’d do it in the States, but we’re not in the States, we’re in a hanging valley at 14 or 15 thousand feet on the north side of Ama Dablam. This is a long way physically and culturally from anywhere I’m familiar with, and the bundle of incense sticks Mingma has just lit and placed on a ledge of the stupa reminds me of that.

We descend. Back at the Snow Lion Apa calls for a basin of hot water. I need to shave he tells me. From experience I know the hot water will be lukewarm in a matter of moments. I argue the point and try to enlist Mingma’s help in my defense. She is too smart to get caught up in the shaving argument and I’m left to my own devices. Last week in Thame I tried to get out of shaving at Apa’s lodge as well. Back then you could see your breath and the outdoor washbasin made me feel the drag of the razor even before I started. For a while it looked like I might have an escape. Nawang Rapten, Apa’s younger brother, the monk was there. He has a short almost wispy beard on his chin. “Look,” I said to Apa, “Nawang has a beard. He looks good.” Apa’s reply: “Nawang’s a monk. You need to shave.”

Mostly for Mingma’s amusement I tease Apa about being the boss and being my fashion consultant. “Apa, you’re a good boss but a lousy fashion consultant,” I tell him. “Remember, though, when it comes to your taking the ginger, I’m the boss. Mingma’s made me the boss for the ginger so you’d better watch out or you’ll be having ginger tea for the next three weeks.”

When I wash my face the lukewarm water turns brown instantly from trail dust, and this is what I shave with. “Miss any places?” I ask Apa. “There,” he says, “a bit there.” So I work the chin some more. “Good, you look good now,” he says. We sit in the sun in the courtyard and drink tea. “Mr. Park had a beard,” I tell Apa. When we arrived at the Snow Lion three days ago we met Mr. Park at this same white plastic resin table in the courtyard. We are sitting in plastic resin chairs, the nesting type from China that you see all over the US, light and therefore perfect for the Khumbu, they’re twisty when you sit in them, the chair legs getting skewed by the rocks underneath. We had just sat down when Apa and Mr. Park spotted each other. “Mr. Park is very famous,” Apa tells me, “A famous climber.” Being a wise-guy I say, “Is there enough room at this table for two famous people?” I have no idea who Mr. Park is. He sits down and tells me he’s climbed all fourteen of the world’s 8,000 meter peaks. Apa tells me Mr. Park is Korea’s top climber, their national hero. “You’re a strong guy,” I tell Mr. Park, not being sure what to say. “My friend is strong, Apa’s strong,” he says. Apa says, “Mr. Park has a route on Everest.” This is quite the news. Having a route on Everest means Mr. Park has pioneered a route, has laid claim to it. It carries his name. I make a note to look into this later on. I’m hoping to get a photo of Mr. Park and Apa together, but it is another photo-missed. Mr. Park has a half-dozen clients and is busy entertaining. When we enter the Snow Lion lodge itself I see two posters of Mr. Park on the wall. One has a list of his accomplishments, and the dates. I read down the list. In addition to climbing all fourteen 8,000 meter peaks, Mr. Park has climbed the highest mountains on all seven continents and trekked to the north pole, and the south pole. The poster bills this final accomplishment as Park’s Grand Slam. “The Koreans take climbing very seriously,” Apa tells me. “They take chances. Mr. Park makes a lot of money.” I can tell this from seeing Mr. Park’s jacket. He has more than a dozen sponsors, perhaps fifteen, and looks like a race car driver with so many patches sewn on it’s impossible to differentiate one from another. “He has too many sponsors,” Apa says.

By this Apa doesn’t mean too many as in more sponsors than Mr. Park should have. When Apa says too many he means a lot. There are too many prayer flags in the Khumbu, or there are too many shops in Namche he’ll say. He means many. Too many is an expression. Many is good, and too many is that much better. “Mr. Park competes with Mr. Om in Korea. They are two famous people, but Mr. Park is more famous,” Apa says. “Mr. Om contributes to the school in Khumjung. He has adopted that school, so Mr. Park contributes to the Namche school.” Then I say, “That’s good, three famous people, and you each have a school to support. This is a good thing.”  A helicopter comes in low and fast. I photograph it. A huge dust cloud rises behind a rock lodge across the trail. “Mr. Park is flying out,” Apa says. “Really?” I ask. “He takes his clients by helicopter, they don’t walk up or down, they only do the walking on the mountain itself. Too many clients, too much money.” Apa says. “I thought Mr. Park was going to Annapurna,” I say. “He is later,” Apa says, “in October. Here he is with trekkers only. Those people you saw, they were trekkers for Island Peak. On Annapurna he will be with climbers. Very dangerous. The route Mr. Park wants to try this year on Annapurna is too many avalanches. I almost got killed there, and the route Mr. Park wants to try is more dangerous. Too many chances, that one.”

Now, with my shaven face in the crisp air, thoughts of Mr. Park at this very table are conflicted by the vivid image my brain has locked on the photo I took of one of one monuments in the valley of death. A bronze plaque on that monument was in memory of a Korean climber whose name escapes me, but it’s in the photograph. The deceased was, and this is the last line inscribed on the bottom of the plaque, part of Park’s Grand Slam when he climbed Everest in 1993. It strikes me as odd, but in 1993 Mr. Park didn’t have a Grand Slam, he was starting what would later become a Grand Slam. So the plaque has obviously been made after the fact. I find it curious that for the deceased climber being part of something that occurs after one’s death is somehow a relevant inscriptiom on your own memorial. But thinking it through I suppose it is a justification of a sort, some solace perhaps for whomever is left behind mourning. It was a death that contributed to a later success. I ponder this and decide that perhaps it’s more of a cultural thing: like our saying in the west “that he died in battle for the cause of driving the Nazi oppression from Europe,” but clearly this isn’t the case. The climber whose name I don’t remember died in the cause of furthering Mr. Park’s ambition, and the ambitions of Mr. Park’s sponsors. There is a disconnect here, and it may be my western philosophy, or maybe not, but I am reminded of just how peripheral mountain climbing is to the grand scheme of things. What really counts is not how many peaks you’ve climbed, or how many times, but who you are as a person while you take on whatever it is you do. I do not know Mr. Park so I make no judgments, nor should I if I did know him, but I have gotten to know Apa over four years, and it is one of Apa’s greatest strengths that the person he is is independent of climber he’s become. Having Diamond Mold sponsor his 21^st attempt carries with it the weight of a paradox. Our sponsorship is a good thing and a bad thing both at the same time. To promote a dangerous activity is not good, but the leverage success allows us, and Apa, should he succeed is arguably the equal counter balance.

But right now at the Snow Lion we are sitting in the sun, not waxing philosophical. We are amusing ourselves with tea and banter, and I am not feeling at all well. The exertion of the flag raising Puja, and it wasn’t much exertion, has taken a toll on me. Actually, an hour ago while on the hill at the stupa I noticed the dizzy feeling was still with me, and that it bounded back, intensifying, but I attributed this dizziness to an adverse reaction to the Diamox (acetazolamide) I’d tried half a tablet of first thing this morning. My theory with trying the Diamox now is this: to experiment with half a tablet to see if I tolerate it well or not. With more time in the States before our departure, and with the benefit of 20/20 hindsight, I can see a year of preparation for a Himalaya trek during which time, among other things, one could try Diamox in various settings and pre-screen the drug for side affects. It does carry an allergic warning among other warnings, and knowing one’s tolerance in advance would be a good thing. But I didn’t have a year to get ready, it was 50 days I think, and that with 12 hour days at the office. Trying Diamox was not on my priority list back then, but it is now, and I’ve tried it, a half tablet of it. Not being a fan of medication, I’d previously avoided the Diamox hoping I could do the climb without relying on a crutch. That said, I do have the prescription for just this purpose—in case of issues with altitude, and issues are what I’m having.

Since I felt remarkably better last night and early this morning, it seemed the altitude sickness had been thwarted, but that it made sense to ease into the Diamox in preparation of our return to higher elevation tomorrow: the trek back up to Loboche. According traveldoctor.co.uk/altitude.htm the literature says, and I paraphrase: Acetazolamide, unlike dexamethasone, does not mask the symptoms of AMS, but actually treats the problem. It seems to work by increasing the alkali excreted in the urine, making the blood more acidic. Acidifying the blood drives ventilation, the cornerstone of acclimatization. Studies have shown that prophylactic administration of acetazolamide before and during ascent results in fewer and/or reduced AMS symptoms such as headache, nausea, dizziness, drowsiness, fatigue…

Translated, I read this to mean that Diamox is designed to facilitate greater oxygen absorption thereby staving off the effects of altitude in advance, the very thing that decked me near Gorak Shep yesterday. But now, sipping tea in the Snow Lion’s courtyard in Dingbouche, the half-dose of Diamox doesn’t seem to be causing the dizzy problem at all. It seems the problem is really something already going on with my head. The vertigo, if that’s the right word, the dizziness and headache have come back, not quite as strong as near Gorak Shep, but still with enough force to be frightening. It feels a little bit like looking through a haze but there is no haze, just the idea of haze, and yet the haze is real and has a clamping force. I have no choice but to tell Apa I don’t feel well again. “Apa,” I say, “I’m afraid I have to go lower again. My head is hurting. The dizziness is back.”

