Becky Gray on Mt. Cube – with the Dartmouth ‘77 Team – The Survivor Series

               

The Survivor Series

 Becky Gray on Mt. Cube – with the Dartmouth ‘77 Team

2,909 ft. 4 miles

The Prouty Mountaineering Program
(the first Prouty Challenge Event benefitting Dartmouth-Hitchcock Norris Cotton Cancer Center)

October 28, 2012

Wes Chapman

Preface

The Prouty Mountaineering Program is dedicated to people dealing with cancer – patients, care providers, families and friends. This is the second in a series of blogs about cancer survivors who come out to celebrate being alive, climbing in the mountains of New Hampshire and Vermont. The survivor series is about a very special group – cancer survivors sharing their stories and a day hiking with us in the Hills.

 

Becky Gray starting the climb of Mt. Cube

Victory in cancer is normally measured in 5 year survival, and by that measure Becky Gray is a Triple Crown winner – a 15 year survivor of breast cancer. But “survivorship” is different than really being alive – and Becky is one of those people who is really alive every hour of the day. Becky is a dedicated outdoors-woman; expert bird hunter, fisher and author of 11 cookbooks about cooking wild game. She recently served as an expert editor for the 75th anniversary edition of The Joy of Cooking. She has written for publications including Saveur, Town & Country, Playboy, and Attaché, and is the author of 11 books on food including her bestselling Eat Like a Wildman and her latest release American Artisanal: Finding the Country’s Best Real Food, from Cheese to Chocolate. Check out some of her publications: food writer and cookbook editor

Unfortunately, the long-term effects of cancer treatment – particularly radiation and chemotherapy – include osteoporosis, and last year Becky shattered her ankle. She is fully ambulatory at this point, but just starting to get her legs back under her. We were both delighted – and a little terrified – to have her out on the first hike post-accident.

The team preparing for the summit push

This climb is part of the Prouty Challenge Event Series, and Becky has been a critical player in getting the Kilimanjaro trip off the ground. She joined the Norris Cotton Cancer Center in ‘09, and has helped the team build the main bicycling/walking event into a tremendous event – both financially and in building participation and awareness. Becky has been a dedicated co-conspirator of mine in building an outdoors program in the Prouty, and has done a terrific job in getting the details squared away for this year’s Kilimanjaro trip.

Martha Chapman and Becky near the summit of Mt. Cube

This should not come as a surprise as she and husband Ed (D ’67, T ’71) built and ran Gray’s Sporting Journal, including a vibrant associated sporting travel business. There is a major point of reinforcement building between folks interested in the Prouty and the outdoor oriented Challenge Events – and the promotional and web based support generated by Becky. Consider that all of the hikers in the photo below are multi-year participants in the Prouty.

Prouty veterans on the Mt. Cube hike

My preferred route up Mt. Cube is from Baker Rd. in Orford, NH up the cross Rivendell Trail. This starts out on Baker Road on the track of the old Appalachian Trail. The Appalachian Trail was re-routed to the south and east several years ago, and the local folks built a foot-trail across the Rivendell School District, utilizing part of the old trail through Orford. Rivendell was originally the fictional refuge of elves in J. R.R. Tolkien’s Lord of the Rings. Rivendell, is derived from the words meaning split valley, and applies to a school district which lies in both New Hampshire and Vermont. This is particularly appropriate moniker for states habitually split by the Connecticut River, political affiliation, fiscal policy and geological origin – Vermont is part of the North American Plate and New Hampshire part of the European Plate.

This hike was supported by the Dartmouth Class of 1977 in general, and the erstwhile brothers of Theta Delta Chi in particular. We were joined on the hike by class President, Nancy Vespoli, a veteran of Kilimanjaro as well. Theta Delta Chi has had the pleasure of being a great supporter of the Prouty, led by a terrific group of undergraduates captained by Tommy Patek D’13, and including Ed Gray (Becky’s husband), Dr. Mark Israel (Director of NCCC) and all of the guys in the photo below.

 

Dartmouth ‘77’s preparing for Mt. Cube

Homecoming brought most of the team into town

Becky showed up ready to climb, and did a great job getting up through the rubble of quartzite boulders on the west slope of the Hill. Always ready to engage in a little wild food foraging, she brought along tools and an encyclopedic knowledge for a little wild mushroom hunting. I’ve been a dedicated hunter my whole life, but this was something wonderfully new – and quite enlightening. We broke through the Valley fog around 2,000 ft., and got a strange view between the cloud layers. Becky made it to a few hundred yards from the summit, and wisely turned around prior to the steep and slippery glacial polished quartzite slabs in the last quarter mile.

