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Showing posts with label wilderness medical training. Show all posts
Showing posts with label wilderness medical training. Show all posts

Sunday, 7 October 2018

5th of October - Morocco - hang out in Marrakesh - post expedition blues - we've been to many places, but not enough of them

Many of the WMT group left town already in the morning, heading back to their respective countries and cities, but a handful of us stayed for a while longer. Today we spent our day in the city of Marrakesh doing regular touristy stuff. A few had the time to have breakfast together and chat a bit before some left to go to the airport, the siblings to their Atlas trip and we others prepared for our city tour.

































My plan was to check into another hotel today, one that I'd booked months ago, a really nice riad with a pool and lots of space, but I decided to start off with just leaving my things in the room with some of the others, though, and go shopping with them. We headed off toward the center plaza and market with all it's intense shopping hysteria. So much glitter and glam, spice, music, incense, animals, colours, glass, decorations, brass and so on and on. Our goal was the Palais Badia. There were huge stork nests on the walls around the palace, some balancing quite precariously.  The palace was once upon a time the largest building around with large pools of water. It now houses a Minbar, a pulpet where an imam stands for the sermon, from the 12th century. Pics were not allowed though. Under the ruins there were former prison areas with old shackles and chains. In the old times people would get 15 day prison sentences and guilt needed to be proven. If found guilty people were either branded with hot irons or lost limbs.
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On the way back to the market, I visited a synagogue museum. Quite beautiful actually with its deep blue decorations.
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I had set my mind on trying to haggle at the market. I'm reeeally bad at this art and I totally prefer set prices, having grown up in a culture where what you see on the price tag is the truth, the whole truth and nothing but the truth. Here though, it is expected and if you don't they will tell you to do it. The salesman will actually get disappointed if you don't. I think I did fairly well though. We passed the market three or more times this day. I tried asking for a price, more or less laughing at them, shaking my head, offering my price and they would think it outrageous. We would struggle a bit. I left shaking my head. They'd call me back after a minute and we'd reach an understanding, they made some, I lost some, a win-win/lose-lose situation and both of us more or less happy =)
I got two brass lamps, a brass candle light stand, a seat pouf and a tiny tea pot for Moroccan mint tea (will get the actual tea at home though).

In the afternoon I got my backpack and headed to my other hotel, Riad Viva, a lovely, classical riad with a fountain in the center, beautiful decorations and a little pool on the roof terrace. On arrival I was offered mint tea (surprise), had a wonderful shower and hopped into the pool.
Later I rejoined the others. Two more in the group were leaving in the evening, Sophie and Ben. We had time to go for drinks at the bar we had been to the day before. Jemma and I decided to try some gray wine. We had never heard of it before so we wanted to find out just what the name entailed. Unfortunately we found out why we never have heard of it. I don't think anyone would buy such a thing back home. It tasted .... well it didn't taste, but it had an aftertaste of yeast, as in sake, but without the niceties of the Japanese beverage. The whole thing turned into a joke and somewhere in between poetry got involved. Our wine became a haiku:

"Grey wine, beautiful.
The bottle, the colour, good.
The taste, not so much."
Jemma.

Quotes and poetry became a theme this evening and as we waited to receive the rest of the drinks and mused about the wine bottle Hillary popped the descriptive:

"bottle neck of the bar"
Hillary

Later came:
"We've been to many places, but not enough of them." as we talked about traveling and post expedition blues.

When Ben and Sophie departed, we headed to a restaurant that Jemma had found in her tourist book. A very nice place with lots of decorations and live music. We had a three course meal - the last real one in genuine Moroccan style with small tajine pots for different veggies, large tajines for the hot food and fruit for dessert. We had the worst background music, however. Some 90:ies melted butter pop music.

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As we left the restaurant we bought even more things from the last open shops. We walked through the nightly chaos on the plaza filled with music, blinking lights, incense and people and the group decided to walk me home. They all received farewell hugs and goodnights.












While I uploaded some pictures in the night I decided to follow my adventure guts and googled activities for  the next day. After having talked to Chris earlier I realized I would regret it if I didn't.

Saturday, 6 October 2018

4th of October - Morocco - back to sea level

The evening after our hike I had a quite serious headache. Not so that I thought AMS, even though some of the others had been affected to a degree that at least one had to take Diamox (check out the article on Acute mountain sickness to the right). I had just really not been hydrating enough and eating had not been very efficient either due to my allergies. Nothing new though, I always eat a bit differently when not at home, the new factor was the level of activity though.  I went to bed with a pounding headache and woke up at 2 AM with just as much pain. I hit the water bottle with a vengeance and fell asleep again. Luckily the headache had let up by the time my alarm clock sounded in the morning.


