Mt Baker - Day 61 (Storm Clouds Ahead -cont)

So there we were at the base of the mountain ready to return to base camp lodge. I felt like a mutiny was at hand, my role as driver of the car soon to be terminated by my disgruntled colleagues. Why were the computer-driven keys to my rental SUV not working? Why were we consequently out there in the minus 25 degree windblown location with the sun beginning to dip beneath the tops of snow-covered pine groves standing on the dark mountains to our west? Only in this frigid situation for less than 15 minutes, we were beginning to look more like the Blue Man Group than intrepid climbers. Except for the sound of my banging knees, there was only silence. Suddenly, one of my more impatient brutish colleagues sounded as if he had a thought. I scoffed silently to myself, "by the looks of this guy, a once in a lifetime event".

"Where did you keep your keys when we are on the mountain", the climber snarled through his face mask. Not quite understanding the significance of the question, I timidly replied "in the outside pocket of my hard shell jacket", pointing haltingly to my left chest. "Give me the keys" was his only response. I could see nothing of his face other than his razor sharp white teeth beneath a narrow slit of his "furry" head cover. He looked like a mama wolf guarding her pup from an unwelcome intruder. I knew then my days as the designated driver were over. Worse yet, they might just leave me here in the cold as a soon to be frigid rememberance to others not properly schooled in outdoor living. To my surprise, he pulled the front waist band of his Gortex hard shell pants forward in front of him looking like one of those success stories advertised by an annoying weight loss program. He followed with a similar move with the middle layer fleece pants, then again with the inner polyester layer, and finally his underwear (the latter not cotton, cotton is a no no, absorbs too much moisture, never wear cotton mountain climbing). The next move made me startle with disbelief. With determined swiftness, the somber climber simply dropped the keys into the abyss of all those layers. Was this some sort of mockery of my manhood? "Now we're just going to have to wait awhile", he replied totally without expression. He couldn't have been comfortable. You know what happens when skin meets frigid metal?

About five minutes later out comes the keys. The climber hands them to me forcefully and and abruptly states "now see if you can open the door and start the car". I noted the keys were no longer as cold as ice. Maybe that was the simple solution we were looking for. I carefully followed instructions and voila. Results were instantaneous. The door lock lifted and my impatient climbers scrambled quickly into the SUV for the long journey to base camp lodge; the circulation alas returning to our feet. Now relegated to the back with the luggage, I had time to consider what I had learned. The message was simple. Don't trust these modern computer driven gizmos when you are in the cold mountain air. One must search for real truths, whether its forecasting the weather or the means to open car doors; truth to be found by a common sense approach that uses the clues nature has provided. Certainly, reason to return to the relevant chapter in Mountaineering: Freedom of the Hills on the understanding of the ever challenging mountain climate. Near the summit and looking for weather's soon to be immediate plans, I know now that I just can't count on The Weather Channel app on my iphone to be there when needed.

But was this the real message to be learned from the vision that day in the first car of the Metro North train travelling from Katonah to Grand Central? For that answer, I returned again to my first seat in the first car at 6:50 AM and waited. (Need to see patients now. I will have to finish later).

Mt Baker - Day 65 ( Storm clouds ahead?)

Remind you that mountaineering requires a variety of skills to meet the many challenges to be endured - at least from what has been explained to me. One must consider physical endurance, mental toughness, determination, keen understanding of climbing techniques, proper equipment selection and handling to name a few. The 6:50 AM Metro North commute several days past from Katonah to Grand Central led me to consider another skill that had not yet been fully addressed.

The stimulus for today's consideration came from a poster on the wall of the train's first car. It was located just before the front doors on the left as I sat facing forward in the very first seat of the train. The poster was about window height, measured approximately 2'3"x 3' 6", all green in color with yellow lettering. It was clean, crisp with neither a smudge nor a wrinkle. Set in clear glass with a thin aluminum frame, the early morning sun streamed upon it making it an almost sacred image to the adoring gaze of my fellow commuters. Seriously.

Now all this meandering over-the-top "where's-he-coming from" chit-chat above may simply be a reflection of two of my obsessive/compulsive tendencies. The first is the need to remember meaningless details, perhaps like those above. The second, but not least, is to always be first to arrive at any destination, ergo, my chosen seat (obscessing on blogs may soon be a third). On the other hand, it may be something else. For while I was sitting there in the first seat of the first car, something very mystical began to happen. The light from the sun streaming through the window became much more intense, for an instant almost blinding. I looked again at the poster and what I saw took my breath away. The poster began to change. First the silver aluminum frame lost its metallic glow and soon morphed into an almost fine mist. The background of the poster began to change colors from the pale green to an almost pure white. The edges of the now white poster radiated a glowing red hue, like a cloud illuminated by the setting sun. The print of the poster also changed to the color of a pure heavenly blue sky peeking its way through the drifting white day's cover, still clear and still easy to see. I understood what the poster had become, a wonderful fluffy cumulus cloud reaching to the top of the train carrying, to my trembing awe, perhaps an important message. A message that needed to be considered. Seriously.

