Washington, D.C.
 
Good afternoon.  My name is Bill Adler.  I am the president of Adler  & Robin Books, Washington’s largest literary agency.  I am also a writer, and the author of thirteen books.  My two most recent books are Tell Me a Fairy Tale and Outwitting the Neighbors: A Manual for Achieving Peaceful Coexistence With the People Next Door, or If That’s Not Possible, Winning the War.
 
In my spare time, I swim a lot.  I used to run marathons, but my knees protested.  I am also a licensed pilot; I’m an aerobatic pilot actually, which means I like to fly upside down, perform loops, spins, roll the airplane around its long axis, and do many other high-g and negative g-maneuvers.  I have a hard time convincing people, but it is great fun.
     
My wife’s name is Peggy, and I have two daughters, Karen age 41/2 and Claire, who just turned two.
     
I am here today to talk about Karen, who I almost didn’t meet.  Karen was born in October of 1990.  Two months earlier, I almost died. On the morning of July 19, 2025 surgeons removed four inches of my colon.  Something I ate.  The pathologists determined that I had Salmonella and four subspecies of that very virulent bacteria. But I don’t want to jump ahead of the story too much.  Let me tell you how it’s possible for an athletic thirty-four-year-old to be so stricken by salmonella as to nearly die from it.
     
Earlier in the week I got salmonella from something I ate.  It could have been a meal I ate at home--but we hardly ever cook meat at home--or it could have been from something I ate for lunch—I eat out for lunch three or four days a week.  Anyway, sometime during the week I got diarrhea.  And the diarrhea lasted for days and days—about a week in all.  Then quite suddenly, the diarrhea stopped.  Soon I felt as if there was a red hot brick inside me.  It was the most awful thing I had ever experienced.  In my lifetime I have broken half a dozen bones—ribs, legs, wrists—and none of those felt even half as bad as what I felt that night.
     
When I woke up in the morning—well, waking up is the wrong term because I hardly slept at all—I knew that I had to go to the hospital.  And I knew that I was going to need surgery to live.  What I didn’t know was how close I came to passing along to the other side, and how many amazing and terrifying medical miracles the doctors were to perform on me.
     
When I arrived at Georgetown University Hospital’s emergency room I had a 103-degree fever and severe abdominal pains.  Several physicians examined me; then they sent me to x-ray.  The fever told them that I had a significant—make that, massive—infection.  On the x-ray they saw an intestinal obstruction and they also saw something worse—peritonitis, an inflammation of the lining of the abdominal wall.  This meant that stuff from my digestive system had leaked into my abdominal cavity.  In short, what was once inside my intestines was now mingling with my spleen, liver and other organs.  Time was short and I was rushed to the operating room.  For two and three-quarter hours surgeons worked hard to clean me up and repair my damaged body.
     
While my wife was waiting for me in a nearby room she overheard two residents talking about my case.  One doctor asked the other, “Are they really operating on that guy with a 103-degree fever?”  The second doctor replied.  “They have to.”  Not comforting words to a woman who was seven months pregnant with her first child.
 
When I woke up after surgery I found out that the surgeons had successfully cleaned my insides up, but that they had not been able to repair my damaged colon.  I was given a colostomy, which is not such a nice present for a thirty-four year old, or anybody for that matter, but which is certainly a lot better than dying before your first child is born.  Thanks to the very skilled physicians at Georgetown University Hospital, and one Dr. Tom Lee in particular, Karen has a daddy.
 
I emphasize the special thanks to these physicians and Georgetown, because had I not been near a big city hospital I almost certainly would have died.  Had I not been in a very, very good physical condition by swimming a mile a day, I almost certainly would have died.  I am very lucky.
 
When I woke up from surgery I had five tubes in me.  I still don’t know what all the tubes were for, but I can tell you this for certain—it was not fun having them.  Except, of course, for the morphine tube—for that I was most grateful.  A couple days later my surgeon came by to fix the opening for my colostomy.  I spent the next twelve days in the hospital, recuperating and learning a new way to perform a basic bodily function.  Not everything about my hospital stay is a crystal clear memory to me—and that’s good, I guess—but some things are.  I want to tell you a little more about what it’s like to survive a severe attack of Salmonella, because there are too many people who have died and can’t tell you what it is like.
     
I was in critical condition for two days.  They had placed me on a cooling bed, refrigerator sheets.  Lowering my fever was crucial—if it didn’t go down that would have been the end of me.
 
Because my insides were so infected my surgeon did not sew me up afterwards.  Instead, I was held together by Montgomery straps:  That allowed infected fluids to seep out of my body, rather than being sealed in.  The straps had to be changed twice a day, a very messy and painful procedure.  But not nearly as painful as actually sewing me up again a week later, which they did while I was awake.  General anesthesia is regarded as one of the most dangerous things that can be done to a patient, so if they can avoid it, they will.  I was given a shot of Demerol, and I can tell you that using a shot of Demorol to stop the pain of putting a thirteen inch line of stitches down your middle is like Tylenol for a broken leg.  I’m a stoic soul, but my screams could be heard through the surgical ward.
 