Becky Gray on the quartzite ledge near the summit

Nancy Vespoli, Gary Rogers and Pete Volanakis at the summit

 

The author at the summit with his canine fan club

This hike was a great opportunity to kick off the day prior to the football game – which turned out to be a study in frustration. The summit team reunited on the descent, and bumped into an unexpected tribute, carved in a fallen beech tree. This was a terrific day with a dedicated outdoors-woman, and a wonderful cancer survivor.

 

The work of a secret admirer

I have the privilege of leading a team of climbers – including a number of cancer survivors – up Mt Kilimanjaro this December. If you have someone that you would like to honor at the top of Kilimanjaro, please let me know who, how you would like them honored, and especially if mountains and natural beauty were important to them – to do this job right, it really helps to know the story (send to mwestonchapman@gmail.com). If you want to donate directly, please see the Prouty page at http://reachforthepeaks.kintera.org/faf/search/searchTeamPart.asp?ievent=1019697&team=5181015.

Please make a donation as you see fit – all amounts great and small are really appreciated. Anything that we can do to support people in active treatment we will try to accomplish – signs, poems songs – you name it. Amazingly, there is good cell service on areas of the mountain and we will get photos, audio and video out for the support of patients in active treatment ASAP.

In the meantime, if you would like to come along on a Prouty prep hike, just drop me a line at the email above – we are out almost every weekend, and we really enjoy meeting new climbers.

Remember, it’s all about people.

 

All the Best from Kilimanjaro

Mark Green on Mt. Moosilauke – with the Kilimanjaro Team

         

The Survivor Series

 Mark Green on Mt. Moosilauke – with the Kilimanjaro Team

4,802 ft. 8 miles

The Prouty Mountaineering Program
(the first Prouty Challenge Event benefitting Dartmouth-Hitchcock Norris Cotton Cancer Center)

October 21, 2012

Wes Chapman

Preface

The Prouty Mountaineering Program is dedicated to people dealing with cancer – patients, care providers, families and friends. This is the first in a series of blogs about cancer survivors who come out to celebrate being alive, climbing in the mountains of New Hampshire and Vermont. The survivor series is about a very special group – cancer survivors sharing their stories and a day hiking with us in the Hills.

 

 

Mark Green on the Summit of Moosilauke

Once in a while you bump into somebody who seems absolutely determined to make the most of every moment – and that is what Mark Green is all about. As best I can determine, this is what he has always been about – this guy is the walking epitome of carpe diem. Mark was diagnosed with stage 3 brain cancer – an anaplastic ependymoma actually – about 18 months ago.

Among other things, Mark is a terrific writer with a very active blog in which he gives a detailed account of the initial seizures and related symptoms of the disease, http://moosevt.wordpress.com. While the tale is both awful and gripping, I loved the metaphor of cancer coming into his life, “Imagine sitting peacefully in your kitchen eating breakfast when, without warning, a locomotive train plows through your home. You are still sitting there, bowl of cereal before you, and you sit bewildered as the debris from the destruction swirls around you. It’s been like that.”

 

Hannah Green on Moosilauke

Mark is the dedicated and proud (justifiably) father of Hannah Green, a wonderful young woman who joined us for a trip up Moosilauke a few weeks ago. Hannah was raising money for the Prouty to join us on Kilimanjaro next year. I got a chance to meet Mark briefly when he picked up Hannah after that hike, and I jumped at the chance to kick off the Survivor series with Mark. Joining us on the hike were Jill and Gary Rogers (just coming off knee issues), and Rick Morse – another Kilimanjaro team member this year.

 

Wes and Rick Morse enjoying the breeze at the summit

Mark’s journey began with the removal of a 4.26 cm sized mass from his brain in August of last year, followed by several courses of radiation therapy (two words which for me still fit rather uncomfortably juxtaposed). The seizures that characterized the untreated cancer have abated in frequency and scope, but still occur enough that an 8 mile hike up the wet rocks of the Glen Cliff Trail presented a bit of a worry. It was great having Rick Morse along – he is an MD – but given that his interventional specialty is prostate biopsies, we were all very grateful that our hike did not generate any need any medical intervention.

