Dead or Just Resting?

May 7.

We were awakened at 530 am with freshly brewed, very strong coffee as well as a bowl of warm water with which to do our limited morning “freshen up”. All was in preparation for what was to be the big day. This was the day I was most concerned about. I felt I could manage the distance, having been walking and hiking a fair distance in preparation, but not at this altitude. Coupled with my slight anemia I was worried about my oxygen carrying capacity combined with the reduced partial pressure at altitude.

Today we are going to go over Dead Woman’s Pass at 4215m. Only hiking a distance of 10Km but with a vertical gain of 1577m!

But first the morning stretches!

Along the way we got regular glimpses of the pass which surprised me. I expected to be only able to see it as we got close but we were offered regular at times frustratingly tantalizing views. Often it seemed so close, yet we knew it was so far.

Our first view of the pass

As we ascended up into the cloud forest the flora changed. Lots of summer wildflowers adorned the path.

Today was also when the path transitioned from the mostly gravel road that linked the small communities along the path to the true Inca paved pathway. Comment is often made about the number of steps. What I found trickier was the paved parts that were still at a considerable incline. Harder to climb and more inclined to be slippery.

We were warned to watch out for the beguiling large, smooth flat rocks which could quickly become slippery. Thea would also call out any loose ones in my path.

Lunch (at 10am!) was at Llulluchapampa at 3760m where we started to emerge above the forest.

It was then the last push over the top. It was here that I discovered my “oxygenation limit” was at about 4000m. The last 200m of vertical was slow going. I would walk 10 to 20 paces, my heart rate would jump to 150, I would pause to let it come down a bit, and then walk 10-20 more.

Normally we would hike a 12-15 min km. For the trail I was expecting to take 30 min per km. Well on this last section it was 45-60 min per km.

The initial  5km-ish hike to lunch at  Llulluchapampa (with many sight seeing stops along the way) took about 3 hours. The last 2km to the pass took over an hour!

All morning the mist threatened, intermittently obscuring the pass from view, but our luck held and upon arrival the mist cleared so we could marvel at our ascent. But also look agog at the descent ahead of us to our camp below down at Phakaimayo (3596m). When the mist cleared even more we could also see the steep ascent up to Runqurakay (3970m) we were going to have to manage the next day.

We lingered long enough to make our offering of coca leaves to the mountains. But not too long as all that exertion, fluid intake to stave off AMS (and maybe the coca leaves?) meant we were all aiming for the stop just a few hundred metres beyond the summit.

Are these possibly the highest flush toilets in the world?

The descent was also what I was a bit worried about as my tight hamstrings tend to bother me on downhills. Also the risk of slipping was higher. But all was safely negotiated. 

In all 10.5km with 1577m elevation gain. 

An expected bonus at camp was showers! Now before anyone gets too carried away these were water straight from the mountain river icy blast showers. So if the exhilaration of altitude, hypoxia, tachycardia and a little bit of coca wasn’t  enough then this icy spray certainly made you feel alive. 

Many have wondered, as had I, what the derivation of the label “Dead Woman’s Pass” was. In particular was it recognition of the fate of an unfortunate pilgrim? Apparently the Inca trail builders felt the rock configurations at the top, when viewed from certain angles, reminded them of a dead woman. 

All seems a little grim. I mean one could consider she might have just been resting to recover from the arduous climb. The retired Midwife in our group and I thought the formation had a more maternal configuration. In fact you could imagine she was well into second stage given the angle of the neck and chin and the evident hormone induced organ hypertrophy. 

So, maybe, Labouring Woman’s Pass? 

Over Dead Woman’s Pass

Inca

May 6.

So today was what it was all about. The trail.

But first… the google review said the cafe was open at 7. It wasn’t. So, hotel coffee it was to be. 

Red in the morning?

First task was weigh in. We were allowed 3kg in our duffel bags that were to be transported to camp each day. Of which 2 was the sleeping bag. So it took some careful planning to pick the essentials (underwear, socks, thermals, batteries, head lamps and snacks!) Anything extra we had to carry ourselves. 

We were bussed to the park registration/entrance to complete the necessary formalities before starting on the trail. After which was a small museum preparing us for what was ahead, including a very useful relief map.

What was immediately obvious was that the Incas did not pick the most straightforward route to Machu Picchu.

Inca Pachacuti: Ok boys. I found the perfect spot for my summer retreat. 

Inca engineers: excellent choice. Easy access via the river valley. 

Pachacuti: no fellas you’re not getting it. This is where you’re all going on pilgrimage to worship me at the summer solstice. 

