A few summers ago, I took a long walk through the mountains of Colorado. Colorado is known for its fresh air, beautiful landscapes, and enthusiastically healthy, aggressively attractive young professionals. I’m from Georgia, known for its excessive humidity, high obesity rates, voter suppression, and a golf course that still doesn’t allow women to play on it.
I started my walk in Denver and ambled southwest across the Rockies, following the Colorado Trail all the way to Durango some 500 trail miles away. On my back, I carried a pack, a tent, and a sleeping bag. In my intestines, I carried exactly zero parasites. But, by the time I left Colorado a month later, this was no longer the case.
***
After a lifetime of camping and backpacking, I’m familiar with the ailments that crop up after spending extended periods of time in the woods. One common distress is what happens when food eaten by hand (like granola bars or trail mix) meets a lack of soap and infrequent handwashing. Hikers of a poetic mindset sometimes refer to this as Ass to Mouth Disease. AMD can also occur in non-hikers: people with poor hygiene, parents of young children, or anyone who even thinks about swimming in a water park wave pool.
There are other ways to trouble your digestion, of course. Often, there are nasty little bugs already living in the food we eat. The toxins released by these organisms send our bodies into full-on flush-the-system mode, and I think we all know what that looks and feels like.
Once, I found myself squatting on an exposed cliff in the White Mountains of New Hampshire with my pants down around my ankles, holding on to a shrub several feet shorter than I was. This shrub was the tallest plant in sight, making me the tallest object in sight. Normally not a problem unless you happen to be in a thunderstorm, which I was.
Two hours earlier, a stranger at the Mount Washington visitor center had offered to buy me lunch, and I gratefully accepted. The random kindness of strangers is one of the nicer things about long-distance backpacking. Two bowls of clam chowder later, I was back on the trail, and the trouble started shortly thereafter.
A quick image filtered through my nausea-addled brain. Two men in dark suits, dark shades, no-nonsense ties, lurking on the stoop of my parents’ house. They ring the doorbell, and my mother opens the door, immediate and terrible understanding blossoms across her face.
“Your son is dead,” the first one says.
“Struck by lightning,” says the second. Mom gasps and presses a hand to her mouth.
“At least it was quick,” she says, weeping.
“Not really,” says the first. Mom looks up at this. The second man takes off his glasses, inspects them, wipes away some imaginary smear, and replaces them on his narrow face.
“It appears as though he was literally shitting his brains out when it happened,” he says. The first man nods. “We found his brains, along with most of his internal organs, and every single thing he has ever eaten in his entire life heaped into a steaming pile next to his charred corpse.”
At this, Mom collapses into a quivering heap.
Mourning ensues.
The funeral is closed-casket.
That image was the only thing that gave me the strength to halt, if only for a moment, the incredible mass evacuation that my digestive system was undergoing. I staggered, pinch-cheeked and bowlegged, down to marginally safer ground and once there uncorked, so to speak. As I hunched, bare-cheeked to the storm and to any passing tourist who happened to be trekking up to the top of Mount Washington, I gave serious reconsideration to the wisdom of accepting free clam chowder from a stranger on a mountain located over 100 miles from the nearest living clam.
All of which is to say that when I started having some issues in Colorado, I didn’t immediately think I had an intestinal parasite. Lots of things can happen to your stomach in the woods, but, by the time my hike was over, and I was monopolizing the chemical toilet on the bus from Durango back to Denver, I was beginning to suspect the truth.
***
Spend enough time in the company of outdoors enthusiasts, and you eventually build up a lexicon of ailments, horror stories, and embarrassing biological happenings.
Lyme disease, spread by deer ticks in the eastern woods of the United States, is particularly nasty and causes severe nervous system damage if left untreated. The tricky thing about Lyme is that its early symptoms include fatigue, aches, swollen joints, and shortness of breath. If you’ve ever been backpacking, you’ll recognize this list. It’s the same exact symptoms that occur when walking up and down mountains with a pack on your back. You can see the problem. Often has the long-distance hiker quietly contemplated an impending hospital stay simply because he was tired at the end of a 20-mile day.
Perhaps unsurprisingly, it’s usually the people who don’t even know what Lyme disease is, and certainly aren’t spending hours a day worried about it, who end up contracting it. Deer ticks can be real jerks that way.
Giardia lamblia often comes up in the same backpacker horror stories as Lyme. Although not as damaging in the long term, Giardia is a more creative bug. Lyme seems to be content with hanging out locally. Giardia, by contrast, is much more cosmopolitan―a real world traveler. It achieves this by choosing as its preferred host organism an animal scientifically proven to be 20 times more of a jerk than the deer tick: those always entertaining monkeys, Homo sapiens.
Oh boy, does Giardia love us.
