We all experience it. We all have moments on rough trips when we wonder why we bother. We wish we were home, or someplace else, anywhere else, where simple things weren’t Herculean challenges and the water was safe to drink. Then once we’re home those thoughts vanish like vapor in the Saharan sun and all we remember is the exhilaration of the journey and we dream about the next one.

The elephant in the room for me on my recent trip to Nepal was illness. When you travel to Nepal you just about know you’re going to get sick, but the phantasmagoria of Kathmandu, the soul-wrenching magnificence of the Himalayas exert such a pull that you forget about it and expect that, as you are at home, you’ll be fit and healthy and capable of handling any physical challenge. But the bugs of Nepal are persistent and pernicious. And they brought me down.

James O’Reilly and I had planned our trip carefully and supplied ourselves well. Bowing to the realities of travel in Nepal, I packed Imodium and figured I’d be fine. If antibiotics were advisable I could get them in Kathmandu at a fraction of the cost in the U.S. without a trip to the doctor for a prescription. But sometimes forearmed is better than forewarned.

The fourth night out, a few hours after I’d had an invigorating stroll up and down the lanes of Khumjung, a Sherpa town above fabled Namche Bazar, rain pelted the tent and my sleep was disturbed by rumblings in the gut, signaling a possible need to head out into the wet night. No way was I going out into the rain, so I tried to ignore it, but rumblings turned to cramps and cramps to shooting pains and, well, I realized that dressing for rain and returning to strip off a wet jacket was far better than lying there fighting those excruciating and irresistible forces of nature. So late into the night, in the pouring rain, I did my duty in the toilet tent.

The next morning, after having slept little, I made my way to our next destination, Tengboche Monastery, a three and a half hour trek down to the river and back up the next ridge. When we arrived all my strength was gone, and I knew I had to pop an Imodium, then passed out in the tent in the warm sun for a deep three-hour sleep.

Two days later, when Imodium didn’t seem to be handling the task, I learned from a medical student working at the Himalayan Rescue Association’s clinic in Pheriche that 80 percent of the gastrointestinal diseases here are bacterial, so Imodium or Lomotil won’t take care of it, you need an antibiotic. The next day (luckily, since I hadn’t bothered to get any antibiotics in Kathmandu) I was able to get what I needed from another medical student working at the clinic, and that problem was resolved. On we went to the high zones—high for us, anyway.

Before I’d left home, everyone I talked to about my trek to Kala Patthar, a bump on the earth at 18,500 feet but four “as the crow flies” miles from Mount Everest, marveled at how I must be working out to get in shape. Well, no. I’d been up there 23 years ago. I knew the terrain. It would be just a long, slow walk. I wasn’t doing anything special to get in shape. And while the climb was indeed challenging, and exhausting at times, I really had no trouble getting up that high because we took adequate time to acclimatize and we really did walk very slowly, being careful not to overstress our knees, ankles, or feet. On the way down we had that spring in our step of lads feeling pleased with themselves, aided, of course, by the drop in altitude and the prevailing downward slope of the trail. When we got to Namche Bazar I emailed home that we’d accomplished all we’d set out to, and I was feeling terrific, absolutely fit and healthy after twelve days on the trail.

But I’d forgotten about that elephant in the room. While settling in to sleep I felt the beginnings of discharge into my sinuses and wondered if a cold was coming. By dawn I awoke on fire: burning head, burning throat, deep burning chesty cough. I’d never had an illness come on so fast. That day we hiked down 2,000 feet, then snaked along the river climbing and descending, and by the end of a four hour hike I was completely exhausted. But that night I was too sick to sleep. And the next day we had another three-hour up and down hike that devastated me. Again I slept poorly, and only felt worse with relentless fever and chills.

The next day we flew to Kathmandu, and it took all my strength simply to wait to board the plane. Back in the city I asked our friend Raj to take me immediately to the international clinic, which he did after feeding me some hot soup, and I got my diagnosis: menopause. Well, I had all the symptoms of menopause, the doctor said as she smiled, and at that moment my heart went out to all women everywhere, because I would never wish those symptoms on anyone. What I had was a bacterial bronchial and lung infection, fever of 102.5. I got an antibiotic, high doses of ibuprofen, and the news that I should begin to improve within 24 hours.

For much of the next 24 hours I lay in bed, alternately sweltering and freezing, growing delirious, eating only intermittently. The next day, needing air, I stepped out on the balcony and was surprised to see the streets of Kathmandu below. I’d somehow forgotten that I was in Nepal, the trek that had been a pilgrimage for me now an evanescent dream. The illness had imposed upon me a reality of no past or future, just the present moment.

I improved enough to fly home without undue discomfort, but the ordeal left me depleted and still fighting off the symptoms. Only now, two weeks after returning, am I beginning to recall those exalted moments among the world’s highest peaks, the milky rivers and peaceful meadows and avalanches that fell literally for miles and the incomprehensible scale of that vast vertical landscape. It’s all coming back to me now, but this time I don’t think I’ll completely forget that elephant. He’s in the room, as he always is, and I now know that I ignore him at my peril.

Sometimes you get sick when you travel. Sometimes very sick. Luckily for me it wasn’t hepatitis or something worse, but it walloped me nonetheless. I swallowed more drugs in those three weeks than I have in the last ten years, and they saved me in more ways than one. I would have suffered less if I’d had the antibiotics with me, but then I would have needed to get the diagnosis right, and I don’t take such drugs lightly. But next time I probably will pack a more thorough medical kit, if only to acknowledge the elephant, and keep him at bay by being prepared.



About Larry’s Corner:
Larry Habegger, executive editor of Travelers’ Tales, has been writing about travel since 1980. He has visited almost fifty countries and six of the seven continents, traveling from the frozen Arctic to equatorial rain forest, the high Himalayas to the Dead Sea. In the early 1980s he co-authored mystery serials for the San Francisco Examiner with James O’Reilly, and since 1985 their syndicated newspaper column, “World Travel Watch,” has appeared in newspapers in five countries, and can also be found on WorldTravelWatch.com and on TravelersTales.com. As series editors of Travelers’ Tales, they have worked on some eighty titles, winning many awards for excellence. Habegger regularly teaches the craft of travel writing at workshops and writers conferences, and he lives with his family in San Francisco. Click here to learn more about Larry Habegger.

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