Engineers: … the river

Pachacuti: no lads.. you have to prove you are worthy to worship me..

Engineers: it’s still quite a long way along the valley.. 

Pachacuti: so it has to be an epic trek….

Engineers: ……… 

Pachacuti: …..

Engineers:… so over 4 mountain passes then? 

Pachacuti: now that sounds more like it. 

Engineers (sotto voce): who’s gonna carry all the paving stones‽‽ 

The start of the trail doubles as the access “road” for a few small communities along the river.  So there was much traffic of various kinds apart from the 200 hikers and 300 porters that are allowed each day. 

Initially we were walking through semi desert. Lots of grasses and cacti with the mountains looming ahead and behind. 

As well we were treated to more examples of the fine Inca terrace work. Perfect back drop for some choice train photos! 

The first major stop was an unmarked Inca site just before the ruins of Willkarakay (and about half way for the day) with breathtaking views over the valley. The centre of the site was notable for a depression where a water mirror, that would have been used to observe the stars, would have been placed. It was also where the elements threatened to steal your headware if you didn’t hold on to it! 

It was also notable for nearby evidence of pre-Inca stonework, as indicated by the lack of slight recline and precision of the later Inca work. 

We next stopped at the ruins at Llactapata which overlooked the sprawling site of Patallacta. 

Patallacta was where one could say the Inca Trail truly begins as it leaves the Urubamba river to begin the mountain pilgrimage. 

Patallacta provided food for Machu Picchu but also where pilgrims were vetted for the journey. Evidence of the extensive terracing and irrigation could be seen. It also has its own Temple of the Sun of similar design to that at Machu Picchu. 

It was from here that we first really started to climb alongside the Cusichaca River. First to lunch at Tarayoc and then to our campsite at Wayallabamba where the trail leaves the river valley to start the climb up to Dead Woman’s Pass. 

Camp was at the junction point of the two valleys in the lee of Huayanay with a view back down the valley to the ridge between Wacaywillca and Veronica.

Today was a relatively easy day. 12.75 km and 795m gained (according to my Strava). 

Inca Day 1

Umasbamba

May 5 2024.

The Google review said “Australian style coffee” and that it was open at 7am. I figured this gave me just enough time to get to Jack’s Cafe and back before our departure to Ollantaytambo via Umasbamba. 

It’s always interesting being up and about as a city is awakening for the day. People going about their usual activities while us tourists were still getting going.

Never had take out coffee presented to me in such style before.

Today continued our acclimatization both vertically and culturally. I have to admit to mixed feelings about these kind of cultural visits. While it was fascinating to learn about the traditional uses of local plants and animals for clothing and food and it is incredibly generous of the locals to take time to show us and involve us, I do still feel a bit privileged and uncomfortable at the ”dressing up for the gringos” experience. 

And gringos can’t dance.

The incredible colours derived from the various plants were beautiful. Who knew that the dye from prickly pear was a) harvestable and b) considered so rare (and apparently expensive). The soap derived from sacta root used to clean the alpaca wool was biochemically fascinating. Not greasy like most animal fat soaps.

And for those who had been asking, yes we did have the guinea pig for lunch. It was like eating rabbit: lots of work getting what little meat there was from the bones.

We then continued on to the Inca fort town of Ollantaytambo, historically known for the only time that the Incas were able to defeat the Spanish in battle. But only temporarily.

Lots of very nice walls to appreciate.

And the local llamas

How High-Low can you go?

May 4

Back when we lived in the UK we regularly watched “Have I Got News for You”. One memorable item was when the British, frustrated with European students’ deficiency in this area, were offering queuing lessons. The punchline was that, once graduated, they would then be taught to stand in the queue, roll their eyes and scoff, “Honestly” when someone jumped the queue. 

Most airports are semi chaotic arenas at the best of times. Our guide was relatively organized as he got our baggage tags and boarding passes as we were outside resorting and repacking. 

Once we ventured inside we figured out to not stand in the “get baggage tags” queue but the “check-in” queue. In saying that I was offered to join the “over 65” queue. Not sure quite how I should have taken that. 

As we stood in our correct queue a group tried to push in ahead of us. Well ahead of me. They argued “We are a group and we got in the wrong queue”. 

My initial temptation was to reply with that line (from Die Hard 2), “Excuse me but you mistake me for someone who gives a damn”. 

However Anthea did not wish for her father to cause a scene so I demurred. 

Honestly. 🤨

We were flying from the low-ish lands of the Amazon watershed to the lofty heights of the Altiplano.