This is a crushing blow for me. At best it’s a setback for Apa, but Apa displays no emotion one way or the other. It’s his bedside manner, all business, no sugar coating the situation, no crying and whining either. He thinks the idea is a good one, the right decision. He tries to console me, “We will check your condition tomorrow,” he says, “if you are good we come back up. Tomorrow we decide. Today we go down.” I appreciate his efforts, but they don’t change the immediate reality—it is a disappointment to be going down, not up.

We were planning to wash socks at the Snow Lion but now that we are descending again Apa says we won’t have time to wait for the sun dry them. I’m not completely incapacitated so I fish around in my repertoire of thoughts and say, “Apa. no worries. Let’s wash the socks and let them dry as long as it takes. We’ll pick them up when we come back up tomorrow.” Mingma also thinks this is a good idea. “See,” I say to Mingma, “that’s why I get to be the boss in America. Good ideas,” and I tap my head as if it is working. “Terrell, laga,” I say, and we get a good laugh out of that, but it’s a trivial comment. I’m trying to stay upbeat in the face of a larger dark cloud of thinking. To keep things light I ask Mingma about the origin of the name of her lodge, “Why is it called Snow Lion? Are there snow lions or snow leopards around here?” Both Apa and Mingma agree that there are. “Have you ever seen one?” I ask. They haven’t, but they’ve heard them. “Really?” I inquire, wanting to hear more. “The snow leopard, it makes a loud growl, something like an elephant,” Apa says, “but different, more like a loud cry.” This description leaves a range of sound possible. “When you hear one you know you’ve heard it,” Mingma says, “they’ll carry off cows lower down, not so much near Dingbouche, but lower in the forest.”

The plan is a descent to Deboche which is near the river in the valley below Tengbouche. Deboche is probably 600 feet lower than Tengbouche. “Better oxygen there,” Mingma says, “lots of trees.” Apa thinks this is a good plan, better than going to Tengbouche because of Debouche’s lower altitude, plus we don’t have to climb the opposite side of the valley to get to Tengbouche. The only question is whether we can get a room. There is only one lodge in Debouche, that and a monastery for nuns. We’ll just have to take our chances.

We arrive in Debouche around 5:00 pm and secure a room at the Rhododendron lodge, probably the last available room. There is a group of Czech trekkers, 20 in all, who have already taken up residence. Jetta is setting down our two duffle bags and, since I’m feeling better, it occurs to me to try hefting his load to get a feel for the 95 lbs I estimate he is carrying. This load is considerably lighter than the corrugated steel roofing load I tried carrying near Khumjung, but it is still heavy. I could probably carry Jetta’s load 500 yards, maybe more if I had to, but I take only a few steps. “Apa, quick, a photo if you can—Jetta and me…thanks.” A good number of the Czechs witness this bizarre display, and once again there is wonderment on every westerner’s face as to how the Sherpa are so strong and carry such heavy loads over uneven ground for such great distance. If there is one indelible memory I’ll take from Nepal it is viewing the feat of human endurance that every porter displays on the trail while carrying loads we would use a forklift for in the west.

Around the iron stove that night the Czechs are playing a rousing drinking game of a musical sort. Charles, you would be proud. Your countrymen take turns drumming a rhythm on the table and the rest of the group has to guess what song it is. The person pounding the table to the beat in their head has to keep going until someone gets the right answer. Between the laughter of 20 people and the table pounding I am content to peck away on the laptop, to photograph one of the cutest Sherpa toddlers yet encountered who is playing with Apa, and crushing and chewing on my Everest region map. I’m enjoying feeling good once more. Emphasis on feeling good—it is remarkable how good normal feels. Descending to Deboche has been a positive setback in a sense; we’ve limited our lost ground to just 3 days. Tomorrow I’m convinced we’ll climb back up to Dingbouche.

It’s dark now. Apa finds a cell phone signal and we make calls to family in the US from the rock-lined yard of the Rhododendron lodge. The stars are out and I have sandals on it is so warm in the dining hall where the Czechs are still at it, pounding and howling away, background music of a sort to the sounds of the forest and the river as it roars on the rocks in a relentless fury trying to get to India as fast as it can, the opposite direction of where we are trying to go—up—toward Tibet actually, and literally in Apa’s case. If he can stand on top of Everest for the 21^st time he’ll once again enter China without a visa. We are planning an early start in the morning. It is time now for a good night’s sleep. All is well. Our trek is back in order. I am feeling optimistic.

April 18. Dawn in the rhododendron forest. After breakfast we are on the trail heading back up to Pangbouche. Gossamer films of a light green moss hang indiscriminately from the branches of all the trees. The birches, the fir trees, all the trees are covered in something like a short version of Spanish Moss. We discuss the possible sources of this stringy green stuff but have no answers. It’s something about a foot long carried by the wind, a stringy spore that some vegetation has chosen for a method to propagate. It’s spring in the Khumbu, Apa reminds me, although it feels more like winter. “The yaks are tired now,” Apa says, “in October they are well fed and healthy, but now they are weak from not enough food.” In the winter the yaks forage the hillsides when they’re not carrying, but the pickings are scarce. I ask Apa if the grass grows again as the spring turns to summer. It looks so short and munched over and brown that I can’t imagine it would spring back to life. There are even square sections of the hillside grass cut out like sod harvested. “Flooring,” Apa tells me, “Some Sherpa use it for the floor, it is warmer than concrete, less expensive that wood.” I haven’t seen a dwelling yet that hasn’t had a wooden floor. “Not a rich house, only a poor, house,” Apa says, “You haven’t been in a poor house.” He then goes on to say, “There is no summer. Only monsoon. In the monsoon the grass grows and the yaks can eat all they want. Right now they have to eat what dried grass their owners carry for them. This is not a good season for the yaks, they are very hungry and tired.”

Not far from Debouche is a fantastic wall of prayer stones that’s at least a hundred feet long. I haven’t described the prayer stones before, but they are carefully chosen rocks, flat, like slate, but not smooth, and about a foot wide, two feet high, a couple or three inches thick. Onto each flat stone are carved by hand in half inch or three-quarter inch high letters line after repeated line of the omane prayer, the lotus blossom. The rocks look to me to be a hundred or two hundred years old—there are never any new ones, only old weather beaten stones, and they are stacked like a long minature straightened-out Stonehenge with none of Stonehenge’s massiveness. Really, the prayer wall bears no relationship to Stonehenge at all other than rock, and old, and stone cutting, and huge effort. Those qualities are all consistent. I could have likened the waqll of prayer stones to the Easter Island statues--another bad analogy. But incredible dedication and laborious work are similar—each prayer stone must have taken a week of chiseling, and there are literally thousands of prayer stones in the Khumbu.

This being my third trip past this prayer wall I am seeing it more closely each time. Suddenly, on the opposite side going in the opposite direction to us, is Puli. She has come down from base camp and is on her way back to Thame. She and Apa are talking but each can only see the other’s head so they move to a break in the prayer wall and it strikes me that this is just like the scene in Kurosawa’s movie Dersu Uzala when the Russian capitan meets Dersu and they are on opposite sides of a massive fallen tree, trying to find a way to reach each other. A classic movie if you are interested in classics. I try for the Dersu photo-moment but again doubt my picture will do justice to the idea, I doubt that it will match the pathos portrayed in the movie. For some reason I have made a practice of not looking at any of the photos I’ve taken. Probably a throw-back to the old days of film rolls when you had to wait until weeks after an adventure to see what story your developed photos turned out to tell. But I digress…

Not far above the prayer wall on the way up to Pangbouche I notice the ground sway and my head feels light and achy. The pressure and haze continue to build. It just has to be a negative reaction to the Diamox. I’ve taken a full 250 mg tablet last night and another again this morning as prescribed. Surely this, being four times what I had in my system yesterday in Dingbouche, is making me dizzy. I work on the logic to support this theory. Why not the Diamox? I was feeling good last night so it can’t be altitude sickness, if it was AMS and it went away, why would it come back? I’d have acclimatized already. Why would AMS come back at a lower and lower altitude every day? There is something not making sense here. The altitude sickness seems to go away when we descend, but as soon as I go up even a little, it seems to come back. But my blood-oxygen levels are so high. Mid-90s and higher in Debouche. No shortness of breath. Heart rate just fine on the steep sections, in the mid-130s. Legs fine. Left knee, fine. I seem physically just terrific. But something is clearly wrong with my head.