Perhaps and certainly possible regardless of my state of mind, the writing on the wall that I experienced that day on the train was an ethereal message of destiny. You see, this mysteriously shining poster on the train's wall, perhaps from someplace"out-there" special, carried words of deep meaning to all of us. It was not just a simple reminder of events to come, no common call for toothpaste or deodorant. No, indeed, it was far more profound. It carried forth a message of common joy, a statement of great significance. I knew also at that moment that there was a purpose for me. One that I could only accept. For I believed I was chosen to be the messenger of its almost sacred promise. You see, it was a listing of apps for our beloved iphone. The message was clear and uncompromising. It set forth that the most frequently downloaded free app by all us 3-G worshippers out there is the one called The Weather Channel. This was, indeed, a calling for those not yet converted to the promise. I looked down quite smugly at my own smart machine knowing that I was, indeed, among the in-crowd, a chosen-one. I even have blue tooth headphones. Well, ok, maybe not as serious as I thought.

Within a second, the image the glowing poster on the commuter train wall coupled with the vision of ever changing mountain climate to which I must adjust in my future adventure caused the content of my daily blog to flash before my eyes. I knew what needed to be said. The facet of mountaineering that needed to be discussed today is ---you guessed it---forecasting the weather. Hallelujah! I mean, more specifically, the ability to accurately predict the weather at that moment you are high up on the mountain, climbing to the summit; a skill not to be taken lightly and one that could be life saving. Now all of us with iphones will know that this is no great shakes. It's easy. Just push the buttons and voila. Current weather reports, weather predictions for each of the next 36 hours, ten day forecasts, weather alerts, satellite images, etc. are all there retold in an instant. What other skills are needed when one is blessed with this well stocked, multitasking, ipod playing, video watching, texting miracle machine for the ages. And who says you can't teach old dogs new tricks! Now that is serious.

But there is more to this story than a good smart phone as experience has taught me. The appropriate selection of apps may be part of the true message that I was chosen to tell but there is something more profound. Another part of the lesson for me happened with yet another miracle computer-controlled gizmo of our time; one that I happened to bring on a previous winter mountaineering climb. That lesson: very simply, when it gets very cold, like the minus 25 degree temperature that we were experiencing on that winter day in the Adirondacks, these little gadgets don't work for crap! The gizmo on that particular day was the computer controlled keys to my rental SUV. There we were back at the rendezvous spot after 12 hours of climbing. We were cold and tired. No time to stand around and chit chat. The feet will freeze quickly. A better time for me to drive four other climbers who were half my age along with equipment back to warm comfort of our safe abode. I walked up to the car to begin the journey back to camp, pulled the keys from my pocket, aimed at the SUV front door, pressed the little designated spot on the gizmo, and waited impatiently for instant gratification. But guess what? -nada, nothing happened. Not a beep, click, chirp, or rattle of any kind. I pressed again - nada, and again several times. I switched fingers. Maybe I was pressing too hard. Was this actually the right car? Details, details - where art thou, my obsessive/compulsive instincts. What will I do? What was I to say to the seasoned mountaineers standing behind me? I felt the heated glare of those raucous cursedly-young genetically-predetermined tall lean climbing machines. I cursed again with silent resentment at their image. Why was I the one that was "short" changed with the DNA base pairs? Why was I the only one with gray hair and aching knees. I whimpered in barely audible tones "I can't get it to work?" Can't get it up when I need to in order to satisfy heated desires (the door lock, I mean!!! I'm talking about the door lock!!!). My self-image was in shambles. You just can't trust these "smart" gizmos in the mountains. What next out there in the frigid night and what is the true message to be written?
( To be completed tomorrow or maybe the next day after that)( not feeling well- have a cold)

Mt Baker - Day 66 (Reaching the Void)

It is all about the joy of giving. Yesterday I met with Richard F. regarding the New York Eye and Ear Infirmary Climbing for Sight and Sound campaign. Our goal is to raise necessary awareness and funds for treatment, care, and rehabilitation of children with vision and hearing disorders. The Mount Baker summit on July 23-25 is a means to promote this very worthwhile effort. Richard brought with him pamphlets, fliers, and materials which I could now distribute to friends, family, colleagues, and patients informing them of the effort and seeking their generous donations. We discussed the campaign further including other ways of getting the message "out there". He left with my readiness to carry-on efforts towards the common goal even more invigorated. There is no question that this whole upcoming mountaineering expedition is now for a greater cause. It actually makes the experience that much more rewarding.

No sooner had the campaign materials been delivered when a colleague( and friend) of mine walked into the office and told me of his intentions. Without me having said a word, Dr W said that the campaign's quest had touched him and that he will be contributing. He even mentioned joining me on later trips. It really made me so appreciative and even more determined to carry-on for as long as I am able. And again this morning, I was in the Infirmary cafeteria, getting a cup of the usual AM coffee when a similar episode happened. A friend and colleague (Dr U) mentioned that he had seen posters of the program. He, too, would be providing a very generous donation. The more I hear of this, the more I want to donate again as well.