It is not often that I bring someone to the cold, windy and cloudy summit of one of the White Mountains – and see such raw joy. From my perspective, there is something wonderful about accomplishing a very difficult – and a little dangerous – in the outdoors. It’s all about life in the moment. On the way back down, Mark described how he loved to push himself right to the limit – and he sure did on Sunday. The hike is over 3,000 vertical feet over tough, steep terrain and is a good day hike for anybody – not to mention someone recently diagnosed and treated for brain cancer.

Gary and Jill Rogers on the summit with a ribbon for Audrey Prouty

Mark has made his career in education, having had a bit of a peripatetic career as a teacher and development officer in schools along the Connecticut River Valley – with an interesting jog out to Arizona for a few years. He’s been successful in these endeavors, largely because he’s a natural at connecting with people. On the way down the Hill we all practiced the delivery of jokes – most off-color – to the delight and horror of all involved. It was a lot of fun. The Prouty Mountaineering Program is all about the people, and it was a real pleasure getting to know Mark Green.

The team at the end of the hike

I have the privilege of leading a team of climbers – including a number of cancer survivors – up Mt Kilimanjaro this December. If you have someone that you would like to honor at the top of Kilimanjaro, please let me know who, how you would like them honored, and especially if mountains and natural beauty were important to them – to do this job right, it really helps to know the story (send to mwestonchapman@gmail.com). If you want to donate directly, please see the Prouty page at http://reachforthepeaks.kintera.org/faf/search/searchTeamPart.asp?ievent=1019697&team=5181015.

Please make a donation as you see fit – all amounts great and small are really appreciated. Anything that we can do to support people in active treatment we will try to accomplish – signs, poems songs – you name it. Amazingly, there is good cell service on areas of the mountain and we will get photos, audio and video out for the support of patients in active treatment ASAP.

In the meantime, if you would like to come along on a Prouty prep hike, just drop me a line at the email above – we are out almost every weekend, and we really enjoy meeting new climbers.

Remember, it’s all about people.

 

All the Best from Kilimanjaro

Transitioning to Value Based Oncology: Strategies to Survive & Thrive

I spoke last week at the 2012 Cancer Center Business Summit.  Click on the link for the PowerPoint Slides given at the Summit: Cancer Business Summit v6.

All the Best, Wes

Opportunities in Healthcare M&A – a Structural and Data Driven Revolution

Opportunities in Healthcare M&A

The FTC and the Alphabet Soup Antidote –

An Information Driven Structural Revolution

October 15, 2012

Wes Chapman

           

My friend Pete is a senior player in a major regional academic medical center, and a terrific raconteur. He was hilarious in his recounting to a group of pals, the horror of trying to put together a small merger a couple of years ago with another not-for-profit hospital across the state in which he operates. The essence of the problem – the FTC was defining competition in such a fashion that no deal could ever be possible, and after years of work and millions of dollars in expenses, his deal was dead. The story was funny, but the telling was understandably bitter. Pete lived to fight another day and another way – and he just won big.

He did a deep dive into the new alphabet soup of alignment and compensation structures, and put together a data driven, ACO centric series of deals that encompasses 10x the geography and population of the original FDA blocked merger. This is very cool – but particularly so, as he did the whole thing in a matter of months, and the money that he saved on lawyers and accountants is the down payment to build a huge new data center to inform the whole thing. Better still, this should allow his organization to reap cost savings and take advantage of purchasing and operational synergies in a way that the simple merger never would have.

Anti-Trust Considerations

The rate of enforcement actions by the FTC in the healthcare service industry has more than doubled over the last decade – largely targeted at traditional corporate style combinations. As hospitals have responded to increasing costs by seeking cost savings in combination, the FTC, DOJ and state authorities have stepped up vigilance to prevent combinations which could lead to anti-competitive pricing. In local-market M&A transactions in healthcare services pose a dilemma; the potential for anti-competitive pricing, is clearly offset in reality by cost savings potential – savings that the system desperately needs. The traditional corporate transactions and corresponding anti-trust regulations are really not designed to bridge this conundrum.

This anti-trust vigilance has spilled over into the not-for-profit arena following the post-acquisition study of the 1999 Sutter Health acquisition of Summit Hospital in Oakland, California. The California Attorney General sued to block the merger, only to have an injunction overturned by a judicial ruling. A subsequent study – two years later – indicated that the consolidation had resulted in price increases of 72%, and the die was cast – not-for-profit mergers were absolutely fair game – and my friend Pete was an unsuspecting “beneficiary” in his failed merger with another non-profit.

