Huayna Potosí (both attempts)

(to follow along with pictures, click HERE.)

Huayna Potosí (above) is the 5th highest mountain in Bolivia, with a peak that sits at just over 6,000 meters (6,088 to be exact). In feet, that translates to just under 20,000 feet (19,973). While only the 5th highest in Bolivia (and not even in the top ten in South America), it's only about 100 meters shy of the highest peak in the US (Mount McKinley in Alaska) and is over 1,600 meters (5,250 feet) higher than the highest peak in the contiguous United States (Mount Whitney in California). Needless to say, I've never before attempted to climb anything close to this height (mount Mitchell sits at a measly 6,684 feet) so this was an incredibly daunting task for me. The funny thing is, we (Christine, Diana and myself) actually made the decision to go on a bit of a whim, making our reservation with a guide on Monday (the 25th), literally a day before we left.

Before I go on, it's important to preface the rest of the account with an unfortunate detail -- the fact that I had acquired a three day stomach virus from our weekend trip to the Salt Flats. One of the girls in our group had come down with it during the trip and unfortunately I started feeling symptoms on the bus ride back to La Paz on Sunday morning. The next few days I was very careful about what I ate and avoided a lot of the symptoms, but just as I thought I was over the bug, I woke up tuesday morning (the day of our journey) with pretty rough stomach issues.

Tuesday morning we drove from La Paz to the mountain in about an hour and a half. What makes this climb one of the easiest (if not the easiest) 6,000+ meter climbs in the world is that we can drive up so close to the mountain itself. We were dropped off at about a 20 minute hike from base camp, which sat at around 4,700 meters. We ate a lunch of rice, potatoes and a cut up hotdog at base camp and then had the first of our many coca teas (coca is supposedly really good for altitude sickness). I had taken anti-diarrhea medicine that morning which had helped a good bit, but unfortunately one of the side effects was that I had no appetite at all, so I had to basically force my food down. The first leg of the climb, the hike to base camp, was a gain of about 500 meters (to close to 5,200 meters) and was supposed to take about 3 hours. We actually were able to make it in two hours -- which our guide told us was very good -- so we were pretty proud.

As you can see from the pictures, the views from high camp were absolutely stunning, and we were able to watch the sun set just behind the peak of Huayna Potosí. We ate a pasta dinner at around 5:30 (once again I could barely eat a thing), then put on clothes and crawled into our sleeping bags to try to get about 5 and half hours of rest before the climb. I slept pretty poorly on account of the cold and the anticipation of the hike. We were restled awake by our guides at about midnight, and that's when I realized that something wasn't quite right with my stomach (my medicine had worn off by this point). Due to my stomach and definitely partially the altitude, I immediately had to run outside to vomit a few times, and then spent about 20 minutes in our outhouse at midnight, in below freezing temperatures at around 17,000 feet above sea level -- an adventure in and of itself. I came back inside to gather my gear and drink what was probably my 4th coca tea in the past 12 hours, hoping that the pains in my stomach would pass.

This was by far the most legitimate climbing I had ever done -- we were tied in by rope and harness to our guide, wore crampons, carried ice picks and were to make the hike only by the light of our headlamps (hiking in the sun is particularly dangerous as the ice can melt and then snow can shift below your feet). I started the climb and was at first able to bear the pains as they came and went in waves. However as the climb got steeper and the air got thinner, it became harder and harder for me to ignore my stomach pains. I had to take frequent breaks to let the waves of nausea pass. After an excruciating two and a half hours and about 300 meters (I wasn't even a quarter of the way there) I simply couldn't make it, and had to turn around and head back down to base camp.

It was an extremely disappointing experience, as although I didn't know whether or not I could've actually made it, I knew that I hadn't had a legitimate shot at it.

And for this reason I decided to go back again the next week (this past Wednesday). I made sure that I felt perfectly healthy on the day before, and then went to the agency to reserve my spot. I went along with a French man and his girlfriend, both who I found out had lots of experience mountain climbing (it turns out the man was a guide in the mountains in southern France). I could only really speak spanish with them, which made the whole experience even more interesting. We ended up having the brother of the guide that I had had the week before, and he was a friendly and yet extremely determined guide.