The events made me think of some of the other important times of giving (and receiving) in my life. Perhaps the first and most important one that comes to my mind took place on April 30, 1983. At that time, I was in the northern mountains of Scotland in a small white chapel near the little town of Kincraig. Though in the majestic mountains, there had been no intention of spending the days with climbing the heights. I had barely thought of such adventures at that time of my life. Achieving success in medicine was far more immediate and consuming. On that day, however, not even medicine was to come to mind. On this particular day, we were in that chapel to pray for success in another venture. You see, that day was our wedding day; Nancy and I, a younger version of the two of us. The giving that I refer to on that bright, clear Saturday morning was both a wedding ring and my heart to my bride.

We had previously written the minister of the Kincraig chapel requesting him to perform the ceremony. We had chosen him and the church from several other options; all of which were of relatively limited understanding (Remember - at that time, the word Google did not exist). Our choice could never have been better. He generously agreed and provided necessary instructions.


We were without family in the Scottish Highlands but not alone. Even though we essentially left those we knew to "quietly wed" in this lovely but distant part of the world, the folks of Kincraig were there to greet us and had, totally unexpected to us, organized a beautiful ceremony complete with organist, flowers, photographer, and good will. A reception they had planned after the ceremony took place in a small inn near the chapel. There was even a reporter from a local Glascow newspaper there to detail the events for his city's readers. The whole experience is not something that is easy to forget and certainly something to draw upon later in life when the going gets a little tougher.

So why the title of today's blog, "Reaching the Void". Perhaps, there are two reasons. The first and why we are even writing the frequent blogs is to know that these children in need, when having neither the means or the ability to correct their handicaps, would have to be living their lives with a certain void. By giving when we can, perhaps we can reach those empty places and provide open doors to a richer life experience. The second is to know that in our own personal quests which can leave us at times with a void yearning to be filled; that these, too, can be reached by remembering the times of giving and sharing with those who make a difference in our lives, including colleagues and loved ones.

Mt. Baker - Day 68-67 ( Self -Arrest, Part 3)

The process of self-arrest begins with the ice ax and how it is carried should the need arise. The process ends with how this same tool is used to stop an unwanted fall. Needless to say that at a time of emergency, it is of no value if the ax is buried inside your backpack someplace below both endless bags of trail mix and clean underwear. No help, also, if the ax is dropped accidentally from your hand and falls below to meet the head of the hapless climber following your lead. This would be especially true if that same climber was tied to you by a rope. Knocked unconcience by the blow, your fellow adventurer would be at risk for an uncontrollable free-fall. The equally bad news would become readily apparent. You would quickly be pulled along. No chance at that critical moment to review the relevant instructions in Mountaineering: Freedom of the Hills (pgs 318-321) on how to prevent such catastrophies.

So was there such a situation then with Mallory and Irvine? Mallory was found with a signifcant depression on the front of the skull, the size of the traumatic defect matching the pick of their ice ax later discovered in 1933. Pictures of that ice ax showed no leash, ie, a cord attached to the carabiner hole in the ice ax head. This cord provides a sure way to attach the ice ax to your wrist. Could head trauma from a runaway ax previously lost from grip have resulted in loss of footing; both climbers, tied to each other then dragged down the steep slopes by the weight of their packs to an icy grave?

Could the depression found on Mallory's frontal bone have been caused by an improper grip on the ax? Is that a consideration? Read again to page 318 of the above provided reference. I'll repeat it here for those who do not have the book. "Place your thumb under the adze and your palm and fingers over the pick, near the top of the of the shaft. While you are climbing the adze points forward". Makes sense? Not likely if you have never held an ice ax. Anyway, the wrong grip puts you at greater danger of the ax pick puncture wound during a fall.; a wound, again not dissimilar to that noted on Mallory's body.

What about the proper technique of self-arrest? Here again, I would remind you that Mallory was summiting Everest with the inexperienced partner, Andrew Irvine. Pictures of our hero's young associate at the beginning of the ill-fated 1924 expedition showed him saddled with two large oxygen cannisters on his back, looking more like a lost scooba diver than an intrepid mountaineer. A gail of wind or loose footing on the powdery snow and rock could have tipped him over backwards, head first, glisssading on his back down the majestic slopes. The oxygen cannisters at that point would have functioned more like the hulls of a slick catamoran sailboat on a windy day than a source of what the Himalayan locals called "English air". It would be certain that Mallory would have been pulled along, each having each been tied together by a common rope.

The proper self-arrest technique to have been used by Irvine in such a circumstance is described in detail on page 320 of our reference. Self-arrest in such a position as possibly his would be considered the most difficult to achieve. "Hold the ax across your torso and aggressively jab the pick into the snow; then twist and roll toward it. Once again, the pick placed to the side serves as a pivot point. Planting the pick will not bring you around to the final self-arrest position. You need to work at rolling your chest toward the ax head while you work your legs to swing around and point downhill. A sitting-up motion helps the roll". Remember that if you are falling down a precipitous slope at 80 miles an hour, you may have problems putting on your glasses in order to read this section of the book. Only previous practice would make the difference and one could easily question whether Irvine was properly skilled in the technique. This, as it is now, would be the end of the consideration of the proper form of self-arrest.

So what is the bottom line in this multiday series of blogs on self -arrest? The answer - order a good mountaineering book such as the one recommended here, buy a sturdy ice ax (preferably with a leash!), and build yourself an icy slope to practice. Oh yeah, I nearly forgot. Perhaps equally important ----pray you are not tied to an inexperienced climber.