From revenue to cost/information driven solutions

The dominance of fee-for-service pricing mechanisms in recent years has driven revenue model dominated business solutions in healthcare. I know that for at least the last 10-15 years, my friend Pete has fixed all of his budgetary problems with a simple formula – charge more money. Pete’s experience has been standard industry practice for at least the last decade, as illustrated by the chart below.

 

Not too surprisingly, this run up in costs has resulted in a system with a fair amount of fat – particularly around overhead associated with software and systems for “coding enhancement” – estimated to be upwards of 15% of total system costs. Additional overhead crept into the system as combined entities – optimized for an HMO environment in the’80’s and 90’s – disintegrated into individual units offering specialty care solutions. These models were vastly more efficient than the in-hospital services that they replaced – but because they did not reduce hospital capacity, perversely overall systems overheads increased. As an example, the rise of ASC’s and related specialty hospitals has further reduced overall system utilization rates – recently exacerbated by the decline in utilization driven by a weak economy and the widespread adoption of high deductible health insurance.

The insurance industry countered this trend by continuously dropping rates to fractionated specialty care providers – creating yawning gaps between prices being paid to independent providers and those paid to hospitals – routinely as much as 2X, as recently noted in the Wall Street Journal, August 27,2012, Same Doctor Visit, Double the Cost. Hospitals successfully defended their higher reimbursement, based on the somewhat strained logic – “we provide a unique and necessary benefit for society, those specialty shops have stolen our most profitable business, therefore you must subsidize our higher overheads. As you might expect, this pricing differential has provided the impetus for a land-rush of physician practice acquisitions by hospitals.

My friend Pete merged his physician clinic with his hospital years ago for this very reason, and has enjoyed higher rates of billing for the same services ever since. Not too surprisingly, a large group of regulatory and consumer advocacy groups have been screaming bloody murder about this recently, and these deals are getting harder to do without some larger and explicit purpose as articulated and encouraged by the Affordable Care Act (ObamaCare).

ACA and Accountability for Quality

Dr. Elliott Fisher, Director of the Center for Health Policy Research at Dartmouth Medical School – first coined the term Accountable Care Organization in 2006 during a discussion at a public meeting of the Medicare Payment Advisory Commission. The concept is actually quite clever – if exceedingly difficult to translate from concept to reality: 1) ACO’s are  Provider-led organizations with a strong base of primary care that are collectively accountable for quality and total per capita costs across the full continuum of care for a population of patients, 2) Payments linked to quality improvements that also reduce overall costs; and, 3) Reliable and progressively more sophisticated performance measurement, to support improvement and provide confidence that savings are achieved through improvements in care. Most importantly, the success of the ACO model in fostering clinical excellence while simultaneously controlling costs depends on its ability to “incentivize hospitals, physicians, post-acute care facilities, and other providers involved to form linkages and facilitate coordination of care delivery.”

Let’s see, we’ve gone from a policy which specifically discourages, and has the power to block “linkages”, to one which actively promoted them. More importantly, the system went full-throttle in support of these innovations, including Bundled Payments (BPI) Co-management Agreements (CMA’s) and a raft of additional acronyms that would have done FDR proud – this is a revolution being done with prototypes, and they are coming thick and fast. We have an alphabet soup of new structures, and a world of new opportunities.

From the point of view of an old M&A hand, what we have is: 1) The ability to form novel combinations driven from physician organizations – medical practices – where value is created by documented care improvement, and cost reductions driven by documented use of best practices – evidence based pathways and the like, 2) The ability to form “cross-border” arrangements between physicians and hospitals that never existed previously, offering the unusual prospect of lower costs and better care, and 3) The wondrously gentle hand of the DOJ which is not requiring prior approval of these combinations and is offering all forms of safe harbors and the like.

The devil lies in the details in these structures – like all healthcare transactions – but with one additional caveat. These systems need information and quality improvement capabilities in scale, and the more complex the deal, the more specialized the information and quality systems. Doing this job properly requires systems that do not exist today from any vendor, targeted at cost reduction and quality improvement – executed across disparate provider groups with incompatible data and management systems.