Thankfully I could stomach all the food that I was given which made a huge difference in my energy level, as, led by the French mountain madman, we were able to make the first climb to high camp in only an hour and 15 minutes (remember that it was "supposed" to take 3 hours). I was obviously straggling a bit behind, but it was definitely a confidence boost to be able to keep up more or less.

That night we rested (I slept a good bit better this time) and then woke up and went through the same routine as the week before -- gear and tea. The girlfriend stayed at high camp (she had made this arrangement before because she knew she didn't handle high altitude well) and then we were strapped into the guide, me first, then behind me the frenchman. This turned out to be a great order, as it allowed me to take the climb at my own pace and not to be dragged along by the frenchman (although he ended up being a fantastic partner -- a good motivator but also extremely patient and understanding of my lack of experience). We began the trek and made it without too much trouble to the point where I had had to turn back the week before, which was very exciting for me as while I was tired, I was definitely feeling strong enough to continue. Just before we reached the "halfway" point we had a climb of about 10 meters which was steep enough to where we actually had to use our ice picks to assist our climb. I put halfway in quotations because in reality, the halfway point was at 5700 meters (a little less than 400 meters shy of the peak). The issue was from that point on, the hike had to be made painfully slowly due to the lack of oxygen.

From that point on, the hike changed both in speed and in the type of landscape. previously we had been hiking on hardened snow paths that while only a few meters wide, were not too difficult to climb. Now we made our way on a bit smaller paths that wound back and forth in and around ice caves and icicles. At this point I had to develop a routine, which was step, mini pause, long, deep breath, then another step. No matter what I did, I couldn't get the amount of oxygen that my body was desperately begging me for. At this point, however, I knew that there was absolutely no turning back so I continued to force one foot in front of the other.

The last stretch before we reached the summit was surreal. It was essentially a snow bridge that ran along, with a pretty significant drop on either side. Thankfully we had about a 5 foot high wall on our right side that we could hold onto, and I actually felt pretty safe as long as I didn't stare too long at the drop off on the other side of the wall. The wind also made that last stretch excruciating, as it was even more difficult to breath the freezing cold air. I've read in books about snot from your nose and your saliva freezing on your face, but on this last stretch I actually experienced it myself.

The feeling I had when I finally sat down on the summit made the journey 1000 times worth it. We arrived just as the sun was rising, and although it was extremely cloudy, we could still see for miles and miles in the occasional breaks in the clouds (we could even see Lake Titicaca and some surrounding cities). There exists a satisfaction like no other feeling when you put your body through physical hell to achieve a task -- and are successful. It still somewhat feels like a dream (probably due partially to the lack of sleep, food and oxygen).



Overall the climb lasted for 5 and a half hours, from 1:15 am to about 6:50 am, and with an ascent of almost 1,000 meters. Our return trip was difficult, but incredibly beautiful as we could see exactly what we had accomplished in the light of the morning sun.

Absolutely exhausted and with jelly legs we finally arrived back at basecamp. It was probably the most physically demanding thing I have ever done, yet absolutely worth it in terms of the unmatched satisfaction that I experienced at the summit and still feel now. I'm also not sure I've tasted a better beer than the one that we shared with our guide at base camp... I'm so incredibly glad that I went at it a second time, as, like they say, when in Bolivia...

That's all for now. Can't believe I have one week left! wow how time flies...

Hasta Luego!
Whitaker

La Entrada Universitaria and Surgery

So it's been quite a while since my last post, so I'll try to update the main things that have happened here in La Paz since then in two separate posts.

First: my clinical rotation. Last week I was technically assigned to volunteer at an orphanage but due to a miscommunication and the fact that I spent two days for my first attempt to climb Huayna Potosí (my next post will talk more about that trip), I didn't end up being able to make it to the orphanage, and instead went to this week's rotation, Surgery, a day early.




I've been shadowing Dr. Galindo, a general pediatric surgeon who works in El Hospital del Niño and who has lots of experience in pediatric surgery (he even went to Stanford for a few weeks to shadow one of their surgeons). As he's just general pediatrics he does a lot of routine surgeries, so the rotation did get a bit repetitive at times, although as it was really my first exposure to surgery I found it extremely fascinating. On Friday we saw two separate cases, a total of four surgeries. Two involved young boys who had undescended testicles which needed to be surgically moved, as without this procedure their risk of developing testicular cancer drastically increases and their fertility drastically decreases. The other two that we saw on Friday were hernias (where a portion of an organ breaks out through the abdominal wall and needs to be surgically replaced). As you can see in the above picture, we were allowed to be extremely close to the surgery and got a really excellent view. I will admit, during the first operation I got a bit queasy (I'd never really seen anything like it before) but ever since I've felt perfectly fine during all of the surgeries, and this experience has helped me to realize how incredibly complicated, fascinating and impressive the human body really is.

