The Lepto Perspective | Positivity and insight from a tropical disease
It’s been a while since I last posted and I figured it was time for an update. Right now I’m in the final stages of planning for a couple of upcoming expeditions—hopefully I’ll get round to writing about them in the next few weeks. Please do sign-up to the mailing list so I can let you know when I publish further posts—it’ll never be more than one email a month and you can always unsubscribe if I get boring.
For right now though I wanted to give a brief account on my experience with leptospirosis—the tropical disease I picked up whilst staying with the Batek tribe in Peninsular Malaysia back last year.
I don’t want to suggest it was any pivotal turning point or dramatic tale worthy of a big story. It’s not. I just wanted to detail the recovery process as a personal record and reminder of the lessons and perspective it taught me. It’s been a long road and I think the full story might be of interest for a couple of reasons.
1) First, I hope that my account may be useful for others in a similar situation, and especially on the challenges of reintroducing training after a major neurological knock-down—I could find very little on the subject during my own recovery. At the least my story can provide a reference point for others with similar frustrations.
2) Second, I wanted to share a few insights and perspective in the hope that they might influence you or anyone else reading this post. We rarely take the time to appreciate our own capacity—perhaps my experience may inspire you to reconsider your own potential and live a little more alive?
If you couldn’t care less for my story and don’t fancy reading my rambles, by all means skip to the second half of this article.
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THE LEPTO DIARIES | AN ACCOUNT OF MY EXPERIENCE
I first fell ill in October 2018. Now, 7 months later, I think I’m just about over it. What follows is a brief overview of those months, including a few sections from my journal—my initial coming down ill through to the frustrations of recovery during the following 6 months.
I had temporarily left the Batek village in early October to work an Outdoor Education programme on the other side of Malaysia. It was there that symptoms began to appear.
6th October 2018 – Gopeng, Malaysia
A long run on the 1st has seemingly triggered me coming down pretty ill. By that evening I had the worst headache I’ve ever experienced, along with a sickness and hallucinations—all night I was in that nightmarish world of fever’s waking dreams. The next morning left me shivering uncontrollably and I had to back down from a gentle hike, unable to keep pace with the kids. Thankfully one of them had a mild case of dehydration I could use as an excuse to head back down the hill. I’ve got a little stronger over the last couple of days but I’m far from sorted – I feel out of it, very tired and with a constant headache I can’t get rid of. The long days of managing kids and missing nights sleep from travel haven’t helped. It’s now the 6thand I still feel tired and weak, and the headache and fever are still there.
By the 7th I was having more issues. I’d travelled back to Kuala Lumpur, stayed with a friend for a night and headed to the airport to pick up another friend before we both travelled back up north to Pahang. All went smoothly, but by the time I met her in the airport I was feeling so weak I had to sit down to greet her and stairs were becoming a challenge. I started making errors of judgement too—I bought a ticket for the wrong train and walked into the wrong toilet—rather ill-advised in Islamic countries….
8th October 2018 – Pahang, Malaysia
Slept last night in the bus station but we made the 6-hour journey up to Merapoh. I woke shaking uncontrollably and weaker than I’ve ever felt—just sitting up from lying leaves me gasping for air and even turning over is a huge effort. Walking is becoming impossible without help and the headache and fever are in full force. At the Merapoh Klinik the blood test and symptoms diagnosed me with leptospirosis and I was immediately hooked up to IV before being ambulanced to Kuala Lipis. I don’t really remember it—I think I may have lost consciousness a couple of times.
Over the next few days I was treated with intravenous penicillin and rehydrated. My liver was damaged and kidneys were beginning to shut down—the resultant dehydration had been only a few days from killing me. But they had caught it, and to the doctors and nurses at Kuala Lipis hospital I cannot be more thankful. In three days I was strong, my blood tests reading normal, and discharged with a week’s course of oral antibiotics. I knew I’d been seriously lucky, but now it was all over. Or so I thought…
I felt great for a month or so, albeit slightly less spritely, but by mid-December my energy levels still hadn’t returned, and when I started to train freediving again a month or two down the line, coupled with Bali’s infection-rife wet season, things went from bad to worse. I began to pick up infection after infection with my compromised immunity, and my energy plummeted—each time I felt strong I would fall hard again as soon as I tried to do anything. For someone so physically inclined the fluctuations were frustrating to say the least. I spent many days in bed. Christmas was a major low.
The symptoms continued well into January despite concerted efforts in dietary and physical rehabilitation: infected cuts, headrushes so severe I fell to the ground in losses of consciousness, mouth ulcers, food poisonings and sore throats, swollen neck glands, headaches, dizziness, and impromptu heart rate spikes—similar to that in-your-throat feeling when you catch yourself from falling over backward, but without warning and far more regular. More than anything it was the fatigue, and I felt drained; even walking up a small hill would leave me panting and sweating.