Mt Baker - Day 70-69 (Self - Arrest, cont)

As legend has it (at least by my vague unvalidated recollection), Mallory and his young climbing partner, Andrew Irvine, had chosen the North Face route to climb the Everest peak. Mallory had previously failed at this route on two separate occasions . He believed, however, that appropriate use of oxygen supplies would lead this time to here-to-fore never experienced success. The North Face route, for those of us who are not familiar, was a favorite of English mountaineers. It led through Tibet and in 1924, several decades before China gained control, was still open to foreigners. Mallory's choice of Irvine, a relatively inexperienced climber, as his expedition partner was considered a mistake by Mallory's more accomplished mountaineering partners. The 22 year old Irvine was chosen by our intrepid hero because of his skills at handling oxygen cannisters; this of major importance to Mallory. Also accompanying the two was Noel E. Odell; the latter chosen to stay at camps below the climbers, assure supplies, and monitor the progress of his two colleagues. As Odell was to later recount, Mallory and Irvine had successfully passed the Rongbuck ice fields, reached the North Cul, and continued passed the North East Ridge's first step. The second step on the North East ridge would prove to be the greatest challenge. The second step on the North East Ridge of Everest is about 80 feet high and, in a rock climber's, descriptive, a challenging 5.8 grade. For Mallory, an experience rock climber, it was certainly not insurmountable. He had performed rock climbs of similar difficulty in England without the advantage of assistance, including ropes and pitons. For Irvine, it was a different matter. His capacity to traverse the step was not to be realized.

As Odell was to recall, it was at the second step that the two climbers separated. According to Odell, Mallory cleared the step which left him only 800 feet below the top of the world. It was at that moment that the picture changed. Remember at this elevation, temperatures never climb above freezing. Snow never accumulates and remains a highly fine powder, easy to be displaced. Odell noted that a sudden gail force blew a snow cloud around the climbers, preventing all visibility. In a relatively brief period and with the clearing of the turbulent swirl, Odell noted that the climbers were no longer to be seen. His limited but frantic search provided no additional clues as to their whereabouts. Mallory and his young friend were gone forever.

Now what does this have to do with the description of self-arrest. The answer could be surmised from the events to follow. It could for purposes of this blog begin with the discovery of Mallory's ice axe in 1933.


The need for an ice axe and appropriate self-arrest techniques is reportedly critical at this part of the Everest summit. The ridge is narrow. The slope, nearly 45 degrees on both sides, is steep. The snow at 28 thousand feet on Mt Everest becomes a hazzard. Given that temperatures never reach above freezing, there is no opportunity for accumulation. The snow is free to blow with the wind, causing loss of vision in a gale, loose footing, as well as no resistance in stopping a fall or buffer to the underlying hazardous rocks.
(will have to continue later, time to cover our residents in the Head and Neck Surgical Clinic)

Mt Baker-Day 72-71 (Self-Arrest)

Folks in Noreal Place, Georgia may define self-arrest differently than where we are headed here. Apparently, if one commits a crime in that town, an opportunity exists to admit to the wrong doing online (no 911 call needed). A form has been considerately provided by the local police. The "application", it appears, provides places for all relevant information including the nature of the self-confessed crime as well as one's email address for return correspondence. Lines are provided for personal descriptives: sex, height, weight, eye color, as well as precise locations of scars and/or tatoos. I did notice, however, that the space for age was kindly omitted; a relief to those who may be chronologically challenged. The latter confession, for some like me, beyond the pale and enough reason to reconsider admission of guilt. Of obvious importance, a line was provided for home address complete with instructions to stay in the house until police arrive. In addition to the nature of the crime, the perpetrator can enter his/her plea (what other than guilty?) , as well as select one of a choice of motives (insanity was perhaps the most fitting option). All this is very convenient for those who may feel sudden remorse for cheating on past income tax reports. On the other hand, there may be other definitions of self-arrest we may come to accept; examples which are no less distressing than committing a felony. Pushing yourself away from the table when served an extra portion of spaghetti and meatballs is one example. Or perhaps, a middle-aged married man, vainly pursuing a young twenty-something year old beauty, comes to his senses when forced to recognize his transgression. He deceases and retreats to more sedate affairs such as writing a blog.

The definition of self-arrest to be discussed here may be of more importance to the mountaineer. In the glossary at the back of Mountaineering:Freedom of the Hills ,the act is simply described as the use of an ice axe to stop unexpected falls. Every mountaineering course I have been apart of has started with hands on instruction for this process. It is not to be taken lightly. The descriptions of self-arrest technique can be somewhat cumbersome to write and even more so to read. Let's consider, however, how the proper technique of self-arrest may have applied to the legendary English climber, George Mallory, during his ill-fated attempt to summit Mount Everest in the late spring of 1924.

