Sunrise over Ganesh Himals at Parvati Kund camp

After signing out my five ICU patients to the senior resident, I eagerly jumped into a cab waiting at the hospital and headed for O'Hare Airport to begin a two day flight to Kathmandu, twelve time zones and half a world away from bitterly cold Chicago.

As I stepped onto the tarmac at the Kathmandu airport I was greeted with a blast of thick, muggy air. The temperature was 90 degrees despite Kathmandu's elevation of 4,400 feet. After customs I proceeded out of the airport into the bright high altitude sun and was welcomed by several dozen sign-waving Nepalese all encouraging me to stay in their guest houses. Through the maze of placards and people I spotted my name held aloft by a gentleman, and I headed towards him. I was quickly greeted by two small Nepalese boys, each grabbing one of my two overstuffed duffel bags. Without a trace of effort each boy swung one of the large bags (equaling close to their weight) onto their back, hooking the webbed handle snuggly on their forehead. After seeing this I had no doubt in my mind that these two would be Sherpas on Everest in a few years.

As we walked to the car I met Kul, a short, pleasant looking gentleman whom would be our tour guide for the trek. Upon arriving at the car the young boys in unison dropped the bags, stuck out their hands and said in near perfect English, "Ten dollars." I looked at Kul, a person whom I had known for a mere two minutes for some honest consultation on this fee; he held up one finger signaling the proper amount to tip. After getting into the car I learned that one of the other doctors, lacking small bills, had earlier tipped these same boys ten dollars, a day's wage for the most experienced Sherpa, and a week's wage for a porter. I reconsidered my thought that these boys would need to climb Everest to make a decent living.

As we pulled out of the airport, the sights, sounds and smells of Kathmandu enveloped us. Our tiny car, sputtering thick black smoke like so many other vehicles on the road, was instantly folded into the daily bustle of this city of two million people. We meandered through many narrow alleys clogged with cars, people, bicyclers and shopkeepers selling their wares. The smells of spices mixed with incense, cow dung and burning garbage wafted through our car window. Our driver, continually on his brakes and horn, was forced several times to make a slalom course out of the pedestrians, bikes and free ranging cows; giving only the animals, bestowed with sacredness by the Hindus and Buddhists, a wide birth. Killing a cow in Nepal is punishable by jail.

After settling into a comfortable hotel, I met the other participants on the medical trek. Anil Parajuli, the Director of Himalayan HealthCare (HHC) and our trek leader, is a sturdy Nepalese gentleman of 40 years with a quick laugh and gentle smile. He has led treks in Nepal for over twenty years; the first ten years as a guide for wealthy hikers, and then after some soul searching founded HHC, a non-profit, non-denominational, non-governmental organization that works to help enable rural Nepalese to achieve their own economic and social development. Through this organization in the last ten years he has led scores of medical treks for doctors from around the world, giving untold amounts of humanitarian aid to the poorest of Nepali people. The other three participants were doctors, an emergency room attending from North Dakota, a pathology resident from Tennessee and a family medicine resident from New Mexico; we were a diverse lot with a common purpose.

After a quick briefing of the trek's itinerary in the hotel lobby I headed across the street for a traditional Nepali dinner of rice and beans called "Dal." Having not slept in two days and knowing that I would soon be testing my lungs and legs I turned in early.