Gradually I realised I could no longer convince myself that it was simply a psychological excuse for inconsistent dives—the intense neurological load of breath-hold diving was just too much and I had to stop training. The Leptospirainfection it seemed, although removed months ago had left organ damage and a shock-load that had severely compromised my immune and neurological systems. Despite previously initially strong again, the Balinese wet-season and nervous demands of freediving were too much, and a downwards spiral began. I’ll admit that I became a bit of an armchair endurance athlete, devouring films and articles about FKT runs and marathon swims, unable to do anything myself.
8th January 2018 – Amed, Bali
Woke up feeling awful—much the same symptoms as leptopirosis: headache, shivering, tingling, fever, elevated heart rate (120bpm at rest) and bad diarrhoea. I lay in the shop barely moving for a while before heading to the hospital—I figured if it was the leptospirosis back again I didn’t have long—especially with already weakened kidneys.
A thoroughly unpleasant journey to Denpasar (3hrs plus), where, after a couple of hours of blood tests and stool samples, I was diagnosed with acute gastroenteritis. I was very low—a final straw to break the back. A fever-ridden ride back to Amed followed by a night of sweating, painful diarrhoea, and headache—a really awful day. My body just feels broken and torn-up. I didn’t sleep much.
After weeks of illness and exhaustion it was the final straw. Three further days of heart fibrillations, light-headedness and stomach cramps and I finally gave in and booked tickets back to England—my compromised immune system just couldn’t deal with the tropical wet season.
I improved rapidly on returning to England, and apart from the odd elevated heart beat and increased tiredness, for the most part I felt fine. But training was still a sticking point. To begin with I could barely manage anything, and even strength-focused exercises such as short climbs would leave me cardiovascularly exhausted, needing to lie down and recover. Aerobic exercise the likes of running was pretty much out of the question, and a fellwalking trip to the Lakes in March ended in disappointment after a single hill. More than anything my recovery capacity was severely compromised—I had to leave days between activities and experienced major energy fluctuations.
So I focused on climbing and strength, and over the course of the last few months have built up my work capacity much closer to where it was before the disease—though serious running miles are still on hold. But it’s been difficult, not to mention frustrating. Consistency has been the key, gradually increasing work capacity and ensuring an excess of sleep and recovery.
7 months from the initial infection I’m now arguably stronger physically than I’ve ever been and certainly climbing better. My cardiovascular capacity is increasing and I’m rarely getting the unexplained heart rate spikes anymore. While I still seem to need an excessive amount of sleep, and aerobic fitness is slow to return, I’m definitely over the worst of it and progress only seems positive—none of the up and downs of previous months.
LESSONS OF LEPTO | WHAT IT’S TAUGHT ME
THE POSITIVE IN THE NEGATIVE
‘Reality is created by the mind. We can change our reality by changing our mind.’
As with any injury, illness or other negatives, much of how you deal with the setback is dependent on your attitude. I was pretty miserable for quite some time, and even most recently it’s still been getting me down when I can’t do what I used to be capable of. But even though I’ve often failed, I’ve tried to make an effort to approach this period of stagnation as an opportunity for growth. Here are a few of the strategies I think are useful in such situations.
1) Everything in life is a teacher—what can I learn from this?
To be honest there’s not a huge amount I could practically learn from the experience. Whether the infection came from drinking dirty water or through leech bites exposed to jungle rivers there’s not much I could do while living with the tribe to avoid it—more than anything I think I was just very unlucky.
But I have learnt other things of use: what my body feels like under life-threatening dehydration; and the intricacies of how my body reacts to high loads of neurological stress. Both are useful titbits of self-awareness both medically and from a training point of view. The recovery has also taught me valuable lessons in training consistency for improving work capacity—something that’s benefited my rock-climbing hugely.
2) Focus on what you can do
In my case that was climbing technique and simple muscular-endurance training—I had to forget about the more complex cardiovascular and neurological strength systems. Happily, through the former I’ve built my work capacity to a point where I can now start to train the cardiovascular system effectively, and push strength training into a more intense, neurological dimension. The nervous demands of freediving next year will in many ways be the ultimate test of my recovery.
The initial lull of complete inactivity also gave me a chance to re-evaluate my thoughts and plans, and get on with some of the more cerebral projects I had in the pipeline.
3) Harness motivation to come back stronger
The opportunity to push through and conquer a low can be incredibly powerful motivation. Whilst it may sound ridiculous I almost see the disease fondly in a twisted way—the ‘lepto experience’ is now a part of me and who I am. Overcoming it is a focus and driver.
4) Plan and get excited
Planning projects and expeditions can be almost as exciting as actually doing them. It’s also an effective way to keep up motivation and maintain the drive to take the necessary steps towards recovery. Over the past few months I’ve been doing some serious scheming and am getting close to the start of some pretty exciting expeditions—the mountains (and midges) are calling… More coming soon subscribe and so stay tuned.
