text:
The instant Jonah let go of his grandfather's hand, his shadow jerked him backward, hard—like a parachute suddenly braking a skydiver's fall, but in reverse.
Okay, that was a bad move, he thought.
|To read Angeling from the beginning, see the table of contents at the Angeling book page.
Instead of rising toward the Light, Jonah found himself being dragged down, swallowed by his shadow. Everything in him screamed to breathe, but there was no air, only a suffocating coldness. He had wanted to save his shadow-self; instead, he was drowning with it, and he had the sickening thought that this, finally, was what it was like to die.
He was shocked, then, when the enveloping darkness shattered in a rush of splashing water and air and light—a dimmer light than the Light he had just left, but bright enough to flood Jonah with relief, and hope. He gasped and coughed and shook the water from his face. More water rained down on his head. He looked up and saw an enormous angel pouring water on him from its cupped hands—or the statue of an angel, he realized with relief; it was the centerpiece of the fountain in which Jonah found himself floating.
And the fountain stood in the middle of the lobby of Aventa Regional Hospital, at least according to the big sign on the wall.
Before he could even begin to make sense of that, though, his grandfather shot out of the water right in front of him in a great whoosh, just like when they used to go swimming at his lake cabin.
"There you are," Grandpa Zograffos said. "You decided to take the scenic route?"
"I'm sorry! I know that was a stupid thing to do—"
"I wouldn't call it stupid," his grandfather said, using a hand to wipe his face as he tread water. "Scramble-brained, reckless, muckled, mole-sighted, and stupid is more like it."
"You said you wouldn't call it stupid."
"On further consideration, I changed my mind."
"Grandpa, you're the one who fell off a roof trying to get a badminton shuttle!"
His grandfather squinted at him. "You think that was stupid? You shoulda seen some of the things I did when I was your age. Amazing I lived long enough to fall off that roof."
People were passing through the lobby without giving Jonah and his grandfather a second glance, as if they were figures in a dream.
"I'm dead, right?" Jonah asked, watching a woman walk right past them with a couple of little kids. Maybe the woman ignored Jonah and his grandfather out of politeness, but surely the little kids would have at least turned to look. "None of these people can see us, can they? But I can still see you, and I know you're dead. Are we ghosts, or what?"
Grandpa Zograffos just snorted and made his way to the edge of the pool, where he pulled himself onto the low, octagon-shaped wall. He moved as easily as a kid, and kind of looked like one, too, in his bare feet. Jonah followed. His sopping wet clothes left a large puddle on the floor; his grandfather, by contrast, sat there in his painter's clothes as dry and composed as if he'd just stepped out of an air-conditioned limo.
"Death wears many masks," his grandfather said cheerfully. "Some of the people walking around here are more dead, in their own way, than both of us combined."
"Grandpa, you know what I mean!"
"You mean are you dead enough for tax purposes? Show me your bellybutton."
"Your bellybutton—you know, that funny little giblet down around your middle."
"The SciFi channel didn't mention anything about bellybuttons during its in-depth report on near-death experiences," Jonah muttered as he stood and lifted his t-shirt.
Grandpa Zograffos peered at his stomach. "If you're relying on the SciFi channel as your authority on the afterlife, then you're in for a few surprises. Hmm. What do you know? You have a bellybutton."
Jonah served up his best Well, Duh! look and dropped his shirt.
Grandpa Zograffos rubbed his chin thoughtfully. "Well, that's a mystery."
"Why do you have a bellybutton? Obviously you died, or I wouldn't have been sent to bring you Home. But dead people don't wear bellybuttons."
"Okay, I'm afraid to ask, but why not?"
"Bellybuttons are a mark of blood-and-bones birth; after your blood-and-bones body dies, your soul is embodied by Light or Shadow, so no bellybutton."
"So I'm not dead?" Jonah asked. He moved into the path of a young woman and raised his hand for her to stop, but she stared through him impassively and never broke her stride. He stepped out of her way at the last second, not quite ready to test the whole passing-through-people thing.
"If you weren't dead, you'd be suited up in your battered old body, not wandering around some hospital lobby. That's the mystery." He looked at Jonah intently. "But a more pressing question is: Why did you turn back toward your shadowling?"
Jonah stared at him for a moment. "Why did I turn back toward my shadowling?" He looked away. "I don't know why."
He had thought he knew, at the time; he had thought he was saving the fighter in himself. When he was younger, he spent the ride to school imagining that he was wearing a robotic exoskeleton, like in the Iron Man movies. He imagined it being jet black, because nothing says, "I've got a grudge against the world, but squashing you just might make me feel better" like black. He didn't pretend that sort of thing anymore, though, maybe because he didn't need to pretend. Maybe that Iron Man exoskeleton had become a part of him. And when he had looked into the eyes of his shadowling, he had thought that the strongest part of him would be destroyed if he let go of it.
But now that explanation seemed as empty as the ashy form of his shadowling, so he didn't say anything about it.
His grandfather placed a hand gently on Jonah's shoulder and drew him closer, close enough to look straight into his eyes.
"This matters, Jonah," he whispered, and Jonah thought he saw something of the Light dancing in his eyes. "This is important. Do you know why?"
Jonah shook his head.
His grandfather spoke as if secretly into his ear. "Because you can't go Home still attached to your shadowling. You have to let it go. You have to drown the thing, before it drowns you."
Jonah considered that for a moment before whispering back. "Um, I thought I already did," he said, tilting his head toward the fountain. "Isn't it—back there?"
His grandfather slowly shook his head. "You ever heard of a ghost with a shadow?"
"What do you mean?" Jonah asked, but then he followed his grandfather's gaze. The shadowling was right there in plain sight, attached to his feet as if it were any ordinary shadow. But once spotted, it shrunk, pulling itself into the smallest possible puddle of gray under Jonah's feet.
Jonah shivered. It was worse than finding a leech stuck to your leg.
"Okay," he said in a low voice, trying to stay calm. "Okay. What do I do to get rid of it?"
His grandfather squeezed Jonah's shoulder. "Well," he said, "the fountain would be quickest, but I'm afraid if we go back that way, your shadowling might try drowning you again. Which is why it would be good to figure out why you couldn't let it go. Fortunately, I know just the place to do that. It's a bit of a detour, but it's also probably your best shot at getting Home. And we should leave now, before that shadowling of yours gets any funny ideas. You're in danger until that thing is good and drowned."
He stopped and followed Jonah's gaze, which had been drawn to a woman hurrying through the lobby, her long black coat and long black hair flying out behind her. She was moving in a sort of limping jog, hobbled by her high heels.
Jonah's mouth hung open. "Mom," he said as she strode by, oblivious to his presence. "Mom! MOM!"
"Speaking of the trickery of your shadowling," Grandpa Zograffos groaned. "That explains why it spit you out here. Jonah, she can't see or hear you—"
But Jonah was already following her, dodging around people as best he could, considering they couldn't see him. The way he moved felt so natural, it was hard to believe he was dead. He looked down and saw hands and legs that looked real—he even had on sneakers, the same ones he had been wearing at the time of the accident.
When he glanced up again, he was looking right into the face of a pudgy-nosed, squinty-eyed man. Jonah yelped in surprise as he and the man passed through one another. There was a slight tug, and then it was over, except for a faint odor of cigarettes, garlic, and gorgonzola cheese.
Eww, Jonah thought, and then he spotted his mother talking to someone at the reception desk.
"And you are—?" the receptionist was asking.
"I'm his mother," his mother answered in her snappy I'm-Losing-My-Patience voice.
"Sorry, I meant your name, ma'am. I just need to collect some information for insurance purposes."
His mother spelled out her name, Catherine Joy Zograffos, spitting out the letters faster than the woman could type. Her face was a tight mask, her lips pressed tight.
Jonah approached to within an arm's length of his mother. He wanted to touch her, to reassure her with his presence; better yet, he wanted her to reassure him, like she used to do when he was little. But he didn't even try; he knew his hand would just pass through her arm. He was still a little grossed out about walking through the smelly man.
He turned. There was his grandfather, shining faintly, lit up from inside by the Light; he cast no shadow. "Come on," his grandfather said. "You don't want to be here for this."
"How can you say that? She's your daughter."
"Yes, which is why you should believe me."
The woman behind the counter had seen something on the computer that made her pause.
Catherine leaned over the counter. "What's going on? The school said he got hit by a baseball, but that doesn't seem like the sort of thing that you call an ambulance for, unless they were overreacting."
"I can't tell you anything, because I don't know," the woman said. "But I'm going to page someone who can help you." She picked up the phone.
"Jonah," Grandpa Zograffos said, "there isn't anything you can do for her right now—she's too anxious to sense anything illuminated by the Light, and you're too Shadow-bound anyway."
"I have to try."
"If you really want to help your mother, come Home with me. You're going to be more present to her there than you could ever be here, ghosting around. It's what she would want you to do, if she knew."
"She would want me dead?"
"No, of course not! But she would want you to be happy—and she would want you to be safe. And you're not going to be either of those things here. Not as long your shadowling is still feeding off you."
"I can handle the shadowling."
"You still think so, even after it nearly drowned you? No one gets rid of their shadowling by themselves, Jonah."
"Anyway, this has nothing to do with shadows," Jonah snapped.
"You think it's all about protecting your mother."
"That's right. What's going to happen to her if I die?"
"You think you have to keep protecting her from your father, even though you haven't seen or heard from him in more than two years."
"He could come back. And then who will be there for her? Because no one was there when he was punching holes in walls and pushing Mom around. You weren't there. I was. I was the only one there."
He immediately regretted blaming his grandfather. But if the comment stung, his grandfather didn't show it, nor did he try to defend himself. The shadowling under Jonah's feet, however, swelled and darkened, like a tick growing fat on the blood of its host.
The receptionist hung up the phone and told Jonah's mom that it would be a minute, if she wanted to have a seat. Catherine cast a skeptical eye over the waiting area, with its large couches and stacks of magazines, no doubt thinking that nothing in a hospital was ever just a minute.
Grandpa Zograffos spoke to Jonah again, kindly. "You promised yourself you wouldn't let anything hurt your mother again," he said. "All right. You keep that promise. And I promised someone that I would see you Home, so if you don't mind, I'll stay with you as long as you choose to be with your mother."
That wasn't the response Jonah had expected. "I don't mind," he said. He looked away, suddenly embarrassed.
He hadn't meant to say quite so much.
~ ~ ~
Catherine found a seat on a couch across from two women who looked like they'd been there a while—empty soda cups and tissues and gum wrappers littered the area around them. Probably somebody had told them it would just be a minute, too.
Jonah half-knelt in front of his mother.
"Mom," he said quietly, "I'm here."
She had been jiggling one foot and staring out across the waiting area with a far-away look, but now she sighed and reached for an outdated copy of Southern Living magazine. "Let's celebrate the peach," the cover suggested.
In a moment you're going to find out I died, Jonah thought, and you're reading about peach cobbler. What was Southern Living even doing in the waiting area of a Midwestern hospital? Life was strange, but death was even stranger. Because how weird was it that he was about to witness his mother being told that he was dead?
