Finding the Balance Between Fear and Desire in Nepal's Himalayan Mountains

On April 24th, 2018, surrounded on all sides by towering Himalayan peaks, I had a difficult decision to make. A week earlier my wife, Lydia, and I had set out to complete the Annapurna Circuit, a trekking route in Nepal. You're supposed to train for these kinds of things. We didn't. Before the Annapurna Circuit, our standard procedure in the past was to rely almost entirely on willpower. Well this was different; the Himalayas demand respect. We began learning that lesson within hours of setting out on the trail. The nice, gentle slopes of the jungle soon became steep rocky valleys with no end in sight, and our heavy packs weren't helping. Still, despite the demands of the trail, the experience was fantastic. 

The typical day consisted of an enormous, home-cooked breakfast, hard hiking until lunch, followed by another push up the valley to arrive at a guest house just before dinner. The surroundings were beautiful, but the Nepali people were what made this new routine so special. Every hour or so on the trail a new village would appear. Then we'd be mobbed by kids or greeted by an old woman carrying what looked like twice her weight; and in every circumstance we'd all say "Namaste" to each other with the accompanying prayer hands. To my western eyes, all of these experiences were pure magic. But things are much harder for the Nepali people. The country is extremely poor, and the living and working conditions in the Annapurna region can be very difficult. It's important not to gloss over the harsh reality that many of the Nepali people face. I couldn't help but wonder what they thought of us and the fact that we could skip work for weeks just to explore the world and have a good time. Whatever their opinion was of us, nearly everyone we encountered was incredibly kind and accommodating. There was more than one occasion in which a thoughtful Nepali helped keep our trip from self-destructing.  

As we gained elevation, the mountains became more and more awe-inspiring. I had spent time in similar landscapes around the world, but nothing could compare to the Himalayas. As we climbed upward, it was common for me to mistake the mountain peaks for clouds and vice-versa. Even as we stood at 10,000 ft, I found myself following glaciers and rock spurs up nearly 10,000 additional feet to the summits of the Annapurna Range. If that wasn't good enough, we were typically sipping copious amounts of tea (we're big tea drinkers) as we stared wide-eyed at these wonders. 

But no matter how spectacular each new day on the trail was, an anxiety was growing in the back of our minds. We knew that we would have to cross Thorung-La Pass at an elevation of 17,777 ft. and this would be the highest either of us had been in the mountains. We had some experience in moderately high elevations; a few years earlier we had summited Grey's Peak (14,278 ft) in Colorado, but that was without heavy packs and the threat of avalanche. And there was another factor we had to keep in mind: time. As much as we would have loved to stay in Nepal for months, we were only able set aside 3 weeks total, which meant we would need to finish the trek in a relatively quick 2 weeks. While the trail was very challenging physically, being able to finish in time wasn't a huge concern, we would just power through the pain. What was a concern, however, was that we wouldn't have much time to acclimatize. The general recommendation was to take a rest day for every 1,000m (3,280 ft) of elevation gain. We didn't have that luxury. 

I began feeling something around 12,500 ft. I had spent time at this elevation before, so didn't think much of it. But once we reached Yak Kharka, a small group of guesthouses at 13,000 ft, the headaches started setting in. At the time, I hadn't yet experienced the symptoms of altitude sickness and wasn't sure exactly what constituted an emergency. Unlike Lydia, I rarely get headaches, so it seemed obvious to me that what I was experiencing was altitude related. And beyond that, our research had encouraged us to treat any illness at high elevations as potentially symptomatic of acute mountain sickness (AMS). This was new territory for me and I couldn't help but feel nervous about the dangers. If AMS goes untreated it can quickly develop into either cerebral edema (swelling of the brain) or pulmonary edema (fluid in the lungs), both of which can, in the span of a few hours, become life-threatening. There is really only one treatment for AMS: you must go down. 

It was April 24th now and we had a week to finish the trek. At dinner I stuffed down as much garlic soup, ginger tea and anything else known to combat inflammation as I could. Water is supposed to be helpful, so I drank an extra liter (we were already drinking 4-5 liters a day as a precaution). We discussed what to do, and we agreed that we should see how I felt in the morning before making a decision. As we walked to our room (which was more like a cave really) a light snow began falling. It was beautiful, but in my anxious state the cold flakes felt ominous. As we laid down to sleep I looked out the window to see nearly whiteout conditions with heavy flakes coating the ground much too quickly for my comfort. I couldn’t help but ask myself what we would do if my condition took a turn for the worse. Would it be safer to wait it out at 13,000 ft or hike back down the valley in a snowstorm? 

Soon I found myself in a sort of fever dream. The combination of a winter storm, which made the possibility of descent a danger of its own, and an increasingly painful headache gave me more than enough fuel to stoke the growing bonfire of anxiety roaring through my body. I’ve experienced panic attacks before, and I found myself right on the verge of another one. At this point, I was feeling pretty rough, but it was hard to discern whether or not the problem was the altitude or anxiety. Lydia, wisely, told me that I needed to calm down and try to sleep. 

She was right. I woke up feeling much better. The splitting headache I was suffering from the previous night had disappeared and the storm had passed, leaving a beautiful blanket of snow across the valley. The decision to stay and wait it out was the right one. I should note that headaches are common at higher altitudes and, generally speaking, are rarely a sign that your life is in immediate danger. But we were trying to be conservative with our health as this was our first trip to the Himalayas. Looking back, I think that it wasn’t as serious as it felt in the moment. However, things did get a bit more serious as we continued to work our way up.  