George Mallory, for those who might not know, was a famed mountaineer who made a lifetime's ambition of reconnaisance explorations of the Himalayan moutains; Mt Everest being his most notable. His legend derives to a greater extent from whether or not he actually was the first to reach summit of the world's greatest peak, 30 years before Sir Edmund Hillary. (to be completed later, time for my Sunday AM run followed by climbing with 60 lb pack and ankle weights)

Mt Baker- Day 74- 73(High Adventure, Apologies, and Lorna Doone cookies)

Only a brief moment. Just finished a case in the OR. A patient with cancer of the tongue. Had been previously radiated some years back for cancer of the nasopharynx. Hopefully, the surgery makes the difference for this young man. Need to get some rest tonight. Have another major surgery tomorrow at 7:30 AM. It is a young woman with a vascular lesion in the infratemporal fossa. It's a difficult case that requires the collaborative expertise of several colleagues - no less a challenge than climbing a summit. Given that I have only a moment, my apologies for being brief and, for that matter, while we are at it, I apologize to those friends and loved ones I know for, at times, saying too much. I will try to correct my ways and avoid embarrasing and uncomfortable statements.

Performing these surgical cases does require some preparation, mostly in the form of rest. Last night for instance, I had just finished a 75 minute workout on the legs with Paul G; the purpose for climbing endurance. I was hoping to later meet a long time friend, Andrew F, along with our drinking mates at the Dive Bar on the upper west side to discuss important matters. Who, for instance, was eligible for the hall of fame in baseball despite a relatively short career? Concerned about the early OR case, I had to settle for more sedate plans. In this case, it was a quiet evening on a soft leather chair in the library of the Harvard Club. I settled in with an evening night cap and a box of Lorna Doone cookies. Mostly just taking in the ambience and attempting to cast away concerns, including medicine, training for climbing, confusing relationships, and the other "business-as-usual"affairs that clutter the mind. Maybe, a good book would help. Although with my attention span, I probaby would only get through the cover inserts. I just happened to look down in front of me at the books on the bottom shelf, not looking for anything or expecting anything in particular. At that moment, I happened to note a collection of old relatively warn out publications. There was one book that was closest to reach and I picked it up. Remind you, this was supposed to be an evening of rest and escape. Brought the book close enough to see and, no joke, I could not believe it. The book with the cover nearly completely torn from the ensuing pages happened to be the first edition, published in 1955, of, you won't believe it, the writings of Sir Edmund Hillary about his journey with the Sherpa, Tenzing Norgay, to be the first ever persons to summit Mount Everest. The book - High Adventure. No lie, no rest for the weary,and within a brief moment the cookies started to go fast. I knew that my early sleep was not to be had. But for now, I will have to finish this story or, should I say, Sir Edmund's story, some other time. Right now, its late at night. The box of Lorna Doones are now gone. I will take my escape with better dreams --- perhaps, Tenzing and I on the top of Mt Everest.

Mt Baker - Day 76-75 (A Soul's Comfort on the Cold Day's Journey)

Walking away from friends and family for the relative solitude of the mountain gives me pause. I search for the words.

The nights will be cold, the weather uncertain
The risks well known, no lessons forgotten
But, alas, no bliss from the gentle touch of love
The ready warmth from only a glove
No cell phone, no desk top, no telephone
The cold night's sound, the mountain's groan
No words of comfort from those who care
When doubt breaks through the icy glare

It made me wonder where it is that I would find the comfort, something to keep me on tract when all else fails. I knew I had to look hard for it. And believe it or not, I found the answer - a link through Alpine Ascents Inc. It seems that other climbers also fear a painful journey.

The true comfort I found which will remain with me for, hopefully, a long time came from a man named Frank. I found him in Middletown NY, a town in the Southern Catskills. I had to drive 3 hours in the rain on a Saturday morning just to meet him. Surely, that time could be more liesurely spent drinking my coffee and reading the Saturday NY Times in the quiet of our Pound Ridge home. Frank met me at the door. We were alone for the duration. He immediately put me at ease with his gentle but penetrating eyes. I felt like he knew me instantly, my past not a mystery, my future soon for him to foretell. In only a moment and without hesitation, he reassured me of all that I was seeking, my biggest concerns put to rest. You see, Frank had a unique talent and not one that is obviously considered. No he was not a psychiatrist, nor a soothsayer or a priest. No, he was not possessed with supernatural powers from which I could draw in time of need. He was not any of those.

To me, as a would-be mountain climber, he was something more important. Frank was a pedorthist, a certified boot fitter; the place of our first encounter, Frank's Custom Shoe-Fitting. The comfort I was looking for were in the boots I came to buy. Think about it. The treck will be long, through, temporate rain forests, crossing cold streams, and spent for many hours on snow and ice. No place to be saddled with boots meant for feet other than mine. A blister, a sore toe, a painful fallen arch would be a disaster. I had to be sure of the comfort of the boot and Frank was definitely the right man for the challenge.