If he was dead. He didn't feel dead. Plus, there was the fact of his bellybutton. He quickly checked to see that it was still there, which it was—his one shred of hope of getting back home. Back to his real home, not the "Home" Grandpa Zograffos kept talking about. He hadn't liked the new apartment when he and his mom first moved in, not the worn green carpet, nor the smell of cooking oil in the dim hallways. But they had been making it home by filling it with all their old familiar stuff: the tatty love seat, the wind chimes on the balcony, his mother's keys on a hook by the door and her fuzzy slippers by the couch. The place was even beginning to smell more like home. Burnt toaster waffles in the morning, burnt microwave popcorn in the evening. And faint traces of his mother's perfume when she walked in the door.
This other "Home" he didn't know anything about.
"If I ever get home, I promise to never complain about your burnt toaster waffles ever again," he said to his mother.
She turned a page and glanced over at the reception area with a look of annoyance.
Watching her face was like seeing her for the first time. It was a face lightly lined by stress, worry, and sadness—but also a lot of laughter. Especially in the last year, Jonah realized, they'd done a lot of teasing and joking around. Something in her had lightened in the last year.
Jonah bit his lip. "I wish you could hear me. All of a sudden it seems like I have a lot to tell you."
One of the two women seated nearby sighed deeply. Dressed in a floral-print muumuu, she reclined in an overstuffed chair with her head tilted back, her hands folded across her round stomach, and her short legs splayed out.
"What time is it now?" she asked her companion.
"Hasn't been five minutes since the last time you asked. Stop bugging me," the other woman answered. Her large eyeglasses reflected the gigantic television mounted on the wall.
"But I feel awful."
"Shh. They're going to interview one of the survivors."
"I might throw up any minute," the splayed-out woman said, moaning. "Georgina! Go check on how long it's gonna be, plee-eaze! I can't take this anymore."
The other woman tore her eyes away from the television and huffed. "I already did. Don't you have any sympathy for other folks who might be worse off than you?"
"Like who would that be?"
"Me—I gotta put up with you."
The two women cracked up at that.
Life is weird. Death is weirder. But these two take the cake, Jonah thought. His mother was peeking at them over the top of her magazine.
"Seriously, Prissy, it could always be worse," Georgina continued once she had composed herself. "There's a kid back there that got whacked in the head with a baseball bat."
"Serious?" Prissy exclaimed, impressed.
Georgina nodded. "Last time I went out for a smoke, some of them orderlies were telling me all about it. He was hanging on by a thread, they said—and they sure didn't look too hopeful. So settle down and count your blessings!"
Catherine Zograffos, whose magazine had fallen into her lap, jumped out of her seat. She opened her mouth as if to say something but then snagged her purse off the couch and flew toward the reception desk, her coat billowing behind her.
"What's with her?" Georgina wondered out loud.
"I don't know, but she'd better not be cutting in front of me," Prissy answered.
Jonah stood and kicked the couch in frustration, but his foot just passed through it with the barest sensation of resistance.
"This is so unfair!" he shouted. The shadowling flared, as if in affirmation.
Grandpa Zograffos bowed his head a little; his face was grim. "Yes, it is," he said, and he turned to follow his daughter.
~ ~ ~
When Catherine Zograffos was pregnant with Jonah, she decided to have a natural childbirth—no drugs or unnecessary medical interventions. It turned out to be some of the most painful hours of her life; each contraction had felt like someone was trying to rip her apart. But at the same time, it had been exhilarating, because she knew her pain and hard work were bringing a new life into the world.
Losing Jonah was like that, only in reverse.
The white-haired, well-dressed woman who intercepted her by the reception desk wore an ID tag that identified her as Pamela Reed, family crisis counselor. The word "crisis" was Catherine's first sign that things were much worse than the phrase "accident playing baseball" might have initially suggested.
The second sign was the firm hand that Ms. Reed placed on her back as she guided Catherine into a small room filled with comfortable chairs and tissues, and then closed the heavy door. There was another woman in the room, a nurse by the name of Phoebe Weaver. The look on her face was the third sign, and it terrified Catherine.
"What's going on?" she barely managed to ask, after Ms. Reed had steered her into a seat.
Ms. Reed looked her right in the eye. "What do you already know about what happened to your son?"
"The school said he was playing baseball and he was in an accident, that's all. I came right away. Someone from the school was going to meet me here, but we must have missed each other. Is he going to be okay?"
Ms. Reed folded her hands together and pursed her lips. "This is going to be hard to hear, okay?" She paused to let that sink in; Catherine had frozen. "Your son was hit in the head with a baseball bat, hard enough to crack his skull and cause massive bleeding in his brain. Then shortly after he arrived here, he went into cardiac arrest—"
"Is he dead?"
"His heart is beating without assistance," Pamela said.
Catherine breathed out loudly.
"But," Pamela added, speaking carefully, "what concerns the medical team is the fact that it took forty-five minutes of CPR and defibrillator shocks to get there. So we can hope your son will recover, but I want to prepare you for the possibility—"
"What are his chances?"
"My understanding, Ms. Zograffos—and I'm trying to be truthful with you here—is that because of the degree of bleeding in the brain, and because they're detecting only minimal brain activity, the doctors are not optimistic."
Catherine put her hands up to her face, covering her eyes. She was very still for what seemed like a very long time. Her body began to shake, silently; and finally she let out a deep sob.
Jonah stood by helplessly. His throat felt swollen, like he needed to cry but couldn't. Could ghosts cry? His grandfather's hand on his shoulder was warm, and it steadied and strengthened him.
"Grandpa, we have to do something," he whispered. He had never heard his mother cry like this—a low, animal moan that rose from deep within her and filled the room. Her back hunched, her face still hidden by her hands.
Jonah glanced at his grandfather and saw tears on the old man's face, which shone more fairly than ever.
"Yes," Grandpa Zograffos said. "And maybe we can."
"How? You said she couldn't sense us."
"She's wading neck-deep through a black river of grief; it's taking everything she's got just to stay afloat. What we need is an angeling—"
"What's an angeling?"
"A little angel—a blood-and-bones person who senses the Light. Someone who stands with one foot in this world, and one foot—or even a little toe—in our Home. Someone to be a bridge. Someone like her."
He nodded toward Phoebe Weaver, who was leaning forward on the edge of her easy chair, her hands held in front of her mouth, watching Catherine with a look of intent concern.
"Maybe you're too Shadow-bound to see," Grandpa Zograffos said, "but the Light dances around her like sunlight on water."
He bent his knees a little and jumped. He rose through the air, doing a slow cartwheel until he was hovering upside down over Phoebe. He looked like an astronaut floating in zero gravity, hanging there. Slowly he descended until his face was near hers, and he held out his hands and whispered something. The Light inside of him sparked and flared, illuminating her face.
Phoebe had not moved and had barely breathed for several minutes, but now she made a small noise as she rose from her seat and went to Catherine, reaching out to touch her arm. Catherine let it rest there a moment before grabbing hold of Phoebe's hand, and then pulling her into an embrace.
"It's going to be okay," Phoebe told her.
Catherine sobbed harder, gasping for breath like she might drown in her own tears. But after a few minutes, she took a last shuddering breath and was still.
"It's going to be okay," Phoebe said again; and even as she said it, she wondered where the words were coming from. They were words to comfort her, as well.
Grandpa Zograffos landed lightly near Jonah.
"How did you do that?" Jonah whispered.
"The laws of physics are more like general suggestions when you're dead."
"No, I meant how did you get that nurse to do what she did? What did you say to her?"
Grandpa Zograffos looked at Jonah in surprise. "Why, I told her that all would be well, of course!"
"How do you know that?"
Grandpa Zograffos spread his arms wide, in a grand gesture of invitation. "If you come Home, you can see for yourself."
Ms. Reed had left the room and now came back with a glass of water for Catherine, who was still breathing deeply.
Jonah said nothing in reply to his grandfather, so Grandpa Zograffos pressed his case. "You know, going Home doesn't take you away from those you love; it brings you closer to them. Close enough to touch."
Jonah lifted his shirt to show his bellybutton. "What about this?"
"If your brain reboots, you'll have to come back, unfortunately."
"Kind of like all those people they interviewed on the SciFi channel, right? They all came back."
Grandpa Zograffos nodded.
Jonah hesitated. His mother was blowing her nose and apologizing for crying. Phoebe said something that made her laugh, just a little, through her tears.
And huddled beneath his feet, his shadowling tried to look smaller and weaker than it really was, even as it sucked life from him.
His mind flashed on the time he and his grandfather had gotten stranded way out on the lake at the cabin up north. Jonah had been seven or so. They'd gone fishing after supper, and they'd cast their lines without catching anything until the sun sat low and fat on the horizon. But when it was time to head back, his grandfather couldn't get the motor started, leaving them no choice but to row for the cabin in the dark. Jonah remembered a blanket of stars in the sky, their wobbly twins reflected in the water below, and his grandpa pulling at the oars for nearly an hour, telling jokes and stories the whole time.
This was like that, wasn't it? Just another dark lake to get across.
A dark lake populated by carnivorous, soul-sucking shadows, but still.
As difficult as it would be to leave his mother, the more he thought about it, the more obvious the choice became. He wasn't doing her any good here, and his shadowling would only grow stronger the longer he lingered. On the other hand, his grandfather really wanted him to head Home, somehow drowning his shadowling along the way. And Jonah trusted his grandfather more than anyone, his mother included.
"All right," Jonah said, without taking his eyes off his mother. "How do we get there?"
Grandpa Zograffos clapped a hand on Jonah's shoulder. "We take the elevator."
Jonah stared at his grandfather a moment, in case he was joking, but Grandpa Zograffos just patted him on the back and slipped through the wall, which made a sound like ripping paper as it yielded. Jonah sighed, rolled his eyes, and followed.
However this all turned out, someday, someone at the SciFi channel was going to have a lot of explaining to do.
~ ~ ~
The way Catherine finally managed to stop crying—which she had to do, if only because her face was becoming a raw mess of tears and snot, and the muscles in her chest and abdomen were so sore—was to start asking questions. Right away, though, Phoebe held up her hand.
"I'll answer all your questions in a moment, but there's something else we should discuss first—a new brain therapy that we'd like to try on your son. The thing is, we need your consent, and time is kind of a factor."
Catherine leaned forward. "What is it?"
"It's called combinational lazaroid therapy. The press are referring to it as the Lazarus therapy, which is a bit sensational. Basically it uses artificial aminosteroids called lazaroids to prevent—or even reverse—brain damage."
Pamela jumped in. "But Ms. Zograffos, I have to caution you not to get your hopes up. This therapy has just been approved for study in humans; your son would be the first to try it. And there are risks, of course—"
"How can there be risks when you're saying he's probably going to die?"
"It could be only partially successful, for instance, so that while your son wouldn't actually die, he wouldn't make a full recovery. Or he could appear to fully recover, but have unexpected side effects."