This time on the ascent we bypass the monastery above Pangbouche and instead take the easier more gradual trail to Pangbouche itself. This is the town mid-way to Dingbouche that we passed through yesterday about 3:00 in the afternoon. Today it looks brighter since the sun is out, and I am sweating from the uphill climb, glad that Apa suggests a break for tea. I am feeling wobbly.

We order hot lemon from another tea house owner Apa knows—he knows people in every town and hamlet we’ve passed through. I haven’t mentioned it before, but when on the trail out of every 30 or 40 Sherpa who pass by 2 or 3 will know Apa personally and stop to talk with him. When we left Lukla for Phakdang Apa ran into a German film producer who knew him and who was making a documentary. He filmed Apa on the spot and half hour later Apa was finally able to catch up with our group. “Too many hands to shake,” Apa has said more than once, “It’s no wonder I have the Khumbu cough so soon,” he says.

Now, at the tea house there is no question. Diamox is not causing my discomfort no matter how hard I wish to convince myself it is. The headache and dizziness are so pronounced and so similar to the Gorak Shep experience that it just can’t be an allergic reaction to the acetazolamide. It’s the damned altitude sickness all over again, but this time at even lower altitude. I just can’t seem to win against this opponent. Going down helps, but only temporarily. The original descent to Dingbouche eased the pressure for a while, then the dizziness came back while there yesterday. The descent to Deboche helped last night, but this morning the headache, mental haze and profound weakness I feel intensifying at the tea hose in Pangbouche are swirling in me with a vengeance. I have no choice but to tell Apa. “I’m dizzy, Apa,” I tell him, “I’ll have to turn back again. I have to go down even further. I think as low as Namche.” He is completely understanding, assures me this is OK, more than OK, he says it’s the right thing to do. “People die from the altitude sickness,” he says, and there is no glint around his eyes, nothing of the imp in him coming out. He is being completely serious. So I suggest: “You go on up, keep going, I’ll be fine. Jetta can go down with me,” but Apa is having none of that. “We’ll all go down together,” he says, “It is better that way.”

First we have to make sure Jetta hasn’t passed us by, he could already be higher up the mountain. We can’t just descend and have our porter headed in the other direction unaware of our change of plan. Apa’s pretty sure Jetta has run into friends and has stopped lower on the trail to talk. He’s confident Jetta hasn’t made it to Pangbouche yet so we sit nearer the wall so Jetta will see us, or we’ll see him, as he comes up the trail. I’m not able to watch for Jetta. The tea house fading in and out; it’s like looking through a lens with Vaseline on it, and then not, and then again. And my head hurts. I can feel it is pressure from the center out, not the outside in, a kind of backwards dizzy headache like something crawling outward from the center of the brain, and the skull not being there so much to contain it as just a sense of expanding pressure with loss of equilibrium, like a balloon stretching as if my head is elastic but fighting back.

This feeling has now been with me for three days and I am beginning to be alarmed. What is the solution if descending hasn’t worked twice now? All I know for sure is that I have to get down and Apa is in complete agreement. Jetta comes up the trail and Apa lets him know we are turning back. I scan Jetta’s face but he betrays no inner thoughts. Does it bother him to be going up just to go down? Or does he see it all as the same thing: up or down, the daily pay being the same? I am not able to speculate further. This time walking down is not easy. I have to force myself to take steps and fear is starting to creep in. What if I can’t drive this cranial plague out of me? What if this torture gets worse?

We get down to the bridge in an hour and cross the river quickly. I’m not interested in photographing the drop into the ravine or the surging water carving the granite bolders. I have these photos already. More won’t help. I need legitimate diversions to get a break from the percussion in my head. At the prayer wall, my fourth time past it, Apa points out that the prayer stones are all set on a foundation of rock about two feet high. “To keep the prayers off the ground,” he says. This makes so much sense I wonder why I haven’t noticed it before, why someone has had to point it out to me. It’s good to know this and I say to Apa, “There are no new stones, only old stones. It doesn’t look like anyone carves new stones anymore. Why is that?” “Cell phones,” he says, and it’s true to a point even though he’s being facetious.

All the porters have cell phones, and when there is an area with a signal they’ll stop with their loads and make calls. With a little imagination they look like semi trucks lined up in the truck stop, diesel engines still running, the drivers are grabbing coffee inside, making calls, buying cigarettes. Inevitable change has come to the Khumbu. Kami Temba thinks 2007 was when cell coverage first started to gain serious ground. It was satellite phones before that, but those were too expensive for most people. Now, the ubiquitous cell phone, it’s everywhere. I have been trying to capture this phenomenon: change in the midst of centuries of tradition. The incongruity between global communication making access to anything available to anyone, and the daily need to heft hundreds of pounds of cargo with a sling around the forehead is a mind-boggling contrast. It reminds me of a photo of an indigenous Papua New Guinea tribesman I saw in 1983, naked with a penis sheath, bones through his nose, red swaths of clay decorating his forehead and cheeks, he’s sitting on a green and white 125cc Kawasaki with a big grin on his face. “I’ll tell you why there are no new prayer stones,” I say to Apa, “It’s because people’s efforts now are going toward preserving your heritage. Look at the foundation those prayer stones are sitting on. It’s brand new rock.” We stop and sure enough the whole foundation and inner structure can’t be more than a few years old. The outer layer of prayer stones has a new support structure holding it up. “What people are doing now,” I say, “is putting their efforts into protecting the culture, perpetuating it in the face of technology. You’ve got to build up a buffer not to lose your uniqueness to western ways. But you have to accept change at the same time. It’ll be an interesting balance to juggle over the next 20 or 30 years.”

Apa says, “At the Thame school we have seven teachers. Three are Sherpa educated in Kathmandu. Four are Nepali from the low land, and brought in to teach. But of the three Sherpa teachers one is for cultural studies specifically. We teach a class in Sherpa ways at Thame School.” “A good decision by the school board,” I say, “It’s important to develop the right curriculum.” Apa wants to know what curriculum means and 500 meters of trail pass by while we pin down the subject. “The Thame School teacher we met on the trail on the way to Khumjung?” I ask, “What’s his name again?” “Lhakman.” Apa says. I have taken a photo of Lhakman and Apa together on the trail to give to University of Utah Health Care so they can see the teacher they’ve sponsored for a year. “What subjects does Lhakman teach?” I ask. “Apa says, “Lhakman,” then pauses, “he’s an administrator not so much a teacher.” “Ahh, administrative, like a principal?” I . “Yes, principal, exactly. Lhakman’s the principal of Thame School,” Apa says smiling. “Well then,” I say, “University Health Care can sponsor the principal for a year. How about that?”

Diversions like this are good. They make the steps feel easier and the distance covered goes by faster. I notice the birch trees have red bark. “Look at that, red bark birches,” I say to Apa. He says, “Male birch trees, the female trees have black bark.” There are large groves of dark gray birch trees with rough peeling bark tinged black at the edges. In the middle of these dark trees are much smaller pockets of red barked birch. “Like a bull in a field of cows,” I say, “Doesn’t take so many red birch.” Whether this is true or not I don’t know, but it passes the time. We come to Deboche. An eternity ago we were just here but it’s only been 4 or 5 hours hours, maybe less. The plan is to leave Apa’s bag at the Rhododendron lodge. He will take only what will fit in the pack on his back. No reason for Jetta to carry Apa’s gear down to Namche just to carry it back up. Mine, however, will have to go down.

There’s the chance I won’t be coming back up. Apa makes this more than clear at Deboche. “We will see what your condition is tomorrow in Namche, then decide.” he says. Apa’s the boss and I’ve been quoted in the Salt Lake Tribune before we left as saying, “If Apa says I go up, then I go up. If he says I go down then I’ll go down.” Words to that effect. Now I’m getting a chance to taste the right hand side of those words, a bitter taste like they’ve come back up from my stomach with an acid burn to haunt me. The going down part. That part isn’t fun, but it is all part of the experience and that’s what I’ve come to Nepal for. To experience something new, not to achieve specific goals, but just to let the Khumbu waft over me and reinvigorate my psyche. The paper also quoted me as saying: “My Everest is right here in Salt Lake City trying to create jobs.” And that is true. Apa’s Everest is here, mine half a world away. But now, in the shadow of Apa’s Everest I’ve been humbled by forces greater than I have any control over. My head is like a pressurized fog generator and Philip’s terse French Canadian words come back from the other day in Dingbouche: “You have to respect the mountain.”