On monday I actually scrubbed in and assisted in surgery, something that I never would've in 100 years been able to do in the US. The surgery was a colostomy, which is a procedure in which a semi-permanent opening is made in the patients side that leads directly to the large intestine (colon) to create a new method to pass excrement. Often this procedure is used for colon cancer patients who have had a part of their colon removed and thus can't pass waste the normal way. In this particular case the patient was a baby girl who had been born with a deformation -- she was missing an anus. Thus as a temporary fix until she could have another operation to give her an anus, we performed a colostomy. The truth is, I really didn't do anything that I could've messed up -- all I did was hold some of the tools that held open the incision and cut the surgeon's sutures. While basically anyone with two hands could do what I did, I still felt extremely useful as in every single surgery there is a trained nurse who does exactly what I did.

I also got a chance to witness surgery for an arm that was broken at the elbow and saw the doctors place the metal rods to fix it, as well as a burn victim, who underwent a surgery involving a skin graft. I really did find surgery fascinating and think it would be a really interesting profession, but I'm still not quite sure that it's for me. While I haven't had much experience with surgery in the States, here in Bolivia, Dr. Galindo didn't have much interaction with the patients that he operated on. In fact, it seemed like it was almost easy to forget that the patient on the operating table was actually a live human being. I've definitely realized that in whatever profession I decide to pursue (even if it's not medical related) I really do want to be able to form relationships with people and have consistent human interaction.

Last weekend was a good one -- I finally stayed in La Paz (or at least not far from it) instead of taking a trip to some exotic location, which ended up being very nice. Friday night, a great friend of mine from Princeton, Allison Vise, who lived in Forbes with me and had been in Bolivia for 8 weeks came back to La Paz to spend her last night before heading back to the States. She had been in the south, in the city of Tarija, for the past four weeks, and it was great to reunite with a familiar face and someone who knew me as Whitaker and not Jeff/Jefferson. On Saturday we checked out La Entrada Folklórica Universitaria, which is an annual folk parade that occurs in La Paz on the last saturday of July. The parade lasts basically all day and includes tons of university students from all across Bolivia that each have their own unique costumes and traditional Bolivian dances. The purpose seems to be to make sure that the nation doesn't forget their cultural heritage. It was very cool to see the city united around it's culture and dance.

The photos of this (and Sunday's day trip to "the Devil's Molar", a rock formation outside of La Paz) can be seen HERE.

Salar de Uyuni (Salt Flats of Uyuni)

I have now seen the sun set over 12,500 kilometers of pure salt.

The salt flats of Uyuni are one of the most spectacular natural formations that I have ever witnessed. Surrounded by mountains, the Salar appears to be a giant lake of salt that at parts goes down more than 50 meters. Currently they use the salt for commercial production (to be used in food) and also to build Salt hotels on the flats for tourists.

(view photos HERE)

http://www.facebook.com/media/set/?set=a.10150332206411718.393655.504936717&l=02fe39fa9e&type=1


We took a bus from La Paz overnight thursday night (about a 12 hour bus ride down to Uyuni). The first 7 hours or so were perfectly nice and smooth, but then things took a turn for the worse, as the road became unbearably bumpy. The rattling of the bus sounded like a machine gun, but I was actually able to turn the experience positive as I simply imagined that I was in a massage chair and that helped ease the pain for a bit. As we neared Uyuni the windows completely iced up, and thus when we actually arrived no one wanted to get out of their cozy blanketed seats. The town was basically dead at 7:30 in the morning and we rushed to find our company in the freezing cold. The town clearly was clearly built around tourism as the main street was lined with tour agencies -- one of which was ours. We ate breakfast and then met our guide (and the three Brazilian ladies who would join our group), loaded up the jeep and headed out.