Prior to my visit I had done some fairly extensive research on the subject of mountain boots. I new from previous experience that lack of due diligence can wreak havoc on an otherwise exciting journey. My last trip, for instance, was ice climbing in the Catskills with a pair of rented plastic boots. What a disaster. I didn't think I would make it back to the rendezvous spot, the return trip spent in silent misery as my fellow climbers laughed with the joy of their shared accomplishments. I decided for my upcoming trip that the six hour approach to the mountain and then up to base camp would be better served with a softer alternative, one not left to a quick rental. I settled on a pair of leather boots, top of the line stuff. Forsake no expense. The manufacturer was Lowa. The boot called Mountaineering GTX would well handle the required crampons. Frank would order it for me but first, the proper fit. He brought out all the measuring tools. The first problem I learned from this man of artistry was my left foot was longer than my right. The right exceeded in width. I had always fitted my shoes with the right foot, a big mistake. We agreed on a size nearly one size larger than previously ever considered. He then put my foot in this strange machine and concocted a custom made foot bed. By this time, I was ready to buy anything else I could get my hands on: running shoes, rock climbing shoes, dance shoes, loafers, anything. I settled for another pair of sneakers. He taught me new ways to lace the shoes, the so-called Sherpa's lace. He told me of the importance of keeping the heel in place. He brought several other inserts for assemblage inside my new purchase.

I trusted Frank. He is a man of conviction. For instance, Frank is also a long distance runner - very long. You see, Frank ran from San Francisco to New York several years back.; not once, but twice. Not only did he accomplish this feat, but he is also listed in the Guiness Book of records as having completed the crossing in the fastest time, averaging nearly 70 miles per day. I knew that anyone who achieved with his feet like Frank would be a true "sole" mate; one that I could count on. I left Frank having paid my bill and wearing my new sneakers, feeling almost reborn, my soul (or should I say sole) comforted and ready to meet any challenge, even the cold rainy drive home.

Mt Baker - Day 78-77 (It's in the legs)

So you just can't just take a casual stroll to experience the "freedom of the hills" that John Muir and others have so eloquently described. Remember that you are carrying a fifty pound pack on your back. The first day of even the most elementary of trips, you may climb for 10 hours just to reach base camp. On the last day, you will ascend to the summit, return to base camp only to pack, and then hike to civilization as we know it. One climber relayed to me on a previous trip that his descent from the Denali summit to his vehicle took 24 hours straight. My knees ached just thinking about it. Remember that 30% of climbers who climb Mt Baker never succeed and are forced to turn back. Not a casual stroll, indeed. Its more about the physical and mental endurance necessary to meet a challenge.The foremost factor that determines success is arguably in the strength of the legs. My training sessions are increasingly focused on this part of my body

Fortunately, from my winter mountaineering experience last January, I learned of one of my weaknesses. At that time, I was a part of the Adirondack Mountain Club winter school. We were climbing various peaks outside of Lake Placid. Spent the whole day hiking on each of the four days of the school. Climbed on snow in weather with temperatures at minus 25 degrees farenheit. For nearly the whole time we were either in snow shoes or crampons. Backpacks were relatively light at 25-30 pounds. No problem with shortness of breath, getting winded and needing to stop to avoid exaustion. However, it was at that point that I realized there was a certain muscle group beginning to fatigue that I had neither anticipated or previously experienced. I began to realize that should muscle fatigue progress any further, they might simply altogether stop functioning. I began to wonder as to what happens if these muscles give out completely; especially, when I am 3/4 of the way up the mountain. I shuttered that I could end up frozen in place, the history of my experience forever captured as an eternal ice sculpture of human failure for all to witness. The experience generated a more intense pulse within my state of chronic anxiety. Being embarrassed by my predicament in front of my fellow travelers would be the least of it. I do not want that to happen again.

So which muscles were the earliest problem? It turns out the first set of muscles to go were ones that I would never have considered, the inner portion of the upper thigh. My anatomy text, which I do not have with me at the moment, would identify several muscles; the adductor brevis longus and magnus, the gracilis, the pectineus are the principal ones that I can recall. I have long forgotten the blood supply, innervation, origins, insertions or other descriptives of this group or much else about the anatomy of the upper leg. I had to ask myself what about this climbing effort caused these muscles to fail. I am still thinking about it but the best I can tell it has to do with the added weight on my feet. More specifically, it has to do with the exertion of lifting your boots up, through, and out of the snow and ice to take your next step. The stress is compounded by the weight of the snowshoes or crampons and the snow and ice that may accumulate around there edges. Remember, the plastic mountaineering boots may by themselves weigh 5 pounds each. This stress can over a period of time add up pretty quickly. Having lived with my generalized anxiety problems for nearly my whole life, I have learned how to compensate. I will be sure to prepare long in advance to avoid the problem in the future.

I have also begun to believe that most of the common exercises do not increase indurance of this particular muscle group. None of the machines in any of the fitness centers previously visited seem to work them. Certainly, not days of jogging on trails or on treadmills. Lunges, dead lifts, bicycling, step stairs,eliptical machines - none of it - nada - nothing. Paul G has, however, come to the rescue. Knowingly or not, he has finally identified for me exercises to be incorporated into the daily routine which seems to answer the call. These will be described tomorrow after I have time to worry about it some more.

Mt Baker -Day 79 (Freedom of the Hills)

Get back from Las Vegas. Do cases in the OR Tuesday and Wednesday. See patients, both old and new. Catch up with paperwork. Sweat out two training sessions with Paul G and three on my own, including two on Sunday. Time to catch a quick glimpse of the two hundred Monarch butterflies that land in our yard on their way to Canada from Mexico. It's then back to the airport to fly to Dayton Ohio. Time to reflect how lonely at times all this can really be. Going to Dayton to see my mother on mother's day. Actually, it is not as considerate as it may seem.Yes, I had made my trip to Dayton to see her. But it was Paul G, my personal trainer and erstwhile spiritual leader, who reminded me it was mother's day. Nancy, knowing my general failure to remember important occasions, had already packed a mother's day card in my carry-on bag. I arrive in Dayton just in time to run six miles on the paved bicycle trail by the Little Miami River. Hundreds of geese were lining the banks of the river making the stepping on the trail a little precarious. Will finish later with strength and endurance exercises, today mostly involving legs, after I finish this blog.