Breakfast was a couple of slices of bread and some porridge and a more or less fantastic cup of Peter Larsen coffee. I think I will buy these for every single trip from now on. Sooo nice and so simple !!

We soon gathered the troops again and head off back toward the kasbah in Imlil. We kept a very good pace and people were chatting in small groups all along the way.
The weather was fantastic, just as all our days have been after the first chilly, rainy one. Already after 15 minutes we had to stop and pack jackets and sweaters away. The member of the group that had been the slowest the day before in the snowy terrain headed down in a faster pace than many of us could manage to keep up with. Haha, who would've known.

I spent the first part of our hike in silence, just thinking, relaxing my mind and occasionally listening to what people said with half an ear. I just felt generally good, although I once again considered changing my career completely and becoming a full time traveler ;)

Later I had a long conversation with Peichii (whom we all have been calling Peachy). We talked about traveling and she really has some good travel stories. She told me about being in Japan among other places. Very interesting. I would love to go. We discussed religion and basic common sense and how the two are interrelated. I bet we could've kept this discussion up for hours. It is always interesting to speak to someone who is not agreeing with you. ;)
I talked a bit about Mexico, my favourite travel destination so far.

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When we reached Sidi we stopped for a cup of coffee, juice and tea before continuing. We had some almonds and figs left from our lunch packs and gave them to the owner of the café as we left.
When crossing the last river bed some of us picked a few rocks to bring with us home. There were so many different colours. Green, red, spotted, striped, just beautiful rocks. (Yes, brother, I can hear you sighing as you read this, I did pick a few...)
On arriving at the kasbah we just had time for a quick freshening up before getting all our backpacks and heading down to Imlil. The WMT team had ordered lunch at a roof terrace in the village, salad, chicken and french fries. Now I finally had the chance to talk a bit with Barry. I'm generally, seriously impressed by all these WMT people.

As I've said before, I've met Barry during a previous course. His accident has really made an impression on me and the others. It is very inspiring to meet someone who is a bit passed the worst part of such injuries. I usually only meet people when they are in the middle of it, bloodied, afraid and terrified of the implications of what has happened, thinking that everything is over, but it's not, right. There is a life after an accident too. Just like with so many other things, you have the possibility to affect your future, even if you won't be the exact same person again. but then again, we change continuously whether such incidents happen or not, we get older, slower, learn other ways of doing things. The difference is that an accident will have it all happen at once. The breaks are pushed suddenly and that's what shocks you. I'm very happy to have heard the story of someone who is over the first part of recovery and has the strength to find his way back to what is important to him, as well as to share his experiences and to keep on organizing such huge events as our expedition.

Thinking of Barry's incident, I remember a specific person running after me in the corridor at work one day some time ago. I had treated a close person to them. I received a hug and they told me how important it had been that we had had a clear and calm talk about the implications of the other persons injuries and a timeline of recovery and most importantly hope for the future. Together we had laid a foundation that they could start working from.Making sure that they knew things would get better even though it would be slow going had been important.

Even though I seldom get the chance to talk more with the people I see, there sometimes is a chance to talk to their loved ones and underline the importance of emotional support and lending of strength, even on the days when the person wants to give up.

Anyhow, after the lunch we packed our bags in buses and headed back toward Marrakesh.

 I sat next to Chris, who told me about his plans for the next few days together with his sister. They are heading back toward the Atlas mountains and the south side of the mountain range. Apparently there's a stretch called the road of a thousand kasbahs (I have really not prepared for this trip at all. I know nothing of this country! It's embarrassing...) that they will travel and maybe stay in the desert and trek too. Sounds like super much fun. I got such a craving for more traveling! He suggested I tag along and my mind right away started working on how to make it happen. Would've been super nice to travel a bit more with someone as friendly as this guy, but crashing a sibling party and being all nordic and weird didn't really feel right. (Although in retrospect, I'd have no qualms about inviting ppl with me on my sibling travels...)
I can't let go of the idea of doing more in Morocco, though.

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We got to our hotel in Marrakesh, close to the main souk (market). I shared a room with Martina from Malta (I think) and Marzanne from South Africa. I spoke mostly with Marzanne and ended up inviting her to Denmark and Sweden. Would be great to meet these people again. Oh and family and friends, if you are reading this, I have promised your couches to these upcoming guests. Now you've been warned... Before the evening meal we had time for a quick look at the market.