As you can see, my heme molecules were initially somewhat naked. I noticed the headache and slight unsteadiness not long after arrival. We had started our acetazolamide and already had the tingling fingers. 

In Cusco we were treated to the incredible geometry and skill of the Inca wall builders. You will note I was quite taken with their masonry. 

The Spanish constructed square was always a hive of activity and we enjoyed the subtle yellow/orange lighting in contrast to our usual North American light pollution.

Dinner was alpaca steak and the largest glass of red wine I have ever seen. Also, unfortunately, one of the most disappointing I have ever tasted. 

As for the cat restaurant? We never went in so we’ll never know if it was such because it’s cat friendly or because cat was on the menu. 🤷‍♂️

For the birds

May 4.

We were invited to have a (relative) sleep in this morning prior to our departure. Unfortunately several of my bodily functions didn’t get the memo. 

The up side was that I tiptoed out to the porch and listened to the sounds of the forest awakening. Each different group seemed to take its turn announcing a different part of the arrival of the day. 

I’m thinking one or two may have been thinking “Birds! He keeps talking about the birds! But where are they?”

Well here’s a collection. I’m sure you’ll be able to tell which were mine and my so-so zoom lens. And which were Jason’s:). 

Hot and Wet

May 3 afternoon. 

The early start meant we returned from the treetop walk with a bit of time to rest up. However the heat and humidity frustrated any sleep. 

It reminded Thea and me of when we were volunteering in Uganda. The humidity was so high that even the clothes we _didn’t_ wear felt damp. We were also meant to be recording our oxygen saturation and our Lake Louise Acute Mountain Sickness rating scale twice a day in preparation for Cusco. However the paper was so damp that we risked tearing it if we wrote on it. 

The afternoon planned activity was to carefully re-board our river boat (now that we had the experience that it was far more stable than a swing bridge!) for a short trip to the Tambopata National Reserve where, after a short hike, we clambered (carefully) aboard our long narrow and shallow drafted paddle boats to paddle to and around Lago Sandoval. 

Here we were treated to many more birds: macaws, several types of herons and the greater ani. 

We also tracked along beside a troop of squirrel monkeys as they danced amongst the branches. 

How do you get a decent photo of a fast moving squirrel monkey?. One just keeps shooting in the hope that at least one of the 3-400 photos you took happens to be in focus. Might have managed maybe five. 

And the red blobs in the distant trees are howler monkeys. Honestly.

Up amongst the trees.

May 3 2024. Morning 

I think it was up again at 5 today for breakfast as my first photos as we set out were at 6 am. 

This morning we were going to be switching the unstable shallow draft of the river boats for the lofty swinging heights of the treetop walk. 

A magnificent way to be up above and amongst the tree canopy with the Rio Madre de Dios in the background. 

Lots of bird life: hummingbirds, woodpeckers, parakeets and more. 

Several different ant species to be wary of. Especially the fire ants which had a predilection for right where you might put your hands on the handrails.

At the end we were entertained by a troop of tamarins dancing amongst the trees just above our heads. 

For reasons of bulk and weight I’d left the 400mm zoom at home. The old 300mm sigma was not quite fast enough in the low rainforest light. 

Fortunately Jason had brought his 400mm. You should be able to tell which photos are his:). 

And then a sample of some of the fungi on the way back to glamp.

Sleeping on top of the sheets

May 2 2024

Up at 5 to get to the airport. Actually a decent latte at the airport. (Some may notice the beginnings of a theme here:). 

In Puerto Maldonado we were bussed to the “waterfront” and tentatively climbed aboard our mode of transport to the Inkaterra Eco Resort some 20-30 minutes downstream on the Rio Madre de Dios. Inkaterra is part research station, part holiday resort, the latter presumably funding the former. “Tentatively” as the long boats were quite narrow with a shallow draft and the weight had to be carefully balanced to keep us upright. 

We had a low key afternoon being shown the local gardens demonstrating some of the local flora and its uses. I didn’t volunteer to have my face painted. 

In the evening we tiptoed back onto our boat for a night boat tour. If cruising the river on a narrow shallow boat wasn’t hair raising enough? How about in the dark? 

Somehow the guide up the front was able to spot the wildlife on the shore or in the shadows. Caymans and capybaras. 

And when we got back to “glamp” a tarantula to help us settle for the night 🙃

Lima

May 1 2024. 

After two previously cancelled attempts (COVID, surgery) Thea and I finally started the trip to hike the Inca Trail that she’s wanted to do since a child (she can explain the back story). 

