JUL-B-13
THE TRIP ALONG THE SPECTACULAR INDUS RIVER CANYON,
STOPPING FOR LUNCH AT CHUMATHANG, 13,470 ft,
AND OUR ARRIVAL AT THE LAKESIDE CAMP
TSO MORARI, AT 15,075
ft,
FOR THE TWO DAYS OF CLINIC, CLIMBING,
AND A LAKESIDE MORNING
RUN, BEFORE DEPARTURE BACK TO LEH, CONCLUDING LADAKH-03
July 29—August 1, 2003
The Indus
River Canyon
is stunning, as always. I sat in front
and took pictures, again, even those I remembered having taken before, since it
is always changing against the infinity of geologic time. On the right side is the Himalayan
Range with its Indian
Ocean floor sedimentary rock and fossils, and on the left the Ladakhi
Range which is melted rock from the
tremendous heat released from the collision of the plates, with the Zanskar
Range and Karakorum
constituting the Asian underbelly that was thrust up. When we got to Kiari military base, the
“purple mountain’s majesty” become more than a lyric when the beryllium content
is coloring the rock red-purple, with scattered green cuprous compounds. I found marble from limestone compression and
other rocks while keeping an eye out for fossil coral, which I would have a
better chance of seeing, or course, in the Greater Himalaya Range when I have
trekked through the Zanskar Range
next weeks.
`Since I
had made the great morning run over Leh, I was mellow and resting when we
pulled up to stop at Thicksay Gompa, not to tour, but to wait for the arrival
of one of our tardy jeeps. Over an hour in the hot sun, finally got me to pull out of the
attaché case a sheet of paper to continue correspondence, when we set out
again. Our long wait had made us
late for lunch which we had by stopping at Chumathang for our box lunches at
the “Warm Spring Baths”---evidence of the still-ongoing movement of the crustal
plates beneath us in this subduction zone.
CHUM is at 13,476 feet and is 33* 21.38N, 78* 19.21 E, 69.8 miles from
LEIL at 321* At
this elevation and without any unusual activity or exertion, my O2 Saturation
is 88% and 88 pulse.
TSO MORARI:
DESTINATION TRAVEL,
FOR OUR FINAL LADAKH-03 MISSION
We crossed
the Indus River
Bridge at Mahe with our special
permit to allow us to enter this restricted area, and passed the village
of Karzok along the dusty
trails. WE then crawled up the roads out
of the highest parts of the Indus River Watershed, to cross a ridge where a
special stupa and prayer flags demonstrate the end of the Indus
and its origin opf waters. We then enter
a high dry basin where waters that run downhill are collected in the basin
where evaporation concentrates the salts and leaves them as a rim around the
salt lake—which mirrors the snowcapped range beyond them. I had cautioned the passengers in my jeep to
be on the lookout for the colonies of golden marmots, once called “gold-digging
ants” in legend larger than a mouse but smaller than a dog, which pawed up the
earth which turned yellow when they dug under ground. These busy marmots are stationed around the
lowest spots where the fresh meltwater of the glaciers far above make a narrow
green ribbon through the alpine desert sand.
They are very busy at this time of the year getting as fat as possible
and laying in I some mown silage to keep them in the early retirement that is
forthcoming when they hibernate better even than bears. During that time they give birth in their
slumber, like bears, and emerge again with the spring thaw. They are as comical as meerkats to look at
when they are startled by the passing jeep and stand up with their staring
faces like myopic door guards on the alert.
Tso
Morari is the large slat lake, second in
size only to Pangong Lake,
and it is at 4,400 meters or exactly 15.075 feet. It is 28 km long and 8 km wide, and is denser
and saltier than the ocean, inhabited only b y brine shrimp, which is what
attracts the nesting birds to the lake, some of them endemic here alone. The distance to Leh from the military base
that guards the entrance to the lake is 227 kms. My saturation of O2 at this level upon
arrival is 84% with pulse 85. Water
boils at 84* here at this nearly three mile elevation. AT reorientation tonight at the campsite, I
told each of my team after they had bundled up to get the best protection they
could after the sun went down behind the peak over the village, that tonight
when they put their head down on the pillow, it will be above all the highest
summit peaks in the forty-eight contiguous states of the US. All the vaunted fourteeners of Colorado
will be below them, all forty three of them in CO, three of them in CA and one
of them in WA. I know many of thee
fourteeners very well, since I have expended some energy to stand on top of
several of them—such as the single one in WA—Mount Rainier or Tacoma. So, if they expected to do any heroics, to
remember that they were three miles up and would need to decrease their
expectations by a third. Specifically
they were not allowed to wonder off alone in the disputed border zone that got
us into trouble last year, despite the warnings repeated to that group. I planed to climb on the second day, but limited
to the saddle behind the village, and then to run the third day along the Tso
Morari lakeshore. All these plans I carried out, around the
clinic set up for the second and third days at Tso
Morari with our departure on the fourth.
