POLE POLE: A KILIMANJARO SERIES

The Mind Before the Body

I watched someone being escorted down the mountain with symptoms I was told were consistent with high-altitude cerebral edema. Around me, people were stopping mid-trail — not to rest, but for real concerns: labored breathing, low blood sugar, nausea and vomiting, fatigue so deep that getting up for another step didn't seem possible.

We were in the last 500 meters.

It was unnerving to watch people fall by the wayside, but I couldn't let my mind stay there. Panic meant hyperventilation, and I couldn't afford to spiral into worse breathing on the steepest part of the climb, in relentless wind and cold, dark hours, running on no sleep.

So I narrowed everything down to one instruction:

Pole pole. Slowly, slowly.

One foot in front of the other. Get to the top.

Before the climb, I'd asked a local guide for his advice. Pole pole, he said. Pace yourself. And above all, keep a positive mind. With a strong mind, he told me, you can "kill" Kilimanjaro.

I came into Kilimanjaro with no background in camping or multi-day trekking. I imagined something active and peaceful — four to six hours a day in nature, a welcome challenge to my body's capacity. I thought the hardest part would be going nearly seven days without a shower or a real toilet.

What I hadn't appreciated was what happens to the human body at 19,341 feet: my own physiology under sustained altitude; temperatures swinging from 30–70°F by day to near-below freezing at night; and the compounding toll of six days of consecutive exertion on top of it.

Just as important were the things I could control: the habits I brought with me, listening to the people guiding me, and, when my body needed more than willpower, using the medicine that was there to help.

How unprepared I was — and how grateful I am that I had a team of expert Tanzanian guides who had made this climb hundreds of times.

The saying "it takes a village" took on a whole new meaning. I would not have reached the peak without them.

The Rules Before the Trek

Before I laced up for the first trek, I was handed a set of rules that had almost nothing to do with pace or gear: no alcohol, minimal caffeine, constant hydration, and electrolytes recommended. We'd have our oxygen saturation checked every morning and evening.

At the time, it felt almost clinical — like I was checking into a regimented program rather than starting an adventure.

In hindsight, it was the first sign that this trip was going to teach me something about health I hadn't fully understood, despite years of education and training.

On this mountain, how I felt and what was actually happening inside my body weren't always going to be the same thing.

Learning to Eat for the Mountain

I came in expecting trekking food: energy bars, freeze-dried pouches, caloric rationing. Food as fuel in the most utilitarian sense — something you tolerate rather than enjoy.

What I got instead was the opposite.

Fresh vegetables at every meal. Rotating proteins — chicken one night, beef the next. Rice, pasta, and portions so generous I actually complained at first. The cooks kept piling on second and third helpings despite our protests. We joked they were the Tanzanian grandmothers none of us had growing up.

Too many carbs, I remember thinking. Too much food for a body that's supposed to be shrinking under exertion. It was such an American way to think — I'd come into the trip expecting to lose five or ten pounds, as if a mountain climb were first and foremost a weight-loss opportunity rather than something my body needed to be fed for.

I was wrong about that too. Four to six hours of daily hiking at altitude doesn't call for less food. It calls for sustained, steady fuel — enough to support the work the body is doing without constantly spiking and crashing.

I protested the carbs being served on my plate, but somehow still found room to ask about dessert — on a deserted mountain, where it was already a luxury to get fresh food. When I asked about chocolate, I was told, almost bemused, that Tanzanians only knew about dessert because tourists asked for it. It wasn't really part of the menu. I'd flown halfway around the world to test my body against one of the tallest peaks on Earth, and somewhere in there my brain still filed a complaint about a no-dessert cart. I never craved dessert the way I did back home once I was on the "Tanzanian trekking meal plan." It turned out to be less of a need and more of a reflex I'd never questioned. At home, dessert is practically a ritual; I have to have something sweet after dinner, mountain or no mountain, apparently. Here, it was a relic of a habit with nowhere to attach itself. My body performed amazingly without it. I still would have happily inhaled a piece of chocolate if one had materialized.

What surprised me most wasn't that I could go without dessert. It was how much the freshly prepared food seemed to contribute to my energy — and to helping me stay well through the temperature extremes and compounding physical exertion. I'd arrived thinking I'd be eating less. The mountain taught me that when the body is being asked to perform, nourishment isn't something to minimize. It's something to provide.

