I have learned from hard experience that it takes more than 25 years to find anything funny about having amebic dysentery. How about you?
In 1987, I took the last of three trips to Central America, traveling with my friend and practice associate, a psychiatrist named Teresa. We went to provide some support to a medical team in Belize. Not the snorkeling resort parts of Belize. The parts where people live. The night before we were to travel back to the United States, I got ill. Really ill. I was up all night with symptoms associated with amebic dysentery, which I’ve already strongly hinted is the illness I got.
Somehow I managed to pack my things with considerable trepidation about how I was going to travel in my condition. The trip home involved a number of legs. The first involved a small, open boat, to ferry us across a body of water. Then a rather rough road trip to a jungle airstrip. Then a plane ride in a 4-seater to the local airport. Then a flight to New Orleans to go through customs and connect home to Birmingham. Challenging under the best of circumstances, I guess, but something entirely different in the acute throes of dysentery.
The term “amebic dysentery” is derived from Latin, as are all medical terms, including “cardiology,” “co-pay,” and “your insurance has denied this procedure.” My Latin is poor, but I believe the Latin roots for dysentery translate literally into Pray-for-Death Gut Agony.
The next morning I stood swaying on the boat dock, preparing for departure, my skin the color of Central American foliage. A kind nurse approached me, held out his hand, and offered 3 Lomotil pills. I took them and swallowed all three of them, at which time the nurse said, “Yeah. I was thinking you might want to start with a half of one. Or maybe just the one. At most.”
A few words about Lomotil. It contains, essentially, a narcotic. So the manufacturers added atrophine to it. The atropine additive strategy is designed to discourage taking more than the recommended dose, which many of our citizens are prone to do with narcotics. It does that by producing severe weakness and nausea if the standard dosage is exceeded. I had just exceeded the standard dosage. Speaking of Latin and word origins, any idea from where the term “oops” is derived?
I’ll spare you the details of the trip. Except for a couple. Let’s fast forward through the boat ride through a body of choppy water by just saying that the rhythmic up and down motion not only reduced further my ability to control my guts & sphincters, it also reduced my ability to even perceive the status of my inside parts. Then the airplane ride over the jungle, low enough for me to see a couple of parrots in tree tops. By the way, my seat belt wouldn’t fasten and the Central American pilot cheerfully suggested, with gestures, that I just keep the buckle together by gripping it tightly with my hand. Sure. Screw physics.
It turned out that we were traveling around the time Pope John Paul II was visiting the United States. His itinerary included New Orleans. At one point, my colleague Teresa the Psychiatrist installed me into a chair in the airport. I briefly opened my eyes, to find my entire field of vision occupied by a massive photo of the Pope, two or three stories high, on the wall of the airport concourse. I don’t know if I’ve ever mentioned that I’m Catholic.
I eventually got home and into my bed, where my wife was able to extract from me a promise that I would not return to Central America. I don’t recall making the promise, on account of being delirious, but I’m sure I did and she certainly considered it legally binding.
It took about a week to get officially diagnosed. Then another week to learn that the traditional outpatient treatments weren’t working. I was then hospitalized. A number of interesting things happened in the hospital.
A nurse woke up my doctor to report that I had diarrhea. His response, he told me later, was “No shit. Seriously. My patient with dysentery has diarrhea?”
A rounding physician came in and told me—and pardon the direct quote here—“You apparently have some kind of hardy, Central American variety of ameba. Not one of those pussy Floridian strains.” The same doctor came in another time and said, “Holy crap! You look like a cholera victim!” This guy had tremendous bedside manner.
When the initial hospital-based treatment (intravenous Flagyl) didn’t work, the doctor came in and told me he had called the Centers for Disease Control for advice. They were recommending that the next step be the administration of arsenic. The idea, he said, was to get the arsenic up to a level that would kill off the ameba without … well, you know. Never got to that point. Happily.
Here’s the last part of the story. When I finally got well and on the first evening I felt like my old self, I had this specific food craving, as if my body was ordering me to get something in my body that I needed to survive. The craving was for medium rare cow flesh. Nothing else would do. My wife and I went to a steakhouse. I ordered a large steak, probably 12 oz. or so, medium rare and ate it. I paused briefly and said to my wife, “I’m sorry, but I have to have another.” And I did. This was my first experience with the restorative properties of 24 ounces of bloody meat. My understanding is that physicians and dieticians generaly recommend against this as a remedy.
With that unpleasantness aside, I want to thank, as always, my co-editors, Laura M. Kaminski and the F Troop, F. J. Bergmann and F. John Sharp. Thanks to all who contributed and submitted. And thanks for your loyal readership. We hope you enjoy the issue.
P.S. If you want to view a version of this The Note, with all the phrases which would make great names for rock bands in boldface, click here.
by Dale Wisely
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