Possible Clues:

• Doctor perhaps ignoring one pressure or another -- he'll work his way to the top
• He¿s contrived to register aide as local guide
• Nepalese turn of phrase
• Guide that woman inside hydro
• Trek guide
• Mountaineer's novel turn of phrase
• Nepali language
• Skilled climber
• Worker in peak physical condition?
• Highly competent guide retraces her path, but not entirely