Catherine looked over to Phoebe questioningly.
"The animal studies have been very encouraging," Phoebe offered. "The odds of success are still small, but Doctor Howell feels it's worth a shot. If you consent, of course."
Catherine didn't ponder the question more than half a second before reaching for her purse to find a pen. "Just show me what I have to sign."
~ ~ ~
Jonah and his grandfather made their way through a maze of hallways to the hospital's main elevators.
Grandpa Zograffos waved Jonah forward. "Press the button."
"How? My hand goes right through anything I touch."
"There are two elevators here—the one they're waiting for," Grandpa Zograffos said, nodding towards the handful of people gathered there, "and the one we're waiting for. Just humor me."
"Do I press up or down?"
Grandpa Zograffos rolled his eyes, and then slowly pointed upward.
"Okay, okay, just checking," Jonah muttered. He pressed the button, which lit up.
The elevator arrived almost immediately with a ding, and its doors rattled open. Several people got off and a few people got on: a nurse holding a coffee, a large woman in a wheelchair, an old man pushing it. Grandpa Zograffos followed, and Jonah followed him, stepping carefully around the others.
"Three, please," the woman in the wheelchair told the nurse, who pressed buttons for the third and fourth floors. Jonah noticed the hospital only had five floors.
"Which floor is ours?" he whispered to his grandfather. It was so quiet in there, he couldn't help whispering, even though he knew none of the others could hear him.
"The elevator will take you where you need to be." Grandpa Zograffos whistled a few bars of a song Jonah didn't recognize. "They used to play music on elevators. Don't you think they should play music on elevators?"
"Um. . . ." Jonah hadn't ever given it any thought.
"What's an elevator but a bunch of strangers stuck in a small box hanging over a really deep hole?" Grandpa Zograffos went on. "Seems to call for music." And he whistled a musical flourish.
The elevator deposited the others on the third and fourth floors, and the doors slid closed with a disconcerting finality.
"You may want to hold on," Grandpa Zograffos advised, gripping the railing that encircled the elevator with both hands.
Just then, the elevator shuddered, making a revving noise; with a lurch, it shot straight up at a speed that made Jonah's knees buckle, forcing him to the floor.
That turned out to be a good place to be, because within seconds, the floor tilted as the elevator changed course, moving sideways now. Jonah went skittering across the floor before he managed to grab hold of the railing and carefully pull himself to a standing position. The digital readout of the floor numbers was a blur.
He glanced over at his grandpa, who was calmly standing in a corner of the elevator with his hands on the railing and his feet braced against the rocking and twisting of the floor. He looked like the captain of a ship standing stolidly at the helm in stormy seas. Jonah had been about to ask whether the roller coaster quality of the elevator was normal, but by the unperturbed look on his grandfather's face, he guessed it must be.
Gripping the railing tightly, Jonah carefully edged his way over to his Grandpa Zograffos, pausing briefly when the elevator made a stomach-dropping loop-the-loop.
"This doesn't seem very safe," Jonah remarked, struggling to keep his balance.
"Fortunately, you're already mostly dead, so I wouldn't worry about it," Grandpa Zograffos replied with a smile.
"If I'm already dead, then why do I feel like I'm going to throw up?" Jonah asked. As if on cue, the elevator spun around several times very quickly before suddenly dropping, causing Jonah's feet to fly into the air. After he'd regained his footing, he added, "Actually, why do I feel anything at all? I thought I left my body behind in the hospital."
"You did," his grandfather replied, leaning into the wide turn the elevator was making. "But your soul is used to perceiving the world through a body, so it's making one up for you. It's like what happens when people lose an arm or leg—they feel a 'ghost limb' for a while, right?"
"They do?"
"Yes, they do. But in your case, you're feeling a whole body—a ghost body. Complete with nausea."
Jonah grimaced as the elevator shot off in yet another direction.
"Then none of this is real? It's all a trick of my mind?"
"I wouldn't say that. Everything you're seeing and hearing and feeling is very real. But until the Light clarifies your soul and drowns your shadowling, the reality you're experiencing has to be translated into a form you can understand.
"It's like your video games. At bottom, the game is just a long series of zeroes and ones—switches being turned off and on. But you'd never be able to play the game if you had to interpret that stream of ones and zeroes directly; there's just too much information passing by too quickly. So the computer translates the code into images you can understand and interact with. Make sense?"
"I think so," Jonah said, frowning in a way that suggested he wasn't entirely sure. "What about you? How much of you is—translated?" The last time he'd seen his grandfather had been in a casket at the wake, four years ago. But the man standing before him sure looked like the man Jonah had known before that: the bony, sun-burned nose, the strong, calloused hands, the twinkling blue eyes.
"I'm not bouncing around the afterlife in paint clothes, if that's what you mean. But this is really me, your old Grandpa Z."
"Who can't help making a rhyme." Jonah smiled, then shook his head. "I have so many more questions—"
The elevator rattled violently, as if it were traveling over railroad ties without the benefit of rails—or wheels.
"Like," Jonah continued through gritted teeth, "when are we going to get there?"
The elevator made a few last hops, flipped over a few times, and finally jolted to an abrupt halt after striking something solid with a loud, bone-jarring bang. Jonah had to peel his face off the wall.
"It's a good thing the laws of physics are more like suggestions around here," Jonah muttered.
"Just be thankful this elevator worked at all."
"Uh . . . why?" Jonah groaned as he found his footing.
"Otherwise we'd have to take a stairway to heaven," Grandpa Zograffos said, barely keeping a straight face. When Jonah looked at him quizzically, his grandfather whistled a few bars of the Led Zeppelin song.
Jonah groaned again. "Please . . . stop . . . now."
The elevator had come to rest slightly askew, the floor tilting slightly toward the back. It made an ominous hissing sound.
"Okay, question two," Jonah said, staggering away from the wall. "Where exactly are we?"
The elevator dropped an inch with a loud clunk, its bell dinged, and the doors rattled open. The view was obscured by a curtain of steam rising up from somewhere beneath the elevator.
Grandpa Zograffos made his way to the entrance, gripping the side of the doorway to steady himself.
"Only one way to find out," he said. He waved a hand dramatically toward the opening. "After you."
|Did you like this preview chapter of Angeling? Share it on your social network using the buttons below. This chapter is a work in progress; your constructive comments are more than welcome. See the Angeling book page for more chapters as they are released, or sign up to receive Angeling chapters and book release news by e-mail.
P.S. Here's an easy peach cobbler recipe from Southern Living magazine.


text: EquipNet is the world's leading provider of used microplates and various other used equipment. Our exclusive contracts with our clients yield a wide range of used microplates from a number of respected OEMs, including Perkin Elmer, Thermo Scientific, Brandel, Tecan, Tomtec,Velocity, BioTek Instruments, Packard Automation, and many others. If you do not see the microplate you are looking for, call one of our representatives and we will find it for you. We can also source the right tooling and change parts that you need through our huge network of corporate clients from around the globe.

subset: commoncrawl


text:
Merry & Bright
It's amazing how fast the holiday season goes. It seems like we were just trimming the tree, decorating the mantle and icing cookies, yet here we are packing away the Christmas goodies and delicately tucking them away for another year. As Nathaniel Hawthorne once said, "Time flies over us, but leaves its shadow behind."
With each and every day we create memories; memories that cast a fountain of shadows over ourselves. While time may pass with the blink of the eye, we are always left with our memory of shadows. And it's these shadows that I franticly run around and collect as quickly as possible, it's these shadows that I attempt to hold onto so dearly with both hands, and it's these shadows that I want to lock away forever.
This holiday season was good to us; we were blessed with good health (minus a family case of the flu), warm weather and joyful times. Unfortunately, this time of the year always brings stress into household. It is the busiest time of the year for our restaurant, which means I don't see my husband as often as I would like and neither do the kids. Not to mention, when he works overtime, I work overtime. As we all know, long hours in the day mean that stress is festering somewhere. But even though we are always faced with stress, we always manage to dispense it evenly until it disappears. And when Christmas morning arrives, it is always magical.
The holiday season may be coming to a close, but I would love its shadow to linger just a bit longer. I would love to hold onto some of that magical Christmas spirit and carry it around with me all year long.
I hope you enjoyed your holiday! This is just a small glimpse into ours, but I assure you it was good.
A Room Makeover with a Star Wars Twist
I don't know about your household, but I'm starting to think that my boys are more excited about the new release of Star Wars than Christmas! It's certainly the topic of most conversations, the wish lists are full of Star Wars toys and legos and I catch my boys sneaking off to watch the trailer, just one more time.
I started working on Joshua's room over the summer as a project for Babiekins Magazine blog. As with any project I tackle these days, it tends to take me a bit longer and I move a tad slower, but his room is finally done and he is over the moon with excitement!
As far as renovations and makeovers go, I didn't actually do too much. I added a fresh coat of paint to the walls, hung new curtains that were a similar hue, switched out the bedding and added a desk so he has a space for homework, writing and Lego building.
For a full list of credits head on over to Babiekins Magazine blog by clicking this link.
December Days
It certainly doesn't look like December days, but as the month rolls on the days grow a little bit colder. Eventually we'll get a white blanket that will cover the ground, dust the trees and rooflines and spread excitement and cheer for the season. And eventually, we'll get out the ski gear, dust it off and put it to use. But for right now, we're soaking up the warmer days and letting the sun shine down upon us.
While parts of me are eager and ready for the traditional winter weather, parts of me love the thought of coatless days, warm sweaters and cozy boots. We still have yet to make a fire, but we've certainly been enjoying our share of hot cocoas and soft snuggles under the blankets.
These days we're keeping cozy with FabKids
FabKids is JustFab's fashion club, started by a team of parents including mom and actress Christina Applegate. FabKids is a convenient way for busy parents to shop. It's an outfit club -- so parents get monthly selections of super affordable, high-quality fashions personalized for their kids.
New styles are in! Winter and Holiday pieces include quality clothing for affordable prices so you can shop must-haves for any season!
Thank you FabKids for patterning with us on this post.
"Gratitude is the fairest blossom which springs from the soul."
Henry Ward Beecher
Sometimes in life it's difficult to find gratitude, it's difficult to wade through the thick nets of despair and discouragement that hinder our view. It's difficult to see through the challenges that have been thrown our way; challenges like Crohn's Disease and other difficulties we encounter. Sometimes it is easier to embrace them than pick them up and thrown them out of our path.
But I choose to clear my path and throw those challenges aside.
I choose gratitude.
This year at Thanksgiving dinner we were handed two pieces of paper to write down what we are thankful for; one piece for a serious note and one for a silly note. We placed them in a jar and at the end of dinner we read them aloud and shared in the thankfulness. It was the beginning of a new tradition.
Thanksgiving may be behind us, but I believe in carrying the gratitude on throughout the holiday season. If there is one thing I have learned over this past year, it is gratitude. It is a true belief in the magic of Christmas. The holiday season is not about gifts, glitter and trees. It's not about cookies, shopping and parties. It is about the spirit of the soul, it's about uniting together as a family, it's about sharing and it's about gratitude to what we have in life.
