Denver. Lyons. Boulder. Carbondale. Ouray. Intermittently over the past decade, trauma nurse Anna Pfaff has called all these places home. That’s when she’s stateside. Pfaff averages two international climbing expeditions a year. And in addition to her nursing work in the States, she also volunteers her time at a medical clinic in Santa Cruz, Bolivia.

Pfaff first climbed rock and ice in her early 20s while attending University of Colorado Denver. She loved it immediately and began climbing almost daily. That path led her to Argentine Patagonia to climb its famed, granite towers. She has since completed numerous first ascents and multiple new routes around the world, as a sponsored North Face, CAMP, La Sportiva and Bluewater Ropes athlete (among other brands).

She recently told us how she manages it all.

What was your first memorable climb in Colorado?

Eldorado Canyon’s classic Bastille Crack (5.7, 350’). I was really scared, but I led it all the way to the top. I enjoyed the fear and the process of overcoming it. Then I tried ice climbing in Clear Creek Canyon and I was immediately hooked on ice climbing, too.

What did you do after college?

I spent several seasons in Yosemite. That’s where I learned to climb big walls and cracks. During that time, I gained skills that I use all the time now on bigger objectives.

How do you balance work and travel?

My nursing schedule varies according to my climbing schedule. Some months I’ll work four days, others 20. I love nursing just as much as climbing.

Why expeditions?

I’ve always had a drive to visit remote and unknown places. That’s just how my mind works. I love the entire process of researching an area, getting there, and being open to the challenges involved in new routing in unknown terrain.

What are some of your most memorable experiences in Colorado’s mountains?

A few years ago, I spent a week climbing several classic Ouray ice routes with a good friend. We did Bird Brain Boulevard, Ames Ice Hose, Bridalveil Falls, Stairway to Heaven and The Ribbon. It was like a greatest-hits tour.

What are a few highlights and low points from your international trips?

So many ups and downs. Major highlights are when an expedition or climb goes well, good decisions are made and everyone is safe. The partnerships are important.

A major low point was getting stuck alone for a week in Pakistan, in 2011, due to conflicts in the country. I had an expired visa and I wasn’t sure I was going to be able to make it out.

I broke my foot climbing the 1,550-meter northwest ridge of Fitz Roy in Patagonia, in 2012, when falling rock crushed my heel. We had to keep climbing because of the traversing nature of the route. We ended up summiting and made it back without a rescue, so it was kind of a high and low!

How do trauma nursing and alpine climbing compare?

They share a similar paradox— they are complicated yet simple at the same time.  You can try and anticipate the outcome [in either scenario] but when the unpredictable happens, you must rapidly yet precisely change your plan. In the mountains, when say, you drop a belay device or core shot the rope, you have to adapt on the fly.

Tell us about volunteer medical nursing in Santa Cruz, Bolivia.

I’ve been working with Mission of Hope Bolivia, an organization that provides basic medical and surgical care to those in need. I go back in April to help with surgeries. Sometimes patients wait years to get the life-changing surgeries that the clinic provides.

What’s NExt?

I’ll be hanging out in the Canadian Rockies for the next few months, then heading to Alaska for the alpine season this spring. I have a return trip to the Indian Himalaya planned for this summer.

I understand you’ve been writing about your travels. Where can people read it?

I have a story in the Spring 2017 issue of Alpinist about climbing in remote areas in the world and overcoming the challenges that come with it. It’s about why I’m drawn to exploratory climbing.

Follow Anna Pfaff on Instagram @pfaff_anna and check out her website annapfaff.com.

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