Getting down to Deboche has been the easy part. Now we have to climb the opposite side of the river valley to Tengbouche. An hour uphill, not more, but it makes my head swim. While we are on a particularly steep section my heart rate on the Suunto display shows 54 bpm, then it drops further, 52 bpm, 47 bpm, then 46 bpm. This can not be. A falling heart rate. If I’m at 46 bpm under full exertion then I’m dying a slow death. Maybe it’s a heart attack in addition to cerebral problems? I have to stop beside a tree and hold on just to discard this thought, sort out reality from paranoia, and get a mental grip. When I look at the Suunto next it shows 137 bpm and this is a tremendous relief. The 46 bpm had to be an electronic anomaly. Roger can isolate the data later on in Salt Lake. If you see a 46 bpm flicker on April 17, Roger, I’ll show you a photo of the section of trail I was on while trying not to lose my mind.  It’s not a real-time photo taken at the 46 bpm instant because photography wasn’t on my mind just then, but it’s a photo of the same stretch of trail taken on April 13 when we descended from Tengbouche. It may even have the same worn tree in the center of the trail because I am grabbing onto that tree, still, trying to muster energy to keep going uphill. We have to make Tengbouche before we can head down the other side to Phunagi Thanga on the way to Namche.

At Tengboche I remember there is an internet café and a connection might be possible. I ask Apa if we can stop to post to the blog. He says this is fine, we’ll have tea, and milk tea is brought out. I can do the post because it is a mechanical operation, no thought required. Insert the thumb drive in the café’s computer, open Word, copy the text, login to the blog, paste into the rectangular box, and click the post button. It’s usually as simple as that, sometimes complications, but this time no problem. The post has gone through. Moments earlier while the internet was connecting it started to hail outside. The steel roof makes a pinging sound and then a drumming sound as the hail turns to rain. Last time we were in Tengbouche there was rain too, but this is a downpour. We open our packs and dig out the rain gear. Unfortunately Jetta has none. He only has a sweatshirt. Incredibly, in addition to carrying loads of 100 lbs, Jetta travels without a winter coat or rain gear. He has a green and red scarf made of connected pom-poms that looks like something an ice skater might wear for a costume in the Olympics. Luckily I have Apa’s spare rain jacket in my duffle bag and Jetta puts this on. It’s too small for him and he can’t zip it up, but it’s better than nothing.

We pull a plastic garbage bag over the duffel bag Jetta is carrying and set out in the mud. Jetta is a Hindu and doesn’t pass stupa, omane rocks, or prayer walls in a clock-wise direction. He passes in any direction on whichever side presents itself as the shortest route. The Hindus and the Buddhists get along fantastically in Nepal, they coexist peacefully and with respect for each other. It’s a very healthy dichotomy. Apa is still talking with a Sherpa he knows lower in the village but has almost caught up. I am a hundred yards ahead of him in a sloping field in front of the Tenbouche monastery. I realize that by following Jetta I’ve passed the stupa in this field on its right, counter-clockwise, the wrong way. Bad luck that, from Apa’s perspective. I stop immediately. Apa is following me. I turn around and go down to where he is. “It’s OK,” he says, “we can pass this one right side.” The rain is beating down and it’s cold. “No way,” I tell him, “Rules, Apa.” So we argue a bit. Finally he says, “Ok,” and we turn around, walk back downhill, and go clock-wise around the stupa. Apparently even in the Khumbu one has to argue with their boss on occasion. It’s proof I’m feeling somewhat better, and I think on the inside Apa’s is pleased that we’ve detoured back and walked around the stupa clock-wise.

The trail to Namche has a series of descents to rivers followed by painful ascents to ridge lines. There’s as much uphill as downhill in each valley we pass through--less about 500 feet since in net elevation we are descending.  The downhill sections are slippery and the uphills are steamy and sweaty. After Phunagi Thanga we come to the fork in the trail to Khumjung, “Fork in the road,” Apa says having picked up that phrase.  We drop down to the tea house near the army barracks where a week ago I photographed a soldier through the trees reading his book on a large rock, his rifle next to him pointed down the valley.  A guard caught off guard if that photo comes out. This time at the tea house we have the same hot lemon, but the fascination with my surroundings has evaporated. The next stretch is a vicious uphill to a ridge in the middle distance. It’s still about three hours to Namche, and while my head has plateaued in dizziness and aching, the hillsides haven’t. We set off uphill, one small step at a time.

In the next valley there’s a large suspension bridge and I cross this oblivious to its height and the view. Right now getting to Namche is all that counts, the scenery can wait. Photos can wait, but no, as we near the top of the next ridge there’s a porter with an enormous load, the largest in terms of cubic feet that I’ve seen. A photo has to be taken. He’s carrying what looks like rolls of building insulation wrapped in white polypropylene. His entire load is literally the size of four small refrigerators side by side: five feet wide, five feet deep, six feet high. It probably weighs no more and no less than the average porter load of 50 to 60 kilos, but its sheer bulk is amazing. “Bad if the wind comes up, that load,” Apa says.

After what I’m calling the huge porter-load valley we come to a greener, warmer valley. More trees here. The rhododendrons are blooming. I know we are getting lower. There is a cove in the hillside like Olympus Cove in Salt Lake, but smaller, narrower, and we are on the left side of this when we hear the strangest, loudest, penetrating sound. It’s like a cross between a bellow and a bark and a howl. Jetta and Apa stop. I stop. We all peer into the forest in the direction of the sound, and it comes again, a unique deep throated growl. “Snow lion,” Apa says. This can’t be. We were talking about snow lions in Dingbouche two days ago. A woman comes down the trail with a nervous look on her face, converses with Apa, moves on quickly. “She is worried the snow lion might have taken her calf,” he says, “It’s down where the sound has come from and she cannot find the calf.” We wait a while longer. I don’t feel sick now. All my senses are tuned to any movement we might see in the trees. I would love a photo of a snow lion in the wild, but it’s not to be. We don’t hear the noise again. We see no motion in the stillness of the forest. It’s time to move on. When we are on the other side of the cove Apa says, “The snow lion will take down horses and cows…” and he trails off. I can see that he’s shook up, even a little nervous. “And people, I would imagine,” I say because I know Apa wants me to say this rather than him. “People?” he asks. “It’s possible,” I say, “we are smaller than horses and cows.” We walk on through the canopy of trees and pretty soon the forest ends and we break out into the late afternoon sunshine.

Around the next ridge the wind picks up and we can feel evening is not far off. A stupa is perched above the trail. “This is the Tenzing Norgay stupa,” Apa says, “It was built here because of the view of Everest. It’s the best view of Everest from this part of the Khumbu.” And he’s right. I take photos and the view with the low sun angle outlines the mountain. You can see the South Summit and the ridge with the Hillary Step. “Not a good day for the summit,” I say, as if I know, but the snow trail blowing to the right off the top looks like a telltale sign. “Not a summit day,” Apa says, “Too much wind, that.”

We leave the Tenzing Norgay stupa behind us. It’s getting colder now, but not too cold, it’s the wind and dampness that makes it feel colder than it is. We round the next bend and a small hamlet comes into view. “Look,” Apa points, “There…!” A wild bird with rainbow colors is unearthing potatoes from a field and eating them as fast as he can. A ten year old boy is chasing him and tossing rocks to try to drive the bird out of the field. His aim is not very good and the bird seems to know this, keeps pulling the potatoes out of the ground, eats them, and runs some more. Apa and I give chase on the trail higher up paralleling the field. We have our cameras out and I can hear Apa’s clicking and see his flash going off over my shoulder. He’s taking as many photos as I am. The light is low, but it’s not dark yet. We’re chasing the most marvelous bird I’ve ever seen in the wild. “Pheasant,” Apa says, “It’s a male and has nine colors.”

The trail loops around the ridge and comes in above Namche on the east side, high above the town. Apa points out the Namche clinic. It’s the highest building on the hill, nothing has been built higher. “Why build a clinic at the top of the hill?” I ask, “What if someone has a bad leg? How do they get there?” These are basically rhetorical questions, not something Apa can answer. I don’t pursue it further. We walk down the steep rock stairs and come in right above the Camp De Base lodge where we stayed 11 days ago. I recognize the internet café and the wooden portal into the De Base compound. Sleep can not come soon enough. “Dinner first,” Apa says, “You have to eat.” So we eat, and I have to drink lots of water too: “Drink as much water as you can,” Apa says. I’ve been drinking so much water for two weeks I feel like a fountain. We buy two liters of bottled water that I’m supposed to consume overnight. All I remember from that point on is waking up sometime in the night to discover I’ve fallen asleep sitting up in the sleeping bag, not even in it. I’m just propped up against the wall, no down coat on, just Dana’s Rowmark fleece, shivering. I crawl lower in the 40-below and am asleep again immediately.