My list could reach for miles, but here are a few thoughts on what I am thankful for:
Our health | even though it's been a journey we are in a far better spot this holiday season than last.
My family | my husband and kids are my rock. Period. We are also so blessed to have a supportive family who are willing to step up and help us when we need them. From picking up kids from school, to cooking for Jonas to watching them while we are away. We couldn't do it without the loving support of family.
Our home | A home is more than just a house and I know that when I walk through our front door I am home.
Opportunities | I am thankful for opportunities we have been given in life and in our careers. I am thankful for the Babiekins Magazine team and the amazing support these women have shown me.
Friends| They are always there, always. I love them more than they know.
Food | Our lifestyle and how we conquer our son's Crohn's disease is unique. I am blessed we have the opportunity to eat and cook how we do; refined sugar free, preservative free, organic and nongmo. It has taken cutbacks in our budget but it's something I believe in.
What are you thankful for this holiday season?
Subscribe to: Posts (Atom)


text:
You are hereGiardia Lamblia and Giardiasis
Giardia Lamblia and Giardiasis
With Particular Attention to the Sierra Nevada
|By Robert L. Rockwell
|June 4, 2003
|[PDF version]
|Figure 1.† Trophozoite Emerging from Cyst[1]
|Figure 2.† Trophozoite Undergoing Division1
Ask the average outdoors person about Giardia lamblia,
and they have certainly heard about it.† Almost always, however, they are considerably
misinformed about both the organismís significance in wilder≠ness water and
the seriousness of the disease, giardiasis, if contracted.
The amount of information easily found on the subject is
voluminous.† Unfortunately, almost all of it is flawed in important aspects,
being unsubstantiated, anecdotal or speculative.† Official informational publications
put out by the United States government are far from immune to this criticism.
This paper is
the result of a critical distillation of relevant articles, retaining only those
from scholarly, peer-reviewed, or otherwise professional and trustworthy sources.
One conclusion of this paper is that you can indeed contract
giardiasis on visits to the high mountains of the Sierra Nevada, but it almost
certainly wonít be from the water.† So drink freely and confidently.† Proper
personal hygiene is far more impor≠tant in avoiding giardiasis than treating
the water.
First, an excerpt
written by a highly regarded wilderness physician:
- ìIn recent years, frantic alarms about the perils of giardiasis have aroused
exaggerated concern about this infestation.† Government agencies, particularly
the United States Park Service and the National Forest Service, have filtered
hundreds of gallons of water from wilderness streams, found one or two organisms
(far less than enough to be infective), and erected garish signs proclaiming
the water ëhazardous.íî [2]
And another,
by researchers who surveyed the health departments in all 50 states and scanned
the medical literature looking for evidence that giardiasis is a significant
threat to outdoor people:
- ìNeither health department surveillance nor the medical literature supports
the widely held perception that giardiasis is a significant risk to backpackers
in the United States.† In some respects, this situation resembles (the threat
to beachgoers of) a shark attack:† an extraor≠dinarily rare event to which the
public and press have seemingly devoted inappropriate attention.î [3]
I first explored this subject in 1987[4] and again in 1996[5],
with an update in 1997 name="_ednref6" title="">[6].† The emphasis has always been to
waters of the High SierraóìHighî meaning elevations of 8,000 or 9,000 feet and
aboveóbut much of the material applies to wilderness water at lower elevations
and beyond the Sierra.
Since 1997 a wealth of additional information resulted in
a follow-on paper[7]
that was not published in the usual sense, but was made available to several
mountaineering and hiking organizations.† As even newer data became available
I incorporated it, keeping the same title but amending the date.† These various
versions were picked up by a number of additional websites,[i]
and have migrated further.†
In 2002, having seen the paper on one of these websites,
an editor at National Geographic Adventure magazine contacted me for details.†
The staff at NGA then independently examined the information and research, and
wrote their own article.[8]†
That article verified the findings of this paper.
From the beginning, the conclusions have always been that
ìthe Giardia problemî in the High Sierra and elsewhere is grossly exaggerated,
and that virtually all of the few cases of giardiasis subsequent to wilderness
visits are wrongly blamed on the water.† After incorporating the most recent
information, those prior conclusions are not only still valid but also considerably
Just who is this little guy, anyway? [ii],
[9], [10],
[11], [12],
The parasite
Giardia lamblia, now known
also as G. intestinalis or G. duodenalis, was first observed in
1681 by Anton van Leeuwenhoek, inventor of the microscope.† It was named in
1915 for two scientists who had studied it:† Prof. A. Giard in Paris and Dr.
F. Lambl in Prague.† There are species of Giardia other than G. lamblia
(e.g., G. muris) that infect small rodents, amphibians, birds and fishes,
but they arenít passed on to humans and most other mammals. href="#_edn14" name="_ednref14" title="">[14]† This paper deals exclusively with G.
Giardia is a flagellated (having
whip-like appendages for locomotion) protozoan that, in the trophozoite (active)
form, attaches itself with an adhesive disk to the lining of the upper intestinal
tract of the host animal.† There, it feeds and reproduces.† Trophozoites divide
by binary fission about every 12 hours, so a single parasite can theoretically
result in more than a million in 10 days and a billion in 15 days.
At some time in its active life, the trophozoite releases
its hold on the bowel wall and floats in the fecal stream.† As it makes its
journey, it transforms into an egg-like structure called a cyst, which is eventually
passed in the stool.† Duration of cyst excretion, called shedding, may persist
for months.† Once outside the body, the cysts can be ingested by another animal.†
Then, they ìhatchî into trophozoites due to stomach acid action and digestive
enzymes, and the cycle repeats.
The trophozoite
is 9 ñ 15 microns long, 5
- 15 microns wide, and 2 - 4 microns thick.† Unlike the cyst,
it cannot live for long outside a host.
Cysts are 8
- 12 microns long by 6 - 9 microns in diameter, so a million
could fit under a fingernail.† Cysts can survive for as long as 2 to 3 months
in cold water, but they cannot tolerate drying or freezing.12, 13, [15],
[16], [17],
They are also destroyed by UV radiation, heat and biocides such as bleach.15
A significant infestation can leave millions of trophozoites
stuck tight to the intestinal lining.† There, they cripple the gutís ability
to secrete enzymes and absorb food, especially fats, thereby producing the diseaseís
symptoms.† The symptoms typically appear one to two weeks after ingestion, with
an average of nine days, but four weeks is not uncommon.† Symptoms can vanish
suddenly and then reappear.† They may hide for months.† They may not appear
at all.13, [19]
There are three ways that giardiasis, the disease caused
by Giardia infections, can be contracted:† contaminated water, contaminated
food, and direct fecal-oral.† A person who has just come down with the disease
and who wishes to identify the source needs to reflect on not only the possibility
of each of these pathways, but in a suspect period ranging from typically one
week earlier to four weeks earlier.
The bad news:† Giardia lamblia is everywhere 2, 10, 11, 12,
13, 14, [20], [21],
[22], [23],
[24], [25],
Giardiasis has been most often associated with travel to
such places as Latin America, Africa, Asia, and the former Soviet Union.† However,
Giardia has always been present in wilderness streams, in the water supplies
of most cities around the world, and even in the municipal water of large U.
S. cities.† In fact, in the 1930s and 1940s, before regulated municipal water
treatment plants, we were all ingesting Giardia all the time.[27]
Giardia lamblia is the most commonly diagnosed intestinal
parasite in North America.31† It is the
most frequently identified cause of diarrheal outbreaks associated with drinking
water in this country.† To be classified a disease outbreak, the US Centers
for Disease Control and Prevention (CDC) must have implicated the source, and
there must be multiple cases.† For 1999 ñ 2000, there were 39 drinking water
disease outbreaks (all causes) in the US, involving 2068 persons. [28]†
This is an average of 53 persons per outbreak, but sometimes a single outbreak
can be devastating:† In 1993, Cryptosporidium managed to get through
Milwaukeeís water treatment system and sickened 403,000 people.
name="_Ref41626580"> name="_ednref29" title="">[29]† We take drinking water for granted
in this country, but it is far from being completely trustworthy.
(AGI = Acute Gastrointestinal Illness of
unknown cause)
Estimates vary,
but fully 20 percent of the worldís population have giardiasis, and 4 to 7 percent
of Americans, most without any symptoms at all.13, 15, 16, [30]† The CDC estimates that
as many as 2,500,000 cases occur in the US, or about one for every 100 personsóevery
Infestation rates of 50 percent of the children in day care
centers across the country have been noted, with many being asymptomatic. href="#_edn32" name="_ednref32" title="">[32]† Institutions for
mentally retarded persons can have high rates.† Other high-rate populations
include promiscuous male homosexuals, international travelers, and patients
with cystic fibrosis.† And family members of these individuals.
In an incident in New Jersey a child had a ìfecal accidentî
in a community swimming pool, and nine swimmers came down with the disease.[33]†
How many Giardia cysts might have been involved?† The number of cysts
shed in feces is highly variable but has been estimated as high as 900 million
a day for a human.24
Municipal water utilities must use filters to remove the
organism.† San Francisco city water, coming primarily from the Hetch Hetchy
watershed in Yosemite National Park, tested positive for Giardia about
23 percent of the time in 2000, although at very low levels:† fewer than 0.12
cysts per liter[iii]. name="_Ref527265631">† This water is of such high quality that the US Environmental
Protection Agency and the California Department of Health Services have granted
Hetch Hetchy water a filtration exemption, meaning that filtration treatment
to ensure its safety from Giardia and other organisms is not required.[34]†
The city of Fairfield, 45 miles northeast of San Francisco,
stated in 2001, ìGiardia cysts were detected three times at levels of
0.19, 0.21 and 0.50 cysts per liter.† At these levels, the source water is considered
an insignificant risk for Giardia.î [35]
The Los Angeles Aqueduct, which transports water to that
city from the eastern slopes of the Sierra Nevadaówhere many wilderness visitors
obtain their water directlyóaverages an even lower 0.03 cysts per liter.[36]†
Of course, there
are contaminants other than Giardia to worry about, and most water districts
treat their water before distribution.
Drinking contaminated water is one way to get the disease.†
Less common in developed countries is direct passage from stool to the hands
of a food preparer and then to the food itself.† When 16 people got sick from
the salad at a Connecticut picnic, the CDC tracked the source to a woman who
had mixed the salad with her hands.† She didnít have giardiasis, but one of
her children didówithout any symptoms.19† A similar
situation occurred in New Jersey, with the salad preparer testing positive for
Giardia along with her child and pet rabbit.[37]†
There is accumulating data that Giardia is one of
the most common parasites of companion animals throughout the world.† The problem
is greater in multi-pet homes, due to the ease of infection from one pet to
anotherómore so if the pets come in contact with animals outside the home.14† And, because
of the generally close and frequent contact with their pets, it is easy for
infections to flow to household members.