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The evening was spent on the terrace writing course evaluations, mingling and having dinner. I sat next to Jim, Mike and PeiChii and we ended up having a discussion on Brexit and IVF. I don't know how we ended up there, but it is interesting to hear how the NHS works. I can't really repeat the information here though, I don't remember the details. We also talked a bit about real British food (real British food and not the immigrant cuisine) and weather or not the Britts learned anything from the time they more or less were the Empire of the World. I think the conclusion was "nah, not really". Funny stuff.
Later we went for drinks at a nearby bar. People were being generally really fun. I learned what floss and dab means - Hilarious!!! Jim demonstrated the moves. Too bad I don't have a picture. We're talking stroke level funny.

I talked a bit more with Nigel, our group guide. He is such an impressive and knowledgeable person, climber, hiker, former army dude and just generally a warm person.
Some of the others got a water pipe and sat in a ring enjoying that. I don't do any kind of smoke (especially since my first delivery of "the bad news" to one of my sweetest patients ever. Can't remember their name, but the eyes....)
Aside from that, just a lovely evening that ended with a stroll through the plaza in front of the large market place. It was super lively, filled with people, musicians, snake charmers, street vendors among other things.








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We fell asleep quite heavily in our room where the AC was broken. We are talking heat stroke sleep...





















3rd of October - Morocco - Jebel Toubkal

We slept surprisingly well the night before the summit part of our expedition. I guess that the 10 km walk and 1400 meter ascent the before contributed a bit.
The summit day started early. I got up just before 6 AM in order to prepare the last part of my day pack and to decide what to wear. Most of us had done as much as possible the evening before. We had expected pitch blackness in the morning, but luckily the generator at the refuge was turned on in the morning so head torches were not needed. also we had expected to need them when leaving the refuge, but the sky shifted quite early from dark to fresh, morning blue.

Breakfast was bread with cheese, marmalade, hot water for our porridge portions and finally I got to try out my coffee bags. The refuge only had Nescafe which I cannot stand, and the Peter Larsen coffee I had with me was just perfect for this morning. I also found that the coffee bag could be reused. It is strong enough.

We were ready to head off just after 7 AM. Our group started the trek first of all, but we were soon passed by another group as we scrambled up a slope of scree. We tried maintaining a very calm and gentle pace, as we were planning on keeping it up for about 4 hours. Somewhere along the way our group name changed from pit vipers to apples!! Whyyy?? We went from super cool to ... apples... well... what to do, what to do...

Our ascent began at an altitude of 3200 m and the goal was 4167 m.  At the beginning of the trek we were quite uncertain as to weather or not the full ascent was doable. It had been snowing during the night also, which further lowered our expectations. Nigel, our group leader, had made it crystal clear that if the path became too dangerous and our safety was compromised, he would turn us back. WMT Barry didn't go to the summit, but stayed behind at the refuge and looked after our things. He later told us that he almost expected us to return by noon, due to the weather.

Before reaching the midpoint of our trek we crossed the ice line which soon turned into the snow line and our pace got very slow. Some passages were a bit tricky and slippery. Nigel, was really keen on keeping everybody safe and naturally, having decades of experience, he was extremely professional about it. Along the way he would give us comments and insights into the way of thinking a leader has to have, mixed with anecdotes from he's life and experiences.

At one point I realized the tempo was so slow that I couldn't keep my temperature up. My toes were getting colder and actually beginning to turn a bit painful. I was wearing all my layers so the only solution would've been a higher pace. That was not possible, however, since not all in the group could keep up. Some were in no way used to snow (at least not like a northerner who has spent half a lifetime rolling in snowpacks, digging holes, falling over, sliding, gliding, skiing,  and just reveling in it). To my great surprise I found that I had a sliver of frustration in the back of my head. Frustration due to the pace and having to stand still in the snow with increasingly aching feet. Well, at least I had the time to take loads of pictures.
I'm usually a very patient person, infuriatingly so, but not right now, not in that situation. So, I find that I learn new things about myself during this trip. Knowing that I actually get frustrated by having to slow down and wait is a great insight and will be easier to work with now that I know.
To keep the group together and to adapt to the slowest person is a key aspect of being a leader.

https://drive.google.com/open?id=1p3SZ5hHsQfF1kHSf6JNFlqL2YN1QJmkW

https://drive.google.com/open?id=1G9XGzFp7BGYX46McFNjXJPKPBCsLIXAy

As we reached the crest of the slope it finally started to look like we would actually reach the top. The snow was fresh and soft as powder goose down and thus easy to walk in. There were no icy, slippery bits higher up. At the crest we had a fabulous view back the way we had come. It was cloudy on the other side of the crest, but apparently you can see the Sahara desert on clear days.
We had another 20-30 minutes to go in order to reach the summit. As we got closer our group gathered and we had our most tired member lead, so that all of us would reach the summit together.
When we finally reached our goal the view was breathtaking.