April 19. Namche. No travel. The day is a blur of nothing, a foggy haze of headache and dizziness and sleep. We eat breakfast and I tell Apa immediately afterwards that I need to take a nap. He insists that I make calls home to speak with Carolee and Dana and Mr. G. I have vague recollections of conversing with Carolee, of her saying that I should go to the clinic, what she’s read about altitude sickness, Diamox, and have I been taking the Diamox? It is too much for me. I can’t follow the conversation or hold up my end. It’s hard to hear parts of what she’s saying and I become irritable about the specifics of a Diamox discussion. I’m half way around the world for hell’s sake. I don’t want to talk about altitude sickness or Diamox, or anything anymore. I just want to sleep. In the end I wish I hadn’t called because I’m sure she’s alarmed. Apa was right to insist though. My family should know I’m alive. Carolee likes to hear my voice. It’s understandable even though I’m not in an understanding mood. It’s 7:30 in the morning in Namche. Night time in the USA. I’ve been sitting on the ground leaning against the building, unable to stand, talking on the cell phone and putting as much good humor in as I can which hasn’t been much. The calls have completely exhausted me. Apa brushes white chalk-like cement dust off my jacket that’s rubbed off the wall of the De Base building. I go straight back to bed but not before telling Apa that after I feel better I want to go back up, to at least try to make base camp. He tells me we will check my condition later on, then we’ll decide.

Apa wakes me up every couple of hours with tea to make sure I am still with us. He’s talked with Dawa Steven at base camp and the decision is that tomorrow Apa will head back up to base camp with Jetta. Khanchha, a Sherpa Apa has climbed with before, is coming down from Khumjung today and will take Apa’s place guiding me. Asian Trekking will pay for Khanchha whether he and I go up or go down. I like this arrangement. Apa will not be held up any longer, he can get started acclimating at higher elevations, and I won’t become an even greater liability to him. It also allows for the possibility that Khanchha and I can retrace my steps and head back up if I’m feeling better.

The next time Apa wakes me up it’s with news he’s located a pharmacy with a nurse lower in the town. “You don’t have to climb to the clinic on the hill,” he says. “This one is close to here.” It’s now 3:30 in the afternoon and hearing the good news I dredge up the energy to make a try for this nearby clinic. It takes me about 15 minutes to sort out my boots and laces, coat and hat. I am moving very slowly, but Apa is ever so patient.

Rhita Doma Sherpa’s Mountain Medicine Center in Namche is about 50 meters below the De Base lodge and easy to find. She tells me she is a nurse and that she will take my vitals. Temperature, normal. Blood pressure, normal. Oxygen saturation, excellent. I ask her about the oxygen saturation which seems at odds with a continuous headache and dizziness. I tell her that descending doesn’t seem to have helped. Does she have any ideas why I can’t shake this altitude sickness? She thinks for a moment, “I don’t believe you have altitude sickness,” she says, “I think you may have cerebral edema. It’s a swelling of the brain caused by fluid leaking out.” She gives me Panatol tablets for the headache and a laxative to clear me out. “Take these half an hour after eating she says, not on an empty stomach. Check back with me at 8:30 tomorrow morning and we’ll see how you’re doing.” “I need to pay you first,” I say. “You can pay me tomorrow morning when you come back,” Rhita Doma says.

Apa and I make it back up to Camp De Base. It has taken all my effort to climb the alley stairs to reach the lodge. Apa can see how weak I am. I’m moving like an old man. When we get to the last steps the lodge’s restaurant is to the left, our rooms to the right, I have to sit on the stone stairs and rest. The late afternoon sun is behind the ridge line of mountains and its after glow is moving slowly across the buildings behind us. “What about a helicopter?” Apa says. He isn’t asking as much as telling me. “Your insurance covers the heli doesn’t it?” I haven’t wanted to think about the helicopter evacuation as an option. I’ve tried to stay positive and optimistic about returning to where the action is—higher up. I look at my watch, it’s 4:38 pm on April 19. If I go out on a heli the trek to Everest will have finished me off in just two weeks.

In the Khumbu they call a helicopter a heli, but I don’t want a heli. A heli’s the end. Trip finished. A period at the end of the project. Done. Over. Any way I think about it exiting by heli isn’t what I had in mind. But I am feeling so weak, so dizzy, so much head pressure, and it’s getting worse each day. It was Einstein, I think, who said the definition of insanity is repeating the same thing over and over and expecting a different outcome. Today I can’t even muster a lame worn out joke. I haven’t got the energy to tease Apa. I have only enough energy to let his heli suggestion penetrate my psyche. I have to agree with him. The heli is the right choice. With Apa having brought the helicopter up, and with Rhita Doma delivering the sobering news that I may have cerebral edema, the pieces of the puzzle are coming together. No wonder descending hasn’t cured the altitude sickness, I have a larger complication that can have severe repercussions. The list isn’t pretty: headache, weakness, disorientation, loss of coordination, decreasing levels of consciousness, loss of memory, hallucinations, psychotic behavior, coma.

Nothing about that list is promising and the further one reads down it the grimmer it gets. I don’t have the list in front of me, and don’t need it. I know the gist of it and that’s sufficient. “OK,” I tell Apa, “I’ll go for the helicopter.”  He makes a call to Asian Trekking in Kathmandu and talks for a few minutes. “Pasang says it’s too late for a heli today, they haven’t been flying this afternoon. The weather’s not been good. Pasang says he can schedule it for first thing in the morning.”

This is a hard pill to swallow. For the few moments until Apa finished his conversation with Pasang I’ve had visions of miraculously being lifted skyward while leaving the crush of headache and dizziness on the ground in Namche. The helicopter was a ticket to freedom from pain and worry, and now this salvation is a long night of dread away at best. Accompanying Apa to Everest has turned into quite a saga, but I haven’t given up completely. “Maybe by the morning I won’t need a heli,” I tell Apa. “What if I’m feeling OK in the morning and can walk down?” “We have to let them know now so they can schedule it,” he says, “You have to decide now.” The weight of the decision is intense. I feel like I have a porter’s strap around my head and a load of corrugated steel dragging me toward hell. But then I devise a plan. The brain is still working after all. It’s a simple plan, but sufficient, and I say to Apa, “OK, please tell Pasang to schedule the heli.”

This does two things: it keeps the heli option alive for the earliest possible evacuation—I may need it, and it gives me the whole night to get better and possibly work out an alternative to the heli before it takes off from Kathmandu.

Khanchha arrives at dusk. He’s wearing a green New Hampshire Forest Service jacket and looks like he’s just stepped off the tram in Franconia Notch. I am weak and unresponsive. I feel bad for Khanchha. He’s walked all the way from Khumjung and the person he’s come down to guide (me) is listless, not entertaining at all, a drag on conversation, and sick besides. I apologize for not being very good company, and Khanchha takes this in stride, tells me it’s not a problem.

After dinner I’m exhausted, achy, tired. The sore throat and runny nose that came on in the middle of last night have gotten worse now. I need to be in bed in a desperate way. We agree 5:00 AM will be the wake up. This will give us time for a short hike to check on my condition. It seems we now have until 6:00 AM to commit the heli. Pasang will be standing by at 5:45 AM on his cell waiting for the final decision. I take my leave of Apa and Khanchha and am asleep in no time.

2:11 AM. I wake up, still in Namche, still the same nightmare. But these are the wee hours. It’s April 20, and no question about the time. The Suunto t6d works perfectly now with a layer of blue duct tape on its pancake battery, i.e. on the battery inside the watch housing. A week ago, in Khumjung, when the face went blank again I did a brief run down of the possibilities: dead battery ruled out since Johann’s external duct tape fix was a good, although temporary fix. It has to be a battery contact issue. In fairness to Suunto, this may not be a general problem with all the t6d models. Apa’s has been working fine with none of the issues mine has, or that Johann’s has had. Still, and granted a small sample size, 2 out of 3 heart monitor watches have been suffering battery connection problems. Johann’s is an older model, I’m not sure which, maybe his is just a t6, I don’t know the model numbers, whereas Apa’s and mine are t6d.