We landed in Lima late the night before. Rejuvenated by surprisingly good hotel coffee, we had enough oomph to go out and tour. Aunty Michele had recommended the Monastery of San Francisco catacombs. 

First we stumbled across this section of the old city wall. Mainly because we were diverted by a large crowd at the Basilica for a religious festival. Never did find out which deity they were festivalling in honour of. Though it was also Labour Day, and there was a big march happening, so one suggestion was the Patron Saint of workers?

The wall was built by the Spanish to hold back both the river and pirates. The area is now quite a pleasant (uncrowded) park. 

The crowds having dispersed just a little we made it back for the catacombs tour. No photos. Not sure why. Not like my iPhone is going to damage anything. And we presume the souls have moved on. But then we noted others taking photos anyway. 🤷‍♂️ 

Did sneak into the church later for some photos. 

Orientation meeting was back at the hotel at 2. The group was planning to go to the catacombs so we chose to walk down to the shoreline. It’s not really shoreline as that is consumed by a freeway, but more the cliffs overlooking the ocean. The area was a nice linear park where we also found late lunch:/early dinner. Found a monument to a famous Peruvian. 

The first Pisco Sour for the tour and my “Chef’s special”

We then express bussed back up into the city to visit the Magical Water Circuit. Again an Aunty Michele recommendation. Disappointing cold hard churros but an entertaining water and light show. 

Found the city sign for the obligatory selfie. 

“Tomorrow” it’s off to Puerto Maldonado in the Peruvian Upper Amazon. (Though purists might argue that the madre de dios is not actually upper Amazon but part of the upper watershed).

Christmas 2023

12-Month Review of Two Middle-Aged Adults Yields Few Insights

Bonertz LM1,2,3, Mackey PV1,4,5,6.

Affiliations

1. Home, Kamloops, BC 

2. Fort St John Pharmacy, Fort St John, BC 

3. Tumbler Ridge Pharmacy, Tumbler Ridge, BC 

4. Apex Surgical Centre for Oral & Facial Surgery, Kamloops, BC

5. Cariboo Memorial Hospital, Williams Lake, BC 

6. GM Baker Hospital, Quesnel, BC.

Conflict of interest statement

Lori would like to be sponsored by Hawkins Cheezies but to date no samples or branded clothing has arrived. Paul would like to be sponsored by Les Paul or Rocky Mountain Cycles to cover the purchase of more musical instruments or another bike.

Abstract

This 12-month, multi-centre, retrospective review reports on the low points and highlights of the Mackey family in 2023. Trends suggest skiing, hiking, mountain biking, paddling, hanging out with friends and family, and attending musical events provide much joy. 

Key words: skiing; hiking; family; friends; healthcare

Introduction

The authors struggled to devise a novel theme for this year’s Christmas letter. Because they participated in a BCCDC Sentinel Household Surveillance Network 1 and Paul is now enrolled in the PATRON study2, a review article seemed the most appropriate. 

Methods

 A random survey of photos and memories collected by the authors over the past 12 months was conducted. A limited search of MEDLINE was performed to survey the current literature. No demographic data was collected, and no statistical analyses were performed.

Results

  Low points

In April, Paul underwent a radical prostatectomy for prostate cancer. We found it rather surreal for him to be a patient in the Royal Inland Hospital where we met in 1989, esp. as the surgical ward has not altered much since Paul was there briefly as a medical student and Lori worked as a hospital pharmacist. Paul’s post-surgical recovery was mostly smooth (much of it spent in his TARDIS housecoat) (Fig. 1). However, he also had to undergo radiotherapy, which entailed being in Kelowna weekdays beginning Nov. 29 (and will continue to January 10). 

Fig. 1

Wildfires were widespread across BC, beginning north of Fort St John early in the season and affecting almost every part of the province by summer’s end. Air quality was often poor and friends in various regions were affected by evacuation alerts or actually forced to evacuate at times. 

Our cat, Pepsi, acquired from the Pimms in 2008, died in August after a short illness and we still find ourselves checking to see whether he needs to be fed or let in the house. 

Highlights

The conditions during the 2022–23 ski season were superb, both for downhill and cross-country skiing. Our skate-skiing technique still needs improvement and Paul had an encounter with Nancy Greene3 on a black downhill run that left him feeling humbled, but we both appreciated our ready access to Stake Lake trails and Sun Peaks4 (Figs 2,3).