Commercially prepared food can sometimes be tainted if it
is moist and not cooked.† For example, one outbreak of giardiasis was traced
to Giardia in canned salmon. href="#_edn38" name="_ednref38" title="">[38]
Contaminated food may be an unlikely source for the general
population in this country but, for wilderness visitors, it may be the most
common one.† Put another way:† If the water is cleanóa topic explored in this
paperófood-borne and direct fecal-oral routes are the only pathways.
On a climbing expedition to Tibet in 1993, members of our
party came down again and again with what was undoubtedly giardiasis.† Our water
came from glacial melt, but all our food in advanced base camp and below was
prepared by Sherpa cooks.† Most of the food they preparedópotatoes, rice, cauliflower,
cabbage, onionsócame from Nepal.† We were continually assured that the cooks
were practic≠ing good hygiene, yet we had major intestinal problems that prevented
many of the participants from getting high on the mountain.
The disease has been referred to as ìbeaver feverî because
of a presumed link to those water-dwelling animals known to be carriers.† However,
it now appears that it is more likely that humans have carried the parasite
into the wilderness and that beavers may actually be the victims.† In particular,
there is a growing amount of data showing that beavers living downstream from
campgrounds have a high Giardia infection rate compared with a near-zero
rate for beavers living in more remote areas.†
In either case, beavers can and do contract giardiasis.†
Being water-dwellers, they are able to contaminate water more directly than
an animal that defecates on the ground.
Other animals that can harbor Giardia lamblia are
bighorn sheep, cats, cattle, coyotes, deer, dogs, elk, muskrats, pet rabbits,
pigs, raccoons and squirrels.† But naturally occurring infec≠tions have not
been found in most wild animals including badgers, bears, bobcats, ferrets,
lynxes, marmots, moose, porcupines, skunks and wild rabbits.† Horses and domestic
sheep were once thought to be Giardia-free, but more recent studies have
shown that they can be infected.15, [39],
Most strains
of Giardia lamblia in animals can cause human infections, but some (e.g.,
in pigs) are apparently unlikely to do so.16
If ìItís everywhere!î
why is it not more of a problem?
The good news:† Most of the time, the concentration of Giardia cysts is very low 2, 9, 11
Outside of places where ìfecal accidentsî occur, dirty diapers
congregate, and cities where water treatment plants break down or are ineffective,
there is little room to worry.† A few Giardia cysts will cause no harm,
and in fact may be useful in acquiring immunity to the disease.
How many cysts does it take to get the disease?† Theoretically,
only one.† But there are no documented cases of giardiasis being contracted
from such low levels.8†
Volunteer studies have shown that 10 or more are required to have a reasonable
probability of it, with about one-third of persons ingesting 10 ñ 25 cysts getting
detectable cysts in their stools.9,
10, 11,
13, name="_ednref41" title="">[41], [42]
But be careful with statistics:† Animal droppings containing
100,000 Giardia cysts deposited at the edge of a 10 million liter lake
may be an average of only 0.01 per liter for the lake as a whole, but in the
immediate vicinity of the deposit, the concentration can be much greater.
A comforting observation is that significant cyst inactivation,
as high as 99.9 percent, can occur as a result of anaerobic digestion in sewage
sludge.[43]† Using
a simple cat hole is not exactly a good approxima≠tion to the sewage plant process,
but this points out the wisdom of burying it.† On the other hand, cysts perish
in a day or less on dry surfaces or when frozen,15, 16
so leaving it exposed to air makes some sense when burial is not feasibleóespecially
when below-freezing temperatures are expected.
Since cysts that ìwinter overî in the Sierra Nevada are
either in liquid water for considerably more than 2 to 3 months, or exposed
to freezing temperatures, fewóif anyósurvive the harsh Sierra winters.† So,
except for pollution by winter visitors and non-hibernating animals, Giardia
contamination in the high country must begin essentially anew each spring.
The viability of Giardia cysts found in water is
commonly assumed to be high, but monitoring experiments suggest otherwise.†
Subsequent to a drinking water outbreak in Ontario, Canada, in 1994, approximately
half of the cysts found were dead. href="#_edn44" name="_ednref44" title="">[44]
More good news:† If you get a Giardia infection, you are unlikely to have symptoms
2, 9, 10, 21, 22, [45], [46]
The symptoms of giardiasis vary widely.† Characteristic
symptoms, when they occur, are mild to moderate abdominal discomfort, abdominal
distention due to increased intestinal gas, sulfurous or ìrotten eggî burps,
horrific flatulence, and mild to moderate diarrhea.† Stools are soft (but not
liquid), bulky, and foul smelling.† They have been described as greasy and frothy,
and they float on the surface of water.† Nausea, weakness, and loss of appetite
may occur, but fever is uncommon.† Studies have shown that giardiasis can be
suspected when the illness lasts seven or more days with at least two of the
above symptoms.10
However, most infected individuals have no symptoms at all.†
In a 1977 incident carefully studied by the CDC, disruption in the Berlin, New
Hampshireís water disinfection system allowed the entire population to consume
water heavily contaminated with Giardia.† Yet only 11 percent of the
exposed population developed symptoms even though 46 percent had organisms in
their stools.† These figures suggest that (a) even when ingesting large amounts
of the parasite, the chance of contracting giardiasis is less than 1 in 2, and
(b) if you are one of the unlucky ones to contract it, the chance of having
symptoms is less than 1 in 4.† But perhaps the most useful statistic is that
drinking heavily contaminated water resulted in symptoms of giardiasis
in only 1 case in 9. 2, 8, [47]†
If you have symptoms it may not be giardiasis 2, 10, 19, 22, [48]
Many people claim that they ìgot itî on a particular trip
into the wilderness.† Yet, upon questioning, they usually report that the presence
of Giardia was not confirmed in the laboratory.† (Only 8 percent of persons
with a diarrheal illness in this country seek medical care.31)† Depending
on the situation, other likely offenders are Campylobacter, Cryptosporidium,
Salmonella, Shigella, Yersinia, Aeromonas, Clostridia,
and some strains of Escherichia coli, with the last being the most common
cause of travelerís diarrhea worldwide.† Food poisoning is also a possibility.
Cryptosporidiosis, in particular, is a growing problem in
this country and, currently, there is no effective treatment for it.† An outbreak
in Milwaukee in 1993 caused 403,000 people to become ill and 100 to die.† A
year later, 43 people in Las Vegas died from the same disease.29†
The severity of cryptosporidio≠sis depends on the condition
of the hostís immune system.† In immu≠nologically normal people, symptoms and
duration are similar to those of giardiasis.† But in persons whose immune systems
have been compromised (e.g., AIDS victims), symptoms can be profound:† Frequent
(up to 25), voluminous (up to 25 liters) daily bowel movements, serious weight
loss, and cyst shedding often persist for months.
The diarrhea being blamed on Giardia from that Sierra
trip a week ago may instead be due to some spoiled food eaten last night or
Campylobacter in undercooked chicken four days ago.† Or, because the
incubation period is usually from one to four weeks, even if it is giardiasis
the uncertainty range indicates that the perpetrators could have been ingested
anytime during a full three-weeks worth of meals and beverages.† People in high-risk
groups for Giardia, such as family members of children in day care centers
or promiscuous male homosexuals, have even more possible sources to consider.†
To indict a particular wilderness stream or lake under such circumstances, without
being able to at least verify that cysts are indeed there at all, is illogical
at best.
The type of diarrhea can help in the diagnosis:† If it is
liquid and mixes readily with water rather than floating on top, and is not
particularly foul smelling, the problem is likely something other than giardiasis.†
Diarrhea that lasts less than a week, untreated, is probably not from giardiasis.
Almost always, giardiasis goes away without treatment 2, 9, 10, 19, 20, 21, 45,
[49], [50]
If you are unlucky enough to get giardiasis with symptoms,
the symptoms will probably be gone in a week or so without treatment.† You may
still be harboring the cysts, however, and can unknowingly spread the disease.†
Thus, practicing commonly recommended wilderness sanitary habitsódefecating
100 feet from water, burying or packing out feces and toilet paper, washing
before handling food, etc.óis an excellent idea.
Looking for cysts and trophozoites in stool specimens under
the microscopic has been the traditional method for diagnosing giardiasis, but
it is notoriously unreliable.† Now, however, an immunologic test (enzyme-linked
immunosorbent assay or ELISA) for the detection of Giardia antigens in
stool samples is available.† The antigens are present only if there is a Giardia
infection.† ELISA is a big improvement over the microscopic search, with detection
sensitivities of 90 percent or more.
Rare individuals not only do not spontaneously rid themselves
of the organisms, but instead develop serious symptoms of malabsorption, weight
loss, ulcer-like stomach pain, and other chronic disturbances.† Fortu≠nately,
this occurs in less than 1 percent of those with infestations.† These unlucky
people need medical treatment.
Metronidazole (Flagyl) has been the standard medication,
with about a 92 percent cure rate.† Recommended by the CDC, it is not approved
by the US Food and Drug Administration for giardiasis because it can have some
serious side effects and is potentially carcinogenic.† Quinacrine (Atabrine)
and furazolidone (Furoxone) are also prescribed.† Tinidazole (Tinebah) is highly
effective in single doses and is widely used throughout the world, but it is
not available in the US; it can be purchased over-the-counter in many developing
countries.10, 31
The problem may not be whether you are infected with the
parasite but how harmoniously you both can live together.† And how to get rid
of the parasite when the harmony does not exist or is lost.9
More on immunity 51
The FDA, observing that giardiasis is more prevalent in children than adults, has long suggested that
many individuals seem to have a lasting immunity after infection.52† Furthermore, citizens of cities and
countries where the parasite is numerous have few if any problems with their own water, which also
points to acquired immunity.
If immunity can be acquired, might a vaccine be developed to counter Giardia?† The subject has been
explored successfully, and such a vaccine is now commercially available for dogs and cats.14,
[53]† Effective agents for the vaccine
have been prepared from antigens on the surface of trophozoites, as well as
from whole trophozoites themselves.† Human response to these antigens has been
studied and found promising.[54]
Giardiasis has been called a disease of ìsomes.î† Some people
do not contract it even from heavily contaminated sources.† Some infestations
vanish with no treatment at all.† Some people become asymp≠tomatic carriers.†
There is some evidence that some people acquire a natural immunity to some strains.†
And some strains seem more virulent than others. 16,
SoÖwhat about the Sierra
Nevada? 2,
9, 10,
11, 20,
In 1984, the US Geological Survey, in cooperation with the
California Department of Public Health, examined water at 69 Sierra Nevada stream
sites that were selected in consultation with Park Service and National Forest
managers.[55], [56]† Forty-two
of the stream sites were considered ìhigh-useî (high probabil≠ity of human fecal
contamination), and 27 were ìlow-use.î† Cysts were found at only 18 (43 percent)
of the high-use sites and at 5 (19 percent) of the low-use sites.† The highest
concentration of Giardia cysts was 0.108 per liter of water in Susie
Lake, south of Lake Tahoe.† The next highest was 0.037 per liter near Long Lake,
south≠west of Bishop.† Samples taken in the Mt. Whitney area varied from 0 (most
sites) to 0.013 (Lone Pine Creek at Trail Camp) per liter.† The concentration
was 0.003 per liter in Lone Pine Creek at Whitney Portal.