THE FAUNA OF TSO MORARI:
CAMPSIDE BIRD WATCHING,
BETWEEN CLINIC SESSIONS
I had told
the group to be on the lookout for bar-headed geese, a bird with a U-2 wingspan
which is the only creature to fly over the Himalayas
without a Pratt-Whitney engine and a pressurized cabin. Obligingly, a group of the
geese bobbed by in a flotilla, leaving souvenir feathers on the salty marsh
shore. There are two kinds of
grebes, the horned grebes and a collared grebe, out giving swimming lessons to
their chicks, who clamber on the adults’ backs when it gets choppy. There were two different terns; one a sooty
tern, and the other that Jim and I decided must
be the Caspian tern, almost the size of a big seagull. We looked but did not find the horned larks,
an endemic species that I had seen each time before; then I went looking for
the little ground nesting birds. Only on
the last day did I see a few of the very busy female Desert Wheatears which
were busy burrowing a simple nest and moving a row of pebbles to an outside
perimeter. I watched as they diligently
continued their very elaborate nest building to produce a nest that looked like
nothing else but a small hole in the ground, subject to the jeeps riding out to
the tents and a pair of horses which were picketed on the salt grass by a couple
of nomads later. We saw a lot of white-banded pigeons, and, to Jim’s
disappointment, no bone crushing eagles, which he said would make a birder
friend green with envy if he came back with one of those spotted. The same thing is being said by the females,
who thought it would be nice if I could trot out a snow leopard for their
viewing. Only the distant nomadic
herders have had close encounters with such an elusive nocturnal beast—or
intrepid explorers marooned on a pinnacle in the Himalayas
overnight.
THE TWO DAYS OF CLINICS IN TSO MORARI
This time
the patients we saw were more interesting than their rather routine
diseases. We had nomadic shepherds
coming in with the usual knee osteoarthritis, Tb, and eye problems with GERD
(Gastro Esophageal Reflux) but the people were very much more interesting. Here would be a seventy year-old Shepherd
who had not changed his clothes which were an outer woolen robe over a layer of
the most bizarre cast-offs from another world, like a bambi t-shirt and a Beetles
sweatshirt, with a French inscribed vest.
But always, they would have a small amulet suspended by yarn and a
portrait of the Dali Lama and a few jewels—mostly fossil coral beads on a
string.
They would
also have the marks of moxabustion scars where they had undergone wet cupping
with what is essentially a “branding iron.”
The physical exam can be conducted like a veterinary medicine review,
since “X marks the spot” of their complaint, typically epigastric (GERD),
shoulder (supraspinatus tendonitis), knees (osteoarthritis—totally disabling
when it involves the know since you perhaps can imagine what an Asian Toilet
might look like, if ever they encounter such an up market device.
We saw the
usual mix of problems, including a group for the presentation by the students,
amoebic abscess and bloody diarrhea from amebiasis, and mycobacterial disease,
and several others that were god for the tutorials later. The students were catching on to the drill of
the intensive case review and that although they had at first squirmed to know
they were tested to and beyond their point of ignorance (“I haven’t had
pharmacology or pathology yet!” is not a valid excuse) they also realized that
by asking questions beyond the information base they already have, they would
learn more than \something they already knew.
We would come back to the tents and have tea, and change from the light
weight cotton to the heavy duty wool and polypropylene to keep from shivering
in the sixty degree temperature drop in this alpine desert after the sun dipped
behind the mountain peak I climbed last two years ago. After dinner, we could look up at the edge of
the Milky Way disc and see the whole galaxy spread out without the interference
of the light pollution seen elsewhere.
Orion and the Big Dipper with Cassiopeia in the North, and Scorpio
rising in the south would give us an unobstructed view with an occasional
shower of meteorites lighting up the sky with action. It was an English watchmaker named Wright who
first figured out that we lived eccentrically in a big disc of stars and coined
the terms of the edge-on view of the universe seen from planet earth. We have moved around to the far side of
planet Earth, and we still have to see anywhere where the stars are so little
interfered with than through the thin air at this 3 mile elevation with no
competing ground light pollution.