APPRECIATE WHAT YOU TAKE FOR GRANTED
The whole experience has been humbling, and if nothing else I’ve gained a new appreciation for things that I’d normally—and still do—take for granted. I realise now that these aren’t always guaranteed, and it’s worth acknowledging just much we rely on them, and equally, just how fragile they can be.
1) More than anything, the ability and recovery potential of mind and body that I had, and indeed now have again. Experiencing its loss made me realise that, for all my efforts to train and improve, that which we already have as baseline is pretty impressive and worthy of appreciation.
2) The immune system I’ve relied on in the past. I’ve been pretty fortunate in that my immune system has always been fairly strong—something I’ll credit to an excessive exposure to dirt over the years—and I rarely come down ill. Until it was compromised… then there was bugger all I could do to avoid infection after infection—food poisoning, mouth ulcers, puss-filled cuts, sore throats and colds. I’m beginning to realise that thank god I was as strong and fit as I was when the disease first hit or it may have been a very different story. Basic fitness and health is something you owe yourself—don’t neglect it.
3) The drugs and resources we have access to.While doing a talk in Cambridge a couple of weeks back on my experiences with the Batek, one of the professors mentioned a statistic that ~75% of colonial British explorers died of tropical diseases. It makes you realise how lucky we are modern medicines. Without a doubt, penicillin saved my life. So don’t go taking antibiotics for viral infections or if you don’t really need them. And please, please NEVER ABANDON A COURSE! Let’s keep these medical marvels effective as long as we can.
LIVE LIFE NOW—‘THE LEPTO PERSPECTIVE’
Most of all, without wanting to sound too sensationalist, the speed and severity of the illness forced me to re-evaluate my approach to living life. Below is a journal entry I wrote in the days of travel that followed my release from hospital in Malaysia.
20th October 2018 – Pahang, Malaysia
I remember well that moment on the hospital bed in the Merapoh Klinik—a drip in my arm and the diagnosis of leptospirosis recently delivered. All I knew of the disease was that a little Batek girl had died of it in hospital a few months previous. I had known her—little Dading—there one day, gone the next. Though only two-thirds conscious my thoughts came crystal clear, and as clichéd as you can imagine. If this were it, do I have any big regrets? Quite honestly: no, nothing of note. But I certainly wasn’t finished either. There was so much more I wanted to do; so much opportunity I’d been given to make my ideas and dreams happen; and it was my duty to do so. I owe it to myself and the world—to work as hard as possible to make those dreams a reality.
I had a bit of a realisation in that moment. The closest I’ve ever been to death, it was a powerful lesson and a reminder to live more alive. I was lucky—next time I may not be…
Critically, in as least morbid a way as possible—you’re never too young to die. Things happen, and you never know when it could all stop or the opportunities before us will simply disappear on an unexplained whim of the world. Whilst I don’t see practical sense in the conviction to ‘live every day as if it were your last’, the principle is solid.
Don’t waste your life in planning, go do things now. Looking toward the future is all well and good—and necessary to get to where we want to be—but you mustn’t let it take over the present. Make the most of the current period of your life; it’s far better to do something now than wait for the perfect set-up that may never happen.
Of course, all this motivational philosophy I know already, but harsh immediacy has hammered it in harder. So many of us squander the gifts we’ve been given—a body and mind capable of incredible things—we must honour that by using them to their full potential.
Here and now I make a promise to myself to redouble my efforts and live life as if it could all disappear—to find the joy in all I can and make a point of living alive through expeditions and the people that compel me onward. Adventure is to be a constant and not a one-off—I mustn’t lapse into mundanity and just let time pass by. ‘The Lepto Perspective’ I can call it: a sobering reminder to make the days count. Less thinking, dreaming and planning. More doing. Dreams are only worth anything when you make them happen— challenge, consistency, presence and commitment.
‘I have looked in the mirror every morning and asked myself: “If today were the last day of my life, would I want to do what I am about to do today?” And if the answer has been “No” for too many days in a row, I know I need to change something.’
AN AFTERNOTE | OF SHAMANS AND GINGER
In late January, just before I flew back to England, I returned to the Batek tribe for one last week—a final farewell and time to remember them and all their society represents. Somehow aware of my continued weakness, the shaman conducted a healing ceremony to free me of the ghost that he proclaimed had me bound to a stake over a blazing fire.
It was quite an event. Surrounded by half the village crowded into a tiny hut I was daubed with copious amounts of wild ginger root, masked in wood-ash and embers, and dramatically exorcised by the chanting and gestures of the wizened old man. For three nights it was repeated at dusk.
I’ve now been covered from both sides—modern medicine and ancient Batek spiritualism—surely I’m on the way to a solid recovery!