This is a bonus podcast, a recording of a lecture from the 2019 Mountain and Emergency Medicine Conference March 22nd at Taos Ski Valley, new Mexico. At this high elevation location (10,200 feet) I discuss three high altitude people - Andeans, Himalayans, and Ethiopians - their genetic changes to altitude, and what that means for genetic lowlanders like me who like to spend time and recreate at high altitude. I also talk about the microbiome changes at altitude and some of the possible dangers of too much oxygen.