Fig. 2
Fig. 3
Fig. 4

 Most of our kids and Lori’s sister Michele and her kids Lara and Aleks joined us at Sun Peaks after Christmas 2022. We also had the chance to ski at Revelstoke with a mix of Mackeys that  included two of Paul’s cousins (David and Patrick, two of Patrick’s children (Lucie and Apie), our sister-in-law Melissa, and her daughter Lexie (Fig. 4). In March, Paul was able to meet Jeryn and Ted in Jasper for spring skiing. 

 Our friend Michelle travelled to Canada in May. We had some time to just hang out as well as do some amazing hikes (Fig. 5). We also tested the utility of having your own  experienced rural physician travelling with you when one (Paul) dislocates one’s shoulder 2 hours from a medical facility. 

Fig. 5

 In 2013, the year of our 20th anniversary, our friends Becky and Leo had met up with us in NYC and they were able to join us there again, 10 years later. (Fig. 6). Michelle rounded out our quintet. Paul sang at Carnegie Hall (Fig. 7) with the choir from Kamloops and we went to several musicals (including Sweeney Todd featuring Josh Groban), an outdoor production of Hamlet in Central Park, and various museums.

Fig. 6
Fig. 7

In July, we travelled to Melbourne to spend time with Paul’s Dad and Sandra and see other friends and family. The light show at the botanical gardens was a bonus, Paul got to see Collingwood win a match, and we dined in the Member’s at the MCG before a Demons match, which they conveniently won for Paul’s Dad’s benefit. (Fig. 8). Of course, Paul was very pleased that Collingwood won the Grand Final in September.5

Fig. 8

In August, we drove to Pincher Creek for Lori’s 40-year high school reunion. There was a solid turnout from our small class, including some parents, teachers, and siblings, and the reminiscing was entertaining. We caught up with family, stayed one night with friends in Waterton, and hiked the trail to Crypt Lake with Lori’s friend Angela (Lori overcoming her fear of heights to negotiate the chain and tunnel  section). (Fig. 9)

Fig. 9

 In November, Paul made a quick trip to California to meet up with David for some hiking and touring around. (Fig. 10)

This year, we hosted three indoor house concerts (Rachel Casponi, Naomi Shore, Danny Bell). Our listening adventures were rounded out by a Frank Turner concert and a Bryan Adams concert plus various Kamloops Chamber Musicians and Kamloops Symphony Orchestra concerts. 

Paul got out mountain biking whenever he could, often joining the local group rides. Lori really enjoys the year-round Friday morning running group. We checked out known and new-to-us lakes for kayaking and stand-up paddle boarding.

Fig 10
Fig 11

Paul continues to do rural family practice/anesthesia locums, mostly in BC, as well as anesthesia for a dental surgeon, and some family practice and teaching family practice residents in Kamloops. Lori helps out when she can at the pharmacies in Fort St John, Keremeos, Tumbler Ridge, and West Kelowna; administers vaccines in assisted-living facilities; and edits medical manuscripts (until she is replaced by ChatGPT). The changes in practice that allow pharmacists some prescribing authority have added to the workload but also to the work satisfaction.

Our kids are forging their various paths: Jeryn and Ted up in Fort St John, Liam and Rachel relocating to BC (Fig. 11), Rachelle in Environmental Studies at Douglas College in Vancouver, and Anthea in third-year biology at the University of Alberta in Edmonton. 

We are looking forward to Paul’s brother Simon and Melissa and their daughters joining us for Christmas.

Conclusion

The year 2023 offered challenges not previously encountered as well as some fulfilling work, inspiring travel, connection with family and friends, wonderful music experiences, and opportunities for outdoor activity. Further research is needed to determine whether these trends persist and what the future holds.

We wish friends and family both near and far a happy Christmas and a joyful New Year.

References

1. https://covid19.research.ubc.ca/research/characterizing-antibody-response-emerging-covid-19-virus-care-covid-19     accessed Oct 21, 2023

2.Menard C, Young S, Zukotynski K, et al. PSMA PET/CT guided intensification of therapy in patients at risk of advanced prostate cancer (PATRON): a pragmatic phase III randomized controlled trial. BMC Cancer 2022;22(1):251.

3. https://en.wikipedia.org/wiki/Nancy_Greene_Raine accessed Dec 4, 2023

4. Spiteri K, Broom D, Laventure B, et al. Barriers and Motivators of Physical Activity Participation in Middle-Aged and Older Adults—A Systematic Review. J Aging Phys Act 2019;27(4):929-44.

5. https://studyfinds.org/i-love-you-happiness-sports/ accessed Oct 13, 2023