Brought with me two books this time. One was a love story by the Nobel Prize winning author, Gabriel Garcia Marquez, entitled Love in the Time of Cholera. The second was Mountaineering: The Freedom of the Hills. Marquez's story takes place in Cartagena, Columbia. It is about the love-struck Florentino Ariza who waits over fifty years to win the heart of his beloved Fermina. The powerful imagery that Garcia is able to create can be transporting. I find myself many times in the old Columbian city.

The book Mountaineering: Freedom of the Hills is actually the best textbook in the country on the subject of climbing and a Christmas gift to me from Paul G. Over 500 pages in length, the book's chapters cover the essentials of clothing and equipment, camping and food, physical conditioning, and wilderness travel to name a few. It is put together by the Mountaineers Club, a group based in Seattle, Washington who date their origins back to 1906. Their initial purpose was to explore the mountains and forests of the Pacific Northwest. The current edition of Mountaineering is their seventh. The book notes that "Freedom of the hills" is a "concept that combines the simple joy of being in the mountains with the skill, equipment and strength to travel without harm to ourselves, others, or the environment" I will likely refer to it on subsequent blogs. The authors convey the words of the naturalist, John Muir. "Climb the mountains and get their good tidings. Nature's peace will flow into you as sunshine flows into trees. The winds will blow their own freshness into you and the storms their energy, while cares will drop off like autumn leaves. Walk quietly in any direction and taste the freedom of the hills."
Makes it all bearable!

Mt Baker - Day 80 ( tying the knot)

Twenty seven years ago this week, my wife and I "tied the knot" It seems only fitting today we revisit the subject (albeit, from a slightly different perspective). Today, there is a also a twist in the tail. My wife warned me this morning about my poor spelling habits in writing a blog that becomes an open record. She also wondered about including stories like the one I concluded yesterday. She noted, for instance, the word veil in these recent blogs had about four different spellings throughout. Well today's tail (that's right, Nancy, tail and not tale) may be more understandable. This tail is actually the end of a rope. The twist that I refer to is about is how one turns and guide it into a particular configuration thereby serving a very specific purpose. We are talking about a climber's lifeline - his knots. I have actually spent a lot of time on this (not the blog! but the knot!). For the last month or so, I have on a periodic basis while sitting in front of the TV, brought with me the necessary tools - two pieces of rope, a book called Mountaineering: The Freedom of the Hills, and my reading glasses. I then begin to weave. I sort of see it as the image of some elderly spinster sitting peacefully in her rocking chair, quietly knitting, eyes focused but hearing all else around her. The issue for me is that these twists for which I am practicing need to be life saving.

I have learned form the above textbook as well as from several climbing instructors on various mountains that there are about 8-10 knots and hitches with which I will need to be proficient. I even have a DVD specifically dedicated to knot tying provided through a link with Alpine Ascents, Inc. The knot usually first mentioned in all these sources and the one most commonly used is the figure 8. If you have ever been rock climbing, that is the one you are tested for proficiency if you are to climb in an unsupervised setting. It is the knot you fasten to your harness that places you "on-belay", ie, the one that attaches you to rope to which you literally entrust your life. That rope leads to the belayer who uses a figure 8 knot tied to his harness for purposes of attaching to an anchor. For those who may not know, the belayer is your guardian in case of a fall, the individual who controls your rate of descent. The figure 8 knot will tie each of my climbing team to a common rope as we pass through crevasse fields within the Easton glacier route of Mt Baker. One would think that a surgeon should have no problem mastering this and other knots and hitches. That is probably why it is always a standard joke to my climbing colleagues as they see how often I made a mess of it. Arguably, the nicest thing about my knots in the OR that avoids this aggravating ridicule is that they are performed with material too fine for anyone to really notice. I am up to proficiency in about four knots to date. Can tie the figure 8 in either hand and can tie it in about three different ways. Would I trust my life with it? Well, there is only one answer to that one. I'm going to half to.

Mt Baker - Day 82-81 (The Painted Veil-the finale)

I am back in NY and the good doctor has once again accompanied me. This time it was during my 5AM MTA commute. He completed his story of the two lovers, sparing no detail, and making the daily slog a little more bearable. I had to wonder, however, why I should be repeating the tale here on this blog of mountaineering. Perhaps, in thinking about it, there may be no reason at all. I simply had a moment in time that was not completely predetermined. A rare event. However, travelling for days to a meeting , for weeks climbing a mountain, or, for that matter, years in a venture to a small village in rural China plagued with cholera does give time for self-discovery. Time to reconsider our place and, if you will, see our own"painted veil". This discovery does not necessarily have to come as a grand revelation from a major lifetime event such as that experienced by Kitty and Walter. It may come in small doses from brief interludes. Regardless, before I get back to preparing for the journey to the summit, let me finish what I learned from the good doctor.

