From the south entrance of the park drive towards the Mt. Carmel Tunnel on Highway 9. Before you get to the tunnel park on the right side of the road at a large pullout at the last switchback (which is the same place to park for the Confluence area). Do not go into the tunnel. Hike to the tunnel on the road and walk around and above it on the left side and head uphill for about 50 yards on a small trail. The route appears on your right with an incredible splitter crack start. There are a few small trees right at the base. Some nationally recognized climbers have said this to be the best handcrack in Utah so expect to wait on nice weekends. It can also be climbed in summer since it is on a northeast facing cliff and gets shade from about 10am on.
Pitch 1 - 100 feet Start with a sustained but spectacular splitter crack. The crack takes lots of #2 camalots. Jam and smile until you get to the offwidth before the anchors. A good arm-bar supplemented with a #4 camalot followed by a high reach with your right arm will get you to the anchors. There are also some face features to the right you can use to reach the anchor. This is a very sustained hand crack pitch.
Pitch 2 - 140 feet Continue the sustained crack system as is follows the corner and becomes very exposed near an arete. Looking down from this pitch is awesome! An interesting face move (to the right) will get you under a roof. Pull-up through the roof with marginal jams and keep jamming as best as you can to the anchors which is pretty pumpy. There is one bolt below the room you can use to protect but the crack is perfect for cams.
Pitch 3 - 150 feet Perhaps the hardest pitch since the last move is tricky however most of this pitch is positive angled. From the anchors traverse left towards the tree and continue with the ever thinning crack until you get to the alcove which will get your head stuck in it (this is the reason why the route is called The Headache). This is the crux where you need to place a #2 camalot in the crack deep in the alcove and make an awkward move to get out of it and into the left leaning crack slightly above it. Place another #1 camalot and reach the anchors just abve.
Descent Make two double rope rappels from bolted anchors to the left of the route. We used 60m twin ropes which are recommended.
Four or five #2 camalots and one #4 camalot for the first pitch. At least doubles of #0.5, 0.75, 1 and 3 camalots. Set of nuts and TCUs from blue to red or aliens from green to red. You need two ropes to get down.
Dow's great description of the route can be found HERE
Mountain Project description HERE