Intestinal Fortitude

I received a call yesterday from my climbing partner, Richard. Lin and I were walking down Cannon Beach on a perfect Oregon summer day. "I'm wondering when the last time was you saw your Doctor," He asked. This can be the lead-up to some very bad news when it's a Physician asking the question. True, I've noticed my gum's bleeding when I floss, but how could he have known this?

"Five months ago," I answered with a sense of resignation, "when I went in to get my High Altitude Meds renewed."

"Well there's a new vaccine out to prevent Travelers Diarrhea and I think you should look into it." Richard recalled how a bout of this had afflicted me the day before our summit push on Kilimanjaro. His wise counsel led me to quit the Imodium I had started taking and shift straight away into full doses of Cipro. My condition stabilized and two days later we watched the sun rise over Kenya from the highest point in Africa. "You take it orally, but it should be administered two weeks ahead of time," he added. I calculated that I was already a few days short of that.
I asked Richard to text me the correct spelling so I could get a prescription from my Doctor. A few minutes later the message chimed in; Dukoral.

It seemed odd that the nurse hadn't heard of Dukoral. "It's new," I explained. "I heard about it from a friend of mine who's a Physician ...in Canada ...with the exchange rate you would think we have 18% more medicines than they do. It must be somewhere on the menu." She said she would look into it and call me back, and friends that's exactly what she did.

"It's not approved for use in the United States," she said. "So we recommend you use Cipro. "
I told her I have Cipro and have used it with success. I explained that using something that prevents me from getting Diahrea would be one logical step better than waiting until I had contracted such an unpleasant condition then addressing it. She agreed and expressed her regrets. I pointed out that it was going to be very hard for me to admit to my friend that the Canadian health care system was a step ahead of us on this thing. I asked if there is some horrible side effect like causing men to grow breasts. She said "No." I pleaded that she give me something to work with. She had nothing.

I tried the side effect approach at first. "Dukoral is not approved for use yet in the USA," I texted to Richard, then adding "Something about a side effect where men become prone to weeping and watch a lot of Oprah." He did'nt buy it.

So I conceded. "We Americans have a long biological legacy built on the mis-guided notion that defiance is a component of preventive treatment." In short, I will "just say NO" to Travelers Diahrea.