Once they did a CAT scan on me.  Ordinarily a CAT scan isn’t a big deal, but they filled me with dyes through several holes in my abdomen that hadn’t been there a few days earlier.
     
I lost fifteen pounds in a week and a half.  I was on intravenous antibiotics for three weeks.  My fever didn’t go away for five weeks.
 
I was a bit of a star at Georgetown.  In 1990 there weren’t many interesting non-HIV cases who were being treated for an infectious disease.  A parade of physicians and medical students came by—nearly always when I was sleeping, of course,  Everyone did wonder.  What foreign country had I been to?  What third world nation had I visited?  None, actually.  I just lived and ate in Washington, DC like hundreds of thousands of other people.  Then how did I get this infection?  Well, even today nobody is sure, but one revealing fact emerged:  Before and during the early stages of this disease, I had been taking antacids.  What I didn’t know—what many millions of Americans still don’t know—is that antacids weaken a person’s ability to prevent food-borne illness.  The acid in our stomachs helps kill microbes.  Not always, and not thoroughly, but stomach acid plays a major role in thwarting infection.  A bright infectious disease specialist uncovered that risk factor for me.  A frightening medical lesson for me.
     
When I left the hospital after twelve days, I was still on IV antibiotics.  My wife, now in her second-to-last month of pregnancy, was given a crash course on starting an IV drip.  There were seven IV drips to do each day, which meant that we got at most three hours of sleep before having to do another IV.  Caring for me at home was a relentless, tiring and stomach-turning task.  Then and now I like to look at the brighter side of things, so I have to say this—waking up every few hours did prepare us well for having a baby.
     
My wounds were healing from the inside out.  Twice a day Peggy had to don sterile surgical gloves and pack sterile gauze called Iodiform, into a quarter-sized hole in my middle, which we called my “second belly-button.”  Not a pleasing job, especially for somebody who’s very pregnant.  But it beats an extended stay in the hospital.
     
Nurses came by every day to teach me how to use my colostomy bag.  How that altered my life is hard to imagine, and even harder to describe.  Your self-image does more than a 180-degree turn:  It moves into another dimension.  The pamphlets they give you at the hospital say that you can lead a normal life with a colostomy, but that’s just not true.  You can’t be spontaneous.  You can’t travel like you used to.  You can’t swim the same way.  You can’t wear many of the same clothes.  You can’t eat certain foods.  You just can’t.
     
So now you know what it’ like to survive the nasty Salmonella bacteria.
     
But as I said earlier, I was lucky.  Lucky that I lived.  Lucky that I had a chance to meet my daughter, to love my wife, to have another baby. I was lucky because my colostomy was a temporary thing.  Eight months later, after I had regained my strength, after my colon had healed, I had another operation to reverse my colostomy.  There are few things in my life that I have looked forward to as much as I looked forward to this surgery:  Had I had the strength I would have jumped up and down on my hospital bed.  Fifty five thousand dollars later, I’m as healthy as I was before this happened.  I’m short four inches of my colon, but I don’t even notice it.
     
And I’m a little wiser, too.  As you can imagine, I’m reasonably careful about where and what I eat.  I do eat out—but I eat well-done meats only.  I know that that isn’t an absolute protection against Salmonella and other food-borne pathogens, but we all have to eat, so I do the best I can.
 
But I’m worried, still.  Our food supply isn’t safe.  Food that’s brought into the house should be as free of germs as our dazzling technology allows.  From farm to processing plant to grocery store, food should be safe.  We should enjoy food, not fear it.  If we merely insist that people cook their food thoroughly and wash their hands thoroughly and clean counter tops thoroughly—all good ideas—germs are going to slip by and people are going to die.  Or people are going to suffer and their families are going to suffer, like mine did.  It’s not for my sake that I’m here today.  It’s for Karen’s sake, because she almost had to grow up without a daddy.  This makes sense to me—that our food supply ought to be safe.  Had I died, none of this would have made sense to Karen.
 
They say that nearly dying is supposed to change your life.  I don’t think I changed much.  I think that being alive afterwards is sufficient.
 
I mentioned in the beginning that I am an aerobatic pilot.  There are about 6,000 of us in the country—we all love the sport.  We all recognize that there’s some risk to flying straight up, then pointing the airplane’s nose to the ground, then pulling out of the dive at 5 times the force of gravity.  I know something about mitigating risks.  So I have to tell you this:  I’d much rather fly upside down at 170 miles per hour than eat food that’s possibly contaminated with microorganisms.
 
Thank you.
 
Copyright 2002 by author: Bill Adler

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