Although strenuous and requiring physical fitness, none of the conventional routes require specialist mountaineering skills or technical rock climbing. The main dangers of the mountain are those common to all high mountains, particularly altitude sickness. This can affect anyone, even those who are acclimatized. In serious cases, it can lead to high-altitude pulmonary edema and cerebral edema, which can lead to difficulties with breathing, paralysis, and death. Climbers are advised to begin their ascent at or before 6 A.M. and to summit and descend before early afternoon to minimize exposure to possible afternoon thunderstorms while at high altitudes. Although the most conventional form of ascent is by hiking, Anna Elizabeth Dickinson, the orator, ascended the mountain on a mule borrowed from the U.S. government.