Rich Land, Rich Food

The more time I spent with my guides, the more I heard the same quiet pride surface: Tanzania is a farming country, rich in land that works the way it's supposed to. This wasn't food built to survive a shelf. It was grown nearby, picked recently, raised on land that hadn't been depleted by generations of industrial use. I started thinking about how different this was from the way I normally eat.

At home, I'd spent the previous several months becoming increasingly intentional about my health — supplements, tracking, paying attention to what I ate. And yet here I was, eating food that was simple, fresh, abundant, and cooked the same day.

My body here in Tanzania was doing exactly what I'd been striving for it to do — something that wasn't as easy despite every tracker, tool, and supplement available to me in America. That observation stayed with me. Not because one week on a mountain answers everything about nutrition — it doesn't. But because it raised a question I hadn't really asked before:

How much of what I supplement at home is filling an actual physiological need, and how much is compensating for the gap between the food I have easy access to and what real, fresh nourishment looks like?

The Mountain Had No Supplement Cabinet

Before I left, I considered packing a few of the supplements I'd built into my routine over the previous three to six months — magnesium, inositol, chromium, vitamin C, B-complex, collagen, fish oil, among others. My own small daily insurance policy. It crossed my mind: would my body hold up without them? Especially given the temperature swings and physical demands ahead, I worried I'd be more vulnerable to illness or have a slower recovery. I decided to let things be and accept what would come as my body adjusted to a new set of challenges.

Thankfully, none of that happened. I went a week with no supplements and no refrigerator, eating only what was cooked fresh that day. I did bring zinc pills, but touched them only once, when the night temperatures dropped below freezing. I never caught a cold. Never had a GI issue. Nothing beyond the fatigue the climb itself demanded.

I'm not drawing a hard conclusion from one week in one unique setting — that would be its own kind of extremism, the mirror image of "just eat clean and you'll never need medicine." But it made me reconsider what I'd been assuming about supplementation.

On the mountain, the food itself was doing what I'd been asking an assortment of pill bottles to do at home. That doesn't mean supplements are unnecessary. It just left me with a real question: Is there a way to nourish myself the way I'm supposed to back home, without constantly wondering and compensating for what's missing from it?

When Altitude Became a Real Opponent

There was one thing food couldn't do. It couldn't change the fact that I was ascending to 19,341 feet, and my body was responding accordingly.

I started Diamox on day three, once the fatigue stopped feeling like normal exertion and my oxygen saturation dipped into the low-to-mid 80s, even after deep, exaggerated breaths in an attempt to boost my numbers. Beyond that and a mild headache I was still attributing to dehydration, I had no symptoms to warrant supplemental oxygen. Our guides checked us twice daily, and the number on the pulse oximeter was only one part of the story. They asked whether the headache responded to ibuprofen or Tylenol and enough hydration. They watched our walking paces and depth of breath. They noticed who finished their meals and who pushed the plate away. Anyone without an appetite got approached with the fussing attention of a worried grandmother:

Eat something. Drink more. Sit here.

They were constantly checking in around mealtimes, not just on the trail. And they compared each morning's reading to the morning before. An 82 that was climbing after a night's rest told them something different than an 82 that had fallen overnight alongside a headache that wouldn't quit.

What made it possible to defer to them was that we'd watched them escalate. They had pulled out oxygen for another trekker without hesitation or discussion who had similar pulse ox numbers but ongoing symptoms that were not improving— no negotiation, no waiting to see. Whatever threshold they were working from was real. Between them, they had several hundred summits, and they knew what those numbers looked like on people who went on to summit and on people who had to turn around.

It helped, too, that half our team were doctors, and not one of us was particularly alarmed. Curious, mostly. A little entertained. We passed the pulse oximeter around like a party trick, reading the numbers out loud, and the low scores got something closer to applause than concern. We knew exactly what an 82 — and, for some others, even lower numbers — would mean in a hospital bed: the workup it would trigger, the calls it would generate, the speed at which someone would walk into that room. But we weren't in a hospital bed. We were high above sea level, in bodies that were busy adapting to a very different environment. So we proceeded with rest, hydration, and a nighttime dose of Motrin, with the understanding, spoken aloud, that a headache surviving the morning or a saturation continuing to drop would end the conversation.