I felt that I was ready to move on to base camp (14,500 ft) so we started a slow ascent, taking as many breaks as our patience would allow. As we reached the end of the valley, the trail disappeared. Now it ascended sharply to the left in a steep set of switchbacks that marked the beginning of Thorung-La pass. Before ascending further we would stop for a night at basecamp, then get an early start to scale Thorung-La and reach Muktinath, the nearest town on the other side, before nightfall.

The atmosphere at base camp was electric. Everyone was excited to overcome the obstacle just above us, and the party seemed to never end. I have always loved these kinds of places, where adventure-loving travelers are huddled up to each other sharing food and stories. In those moments I always feel that incredible sense of belonging that is best defined by the words “these are my people”. 

As we settled down for lunch, my headache returned with full force. I knew by now that with time my body would eventually acclimatize and that I shouldn’t get myself too worked up about it. But an hour later I began feeling strangely dizzy and even drunk. This was a bad sign and I knew that if the symptoms continued to progress we would have to descend, which, because of our tight schedule, would mean the end of our trek. Lydia seemed to be feeling fine and shared my determination to reach the other side of the pass. So I began gathering as much information as I could from the owners of our guest house about AMS and how I could acclimatize enough to finish our objective. While they didn’t claim to be doctors, their assessment was very accurate and helped me to understand how to make the best decision. I wasn’t feeling any better that night, so it was clear that we would have to wait things out and hope that I would feel better after a day of little to no physical activity. Twenty hours later I had acclimatized and we were heading up the pass underneath the most vibrant display of the Milky Way I have ever experienced. 

We were really touching the Himalayas now, and whatever difficulties we were experiencing physically were well balanced by the beautiful site of towering white peaks coming to life around us in the pale morning light. I later learned that around just 15,000 ft. Lydia was already feeling the effects of the altitude (she didn’t tell me because she knew I would have made her turn around if I had known that she was experiencing symptoms this early in the day), beginning with what was now becoming a familiar headache. I was feeling it too, but the desire to experience those mountains in such an intimate way overcame my desire to play it safe. Some unspoken need in me was being met, and I didn’t want to deny myself the chance of being transformed in the process. 

As we approached 17,000 ft. something strange happened. I heard drums in the distance. I thought to myself that maybe someone was playing music at the top of the pass in celebration and that we were just now close enough to hear its low frequencies ringing through the valley. But a few steps later I realized, with a feeling of horror, that what I was hearing was in fact my own heartbeat. It’s not uncommon for me to hear the sound of my heart beating in my ears during a hard run. In that case, the sound is almost high pitched and is local to the area around my ears. This was different. It was very low-pitched and seemed to be pulsing throughout my body. I decided that I needed to stay calm and not allow this new experience to spook me. But that wasn’t all. I had lost the ability to burp out the air bubbles that inevitably result from drinking water while exercising. The bubbles would just get caught at the bottom of my throat and cause me to gag. I nearly threw up several times as a result. Lydia, who up till this day had avoided any adverse symptoms related to the altitude, began talking in ways that didn’t quite make sense. She also stumbled a few times and didn’t have an appetite. Those were all symptoms of AMS and I began worrying that she might be in danger. Still, we were both hiking strong and it was clear that although our symptoms were growing worse, we weren’t yet in need of evacuation. We continued on, breathing heavy and feeling like we had just shared two bottles of wine. The sky above us looked nearly black, as if the atmosphere were thinning out and the cold reach of space was just above our heads. I absentmindedly turned around at one point and, upon seeing her face, exclaimed “your lips are purple!” to which she responded “so are yours”. We were both starved for oxygen and our faces began to show it. She then said what we both knew was true “we need to go down”. 

At this point we were in a sort of no-mans-land. We could descend back to base camp, but that was just as far as overcoming the pass, just a few hundred feet above us. Plus, if we could make it over, we would have the luxury of descending to the oxygen rich air at 13,000 ft in only a few hours. We were feeling very sick but after working so hard to reach this point, turning around felt impossible. A woman passed us soon after and with a smile on her face informed us that we were just a few hundred yards away. I don’t remember that last push, but as we plowed ahead, the trail which until then had towered above us, gave way to an open sky. We had reached the top of the pass. 

It was a powerful moment for both of us. Accomplishing something so demanding was deeply rewarding, but doing it together was what really made it special. There was a group of celebrating trekkers there to meet us and take pictures. We took a few images and quickly gathered our things for the much needed descent. Amazingly, after a few hundred feet I began to feel remarkably better. My headache would last the rest of the day, but the other symptoms soon faded as we stumbled down the steep path. Lydia wasn’t so lucky. She has dealt with chronic neck pain for the entirety of our marriage and combined with everything else she was experiencing that day, her body was trying to shut down. That wasn’t an option at this point so I encouraged her to keep going. I took as much weight from her pack as I could carry as she fought through what was most likely a migraine. 

By the time we reached Muktinath my symptoms were gone, but Lydia’s migraine hadn’t improved. We considered hiring a jeep to take us further down the trail in case the altitude was still to blame, but it was nighttime now and we decided to sleep and see how she felt in the morning. Luckily this was exactly what she needed and we woke up feeling tired, but back to normal. 

This wasn’t the end of our adventures in Nepal (we had a few wild days involving buses breaking down and rock slides) but summiting Thorung-La was a singular moment in all of our travels up to that point. We certainly made some mistakes in planning out our acclimatization, but overall, the experience of trekking in the Himalayas was incomparable. Nearly a year later, I think about Nepal almost every day and am continually scheming ways to go back. 

Being in high places is for me a spiritual thing. I wish everyone could experience it. Namaste.