POST CLINICS, CLIMB TO THE VILLAGE OF KORZAK,
AND THEN CLIMB THROUGH THE SADDLE TO THE GLACIAL STREAMS AND SEE YAK
HERDER TENTS OF NOMDIC SHEPHERDS AS WE MAKE THE LONG TRANSIT FROM 16,000 FEET
After the
last clinic, I grabbed Lee Dutton
and Jim Campbell
and walked up through the village next to the Gompa on the hillside where we
had seen swarms of sheep climbing to their respective grazing areas in the morning. There were shepherds coming in in their
nomadic worn costumes selling their fleeces measured by a trip beam balance
against the weight of a standard stone.
Their skin was rough and tough, but their hands were soft from the
continuous lanolin cream they seem to be immersed in.
We went up
above the village to the chortens and Mani walls above looking
back over the lake. We kept climbing
until we passed the saddle where we could go off to the right and re-climb the
peak I had summitted two years ago. Jim
had never walked so high, so we left the saddle at 16.000 feet and came down
the defile to the canyon where the runoff from the glacier was roaring down
through the desert, leaving glacier scraped “paving stones” behind in its
wake3. I found a piece of fossil coral,
to identify this as once a part of the Indian Ocean
floor. I also saw other rocks that were
limestone and marble, which also confirms of the several ranges of the
Himalaya—first the Great Himalaya Range (Indian Ocean bottom), Zanskar Range
(which we will be crossing next week and which is in the “rain shadow of the
Greater Himalaya Range) and the Ladakhi Range which is essentially molten rock
from the tremendous energy generated by the collision of the subcontinent
pushing the Asian continent up, some of which is reflected in the Karakorum
Range. All through the middle are the
results of secondary accretion, of river deposits of the great Indus
canyon and glaciers which were at play
here for a long time even more than the ice ages from the altitude to which
thi9s collision of continents raised them—a process still in progress.
WE cam down
to the fast and silted stream and saw a few parachute tents darkened by the
fires of the yak dung cooing fires within.
I saw mating donkeys and stolid yaks, including my first grey one, with Zoes
the cross breed yak bull, cow crosses. I
saw a shepherd family trying to get across the stream by wading with the man
carrying first his wife on his back, and then returning for the precious
fleeces he was carrying to Karzok for the same process of sheep fleece
selling. A big wind came up behind us in
the wind funnel as we headed back to the Tso
Morari down the stream which rose noticeably
underfoot as a large sandstorm was kicking up behind us. WE made it back to the tents just in time to
get the blow over, and I searched again for the Desert Wheatear and its busy
nest building, but not yet taken time to sit in it and lay eggs. What had happened in the interval of rising
ground water was a group of the meadow voles popped up above their flooded
burrows, and ran around in excited pairs, copulating in front of my camera
shamelessly.
The
students came to the tent heavily dressed in the expected cold night, and sat
waiting me to pour it on in the final didactic presentation s and their
tutorials. I said nothing since I had
told them earlier that I would let them have the last word on this
experience. It started off as a Quaker
Meeting, with one after another expressing what this had meant to them. : Lee started off saying he had not expected
the high quality of the tutorials and the instruction that would come from the
depth of experience of a very seasoned professor, and a few others chimed in,
and then a few rather nonsensical “case reports” were presented, largely
dealing with the non-[participants and their diarrhea as the reason for their
withdrawal.
THE FINAL MORNING COMES WITH THE STRIKING OF CAMP---
AND, WOULD YOU BELIVE, -- A LAKESIDE RUN,
AT 15,175 FEET!
It was a
good brisk run, with the tents struck and the bags rolled up. We stopped after the heavy hauling along the
lake shore, and we splashed water over our heads for a cleanup before dressing
for the long ride back. I had to change
vehicles a few times as one or another of our drivers dropped out. But, we got the same view of the spectacular
Indus River Gorge on the way out as in, with a return to our Leh Hotel Kangri
base, where three more new joiners were awaiting us for the Lingshed trek.
Tomorrow is
farewell to the participants of the Ladakh-03, including Lee
who will be taking back my Action Packer and film mailers, and will drop the
case at Derwood on his way back to Geisinger to arrive in time to participate
in a few cases there. I will say goodbye
to the Campbells and other participants for whom I have to write evaluations,
and also send back notes with a few of them, including to the pathology
Professor at UMMC who was one of my instructors and is still giving inspiration
to the students at Michigan accord gin to Sophie, my UMMC med student.
This winds
down the Ladakh-03 trip, with a good morning run coming up in the dawn tomorrow
along with the packing up of the Reeboks and sending them back in the mail with
Lee Dutton, a bit of shopping assistance to the Campbells and others, greeting
of my GWU three students and a number of other arrivals for Lingshed, and a
farewell diner for the Ladakh-03 sendoffs who will be leaving at 6:00 AM back
to where they each had originated.
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