The first stop on our journey was the "train cemetery," which was exactly how it sounds -- a graveyard of rusted old decaying trains. By itself it probably would have been a pretty cool sight, but unfortunately it was absolutely littered with tourists clamoring to get a photo of themselves standing on top of the train, and thus it lost a little bit of it's appeal.

Our next stop was the salt flat itself, which was overwhelmingly expansive. Everywhere you looked was miles and miles of white, flat ground. We took our standard tourist photos (including several trick photos that used the hindered depth perception) and then headed on to the salt hotel where we ate our lunch. We then drove for about 2 hours all the way across the flats towards the base of the volcano Tunupa where our hotel was located. We drove over several different formations of the salt, including salt formed into thousands of tiny cylinders that poked up, beautiful hexagonal formations, and my personal favorite, salt with a two inch layer of water on top which reflected the surrounding mountains with absolutely perfect clarity.

When we approached the land at the base of the volcano, as if we weren't already in a strange enough dream world, we saw a flock of pink flamingos posing outside our window. The flamingos were so majestic and composed that I had to remind myself that no... these pink creatures weren't actually a normal sight...

We arrived at our hotel, unloaded our gear and then walked around to take pictures. The town seemed to be built with simple stones stacked on one another, and in one of these stone enclosures we found a pack of llamas, of which we took about 1,000 pictures of (for your convenience I've eliminated a lot of these pictures from the facebook album). We returned to the hotel for coffee (and a game of hearts to pass the time) and then dinner, which was soup, spaghetti, bread and a bottle of wine. When we had each had enough wine to warm us up a bit and make us a little sleepy, we put on a few more jackets and our gloves, scarves and hats and headed to bed (the nights there got absolutely freezing and our hotel had no heating).

The next day we woke up to watch the sunrise over the mountains and then headed out to the volcano. We walked to a cave where Incan mummies were buried and then had a chance to hike up to a viewpoint, where we had fantastic views of the flats and of the volcano itself. Next we drove over to Isla del Pescado (fish Island) which was another bizzare sight -- a small fish-shaped island absolutely covered in cacti.

As we drove back to catch our bus in Uyuni, we were able to pause for a bit to watch a spectacular sunset over the salt flats.

I definitely caught the travel bug on this trip, as I feel like there is so much of this world that I have yet to explore. I also was once again reminded (and overwhelmed) by the absolute beauty and diversity of landscape that Bolivia has to offer. From miles and miles of salt to volcanoes to the world's highest lake, to incan ruins to cities like La Paz, there is so much to see here.

Speaking of, on somewhat of a whim we decided that tomorrow we will embark to climb (literally climb) Mount Huayna Potosí. It will be a two day trek, hiking to high camp tomorrow, going to sleep around 6 pm and then beggining a 6 hour trek to the summit at 1 am. We'll hopefully be able to observe the sunset from the peak, which is situated at 6,080 meters (19,947 feet) -- higher than Mount Everest Base camp. It's going to be one of the toughest hikes of my life... But I am so pumped. After all, when will I ever get another chance like this?

As they say... When in Bolivia....

General Pediatrics with Dr. Tejerina (and Patch Adams!)

Last week I was with Dr. Tejerina in the general pediatrics ward. She is a fantastic teacher and is extremely enthusiastic about the work that she does which is fantastic to witness. She works incredibly well with kids and you can easily tell how much she loves young people.

On a normal day I would help her take notes on the patients and also help interview the patients' mothers about 4 things: how the kids are eating, if their vaccines were up to date, how they were born (normal birth, c section, etc.) and how they were growing (is their height/weight, etc. normal). Tejerina deals a lot with Down Syndrome patients, and she taught me how to identify a few early signals, including the lack of a joint in the pinky finger, a line dividing the big toe from the others, heart problems (present in about 50% of Down patients) along with the basic signal of slow development.

Tejerina also dealt a lot with intoxications/poisons, and on our second day we say three different patients with three different poisons. One was an iron pill intoxication (they're used as supplements for pregnant mothers and are easily mistaken for M&M's), another was pesticides and the other was a calculator battery stuck in the kids nose. On this day I also helped translate an english textbook that described these intoxications.

The third day was specifically dedicated to Down patients, and I watched Tejerina advise a distressed and panicked couple who had a baby with Down that the diagnosis "opened a door to a beautiful new world", and that if diagnosed early enough, the hospital can help speed development as fast as possible so the child will have as normal a life as was possible.