Apa’s signature watch, his own Everest Edition orange bezel Suunto which he wears daily, has been working flawlessly more than a year, two years possibly. The way I remember it he was given this watch by Suunto in Copenhagen at the World Conference on Climate Change in 2010, or it could have been 2009. There’s a story behind his receiving the watch that I don’t recall right now, but his is serial number 0001 of only 8,848 made. One watch manufactured for every meter of Everest’s height. Apa’s signature is etched on underside of each one. I have serial number 0023 which Apa has given me, and I thoroughly enjoy. It works great. I have left this watch in Mr. G’s care so I don’t scratch it up on the Everest trek. Besides, I don’t need two watches on my wrist at the same time. There’s also the pulse-oximeter’s watch to deal with.

In any event, the solution I’ve devised in Khumjung for the t6d, and which has worked great since, is to razor-blade a ½” diameter round circle from a strip of duct tape. This duct tape circle is just a hair smaller than the size of the innermost diameter of the circular ridge on the inside of the watch’s backing plate, and the circular ridge is what contains and positions the battery side-to-side when it’s in the watch. Sticking this duct tape disk on the battery surface makes the battery just slightly thicker. This in turn makes for more pressure of the watch’s back plate against the battery when the back plate is closed, and this keeps the battery in touch with its contact surfaces 100% of the time.

At our lunch break in Thamo the week previous, Johann and I discussed and even practiced opening and closing the watch’s backing plate. It is possible to close it in an unseated position, i.e. not pushed far enough into the watch housing.  This was more of a problem on Johann’s watch than mine, and that may account for why the external duct tape solution has worked well for him. On my watch, the back plate when closed properly nests a good .050” below the watch’s back proper, and even when the back plate is good & snug and depressed properly in the closed position it has not been able to maintain the display’s readout. Since Khumjung, however, with the duct tape shim on the battery, no problems.

I’ve taken photos of this duct-taping operation thinking Roger F. will get a kick out of the food chain that relates tangentially to his electro-cardiology. I am the downstream element using duct tape to keep the t6d heart monitor running to collect data for Univ. Health Care, whereas Roger is upstream using far more complex electronics to track catheters on their path as he manipulates them to the heart. That said, Roger, wouldn’t it be useful for you to keep a roll of duct tape handy in the cardiology lab during your pacemaker insertions? Please consider this my official recommendation from 12 time zones away for advancing the state of medicine in the United States.

It may turn out the duct tape suggestion is my only contribution to U. Health Care since the data collecting for HR and oxygen % have fallen on hard times: collateral damage from the altitude sickness fallout. I didn’t collect higher elevation data like we’d hoped, and the data recorded at lower elevations may be fragmented and inconsistent since Apa and I were still working out our system for wearing the chest belts. Putting them on in the mornings in the cold takes some nerve, so I started to sleep with mine on just so it would stay warm, Apa’s bothered him when sleeping…and so on.

Enough on watch repair and data. It is 2:11 AM. There are dogs barking. The “free dogs” as Apa calls them. Not wild, but not attached to anyone either. Just dogs. The free dog ruckus is not a novelty anymore. My thoughts are of extricating myself from the dilemma of massive head pressure, dizziness, chronic weakness, and concern, intermixed with an almost but not quite equal number of thoughts for how to get well quickly by descending even lower. With nothing to do but wrestle with these conflicting thoughts I rough out a calendar in my head and later on a scrap of paper to see if it is mathematically possible to descend, to get well, to return upward in the number of days I have remaining. By my calculations given the 18 days that remain, it would be possible at my western pace to descend to Phakdang, which is even lower than Lukla, rest for a day, then retrace my steps back up with rest days interspersed, with the goal of reaching EBC (Everest base camp) by the 29^th of April. Then descend on May 1st, and each day thereafter. If this schedule worked I’d still have a two-day buffer for bad weather, delays, etc. built in before the flight departing KTM for Bangkok on May 7.

Reaching base camp is a theoretical possibility. So much for the positive side of things, and I realize in the darkness of the Namche night while listening to the free dogs bark, huddled in my down coat and Apa’s 40-below sleeping bag, that this my mind trying to hang on to its sense of being OK, to its desire to seize some sort of moral victory from what has become a meltdown of the physiology.  Reality, however, is considerably different. I’m drinking as much water as I can swallow and this doesn’t help. I ate not one but two garlic steaks for dinner and that didn’t help. I went to Rhita Doma Sherpa’s Mountain Medicine Center in Namche and she gave me Panatol and a laxative, and that hasn’t helped. I’m feeling weaker and weaker and more and more dizzy, and this is in the face of having descended further and further. After 3 days there is no correlation between descending and regaining equilibrium and strength. Quite the contrary, I am feeling worse. Making it up the ladder-steep ten or twelve steps to the room earlier tonight was a huge challenge.

Sitting here now I’m seized by a feeling of dread and despair. Something is definitely wrong with my head. Rhita Doma said she didn’t think it was altitude sickness; she thought it was cerebral edema. A swelling of the brain caused by leakage of fluid. This potential diagnosis is not a pleasant prospect. Weaving my way to the loo on shaky weak legs is proof of my debilitated state. So why even let thoughts of trying to make EBC enter my mind? Well, in part because my physical condition seems so promising: heart rate is running 59 to 65 bpm at rest and my blood-oxygen saturation level is fluctuating between 91% and 96%. Plus nurse Rhita’s blood pressure readings of 110/80 were normal too. All these vital signs being normal is encouraging, so that’s one reason for staying in the goal-oriented frame of mind, but physically I’m experiencing something quite different, something like sea-sickness without the nausea, like my head’s in a vise, like my ears have rods pressed in them. The analogies can go on and on, but it’s the list of cerebral edema’s symptoms that is so frightening, especially the last one: coma.

The problem with drowning in self-pity in the darkness is that it’s not coming just from what I’ve read. Apa’s words to me that altitude sickness can kill are a chilling reminder that I am not sea-sick on the way to Hawaii, I’m stranded on a mountainside in Nepal in a hanging basket of nightmares squeezed like eels through the wicker sides by cerebral edema, and fluid is leaking out everywhere. With these flitting thoughts the idea of resurrecting another effort to achieve base camp seems perverse. I sit up straighter and turn instead to the task at hand which is to feel better first and foremost. Everything else, if there is anything else, can follow from that.

Suddenly it occurs to me that I have the Global Rescue’s US phone number in my wallet and we need to call them. We can’t just have the heli pluck me out of Namche and expect Global Rescue to pay US$ 6,500 after the fact. Pasang has confirmed the cost. We know that much. What I need to do at first light is ask Apa to call Pasang.  Pasang in turn needs to call Global Rescue and sort the details out. We’ll have to establish cell phone contact at 5:00 AM, definitely not later than 6:00 AM. If the heli takes off before Global Rescue is notified it may be too late.  Global Rescue’s number is laminated between two pieces of clear packing tape. It was a last minute thought in Salt Lake before departing to tape over the paper printout with Global Rescue’s phone and my membership number. I’d cut the printout down to 2” x 3” with just the pertinent info, and taped both sides of that—just in case I might need it later on and wish it were legible, not dog-eared or smeared from water.

There’s a knock on my door. 5:00 AM arrives early even when you are half-sleeping half waiting for it. Apa’s head appears around the corner first. Immediately he asks, “How are you?” I give myself about 8 seconds to consider his question. My head is a pressure cooker, the room semi-distorted, like looking in funhouse mirrors. “Not well,” I say. Khanchha comes in carrying a thermos of milk tea and glasses. I can see my breath but what I’m really interested in is the weather outside. Apa pulls the curtain. It’s only dawn but I can see a clear blue sky above the mountains. This is good. The heli can fly in this weather unlike yesterday afternoon. “We have to call Global Rescue and clear the heli with them first,” I explain. Apa agrees, this makes good sense even though in his experience Asian Trekking and the hospital will provide the requisite paperwork for the insurance company. But I insist. “Let’s try the Global Rescue number. I’ll feel better if I just let them know before hand.”

The voice at Global Rescue turns out to be Matt. He wants to know what number he can call back if we are disconnected; he wants to know all my symptoms, the efforts at self-rescue made so far. I explain that Pasang at Asian Trekking has the helicopter scheduled to take off at 6:00 AM. Matt wants to know what heli company Asian Trekking has contacted, “some of the companies run the price up,” he explains. “In the Everest region we use Mountain Helicopter,” he says. “Apa, do you know what heli company Pasang contacted?” I ask. Apa doesn’t know this. We’ll have to call Pasang and ask him, or better yet, have Matt call Pasang. Problem is Pasang’s cell number is in Apa’s phone, the phone I’m talking on. I explain this to Matt. “Ok,” he says, “You try Pasang first, see what company, and call me back with that info and Pasang’s number.”