These are radically different systems requirements than almost all existing medical management systems, which are targeted at three fundamental characteristics espoused by my old friend Jock – a longtime physician and infomatician: 1) Save time, 2) Make money, and 3) Stay out of jail.

We have selected oncology as perhaps the most appealing clinical target – based on the three key attributes of 1) Clinical and cost benefits from combined disparate clinician groups, 2) Defined clinical pathways and defined best practices to inform clinical activities post combination, and 3) Opportunities to dramatically improve patient experience through combination and advanced information management. The trouble is: 1) These are difficult and time consuming transactions to structure with multiple parties, 2) Payer involvement is critical, and 3) Advanced information systems are a requirement to make this work – and we need to build them.

Is it worth the trouble?

Yes – for three reasons. First, from a financial point of view, we are fairly certain that we can take 10-15% of the cost out of a combined oncology care platform, and do it fairly quickly. There is a fair amount of “secret sauce” in pulling this off – but it can be done.

Second, we can actually improve the patient care experience. This needs to be the central quality objective of the project.

Finally, done right this is both a quality management system and can facilitate rapid learning – regarding care, cost, and satisfaction. Remember the data should be a treasure trove of information and value.

What’s Different this time?

Structured information about cost and quality – the answer is really that simple. There has been an explosion of structured data used in clinical care in the last 5 years – most famously in the electronic medical record (EMR). While these systems are truly atavistic by modern IT system standards – lacking even the most modest of decent data field definition standards – they are vastly better than what existed even 10 years ago. Better yet, the best of these systems are moving to the cloud – bringing with them the promise of continuous improvement and uniform versioning inherent in such systems.

The wild proliferation of incompatible data systems between and within medical systems has resulted in a commensurate explosion in the demand for gigantic data warehouses – both wildly inefficient and grossly over-powered for most of the problems actually faced by medical quality professionals – tantamount to shooting a fly with a cannon. Cloud based solutions are actually very well suited to address these issues, particularly when coupled with rules engines, and fed data from disparate sources.

Like in the pharmacy industry, information in oncology care is changing into a control mechanism – integrating patient, payer and provider. This is a fundamentally different configuration than ever before – and it will drive changes in care delivery and ultimately lead to tremendous industry consolidation. Stay tuned.

First Snow – Mt. Moosilauke – with the Kilimanjaro Team

First Snow – Mt. Moosilauke – with the Kilimanjaro Team

4,802 ft. 7 miles

The Prouty Mountaineering Program
(the first Prouty Challenge Event benefitting Dartmouth-Hitchcock Norris Cotton Cancer Center)

October 15, 2012

Wes Chapman

Moose Mountain from Holt’s Ledge

 

Martha Chapman with Baby and Kate on Holt’s Ledge – a warm-up hike for Moosilauke, then Kilimanjaro

The concept at the heart of The Prouty is simple – get people to engage in the outdoors and raise money to fight cancer for our NCI-designated comprehensive cancer center. This past Saturday Martha agreed to take me along on a warm-up hike up the mighty Dartmouth Skiway – getting prepared for a hike up Moosilauke the next day. The weather on Sunday was as ugly as you can imagine, but Kelly Michaelsen from the Kilimanjaro team joined me for the hike up Moosilauke via the Glen Cliff Trail.

Kelly is in great shape, and tolerated my relatively slow pace up the Hill. We hit snow at about 3,000 feet, and were the first ones on the summit for the day. On the way back down we encountered a Monarch butterfly, alive but nearly frozen on its trip south. We also bumped into the Dartmouth ski coach, planning to wait for the team at the top – these young guys routinely run up in weather fair or foul.

A monarch butterfly blown off course

Moosilauke near the summit – a nasty day

Kelly on a breezy summit

Cancer is ultimately a disease about people – those fighting the disease, those providing care, and those who have passed on. We conceived the Prouty Mountaineering Program with a very simple premise; honor those people.

Mountains are a very special place – particularly very high mountains. The beauty, the isolation and the simple elevation combine into a unique spiritual experience.

Our thesis in the Prouty Mountaineering Program is really simple – go climb the highest mountains that you can find, get to the top, and honor cancer survivors, care givers and the victims of the disease. On or around December 20^th of this year we’ll have a team of 6 mountaineers to the top of Kilimanjaro to do just that.

We continue the yellow ribbon campaign on this hike with ribbons for Audrey Prouty – the inspiration for this event. We’ll gradually be working more yellow ribbons from supporters into photos over the course of the fall training hikes.