Recall that San Francisco water can contain a concentration
approaching 0.12 cysts per liter, a figure now seen to be higher than that measured
anywhere in the Sierra.† San Francisco city officials go to great lengths to
assure their citizens that the water is safe to drink and, if trueóas it most
assuredly must beóthis comparison is quite revealing.
If San Francisco water is reasonably pure, Los Angeles Aqueduct
water is even more so, with only 0.03 cysts per liter.36†
But 0.03 cysts per liter is a higher concentration of Giardia than all
but two of the 69 Sierra sites examined in 1984.† Los Angeles Aqueduct water
is collected from the streams of the eastern slopes of the Sierra:† the very
streams some people worry about when visiting those wilderness areas.† It is
interesting to conjecture how individual water sources in the eastern High Sierra
can be seriously contaminated, if those sources are at the same time providing
almost perfectly pure water for the aqueduct.
Taking the highest concentration measured in the Sierra
(0.108), we can make some calculations.† The probability[iv]
of finding 10 or more cysts in a liter of wateróto have at least a one-third
chance of contract≠ing giardiasisóis about 10-17.† Ten cysts in 10
liters of water, about 10-7.† In fact, one would have to drink over
89 liters to have a 50 percent probability of ingesting 10 or more cysts.
A word of caution:† 1984 was quite a while ago, and areas
of the Sierra may be differ≠ently contaminated now:† some perhaps more and some
perhaps less, depending on visitor population statistics.
Another reason for caution:† A cyst does not just materialize,
here and there, now and then.† It was deposited by a mammal at a specific location
in the space of a few seconds, along with many of its companions.† They were
then dispersed by the dynamic actions of water and wind, with some being killed
by freezing, drying or aging, to eventually reach these low concentrations.†
The person, who fills his canteen too close to that location and too soon after
the deposit, is unlucky indeed.† Fortunately, the fact that people rarely contract
giardiasis after wilderness visits means that this is not at all common.† Later,
some tips on ìdrinking smartî will be given to further reduce this already-minuscule
And another:† While so much attention is being given to
Giardia, there are more serious organisms to worry about such as Campylobacter,
Cryptosporidia, E. coli and the others mentioned earlier.† But
are these likely to be found either?† While it is easy to conjecture about such
organisms in High Sierra water, and many people do, searching for evidence of
it is fruitless.† Each year the CDC documents many disease outbreaks involving
recreational water, but almost all occur from swimming pools, hot tubs and water
parks.† Some do occur from lakes, streams and rivers, but these are all at elevations
of a few thousand feet or lower.† If people are contracting these diseases from
water sources like the High Sierra, or measuring contaminants in them, they
certainly arenít reporting it (see, for example, References 28
and 29).
A valid claim that giardiasis (or any disease) was contracted
from a specific water source requires affirmative answers to each of the following
questions:† (1) Was the presence of Giardia confirmed in the laboratory?†
(2) Was the person Giardia-free prior to drinking it?† (3) Did the suspect
water source contain Giardia cysts in sufficient numbers to cause the
disease?† The answer to question (1) is easily obtained, and that to question
(2) can usually, but not always, be presumed.† In the case of wilderness water,
however, the answer to question (3) is virtually never pursued.†
In an informative study, investigators
contacted thousands of visitors to one of the high-use sites during the summers
of 1988 through 1990.† Water samples taken on 10 different dates at each of
three locations exhibited Giardia cyst concentrations between 0 and 0.062
(average 0.009) per liter.† A goal was to enlist volunteers who were cyst-negative
before their trip, verified by stool analysis, and later determine what fraction
were cyst carriers after the trip.† Unfortu≠nately, stool collection is not
a particularly enjoyable task, and only 41 people agreed to participate.† Of
these, two acquired Giardia cysts during their trip, but neither came
down with symptoms.† Six of the others exhibited post-visit intestinal symptoms,
but none tested positive for Giardia (interestingly, all six had filtered
their water).† In sum, no cases of laboratory-confirmed symptomatic giardiasis
were found. name="_Ref528281379"> name="_ednref57" title="">[57]
Beyond the Sierra
Outside of the Sierra, Giardia cysts in concentrations
ìas high as four per gallonî [v]
have been detected in untreated water in northeastern and western states.[58]†
But, even with this concentration, one would have to consume over nine liters
of water to have a 50 percent chance of ingesting 10 or more cysts.
Indeed, there may be as much unwarranted hysteria surrounding
Giardia in wilderness water in these other areas as there is for the
Sierra.† For example, an oft-cited report describing acquisition of the disease
by 65 percent of a group of students hiking in the Uinta Mountains of Utah href="#_edn59" name="_ednref59" title="">[59] is now viewed with
considerable skepticism.† Specifically, the attack rate of 65% was far beyond
that usually seen with water-contracted giardiasis, no cysts were identified
in the suspect water, there was no association between water consumption rates
and the likelihood of the disease, and the authors categori≠cally discounted
food-borne or fecal-oral spread, stating that it had never been reported (which
was correct at the time).3
Summary figures
Here are some of the figures
discussed in various places above.† Units are cysts per liter.
Table 3.† Giardia Cyst Concentrations Discussed in This Report
If not from the water, from where?
The water that wilderness travelers are apt to drink, assuming that they use a little care, seems almost
universally safe as far as Giardia is concerned. The study referred to earlier,3
in which the researchers
concluded that the risk of contracting giardiasis in the wilderness is similar
to that of a shark attack, is telling.† What they did find is that Giardia
and other intestinal bugs are for the most part spread by direct fecal-oral
or food-borne transmission, not by contaminated drinking water.† Since personal
hygiene often takes a backseat when camping, the possibility of contracting
giardiasis from someone in your own partyósomeone who is asymptomatic, probablyóis
real.† Recalling that up to 7 percent of Americans, or up to 1 in 14, are infected,
it is not surprising that wilderness visitors can indeed come home with a case
of giardiasis, contracted not from the waterÖbut from one of their friends.
This theme, that reduced attention to personal hygiene is
an important factor for contracting giardiasis in the wilderness, is becoming
more frequent in the literature.3, 13, 20, 57, [60]
Personal observations
I started visiting the Sierra Nevada in the early 1950s
and have spent much of my free time there.† I have never treated the water,
and I have never had symptoms of giardiasis as a consequence of my visits.†
My many similarly active friends and acquaintances also drink the water, in
the High Sierra and elsewhere, with no ill effects.† But we are always careful
to ìdrink smartî:†
- Drink from large streams whenever possible, preferably those entering
from the side rather than those paralleling the trail.†
- Water in fast-flowing streams is safer because any contaminants
present at any location are swept downstream, being quickly displaced by presumably
clean water from above.[vii]
- Water at higher elevations
is safer, partly because of reduced human and animal presence, and partly because
water flowing to lower elevations has a chance to pick up more contaminants
the farther it travels.
- Taking water from a lake is best advised at the inlet, with the
next best place at the outlet.† Inlet water has a tendency to flow somewhat
directly to the outlet, undergoing little mixing with the lake water as a whole.
- Few Giardia cysts survive harsh Sierra winters.† Contamina≠tion
begins essentially anew each year, so springtime water is safer than summer
or fall.
- The colder the water is, the more likely it is freshly melted,
meaning less opportunity for contamina≠tion.†
- Because filtration of water through soil removes Giardia
cysts, deep well water is considered safe.10†
By implication, springs in the wilderness should be, too.
- One would think that, after a heavy snow year when streams run
full and long, some kind of ìflushing outî of lakes and streams must be occurring.†
Conversely, it makes sense to be more cautious in dry years.
- Avoid water that likely could have passed through an area subject
to heavy human or animal use.†
- If it doesnít look
goodóitís cloudy or has surface foamótreat it or donít drink it.
If in doubt, treat itóbut how?† While useful in many instances,
chlorine is not very effective for Giardia disinfection, which is why
swimming pools are primary sources for the disease.† The best filters work,
although they are costly, heavy, and bulky, and many are somewhat awkward to
use.11, [61]
Boiling is usually inconvenient, but if you are preparing
hot water for meals anyway, you may as well take advantage.† Giardia
cysts are highly susceptible to heat, and simply bringing water to 150∞ F. for
five minutes, 176∞ for a minute, or 190∞ momentarily, will kill them.11,
But boiling for a few minutes is usually recommended because of the other organisms
that may be present.† At 10,000 feet elevation, water boils at 194∞; at 14,000
feet, 187∞; so longer boiling times are recommended at altitude.
Iodine is perhaps the best treatment choice, being inexpensive,
convenient, and safe.† Iodine is effective against most bacteria and viruses,
tooóand over a wide range of temperatures.† But Cryptosporidium may be
resistant to iodine.† A popular system uses iodine crystals in a saturated water
solution.† Methods exist to mask or remove the iodine taste.
Does it matter what the organism is, if you are going to
treat the water anyway?† Filters effective for Giardia (a protozoan)
are not always effective for Campylobacter (a bacterium).† Chlorine may
work against Campylobacter, but most of the time is ineffective against
Giardia.† You need to know your enemy.
Advice for visitors
On the subject of drinking water safety in the Sierra Nevada,
we are told,† ìAn intestinal disorder called giardiasis may be contracted from
drinking untreated ënaturalí water. This disorder is caused by a microscopic
organism, Giardia lamblia, the cystic form of which is often found in
mountain streams and lakes. Such waters may look, smell and taste good,
but you should be aware of possible danger.î name="_Ref41729565"> name="_ednref62" title="">[62]† We are instructed to filter or boil
all drinking water.62, [63]
Many people make the leap to a belief, approaching paranoia,
that every water source is seriously contaminated.† I have seen day hikers to
Mt. Whitney carrying 3 gallons of water from the grocery store.† I have seen
people filtering water for washing their dishes.† If their filter breaks down
on a hike, some will endure thirst in their rush to camp to boil water, passing
pristine streams along the way.† They do not trust fresh snow, and they certainly
do not trust the trickles coming from it.†
In 2001 I wrote to the Inyo National Forest office, asking
for evidence that the water quality could be as questionable as they suggest.†
The Forest Supervisor wrote back: †ìAs to whether or not Giardia exists
in the Sierra, we are not in a position to state a fact one way or the other.î[64]†
This is a significant admission.† So why do they persist in informing everyone
that giardiasis is a potential hazard when visiting the Sierra Nevada?
First:† They know that some waters can be contaminated by
something, and Giardia is the organism on peopleís minds so needs no
elaboration.† Contaminated water, with Giardia or otherwise, is certainly
possible at lower elevations and in some locales.† Noting that novice hikers
in particular cannot be expected to make correct choices of which sources may
be safe to drink, they suggest treating all water.†
Second:† If a person believes, albeit incorrectly, that
they contracted giardiasis from Sierra Nevada water, they cannot claim they
werenít informed.† Potential confrontations are therefore avoided.