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We had a kind of a victory milling about, taking pictures, laughing and smiling and having something to eat.
The scenery was absolutely fantastic, snow capped mountains around us, lowlands visible in a brown haze below, brilliant sunshine reflecting off the snow. We had covered us up with loads of sunscreen. Nigel of course had an anecdote with sunscreen and snow. During an ascent and breathing heavily in the hypoxic air, facing the snow, he had once burned his tongue on the slopes of Everest. The snow reflects so much of the sunlight! Well, I burned my lips, even though I kept putting on more and more sunscreen...

I was surprised to feel so strong throughout the ascent. If you've read my pre-Morocco posts you know I did a lot of step training the month before the trip. I can tell you, it really works. I felt GREAT! And just generally happy and content.

What goes up, must come down. At one point we had to turn back in order to make it back to the refuge in good time.

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The descent was very messy. People were falling over, sliding in the snow, not trusting the snow and not daring to walk briskly. Running down a snowy slope is actually very much fun, especially since you are more or less incapable of getting hurt, whatever you do. There is always a soft cover to dampen your tumble, no matter how you attempt to somersault your way down. Anyhow, we ended up spending as much time heading down as going up and my frustration bubbled up even more.  Even so, we kept our group together, just as we were supposed to. Nigel was extra cautions going down, as the groups who had gone before us had walked and tumbled the path very slippery. We ended up going down the untouched slopes beside the path at many places, instead of risking the icier areas on the path.

At one point a member of the group had the symptom of some unfortunate food intake present itself. If you gotta go, you gotta go. Well, we all knew this could happen. Just a bit unlucky spot, though. To me it seemed as Nigel had experienced this before (what has he not seen or heard of already? I mean seriously...) so no worries, we waited patiently again for a very long while and just as Nigel started taking small steps up the slope again our final member showed up. Still alive then.

Luckily the rest of the way down went more or less smoothly for us all, including our member who had gotten ill, which did worry me a tad (and probably all the other doctors as well - D&V can really be a bitch).

When we fiiinally arrived back at the refuge the sun was high overhead and we were welcomed with warm sweet tea. I felt I needed to wash up and attempted to shower, but I failed horribly. I swear the shower spewed out icicles. Even attempting to wet my hair gave me brain freeze and nearly a stroke. After some feeble splashing about with small droplets of ice I had to give up washing my hair and keep on having it feel as fresh as a rats fur in a sewer.

Later we had some lessons and discussions on female health during expeditions, which was quite interesting. I have never really thought about it as a "thing" as its kind of private, but of course it should be seen as a "thing". I learned some interesting facts such as birth weight decreasing by 100 grams per km higher altitude of living. I think I'll write some more about this topic at a later time.


Next we had a fabulous dinner (everything is tasty after a mountain summit above 4km). I got a super tasty chicken tajine, the others couscous with chicken. I sat next to Chris and Peichii. Peichii and I had a discussion on religion (even though we weren't drunk at all - no alcohol at the refuge ;) ). Chris told me about his interest in Caucasia, a place that I must admit, I know nearly nothing (read absolutely nothing) about. I told him a bit of life on the Faroe Islands (I've lived there for a year) and my silly attempt of driving over the mountains in a snowstorm with a pocket size Suzuki Alto without winter wheels. Silly, as in really stupid. Chris has a knack for story telling and relayed a story of a trip to Armenia and a visit to a family's home. It was a single mother and grandmother and the English speaking son, if I remember correctly. He and his travel buddy had noticed a painting on the wall in a different style than all other artwork in the house. It depicted a man being attacked by a mountain lion, I think, and a woman protecting the man with an axe. It turns out it was a true story. The grandmother in the family had actually done that, and it was her in the painting, killing a lion. Fascinating.

The final lesson came after our dinner. This time the topic was heuristic bias, such as your own experiences affecting your judgement and what decisions you make when assessing risk for example. Another one is the kind of lemming-effect, you see someone do something and because they do it successfully you believe you can too and assume that the conditions are staying the same. The next topic was mountain leader education programs. Only UK based of course. I would have loved to know more of international educational programs.


The night ended with a quiz about all we had been taught - A competition ! YAY! - and my group ended next to last haha. We got 23 out of 25 correct answers and the questions were such as what is the prophylactic dosage of Diamox for mountain sickness, or at what temperature does live tissue freeze, the steps of frost bite, when not to do CPR in a hypothermic person and such. It was fun :-)
We all won some chocolate. I was completely wrung out and had a pounding headache as I went to bed at 22 PM. Some of the others still had energy enough for socializing, which I would've liked doing, but I simply could not at that point.