On the first day we only saw a few patients as Patch Adams (the real guy that the movie is based off of) visited the hospital and so we ran to try and see him. He was dressed ridiculously (see above picture) and he really seemed to be able to connect well with the kids. He gave a talk in which he described his hospital which was free of charge, that required no insurance and that paid all of it's workers (from custodians to doctors) just $300 a month. For forty years, he "paid to be a doctor". While his talk was relatively broad and spoke of generalities like love and care (and was also painfully anti-american) I really do respect what he's done with his hospital and what he continues to do all around the world. He preached compassion and patient connection in hospitals, also saying that "the saddest thing that was last in the US medical world was the house call."

Photos for Last Post!

Here they are:

http://www.facebook.com/media/set/?set=a.10150331954481718.393564.504936717&l=c8a3cd1408&type=1

Enjoy!

Día de La Paz and The World's Most Dangerous Road

This past Saturday, the 16th of July was "La Paz Day", a day to celebrate the citizens and culture of La Paz. Most of the festivities went on the night before, however, and so at around 6:30 Friday night we went out to the main street of La Paz, El Prado, to observe the celebrations. The street was packed with people, and we saw many groups of Paceñas (citizens of La Paz) marching by with bands playing and lots of people watching. I tried Anticucho (beef heart kabobs) and a special drink that is really only served on holidiays that is made with Singani (a grape brandy – national drink of Bolivia) warm milk and egg whites. We also grabbed ice cream and watched as many cebras (people who man the crosswalks dressed literally from head to toe as Zebras) ran past. We headed down to the Stadium where there was a pretty cool Bolivian band playing and a really large crowd all drinking and celebrating. Unfortunately we couldn’t stay out too late because we had to get up early the next morning to go on the bikes.

On Saturday we woke up early (around 6:30) and had breakfast at Alexander café before heading out on our drive to El Cumbre (Spanish for the Summit) where we began the most dangerous road bike trek. Our guide was a really cool guy from Asheville named Phil – he was also a stereotypical Asheville native (long hair, scraggly beard, had been doing outdoor activities since early high school). He and the Spanish speaking guide, Javier, were in charge of 14 of us bikers on our trip (from all over the world, but most spoke English). After arriving at El Cumbre and receiving our helmets, gloves and bikes, our guides went through the safety speech and then procured a bottle of a clear liquid which Phil informed us was basically straight alcohol. It was a tradition that in order to guarantee safe passage on the trek to Coroico one must make an offering to the god Pachamama – which entailed splashing a bit of the vile liquid on the ground and our front tire, as well as touching a bit to our lips before passing it along to the next traveler. We started the trek at 4700 meters (15,419 feet) and first biked downhill on a smooth paved road for 63 km (almost 40 miles). We really flew down this part (which was extremely fun) probably going close to 40 to 50 mph and we passed several buses and cars along the way. This was a great opportunity for us to get used to handling the bikes before we got on the World’s Most Dangerous Road. The road itself is really no longer much in use beyond for tourist bike trips (there is a new, much safer road from La Paz to Coroico), but there was still the occasional local who drives the road to get to their house in one of the villages that’s located along the road. It’s a gravel road that at times can be pretty wide, yet also at times can be so narrow that a single minivan uses up most of the space of the road. There are lots of sharp, blind turns without any barriers between you and a 250-meter straight cliff drop (see example image above).