Wes Chapman enjoying the fresh air

If you have someone that you would like to honor at the top of Kilimanjaro, please let me know who, how you would like them honored, and especially if mountains and natural beauty were important to them – to do this job right, it really helps to know the story (send to mwestonchapman@gmail.com). If you want to donate directly, please see the Prouty page at http://reachforthepeaks.kintera.org/faf/search/searchTeamPart.asp?ievent=1019697&team=5181015.

Please make a donation as you see fit – all amounts great and small are really appreciated. Anything that we can do to support people in active treatment we will try to accomplish – signs, poems songs – you name it. Amazingly, there is good cell service on areas of the mountain and we will get photos, audio and video out for the support of patients in active treatment ASAP.

In the meantime, if you would like to come along on a Prouty prep hike, just drop me a line at the email above – we are out almost every weekend, and we really enjoy meeting new climbers.

Remember, it’s all about people.

All the Best from Kilimanjaro

Climbing The Twin Mountains with the Kilimanjaro Team

         

Climbing The Twin Mountains – with the Kilimanjaro Team

North Twin Mt (4,761ft), South Twin Mt. (4,902ft), Galehead Hut, 14 miles

The Prouty Mountaineering Program
(the first Prouty Challenge Event benefitting Dartmouth-Hitchcock Norris Cotton Cancer Center)

October 8, 2012

Wes Chapman

 

Liz (in red jacket) supervising Rick Morse and Pete crossing the Little River

Ted (in red jacket) learns the art of stream crossing from Masters

The concept at the heart of The Prouty is simple – get people to engage in the outdoors and raise money to fight cancer for our NCI-designated comprehensive cancer center. This past Sunday the gang slated for the December climb of Kilimanjaro – the highest mountain in Africa – took on the Twin Mountains in the White Mountains. Joining us on this hike were Dr. Richard Morse, Pete Volanakis, Jill Rogers (a Kilimanjaro veteran), and three big dogs.

Our route took us up the Twin Mountain Trails, across the ridge to the Galehead Hut, and then down the Gale River Trail. This was a long day and very good training for the last day on Kilimanjaro – which involves 4,000 feet of climbing, 9,000 feet of descent, and 18 hours on your feet. The weather held, and the mountains were full of fellow climbers getting out over the Columbus Day weekend.

 

Jill Rogers on North Twin

 

Nancy Pond tucked between the peaks

Galehead Hut, Owl’s Head and the Franconia Brook Valley

Cancer is ultimately a disease about people – those fighting the disease, those providing care, and those who have passed on. We conceived the Prouty Mountaineering Program with a very simple premise; honor those people.

Mountains are a very special place – particularly very high mountains. The beauty, the isolation and the simple elevation combine into a unique spiritual experience.

Our thesis in the Prouty Mountaineering Program is really simple – go climb the highest mountains that you can find, get to the top, and honor cancer survivors, care givers and the victims of the disease. On or around December 20^th of this year we’ll have a team of 6 mountaineers to the top of Kilimanjaro to do just that.

We continue the yellow ribbon campaign on this hike with ribbons for Audrey Prouty – the inspiration for this event. We’ll gradually be working more yellow ribbons from supporters into photos over the course of the fall training hikes.

Pete Volanakis on the Twin Mountains

Pete, Jill Rogers and Wes Chapman on the Twin Mountains

Rick Morse on the Summit of South Twin

Franconia Ridge and Garfield from the Twin Mountains

If you have someone that you would like to honor at the top of Kilimanjaro, please let me know who, how you would like them honored, and especially if mountains and natural beauty were important to them – to do this job right, it really helps to know the story (send to mwestonchapman@gmail.com). If you want to donate directly, please see the Prouty page at http://reachforthepeaks.kintera.org/faf/search/searchTeamPart.asp?ievent=1019697&team=5181015.

Please make a donation as you see fit – all amounts great and small are really appreciated. Anything that we can do to support people in active treatment we will try to accomplish – signs, poems songs – you name it. Amazingly, there is good cell service on areas of the mountain and we will get photos, audio and video out for the support of patients in active treatment ASAP.

Liz, Ted and Brewer at the Galehead Hut

In the meantime, if you would like to come along on a Prouty prep hike, just drop me a line at the email above – we are out almost every weekend, and we really enjoy meeting new climbers.

Remember, it’s all about people.

All the Best from Kilimanjaro