Scientists find it in every major human population on the planet. Some health organizations estimate that Giardia lamblia exists in 30 percent of the undeveloped world, and that it lives in anywhere from 3 to 7 percent of the population of the United States. It was first formally described in Europe in 1681, and it’s been around for a lot longer than that. Giardia was hanging out with human beings before it was cool, know what I mean? Looking at you, syphilis.
To Giardia, the intestines of a human being are a turnkey property, fully furnished and move-in ready. After taking up residence, Giardia wastes no time making itself at home—reproducing asexually, forming organisms called cysts, and flushing itself out of your digestive system in the favored way of creepy crawlies everywhere—spectacular and highly pressured diarrhea.
Once out in the wild, the cysts are resilient and quasi-indestructible. Cold doesn’t bother them. Neither does heat. Chemical treatments such as chlorine and iodine are mostly effective but mostly are not always. If left to their own devices, the cysts can remain dormant but viable for up to three months, waiting on someone to ingest them, and then the whole explosive process starts all over again.
And that’s the life cycle of the Giardia lamblia organism in human beings. But as much as it loves us, Giardia will make do with less lucrative properties. Cats and dogs work just fine for it. So do birds and cattle, sheep and rats. Beavers are a very common vector, which is why in North America Giardiasis (the set of symptoms caused by the Giardia organism) is commonly called Beaver Fever. Beavers spread Giardia easily because they spend a lot of time swimming around in beavery lake water. You can imagine where beavers use the bathroom.
Most people in the developed world don’t have to worry about Giardia lamblia causing all kinds of merry hell in their intestines because most people have the incredible luxury of drinking water that is free of rat diarrhea, and, with very few exceptions, they refrain from eating the feces of the family pet. However, should you happen to be backpacking through the wilderness of North America, chances are you will find yourself, at some point, drinking water that a beaver has shat in. It’s simply statistically likely. No human feels very good about this, but, short of hauling trailers full of bottled water around behind you any time you go camping, there’s nothing anyone can do about it.
Nobody knows for sure how the beavers feel about it. Possibly, they think of it as karma for centuries of being used as hats.
***
Giardia has a variable gestation period, so it’s hard to know precisely where and when I contracted it. Somewhere along the 500-mile path in Colorado, I saw a sparkling, pristine-looking font of mountain water, stopped to fill my bottle, treated the water with fancy chemicals, and drank deeply. Let me reiterate: I chemically treated my water.
I’ve spent decades in the woods and mountains: backpacking, hiking, paddling, mountain biking, and climbing. By the time I got to Colorado, I had already completed a solo hike of the Appalachian Trail. I treated my water with chemicals on that hike as well, using a ubiquitous product aimed specifically at backpackers and other outdoor enthusiasts—Aquamira. On the bottle this product clearly states that it is effective against Giardia. But, and here is the really important part, not always. Maybe there was a cyst hiding in the lip of my water bottle that didn’t get fully exposed to the chemicals. It only takes one (though it usually takes more). Maybe I lost track of time and didn’t allow the chemicals the full 20 minutes they needed to kill the organism. Maybe one of the cysts was just especially tough.
Who knows? At some point, spending extended time in the outdoors always becomes about risk management as opposed to risk avoidance. With water, you choose your source carefully, try to find something flowing, don’t drink anything near human or livestock habitation, chemically treat it, filter it, or boil it, and hope for the best. Sometimes, you draw the short straw. Shit, as they say, happens. Sometimes it happens a lot.
***
By the time my wife, Rachael, picked me up from the airport, I was in rough shape and determined to ignore it.
The symptoms of Giardiasis are inspiring in their breadth and variety. As I said, this is a creative bug. There’s diarrhea, of course: pretty predictable. But constant diarrhea is boring, so the Giardia organism likes to toss in occasional bouts of constipation just to liven things up. Then, it sprinkles in some sharp, throbbing cramps. All very well, but my personal favorite symptom on a cross-country plane journey has to be the constant and odiferous flatulence. Had there been an air marshal on that flight, I’m sure I would have been arrested and removed from the plane. We were all lucky that the caustic atmosphere I produced didn’t disintegrate the rubber seals around the windows. On the other hand, we were flying Spirit, so maybe that’s just the experience the other passengers were expecting.
But why stop there? Like an overachieving high school senior giving up an hour a week at a soup kitchen, Giardia seems determined to be as well-rounded as possible.
So, burps. Really sulfurous, burning burps. Burps from the ulcerated stomach of the devil himself. Like the flatulence, the belches occurred on a more or less constant basis. At the height of my symptoms, I was producing more poisonous gasses than a tire fire in the parking lot of a West Virginia coal plant.
This is the state in which my wife found me leaning on my luggage at the airport. It didn’t take her long to realize I was ill; it was an hourlong car ride back to our house. I can’t even hide Christmas presents from my wife—trying to act like my internal organs weren’t dissolving while sharing a closed environment was a futile exercise.