Third:† It is the CDCís Division of Parasitic Diseases that
advises the national park and forest managers in devising and revising those
agenciesí warnings and recommendations.8† It is
not surprising that this office would take a very conservative stance.
Unfortunately, the result is an incorrect perception of
overall water quality in the Sierra by the general public, tainting the image
of this pristine wilderness.† It also means that if someone contracts a gastrointestinal
illness after a visit, they will be more apt to blame the water, having been
ìforewarnedî that all water is suspect.† And so the egregious myth is perpetuated.
But what do rangers say off the record, and what practices
do they themselves follow?† Here are three data points:
- At a National Forest display booth recently, I approached a wilderness
ranger I was acquainted with, one who had spent a lot of time in the Mt. Whitney
district.† The rangerís initial greeting was ìYou are right on about the water.†
Itís just that, as an agency, we canít say it.† I havenít filtered water up
there for years.î [65]
- After reading the then-current version of this paper, a National
Park ranger wrote me ìI've been a backcountry ranger in Sequoia and Kings Parks
for 30 years, and your article matches my experience.† My wife and I have never
treated the water.î† He went on to say that almost none of the backcountry professionals
heís worked with over the years do, either. href="#_edn66" name="_ednref66" title="">[66]
- One of my long-time climbing companions recently retired from
the Inyo National Forest after 34 years, much of it as a wilderness ranger.†
My friend and I have always followed the same protocols regarding the water.
Untreated Sierra Nevada water is, almost everywhere, safe
to drinkóif you ìdrink smart.î† If you donít ìdrink smartî you may ingest diarrhea-causing
organisms.† But they almost certainly wonít be Giardia.†
Still, because up to 1 in 14 of us carries the Giardia
parasite, we all need to do what we can to keep the water pure.† Defecate away
from water, and bury it or carry it out.
Camp cooks in particular need to pay special attention to
cleanliness.† Wash hands thoroughly, especially before handling utensils and
preparing meals.†
In summary:† High Sierra water has too few Giardia
cysts to pose a genuine risk.† Even if you drink water elsewhere where the concentration
is high, you probably wonít get giardiasis.† If you do get giardiasis, you probably
wonít have any symptoms.† If you have symptoms, they will probably go away by
them≠selves in a week or so.† If they donít or you develop serious persistent
symptoms, you should seek medical treatment.† Finally, those contracting giardiasis
may develop immunity to it, thus lowering the likelihood that they will get
it again.
There is certainly no reason for anxiety about giardiasis.†
Less than 1 percent of those who have an infestation, or about 5 percent of
those with symptoms, needs medical help.
Closing thoughts
Wilderness managers are in a position to educate the outdoor public about the real culprit in the
Giardia lamblia story:† inadequate human hygiene.† When they acknowledge that Sierra Nevada water
has fewer Giardia cysts than, for example, the municipal water supply of the city of San Francisco,
maybe they will turn their attention to it.† The thrust of the following observation is long overdue:
- ìGiven
the casual approach to personal hygiene that characterizes most backpacking
treks, hand washing is likely to be a much more useful preventative strategy
(for Giardia) than water disinfection! title="">[viii]† This simple expedient,
strictly enforced in health care, child care, and food service settings, is
rarely mentioned in wilderness education materials.î 3
We are cautioned, ìWilderness water might be contaminated,
so you should always treat it.î† Given the well-documented instances when municipal
water treatment systems have failed or been contaminated, the same warning could
apply to drinking waterówith much more validity.† But the government does not
say, ìDrinking water might be contaminated, so you should always treat it.î†
Nor should they.† We fill our glass from the tap without concern, well aware
that on rare occasions our confidence is breached.† We accept the minuscule
Yet a few Giardia cysts are found in some wilderness
waters, with no evidence that it is even remotely a problem, and an all-encompassing
warning is issued.†
How much more useful, candid and factual information would
About the author
The author is an active mountaineer who made his first trip
into the Sierra Nevada in 1952 to climb Mt. Whitney, and he repeats this climb
several times annually.† He has a bachelorís degree in Physics from UC-Berkeley,
and a PhD in Aeronautical and Astronautical Engineering from Stanford University.†
In the course of making well over a thousand ascents of hundreds of individual
Sierra Nevada mountains, he has never filtered or otherwise treated the water,
and he has never contracted symptoms of giardiasis.† Retired since 1990, he
is now able to fully indulge in his favorite pastime and spends more time up
there, drinking freely out of the lakes and streams, than ever before.
Erlandsen, S. L. et al:† Investigation into the Life Cycle of Giardia Using
Videomicroscopy and Field Emission SEM.† In Giardia, The Cosmopolitan
Parasite, edited by B. E. Olson, M. E. Olson and P. M. Wallis.† CABI Publishing,
Wilkerson, James A.:† Medicine for Mountaineering and Other Wilderness
Activities. The Mountaineers, 4th edition, 1992
Welch, Thomas R. and Welch, Timothy P.:† Giardiasis as a Threat to Backpackers
in the United States:† A Survey of State Health Departments. Wilderness
and Environmental Medicine, Vol. 6, 1995
Rockwell, Bob:† Giardiasis:† Letís Be Rational About It.† Summit Magazine,
Nov./Dec. 1987
Rockwell, Bob:† Giardia Lamblia and Giardiasis, with Implications for Sierra
Nevada Visitors. California Mountaineering Club Newsletter, Vol. 7 no.
2, April 1996
Rockwell, Bob:† Giardia Update. California Mountaineering Club Newsletter,
Vol. 8 no. 2, April 1997
Rockwell, Robert L.:† Giardia Lamblia and Giardiasis, With Particular Attention
to the Sierra Nevada. Unpublished note, 18 October 2001
Thompson, Kalee:† Water Wary?† Your Backcountry H2O May be Safer
Than You Think. National Geographic Adventure, June/July 2002
Juranek, Dennis D.:† Giardiasis.† Centers for Disease Control and Prevention,
Swartz, Morton N.:† Intestinal Protozoan Infections.† Scientific American
Medicine, 1994
Kerasote, Ted:† Great Outdoors; Drops to Drink.† Audubon, July 1986
EOA, Inc.:† Microbial Risk Assessment for Reclaimed Water. †Final Report.†
Prepared in Association with the University of California School of Public
Health, Oakland, CA.† May 1995
Backer, Howard D.:† Giardiasis:† An Elusive Cause of Gastrointestinal Distress.
†The Physician and Sportsmedicine, Vol. 28 no. 7, July 2000
Thompson, R. C. A.: Towards a Better Understanding of Host Specificity
and the Transmission of Giardia:† the Impact of Molecular Epidemiology.†
In Giardia, The Cosmopolitan Parasite, edited by B. E. Olson, M. E. Olson
and P. M. Wallis.† CABI Publishing, 2002.
DeReigner D. P., et al:† Viability of Giardia Cysts Suspended in Lake,
River, and Tap Water.† Applied Environmental Microbiology, Vol. 55 no.
5, 1989
Olson, M. E:† Human and Animal Pathogens in Manure.† Conference on
Livestock Options for the Future.† Winnepeg, Manitoba, June 2001
Olsen, M. E., et al:† Survival of Giardia Cysts and Cryptosporidium Oocysts
in Water, Soil and Cattle Feces.† American Association of Veterinary Parasitologists,
43rd Annual Meeting, 1998
[18] National Food
Processors Institute: †Fact Sheet on Enteric Protozoa and the Food Industry.†
October 1998.
Moser, Penny Ward:† Danger in Diaperland.† Health, September/October
Suk, Thomas:† Eat, Drink and Be Wary.† California Wilderness Coalition
Berkow, Robert, MD, Editor:† Parasitic InfectionsóGiardiasis.† The
Merck Manual, 14th edition, 1997
Wilkerson, James and Caulfield, Page:† Wilderness Water Disinfection.†
Appalachia, No. 4, Winter 1985-86
Bemrick, W. J.:† Some Perspectives on the Transmission of Giardiasis.†
Giardia and Giardiasis: Biology, Pathogenesis and Epidemiology, edited
by Erlandsen and Meyer, Plenum Press, 1984
[24] Feachem, R. G., et al:† Sanitation and Disease: Health Aspects of Excreta and Wastewater Management.† John Wiley and Sons, 1983
of California Department of Public Health: †Communicable Diseases in California,
1994, 1995. †
Erlandsen, S. L. and Bemrick, W. J.:† Waterborne Giardiasis:† Sources of
Giardia Cysts and Evidence Pertaining to their Implication in Human Infection.†
In Advances in Giardia Research, edited by P. M. Wallis and B. R. Hammond.†
University of Calgary Press, 1988.
Vitusis, Ziegfried, chief microbiologist at the EPA.† Quoted in Backpacker,
Dec. 1996
Lee, S. H. et al:† Surveillance for Waterborne-Disease OutbreaksóUnited
States, 1999-2000.† Centers for Disease Control and Prevention, November
22, 2002
Kramer, Michael H. et al:† Surveillance for Water-Borne Disease OutbreaksóUnited
States, 1993-1994.† Centers for Disease Control and Prevention, 1996
Kappus KD, Lundgren RG and Juranek DD:† Intestinal Parasitism in the United
States: Update on a Continuing Problem.† American Journal of Tropical
Medicine and Hygiene. Vol. 60 no. 6, 1994
Centers for Disease Control and Prevention:† Giardiasis SurveillanceóUnited
States, 1992ó1997.† August 2000.
Pickering, L. K. et al:† Occurrence of Giardia lamblia in Children in Day
Care Centers.† Journal of Pediatrics, Vol. 104, 1984
Porter, J. D. et al:† Giardia Transmission in a Swimming Pool. American
Journal of Public Health, Vol. 78 no. 6, 1988
Stanford Utilities Division and San Francisco Public Utilities
Commission: †2000 Annual Water Quality Report.