We began the trek on the old road still above the clouds, as all we really see out in the horizon is white mist. Much to our dismay, our guide informed us that this road is the only one in Bolivia where traffic drives on the left side of the road (so that the driver can see the cliff edge outside his own window) and so he tells us to stay on the left side (close to the cliff edge) in order to avoid a possible collision. After our first segment of road my hands felt numb from my death grip on my brakes. However little by little I become more and more confident of my ability, and begin to ease off of the brakes a bit more as we finally passed underneath the clouds into a phenomenally lush green mountainside. We took the trek in small segments, pausing to drink water, double check that everyone was still with us, and for the guides to tell us a quick anecdote about the segment of road that we were approaching (along with any safety tips they had for us). We consistently flew by roadside crucifixes and monuments, just in case we needed a reminder of exactly what was at stake for each of us. To be completely honest, however, I was so focused on the techniques of safe riding and on the safest path (with the fewest loose rocks) that I never really had time to be too terrified of how close I was to the edge. As we got lower and lower in altitude we shed layers, and the scenery became even greener and lusher. We passed directly under a few waterfalls, and adrenaline and an appreciation for the unbelievable beauty of the surroundings replaced the fear that I had felt previously. I really didn’t want the ride to end when it was all said and done. We finished at an animal refuge that had rescued mistreated animals that had been taken captive from the wild and sold on the black market (i.e. pick pocket monkeys). There we had a beer, all we can eat pasta buffet and a fantastic swim in their pool (which was exactly what my body needed after the long ride). Then the four of us who had bought the zipline tickets were taken to get our gear and then drove back up the road to the first zipline departure point. We zipped over huge valleys over 1500 meters total (three segments of 484, 505 and 587 meters, respectively) and got to speeds of over 85km/hr (about 52 mph). (click here for a video of the zipline we did). We then met up with the rest of the group for the ride back to La Paz.

The bus ride back actually was almost more terrifying than the bikes down, as we traveled back up the exact same road to see the views we had missed on the way down. I will admit, it was incredibly beautiful and I once again realized just how gorgeous of a country Bolivia is.

This weekend I think we plan to spend a few days at the Bolivian Salt flats, which are supposed to be amazing. I will post pictures from this weekend sometime later this week (I got a cd of video and photos from our bike trip for free along with a t-shirt).

Best wishes!
Whitaker

Servicio De Los Adolescentes

Last week I spent my clinical rotations in a clinic for Adolescents in Mira Flores, a neighborhood on the outskirts of La Paz. Most of the patients come from the surrounding neighborhoods as apparently in order to get an appointment at a hospital one must first get a check up at a local clinic (like this one) and then be referred to a hospital. The clinic serves boys and girls from ages 10-25 with any problem that they might have, however the most frequent cases are adolescent mothers who come in to check on their babies or to get help for any illness they might have.

One of the main goals of the clinic is education. They hold classes for pregnant mothers on how to take care of themselves during their pregnancy and their babies after birth, as well as knitting classes (Christine and I sat in on one of these classes during one of the days). They also empower youth leaders to go and inform the youth of the area about forms of birth control to prevent teenage pregnancy. We worked with Dr. Santivañez, a fantastic doctor and even better teacher (it's interesting how the two professions seem to go hand and hand) and we could tell right away how much each patient really respected her. Her office is small and very cold filled with a desk, a filing cabinet, and an exam table. There is also a small dirty bathroom where the patients can change (and take urine tests). The walls are painted yellow so it is not difficult to notice the permanent line of ants that crawl in a line around the window every day (it never seems to bother Dr. Santivañez). The office was not very hygienic at all (particularly using USA hopsital standards), as they used the same sheet for every examination (which even had a small bloodstain already on it) and there was dirt all over the floors.

During our time at the clinic we took patients' blood pressure, learned how to feel the baby in the mother's stomach, listened for the fetal heartbeat and placenta sounds as well as measured the height of their stomachs. By the end of the week we were experts at this. As I said before, we mostly saw pregnant adolescents, and they all seemed much older than the age on their chart, both physically and emotionally.

On our first day we saw a girl who was pregnant with her second child at the age of 16 which I found very interesting. Even more difficult to believe was that she had listed her pregnancies as "planned". When I asked Dr. Santivañez about this, she said that although not common, this occassionally occurred here in La Paz. She gave a hypothetical situation of a girl in a poor family with 8 kids that struggled to give each child enough food -- an extremely tough existence. Along comes a man who gives this girl an opportunity to escape from this tough life through the possibility of beginning another family. She takes this opportunity, becomes pregnant and hopes that maybe this other life will be better. Unfortunately, according to Dr. Santivañez, what these girls fail to realize is that from that moment on they become "slaves" to this new family and household, unable to get any education or to ever escape the obligation of providing for this new family. It's a vicious cycle that can exist in many of the poorer families of La Paz.

All in all it was a fascinating insight and experience.

Tomorrow I'll hopefully post about this past weekend and my adventures on the "World's Most Dangerous Road"!

Hasta Mañana!
Whitaker