“It’s possible I picked up a bug in Colorado,” I belched.
“You should go to the doctor tomorrow,” she said. She had just kissed me with an enthusiastic “I haven’t seen you in a month” kind of kiss, and now, as she rolled the windows down and stuck her head out into the fresh night air, I suspected she was regretting it.
“I think I’ll just wait a few days and see if it clears up on its own,” I said, clutching my stomach and squeezing my hindquarters together as tightly as possible.
***
Over the next few days, Rachael continued to encourage me to seek medical help, and I continued to refuse, insisting that my symptoms would clear up given some rest. This line of thinking objectively made no sense. It made no sense then, and it makes no sense now, as Rachael, to her credit, has only pointed out every couple of weeks for the last few years.
I have no defense for my idiocy other than to say that, according to WebMD, exhaustion, loss of clear thinking, and irritability are yet more bonus symptoms of Giardiasis. I have no idea if this is medically accurate, but I do know that after walking 500 miles in a month and carrying a parasitic hitchhiker for an unknown length of time along that distance, I was definitely experiencing all three. The day after arriving home, I fell asleep standing up in the shower and only woke up when the hot water ran out. It was two o’clock in the afternoon.
I picked pointless fights. I napped a lot. I oozed unspeakable things from every orifice. I stumbled from room to room, woozy, forgetting what I was searching for. Things kept getting worse.
And then we went to the beach with my in-laws.
The trip had been planned for over a year, the beach house booked, the plane tickets purchased. We left for Florida only a few days after I arrived home from Colorado, flying down on a budget airline. They lost my luggage and found it at the Florida airport a week after I was already home, two weeks after it vanished on a direct flight. Only the most valuable things had been stolen, but the thief was careful to make sure my clothes remained folded, so that was nice.
Every romantic partner has a breaking point. My wife, more saintly than most, reached hers about three days into sharing a beach house with her parents and a husband who, when he wasn’t napping, spent his time belching, farting, groaning, aching, moaning, curling up on the toilet, picking fights, vomiting popcorn shrimp into a shared beach house bathroom, and tossing and turning all night long (did I mention the anxiety and racing heart, particularly at night? Bonus symptoms!).
Words were had. I was told that my symptoms were not getting better. I was told that I had had a chance to get better and blew it by being stubborn and idiotic. I was told to keep my mouth shut, to paste a smile upon my face, and to join the family at the beach at any and all times I wasn’t sequestered in the bathroom. I was told to book a doctor’s appointment for the day we returned home. I was told that, although our marriage would remain intact regardless, any and all future marital bliss was absolutely dependent upon all of these conditions being met.
Something in her tone of voice finally made it sink in. I needed medical help. I made a doctor’s appointment and tottered out to the beach to play bocce ball.
I smiled as I did it. I just made sure to stand downwind.
***
“Guess what? I have Giardiosis!” I announced merrily after getting my lab results some weeks later. “The Doc says with the antibiotic he prescribed it should clear up in a few weeks.”
We won’t speak of the noxious plane ride home or the difficulty of obtaining a stool sample while suffering from alternating constipation and diarrhea. We won’t speak of the fact that yet another bonus symptom of Giardia is lactose intolerance, therefore ruining ice cream for me. And we certainly won’t speak of the fact that I had to explain Giardia lamblia to a northern Ohio doctor and insist upon lab tests. He kept saying I had “a little case of traveler’s stomach.”
Turns out I’m not the only idiot in this story.
Rachael looked up from her corner of our tiny apartment, where she had retreated in a vain attempt to breathe air that I hadn’t befouled. She fixed me with an even gaze, then looked back down at her paperwork.
“If you had gone to the doctor when I first asked you to, you’d already be better,” she said. “But your bullheadedness and masculine stubbornness is what I love about you, you sexy specimen of a man! Now go get well so I can ravage you!”
My memory is pretty hazy but I’m pretty sure that’s how it went down.
***
At the pharmacy, the tech found my order, bagged it, and started running my card.
“Did you know this medicine reacts violently with alcohol?” he asked. “Did the doctor tell you that when he prescribed it?”
“Nooooo,” I said, thinking it was really time to get a new doctor.
“Yeah. You can’t even use mouthwash. And especially no drinking. No wine, no beer, no liquor.” He eyed me for a second and then, making what I felt to be an entirely unfair judgment, asked, “Is that going to be a problem for you?”
“No!” I said, maybe a little bit defensively. “Does this medicine have any other symptoms?”
“Yeah,” he said. He finished running my card and handed it back to me then slid my cure across the counter.
“Diarrhea.”
This story originally appeared in Offbeat Magazine in 2018