I knew altitude and low blood oxygen don't negotiate with good intentions. I wasn't going to test my body further to see how far a well-balanced plate would carry me once the data was showing otherwise. The medication did its job, and I was grateful to have it. I don't recommend doing what I did. Diamox is commonly used prophylactically, before symptoms develop — something our guides urged us to consider from day one. I believed too much in my own baseline health and gambled on going without it. I was lucky I was healthy enough to hold up the first few days, and that I had the education to recognize when something was changing. If I'm honest, part of that gamble was vanity: Diamox can increase urination, and between the toilet situation and the prospect of multiple bush pees, I talked myself into believing I could tough it out. Being healthy going in didn't make me immune to what the mountain could demand of my body. Diamox wasn't replacing acclimatization, food, hydration, or rest. It was addressing a different part of the problem.

Food was doing something else entirely: giving my body the energy and nutrients it needed to keep functioning and recovering — steady protein, vegetables at every meal, enough carbohydrates to support four to six hours of daily exertion, and consistent hydration and electrolytes. From past experiments with continuous glucose monitoring, I had a good sense of how different carbohydrates affected my blood sugar, so I ate accordingly, despite my "Tanzanian grandmothers" continuing to heap rice and pasta onto my plate. My blood sugar stayed steady, and I felt like I was actually recovering each night instead of sleeping on top of depletion.

Two different systems, two different jobs. Diamox helped with the physiological demands of altitude. Food supported the energy and recovery I needed to keep going.

I needed both.

It Takes a Village

The third piece was the one I hadn't fully named before the trip. None of it holds without your tribe. The people around you matter.

Our guides knew this mountain in a way I never could after one week. They knew when to push, when to stop, when to make us eat, when to make us drink, when to let us rest — and when something wasn't normal.

Around day three or four, climbing the Barranco Wall — an 843-foot rock face requiring hands-on climbing — I saw a helicopter overhead, likely carrying someone down the mountain. I didn't know what had happened, so it didn't fully register in the moment. But it sharpened something in me: the risks of this climb were real. The Tanzanian guides were watching the trail, watching our oxygen levels, making sure we ate. Someone knew what my body was about to encounter because they'd seen hundreds of people encounter it before me. That kind of knowledge is its own form of health support.

We talk about health as if it's almost entirely an individual project — what we eat, how much we exercise, how well we sleep, what supplements we take. Kilimanjaro made it very clear there's another piece: community. The people who know what you don't. The people who notice what you can't. The people who carry you when you can't carry yourself.

By summit night, I finally understood what my guide had told me before the journey.

Pole pole — walk slowly, slowly. Pace yourself.
Positive mind — don't let the mountain become bigger than the next step.

One foot. Then another.

Eat. Drink. Breathe. Rest. Listen. Keep going.

We made it.

The Lesson I Brought Home from the Top

This blog has always circled the same question: what does it actually take to be healthy in the modern world?

I thought I knew the answer before I climbed Kilimanjaro. The daily habits — what we eat, how we sleep, how we move — are the foundation. Western medicine absolutely has its place, but we shouldn't outsource our health to it; we use it when our bodies need more than habits and mindset can provide, when illness, injury, or something beyond our control requires intervention.

And then there's community: the people who carry knowledge we don't have. Perspectives we can't access alone. And sometimes the physical and emotional weight we can't carry ourselves.

Kilimanjaro brought all three into focus at once. The daily habits I'd built helped prepare me. The local guides kept me safe throughout. And as the altitude asked more of my body than preparation and willpower could give, Diamox became part of the equation — medicine stepping in when habits, preparation, and mindset weren't enough on their own.

Food nourishes.

Community provides knowledge, support, and perspective.

Medicine intervenes when the body needs something those things can't provide on their own.

I also came to understand that a steady mind doesn't exist entirely on its own. It's downstream, at least in part, of a steady body. It's much harder to stay positive, to keep taking the next step pole pole, when you're dehydrated, depleted, freezing, nauseated, or your blood sugar is swinging underneath your thoughts. The mental fortitude I'd always thought of as a learned habit — something built up like training a muscle — turned out to be physiological too. Nourish the body well enough, consistently enough, and the mind has something stable to stand on. Surround yourself with people who know what you don't. And when something falls outside the reach of habits, preparation, and mindset, use the medicine that's there to help.

What the mountain gave me wasn't new information — I already knew, in theory, that food, community, and medicine all mattered. What it gave me was the lived experience, in a high-stakes situation, of watching them work together seamlessly and successfully.

And of course, I came home with more questions than I left with. What happens to our nourishment when we optimize food for shelf life instead of freshness? How much of what we supplement is filling a true nutritional gap — and how much is compensating for the way we've come to eat? And perhaps most importantly: how much of our health was never meant to be an individual project in the first place?

Those are the questions I'm bringing home from Tanzania.

Pole pole.