Apa rings Pasang, says a few sentences, hands the phone to me. “Hello. Pasang,” I say, “my insurance company wants to know what company you have scheduled the heli with.” “Mountain,” Pasang says. “Good, that’s good,” I reply, this is excellent news. “They’ll take off soon,” Pasang says, “I have to tell them whether to fly or not to fly. I you’re your confirmation. You have to tell me if you want the heli--with or without the insurance company’s authorization.” This is a US $6,500 predicament I’d hoped not to be in, but the pressure in my head, the dizziness, the total weakness of being…making a decision based on monetary issues pales in comparison to the alternative: what if I decline the heli? What if communication with Global Rescue causes a delay and the heli goes elsewhere, can’t return for me for another 24 hours? What if 24 hours from now the weather is bad and the heli can’t fly? Can I hold out for 2 or 3 more days? I need this heli right now, not in an hour or 24 hours, or two days. I need it right now. Sooner if possible. “Ok, Pasang, yes, tell them to fly.”

With that call made Apa dials Global rescue. When he hears the phone ringing he hands it to me. An automated attendant answers but it sounds like a disconnect message. The call hasn’t gone through. But it has. The message is saying all calls will be recorded. I recognize this. I’ve heard it earlier. So far a live person has always picked up immediately after. Now it seems to take forever. I know this is my mind screaming that time is standing still. A voice. I hear someone say something. “Is this Matt?” I ask, and I wonder if I’ve got it backwards. I’m not Matt. Are you Matt? Would that make more sense? My friend Ken in Washington, DC will answer the phone: “Is this the party to whom I am speaking?” But I can’t unravel that right now. The voice in Boston says, “This is Matt.” So it is Matt that I’m speaking with.

Getting to this stage in the conversation has taken an effort. I’m trying to contain my anxiety which wants to escape but has nowhere to go. I say to Matt, “The heli Asian Trekking has scheduled is Mountain.” This is good news from Matt’s perspective too. I’m relieved to hear that. I read Matt Pasang’s phone number which I’ve transcribed from Apa’s phone onto the same dog-eared paper I’ve been carrying in my pocket for two weeks. The numbers are thin and light. Is the pen running out of ink? 9851020738. but is the 3 a 3 or is it an 8? Apa and Khanchha agree the 3 is a 3. Matt wants to ask more questions. He wants to know on a scale of 1 to 10 the variousness of this and that: headache severity, pain threshold, and so on. “Look,” I say, “just having this conversation with you is about all I can do. This conversation is a huge challenge for me.” “OK,” Matt says, “I have all I need from you.”  He agrees he will contact Pasang and confirm the Mountain heli. “I will call you back,” Matt says, “If you don’t hear from me in half an hour or 45 minutes you can call me back.” “Which?” I ask him, “Half hour or 45 minutes?” I’m not comfortable with the a time frame could possibly expand to include open-endedness, but Matt remains non-committal. “Either,” he says. It’s clear I’m not going to be able to squeeze time down to a smaller increment and inject into that compressed space the desire for the heli to show up instantly. This is going to be another opportunity to practice patience.

What follows is a blur of fragments, but I know it is gotten later by angle of the sun. “We will have tea and wait inside,” Apa says. There are double sets of wooden doors which keep out the cold. The same door that only opens part way jams the uneven floor boards, wedges to a stop. We have to squeeze past. “When the heli takes off they will call,” Apa says, “Milk tea or lemon tea?” but I want to know who will call, and to whom. I’m grasping, clinging to details as a way to stay connected. I know it must be irritating to Apa to answer every trivial question, but I ask anyway. He is patient and calm. I need to hear the answers and layer the details on each other to build a platform of reassurance. It’s like a craving, wanting to construct a framework of certainty that this will work out, that it will end. “Pasang, will call,” Apa says, “to the kitchen desk here.” I look at the phone on the counter. It will ring at some point. For now, sitting, waiting, time has slowed. The clock on the wall is 5 or 6 minutes ahead of my watch. The big hand seems stuck, doesn’t seem to move, but maybe it has. It’s 6:58 on my watch. “After they call, the flight will take an hour, maybe an hour and a half to arrive,” Apa says. I can feel the tension of waiting and work to control it.

The call comes through. “The heli is in Lukla,” Apa says, “they are off-loading fuel. They’ll call again when it takes off.” I don’t ask questions this time. I can figure this much out: the fuel is being siphoned or pumped out, and stored in containers to lighten the heli for the flight to Namche. I like this. It brings specificity to what previously was only the idea of a helicopter. Now it is a specific machine in a specific place doing a specific thing, and it will be here soon.

We take care of last minute details while we wait: I give Apa 1,500 rupees to go toward what I’m guessing Rhita Doma might charge. I won’t be able to go in person and pay her so Apa will cover any shortfall. We’ll settle up later. The photos we were hoping to take from Kala Patar: Nuptse would be at right-center, the Khumbu glacier to the far right, the ice fall slightly left, above the ice fall and in the background the peak of Everest, and the western shoulder of Everest stretching to the left. Apa and Arita, his brother, will pick a clear day and go up Kala Patar, and take the photos.  I draw a couple of sketches on a napkin showing Apa where I think he might stand holding the CathWorks banner, the company we’re hoping to launch in June. “If you’re to the left, here,” I say, and I draw a small stick figure holding a rectangle “that’ll be the wide-angle shot. We’ll also need a few shots closer in so the banner shows larger.” These, along with summit photos if Apa achieves the summit, are what we’re hoping will be a nice backdrop for the trade show booth. “Best to take all the same photos with the Diamond Mold banner too,” I tell him, “just in case.” Apa doesn’t ask what just in case means and I’m glad he doesn’t, it would require more explanation than I have energy for. “Do you want the tripod?” I ask. He does. Roger’s tripod will go higher on the mountain than me. A souvenir for you, Roger, that and your Leatherman knife which is already at base camp. They’ll both come back to you in June certified for use at altitude.

Another call comes in. “The heli will be here in 15 minutes,” Apa says, “We have to move fast now.” Somehow my reddish-orange duffel bag is already on Jetta’s back. “I’ll carry your laptop,” Apa says, but I decline his offer. I want the satisfaction of doing one thing with consistency. The helipad is at the uppermost left of the bowl shaped hillside Namche is terraced into. Jetta is way ahead of us, already on the trail heading left above the town. Kanchha, Apa and I are still climbing up through Namche’s buildings. The narrow rock stairways wind and weave upward, and their steepness fatigues me to exhaustion. We’ve only gone two hundred yards and I’m forced to stop and lean on my trekking poles. Apa and Kanchha are behind me, waiting patiently. It has to be a darkly comic sight. The businessman from Salt Lake almost brought to his knees in the surging metropolis of Namche. I start up again.

The steps I am taking are so small and my pace is so slow that I realize just making the helipad is going to take everything I have. It reminds me of what I’ve heard over and over again: that the top is only halfway, the other half being the distance back down. The way I feel right now if the helipad was the summit of Everest, and I had to reach that, turn around and walk back down to Namche, as if it was camp 4, I wouldn’t make it. I’d have a memorial in the valley of death above Pheriche along with so many others. This sobering thought actually gives me the impetus to plod on. I’m not on the top of Everest and I don’t have to go back down—as long as the heli arrives.

At the helipad I lean against a large rock and look at a cloud to my right that’s hanging at the mouth of the valley to Thame. I’d rather see no clouds, but this one does not look like it would ground a heli. The wind is stiff, blowing in our faces up the valley where we’re peering for the first sight of the heli. “Let’s move over here out of the wind,” Apa says, and we descend twenty-five feet behind an outcrop of rock. “Can the heli fly in this wind?” I ask Apa. He laughs. “This is nothing,” he says, “the heli can fly in much worse. Even if they get caught in the clouds they can go down and fly along the river bed and follow it out. This is perfect weather for the heli.”

My watch says 7:45 AM. I take a photo of it thinking the heli will arrive in the next minute or two, but it doesn’t. Ten minutes go by. Fifteen. Still no heli. Apa and Khanchha are busy packing my hiking poles into the duffel bag, but the lower sections won’t telescope. I can see the difficulty they’re having. It’s a purely mechanical thing. I walk over to them and loosen the sections which telescope immediately. “See,” I say, “the westerner can still do something.” We all laugh. It will be my last joke with Apa. The sound of the heli has come up the valley and Khanchha sees it first. He points but I can’t see it. “Where?” I ask. “There.” But I see nothing. Then I see it--not at all what I was looking for. It’s just a mosquito speck almost indistinguishable from the brown rock mountain behind it. The sound has funneled up the valley so far in advance of the heli that it’s fooled me. I was looking for something much closer. When it’s large enough to photograph I click two pictures. Then the heli disappears behind the ridgeline. This isn’t right. It’s supposed to be coming over here, not heading toward Everest, but look, it is heading toward Everest, it’s not coming this way at all. We’re left with the sound of the wind. I feel a bit discouraged. “Where’s that heli going?” I ask, but no one has a good answer. Fifteen, twenty minutes go by--an eternity later, and the same heli comes racing back into sight. The sound doesn’t precede it. Now it’s headed in the opposite direction down the valley on its way to Lukla. Maybe a rescue from higher up I think to myself.