[35] City of Fairfield, California:
†2001 Water Quality Report.†
Los Angeles Department of Water and Power:† Annual Water Quality Report
for 2000.†
Bean, N. H., PhD et al:† Foodborne Disease Outbreaks, 5-year Summary, 1983
ñ 1987.† Centers for Disease Control and Prevention, March 1990
Osterholm, M. T. et al:† An Outbreak of Foodborne Giardiasis.† The
New England Journal of Medicine, Vol. 304, 1981
University of California Agriculture and Natural Resources:† Giardia and
Cryptosporidium Levels are Low in Sierra Nevada Pack Stock.† News Tips,
December 1999
OíHandley, R. M.: Giardia in Farm Animals. In Giardia, The Cosmopolitan
Parasite, edited by B. E. Olson, M. E. Olson and P. M. Wallis.† CABI Publishing,
[41] Ortega, Y.R. et al:† Giardia:
Overview and update. Clinical Infectious Diseases, Vol. 25, 1997
Rendtorff, R:† The Experimental Transmission of Human Intestinal Protozoan
Parasites. †American Journal of Hygiene, Vol. 59, 1954
[43] Cravaghan, P. D., et al:† Inactivation of Giardia by Anaerobic Digestion of Sludge.† Water Science Technology, Vol. 27, 1993†††
Wallis, P. M. et al:† Risk Assessment for Waterborne Giardiasis and Cryptosporidiosis
in Canada.† Unpublished report to Health Canada, 1995
[45] Mayo Clinic Family Health
Book. Mayo Clinic Foundation for Medical Education and Research, 1996
Tintinalli, J. et al, editors:† Parasites:† Giardia Lamblia.† Emergency
Medicine, 3rd edition, 1995
Lippy, E. C.:† Tracing a Giardiasis Outbreak at Berlin, New Hampshire.†
Journal of the American Waterworks Association, Vol. 70, 1978
Soave, Rosemary:† Cryptosporidiosis.† Textbook of Medicine, edited
by James B. Wyngaarden et al, 1991
Peter, G., MD, editor:† Chapter 3: Summaries of Infectious Diseases. †American
Academy of Pediatrics. 1994 Red Book:† Report of the Committee on Infectious
Heyworth, M. F.:† Immunology of Giardia Infections.† In Advances in
Giardia Research, edited by P. M. Wallis and B. R. Hammond.† University of
Calgary Press, 1988.
Olson, M. E. et all: Giardia Immunoprophylaxis and Immunotherapy.†
In Giardia, The Cosmopolitan Parasite, edited by B. E. Olson, M. E. Olson
and P. M. Wallis.† CABI Publishing, 2002.
US Food & Drug Administration:† The Bad Bug Book.† Center for Food
Safety & Applied Nutrition, 2001.
Olson, M. E. and Morck, D. W.:† Giardia Vaccination.† Parasitology
Today, Vol. 16, No. 5, 2000
Ortega, M. G.:† The Response of Humans to Antigens of Giardia lamblia.†
In Advances in Giardia Research, edited by P. M. Wallis and B. R. Hammond.†
University of Calgary Press, 1988.
Dept. of the Interior, US Geological Survey:† Open File Report No. 86-404-W.†
Suk, T. J. et al:† The Relation between Human Presence and Occurrence of
Giardia Cysts in Streams in the Sierra Nevada, California.† Journal of
Freshwater Ecology, Vol. 4, No. 1, June 1987
Zell, S. C. and Sorenson, S. K.:† Cyst Acquisition Rate for Giardia Lamblia
in Backcountry Travelers to Desolation Wilderness, Lake Tahoe.† Journal
of Wilderness Medicine, No. 4, 1993
Ongerth, J. E. et al:† Backcountry Water Treatment to Prevent Giardiasis.†
American Journal of Public Health, Vol. 79 no. 12, 1989
Barbour, A. G. et al:† An Outbreak of Giardiasis in a Group of Campers.†
American Journal of Tropical Medicine and Hygiene, Vol. 25, 1976
Centers for Disease Control and Prevention:† Giardiasis Fact Sheet. †May
Gorman, Stephen:† Mountaincraft:† Water Treatment. Summit Magazine,
Fall 1993
[62] Inyo National Forest web
site: href="http://www.fs.fed.us/r5/inyo/water/r5/inyo/recreation/wild/safety.html">http://www.fs.fed.us/r5/inyo/water/r5/inyo/recreation/wild/safety.html.†
Modified March 26, 2003
US Forest Service:† Wilderness Ethics and Etiquette.† Inyo, Sierra and
Sequoia National Forests.† Brochure handed out with 2003 wilderness permits.
1994 (rev. 5/95)
Bailey, Jeffrey E., Forest Supervisor, Inyo National Forest.† Official correspondence,
File Code 2320, November 19, 2001
Informal discussion.† Eastern Sierra Mountainfest.† Bishop, California, October
25, 2002
Durkee, George, Sequoia National Park Backcountry Ranger.† Personal correspondence,
January 30, 2002
[i] Examples:
http://highadventure.bsadpc.org/wisdom. href="http://highadventure.bsadpc.org/wisdom.htm">htm and href="http://www.uoregon.edu/~opp/ws/wildsurvival.htm">http://www.uoregon.edu/~opp/ws/wildsurvival.htm.
When a reference number appears after the title of a section, such as here,
that reference has been used repeatedly within the section.† When a reference
number appears embedded in a section, information from that reference has
been used for that specific statement or concept.†
[iii] The referenced sources use a variety of units
for portraying cyst concentration:† cysts per 100 liters, per 100 gallons,
etc.† For uniformity, all have been converted to cysts per liter.
[iv] These calculations involve use of a mathematical
tool called the Poisson distribution.
[v] Quoted from the original.
[vi] If one liter is consumed.
[vii] ìIn rivers, the water that you touch is
the last of what has passed and the first of that which comes; so with present
time.îóLeonardo da Vinci
[viii] Emphasis is in the original.


text: Our highly qualified beauty therapists offer only the best in beauty treatments. Working with Environ Skincare products we can help with anti-aging, acne, dry skin and all your skin concerns. Our CND nail products, whether Shellac or Vinylux will leave you looking a million dollars. Whatever your beauty needs, our staff will always be on hand to offer help and advice. If you just need to relax our massage team will ensure you leave us stress free and totally chilled.


text:
This meme was my gateway drug to the Star Wars Meme universe, and I always snort-chuckle whenever I see it. Three things:
- A while ago I was watching AotC with my little sister and we kept laughing at how Obi-Wan always addresses Anakin with too many modifiers. "We will not exceed our mandate, my young padawan learner." "Only in your mind, my very young apprentice." For the next few days, every time we talked to each other my sister and I would extend this as much as possible. She asks for me to pass the salt, I respond with "Of course, my little tiny baby young child apprentice student padawan learner." This meme bastardizes the phrase "my young padawan" in the same way.
- This is that perfect balance of Dad Joke and Absurd that the internet, especially Tumblr, does so well. It is… an exquisite specimen.
- I feel a special connection to anyone who spends their free time badly photoshopping unflattering pictures of Anakin. I think said connection is the closest I'll ever get to the Force.


text:
For William Donnelly, the theater is a world of possibilities.
When the 41-year-old Shrewsbury dramatist works on a play, he says, �I like to let the subconscious do as much heavy lifting as possible.�
He is finding this to be as true about the rolling world premiere of his latest play �Homestead Crossing� � initially at the Berkshire Theatre Festival in Stockbridge, now at Merrimack Repertory Theatre in Lowell and soon at Portland Stage � as about the theater itself.
�I love the different possibilities that live in it,� he says.
Set in the study of a suburban home in an unspecified city and state, �Homestead Crossing� opens with a married couple � Noel and Anne � who have been married for 31 years and seem to be suffering from a kind of emotional inertia. In the back story, many days of heavy rain have been no help. In fact, Anne � in a Biblical illusion � hyperbolically calls for getting out the gopher wood, the material from which Noah built his ark. The entry of a spirited young woman named Claudia � and later her easy-going husband Tobin � serves as a catalyst for exploratory exchanges about life, reality and the future that call into question not only the character�s feelings and perceptions, but also those of the audience. Are all of the characters real? Is one couple a figment of the other couple�s imagination? Whose homestead is it? Theatergoers should enjoy trying to figure out the answers to these questions and the play�s messages about relationships.
The play may call to mind Edward Albee�s plays � for example the contrast of older and younger couples in �Who�s Afraid of Virginia Woolf� � and the seeming inertia of the host couple in �A Delicate Balance.� There is also an element of escape, as well as wittiness a la Noel Coward�s �Private Lives� (though Donnelly claims he was not thinking of Coward in naming the older man in his play Noel). In fact, Donnelly maintained that he was influenced more by Harold Pinter � specifically his play �Old Times� � than by Albee or Coward.
There�s something about the mystery in �Old Times,� he said, �because you�re starting in a world that�s very grounded.� The precariousness of that world apparently influenced Donnelly. �Somewhere along the way I became intrigued with the idea that the older couple (Noel and Anne) was the imaginary one,� he offered. Refraining from explaining a play with a multiplicity of interpretations, he chose to be more specific only about the setting. �I don�t usually specify the location,� he admitted. Still, �They (my plays) mostly feel like New England.� This has been the case with his 2006 Clauder Competition winner, �Magnetic North,� and generally so with both his other full-length plays, as well as short works produced at the Boston Playwrights Marathon in recent years.
With New England so much in his thinking about setting, it seems fitting that �Homestead Crossing� is moving to Portland Stage in Portland, Maine, next month after runs in Stockbridge and Lowell. The rolling premiere, he contended, �is a really interesting process. The director, Kyle Fabel, has a history with Merrimack and Berkshire Theatre Festival. The scenic designer, Anita Stewart, is artistic director at Portland Stage and works at the BTF. They all pooled their resources to get it down.�
Audiences should enjoy the evolving realities of �Homestead Crossing.� If Anita Stewart�s poetic set for the cozy suburban study suggests a warm port in a storm � here the formidable rainstorm seen through large windows, it also hints at shifting emotional landscapes. Fabel makes the play�s visit to those landscapes 90 minutes of insightful fun. While the resolution may seem a bit neat, the dialogue is crisp and the interactions of the characters always absorbing.
Fabel smoothly guides apparent homeowners Noel and Anne from an initial stasis to an awareness of the possibility of a second chance at adventure and shared excitement with the arrival of Claudia and Tobin, whose car has fallen victim to the storm. David Adkins captures Noel�s early grumpiness as well as his fascination with free-spirited and mysterious Claudia. Corinna May finds all of Anne�s opening spunkiness and her willingness to embrace Tobin�s nonchalance. Best are in a stellar quartet are Lesley Spires humorously talkative and gutsy Claudia and Ross Cowan�s charming if unpredictable Tobin.
Donnelly is a playwright whose talent deserves audience attention. Make sure you make a stop at the beautifully renovated Merrimack Repertory Theatre for his wonderfully grounded �Homestead Crossing.�
Donnelly began his theater work as an actor during his B.A. in communications (with concentration in theater) studies at Bridgewater State (now Bridgewater University) � in such productions as the Sondheim musical �Into the Woods� and the play �The Shadow Box.� As a dramatist, he served as resident playwright for the Taunton-based Industrial Theatre from 1997 to 2008 (Donnelly was raised in Taunton). His Natick-native wife Heather McNamara is an actress and a director. Donnelly called her his �go-to director� at Industrial Theatre. For now she is on hiatus from the theater with their two young children.


text: Music Video: Ariana Grande Ft. Iggy Azalea & Big Sean- Problem Ariana Grande and Iggy Azalea have released the official visuals for their #2 Billboard track, 'Problem'. The retro video also comes with a cameo from Big Sean. Check it out below! LEAVE A COMMENT comments ariana grande Big Sean Iggy Azalea Problem 2014-05-31 @Lee_Carrie Share Facebook Twitter Google + Stumbleupon LinkedIn Pinterest