Pheriche is where we started to get serious about dealing with the effects of the altitude. At 14,000 feet and above the effects were no longer a myth for us. I, for one, had a terrible night with a splitting headache, and after an unbearable wait until morning I raided Gaye’s stash of ibuprofin and diamox pills. There is, of course, the a clinic in Pheriche devoted to treating and educating hikers regarding headaches and acclimatization. I got some very informative background information on high altitude headaches from Dr. Lipmen, who was leading a pharmaceutical trial up there. We also met Christina, who was actually on her way down from Lobuche and Kala Patar, but actually, even further “up the trail.” She’s from Georgia, but she had spent the summer in sourthern China at the Utahloy International School, which is in Zengcheng, near Hong Kong.