Suddenly the heli banks to the right and makes a big loop back in our direction. This is my heli after all! It’s at eye level heading directly at us since we’re perched on a ridge and the heli has thousands of feet of airspace between it and the river below. I’m surprised at the speed of the approach, one instant in the distance, the next hovering right in front of my face. Sheets of sand blast me. I duck and point the camera down too. The lens is still open and has taken a direct hit. Nothing I can do about that now. The sand stings and it occurs to me that I should have anticipated this, I should have crouched lower, sooner, but now I can hear the engine slowing down, or maybe it’s just the pitch of the blades that’s changed. We are running toward the machine in a crouch, all of us, as if the heli might take off before we can get there. Apa and I give each other a hug and yell words of encouragement tghat neither of us can hear. The right-side door opens and a Nepali jumps out with a small backpack. Explains why the heli went higher first: brought down a passenger. Khanchha stuffs my duffel bag inside. I climb in after him. He motions me back out. He has to get out first before I can get in. This heli’s only a four seater, more like two seats in the front for the pilot and someone next to him, and a bench seat behind. I’m sideways on the bench leaning on my blue Kelty pack. The door slams shut. I see Apa running around the front of the heli then off to the left-side, to the spot we just came from. The pilot flips a couple switches overhead then puts his right hand on the stick, his other hand is on a device lower down to his left. We’re lifting off and I can see Apa waving. I wave back. Twenty feet in the air, maybe 30 feet, and the pilot dips the nose, turns right, and the heli’s sheet-metal skin slides over my view of Apa like a curtain closing. Six or seven seconds is all it took. Apa and Jetta and Khanchha have disappeared from view just like that. There’s nothing Hollywood about it; no long parting shot of three figures getting smaller and smaller on the screen as we fly into the rising sun. There’s only noise and vibration, and the ground dropping away below us as the pilot guns the ship and we’re on our way to the hospital in Kathmandu.

When Lukla comes into view the pilot makes a wide arc and brings the heli onto the same approach as our original arrival on the Agni airplane, a Dornier 233 I’ve since figured out. We fly down the runway and it’s just like the plane landing except we don’t slam into the ground, we don’t even touch down. We just keep flying down the runway and even make the hard right turn at the end right in front of the terminal, but we’re still in the air. It’s the oddest floating sensation. It’s no wonder some people love to fly helicopters, they are truly fantastic machines. The pilot sets us down near four or five army soldiers standing guard over half a dozen, maybe eight plastic jugs of aviation fuel lined up against a rock wall.. The off-loaded avgas that now needs to be poured back in. I ask the pilot if I can get out and he says yes. We both climb out. I take photos of the workers pouring the gas into the tank from the jugs. Someone brings the pilot a bowl of ramen soup. Another worker brings a bucket of water and douses the tarmac where the fuel has spilled. We climb back in the heli, but this time the pilot offers me the seat next to him. He hands me a set of head phones and shows me how to trigger the microphone so we can talk back and forth to each other. It’s a clever system. I can hear the control tower exchange, but if the pilot talks to me, or I talk to him, it will override the other communication and stay internal to the heli. I learn that the pilot’s name is Capt. Hira Dahal. We lift off and zoom down the runway twenty feet off the tarmac. The ground slopes away sharply, then completely. If we were a plane it would probably feel like taking off an aircraft carrier, a momentary drop into the void before the wings offer lift.

Visibility from the cockpit is superb. We fly high and low, not changing altitude so much as letting the valleys fall away and the ridges rise toward us. Hira points out Manaslu, the Anapurna range, the border with Tibet. I ask him if he’s flown into Tibet. “Oh no,” he says, “They will shoot at you if you cross over there.” To our right is a verdant valley with a cluster of houses. Hira says this is site of of Hillary’s lowest camps. In 1953 he had to trek all the way from Kathmandu. Closer to KTM we fly so low to the ground that Hira shows me a cluster of new blossoms in a grove of rhododendrons that he’s particularly fond of.  When we skim over some of the smaller hamlets I can see cooking pots and fires, shirts drying in the sun, the faces of people in doorways.

Ahead of us is a ridge and we climb slightly to clear it. “On the other side is the Kathmandu valley,” Hira says. “You’ll see a wall of pollution and we’ll fly right into the side of it.” The extent of the smog is shocking, and the way it is trapped in the Kathmandu valley is more apparent from the heli than it was from the Airbus when we first flew in. Perhaps I’ve just become accustomed to crystal clear air in the Himalaya, I’m not sure which, but the smog is a blatant reminder that certain conditions on our planet need attention. We fly over dozens of tall smokestacks that look like coal fired electric generating plants. “What are those?” I ask. “Brick factories,” Hira says, “I call them the pollution factories. They’re worse than the cars.” There are literally twenty brick factories spewing smoke into the air just in the corridor we are flying in. Off to the side I can see still more. Kathmandu obviously has an insatiable appetite for bricks.

A half-size minivan belonging to Mountain Helicopters is waiting when we land. I thank Capt. Dahal for the flight. It has served two purposes: foremost, Hira got me down off the mountain, and as a temporary respite for an hour at least, the heli flight has helped pull my mind off its inner troubles. In the van we bounce along a rutted road skirting KTM’s main runway. The potholes have water in them. Soldiers are milling about, and off to the side the carcasses of wrecked airplanes. I take one or two photos but don’t have the energy for more. We are headed for the edge of the airport where an Asian Trekking representative will be waiting with another truck to take me direct to the hospital. It’s hot in the long underwear and down jacket, and when we stop and I transfer to Asian Trekking’s truck I forget to grab the nice hat Apa has loaned me from the backseat of the minivan.

Kaju asks me if I want to go to CIWEC or to the main hospital. Clearly I have no idea, so I ask him the difference. “CIWEC is not far from Thamel,” Kaju says, “and the main hospital isn’t either.” The heat of Kathmandu is surprising. It feels so much hotter than three weeks ago, and maybe it is. I roll down the window further. “Which is better?” I ask Kaju. “CIWEC is more expensive,” he says.  We are crossing a river I recognize. The banks are lined with garbage and lean-to shacks, and a black cow is rummaging in the mud. “Ok,” I say, “let’s go to CIWEC.”  Apparently satisfied with my decision Kaju says, “CIWEC is better, they will take good care of you there.”

Nurse Jharna checks my vital signs. Temperature, normal. Blood pressure, normal. Blood-oxygen saturation, excellent--97%. She draws two vials of blood and hooks me up to wires for an EKG. I ask Jharna if she will take a few photos of me all wired up, and hand her my camera. She tells me she took a photography class in college in Syracuse, New York, and likes to take photos. I tell her about the EKG I had in Salt Lake City just before leaving, how they shaved two stripes on my chest. “We don’t do that here,” she says, “these leads will stick on almost anything.” The EKG wires run to small suction cups and those definitely feel attached. They have small levers which seem to actuate them. I tell Jharna I’ll email her the photos after I get back to the US.

Doctor Betty is from Indiana. She asks me a barrage of questions. Has me do a series of coordination tests. I fail two key tests. Standing upright with my eyes closed without weaving. I sway to the right. And I’m not able to touch my finger to her finger when she places it here and there. I keep missing to the left.  Her diagnosis: HACE. High Altitude Cerebral Edema.  With HACE the cure is time, not medication, Dr. Betty says. “You’re not dehydrated,” she says, “We won’t need to start an IV. We had someone here yesterday with a severe case who needed an IV, but you’re lucky, you don’t need to be checked-in. You can rest at your hotel.” So I’ll just have to wait for the headache and dizziness to go away. “It could take two, even three weeks to feel completely normal,” Dr. Betty says. I can see this is going to be another opportunity to practice patience.

It makes me think of Apa and his ability to take each moment as it comes rather than sum the past into a collective frustration to lever his immediate emotions. I remember on the trek to Phakdang a particular instance when Apa came across a guide who knew him. The guide introduced Apa to his group. “Awesome,” a woman says, “That’s totally awesome. You’re Apa Sherpa. I can’t believe I’m talking to Apa Sherpa. I want to know the biggest thing you’ve learned from climbing Mount Everest Mr. Sherpa. I want to hear the biggest thing you’ve learned. Tell me a big thing.”