As the story goes---Kitty, after days of solitude, finally ventures forth and enters the walled village of Mei-tan-fu. Accompanied by a local Englishman town official, she is introduced to a group of French nuns who run an orphanage. Kitty and her new companions become enduring partners. Our heroine begins to emerge as a deeply sympathetic individual, caring, and compassionate. She abandons her shallow desires and soon reveals her insightful and nurturing nature, both to the orphans, as well to those souls around her. She and Walter begin to see each other in a new light. Their discoveries draw them closer together. Their awareness of the passion and profound tenderness within each makes a bond that is foreever life changing. But, alas, Walter contracts cholera. He weakens and finally succumbs but not before learning that Kitty was pregnant, the true father uncertain (remember Charles Townsend?)

Kitty returns to her former life with its many shallow relationships. Her mother dies. She renounces Charles Townsend ("a most vain and fatuous ass"). She eventually leaves all behind to search for a more meaningful existence, to care for her new child as well as her aging father. Her greatest desire was that she had learned the deepest capacity for "compassion and charity". Her will remained to follow the "path to peace that she dimly saw before her".

The story concludes and the good doctor and I part ways. So now what - the painted veil, an allegory for the coming adventure- to find the capacity for charity, to place aside shallow pursuits to find a greater purpose?? Or just some free time on a plane in a lovesick moment? Perhaps, it's just an unexpected , fleeting event as a result of this whole expedition. An expedition which involves many new "work-outs", including writing a blog. As much time as this took, it will only strengthen my own personnel commitment to this whole adventure. Anyway, time to get back to the OR. Aerobics and weights this early evening

Mt. Baker - Day 83 (The painted veil - cont.)

Walter, motivated more by a broken heart than anything else, sought to emotionally punish both Kitty and himself; his own self-disdain based simply upon his love for his unfaithful wife. He accepts a position to travel to the remote Chinese village, Mei-tan-fu. An epidemic of cholera was ravaging the town and claiming lives of nearly half the population including Walter's physician predecessor. Given his skills both as a healer and a bacteriologist, our painfully detached and suffering doctor is called upon to aid villagers in controlling the spread of the deadly disease. He threatens Kitty with divorce unless she accompanies him. He procedes to emotionally isolate himself and Kitty, treating her with cold disdain. Our young beauty, much to her misery, is forced to accept the situation rather than suffer the humiliation of divorce within the frivolous society in which she had willingly become immersed. Their days pass. She remains tortured and alone in their remote bungalow outside the village, her interactions only brief with casual acquaintances. Walter immerses himself both in the care of villagers and establishing the source of the cholera outbreak rarely speaking to Kitty. He becomes loved by the villagers who view him in awe as a hero.

Within this dreary existence, however, Kitty begins to change. She begins to see, in an almost dreamlike manner, her desolate world with here-to-fore never experienced brutality and beauty. It is with an awakening to a reality viewed in different, more profound imagery that she begins to shed the painted vail that had previously colored her existence.



Now, at about this time, I landed in Chicago to make my next connection to LaGuardia. Fortunately, my physician companion with his engrossing tale were not to be left behind. Now also at this moment, however, I must get on with my daily CME schedule. I will complete the recounting of his story tomorrow. This is fortunate because writing these blogs for me is as strenous an act as the climbing I need to complete this morning. To me, also I would add, the genious in my physician's recollection resides in how our good doctor's words may influence the new journeys we all may come to accept.

Mt Baker - Day 84 (The Painted Veil)

"...the painted veil which those who live call Life" These were words, recalled by a certain physician who accompanied me during the return flight from Las Vegas, taken from an untitled sonnet by Percy Bysshe Shelley. My good and fellow travelling doctor went on to relate the story of two individuals, Kitty Garstin and Walter Fane which drew further meaning to these somewhat cryptic words. It is a love story about two souls with whom he apparently had some connection. I will eventually relate why such a story should be mentioned here given the goals climbing for sight and sound and why I would try to repeat it justly. It is a story that speaks to perhaps all of us of the human capacity for personal growth and change.

It happened several years ago. Kitty was 27 at the time. The daughter of a London socialite, engaging, and radiant ("her beautiful eyes, dewy ponds under forest trees, held an enchanting kindness") , our heroine was regretably filled with shallow ambitions, the greatest of which was to marry before her younger sister, Doris. Walter on the other hand was a reserved, somewhat bland individual; a bacteriologist/MD who came to be quite fond of Kitty and eventually proposed marriage. He brings his beloved but, as I begin to understand, indifferent companion to Hong Kong so as to complete his work with an English international aid group. There existence becomes rather mundane. It was clear Kitty really saw this more a marriage of circumstance than passion. She soon comes to resent their relationship and eventually begins a torrid affair with a fellow by the name of Charles Townsend, a married man who turns out to be equally shallow, self-serving, and deceitful. Walter stumbles upon this affair and, under English law, threatens to expose both individuals in court as a basis for divorce. Charles, to avoid scandel that would threaten his career in the diplomatic service as well as his marriage, breaks off his relationship with Kitty.

Now the real story begins. I will continue tomorrow.