This article was published in Scientific American’s former blog network and reflects the views of the author, not necessarily those of Scientific American
Editors note: Matty Litwack will be appearing live at the Laughing Devil Comedy Festival in New York City May 14-18.
One year ago, I thought I was going to die. Specifically, I believed an amoeba was eating my brain. As I've done countless times before, I called my mother in a panic: “Mom, I think I'm dying.” As she has done countless times before, she laughed at me. She doesn't really take me seriously anymore, because I'm a massive hypochondriac. If there exists a disease, I've probably convinced myself that I have it. Every time I have a cough, I assume it's lung cancer. One time I thought I had herpes, but it was just a piece of candy stuck to my face. In the case of the brain amoeba, however, I had a legitimate reason to believe I was dying.
Several days prior, I had visited a doctor to treat my nasal congestion. The doctor deemed my sickness not severe enough to warrant antibiotics and instead suggested I try a neti pot to clear up my congestion. A neti pot is a vessel shaped like a genie's lamp that's used to irrigate the sinuses with saline solution. My neti pot came with an instruction manual, which I immediately discarded. Why would I need instructions? Nasal irrigation seemed like a simple enough process: water goes up one nostril and flows down the other – that's just gravity. I dumped a bottle of natural spring water into the neti pot, mixed in some salt, shoved it in my nostril and started pouring. If there was in fact a genie living in the neti pot, I imagine this was very unpleasant for him.
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The pressure in my sinuses was instantly reduced. It worked so well that over the next couple of days, I was raving about neti pots to anybody who would allow me to annoy them. It was honestly surprising how little people wanted to hear about nasal irrigation. Some nodded politely, others asked me to stop talking about it, but one friend had a uniquely interesting reaction: “Oh, you're using a neti pot?” he asked. “Watch out for the brain-eating amoeba.” This was hands-down the strangest warning I had ever received. I assumed it was a joke, but I made a mental note to Google brain amoebas as soon as I was done proselytizing the masses on the merits of saltwater nose genies.
Not only are brain-eating amoebas (Naegleria fowleri) real and deadly, but there have been multiple cases of people contracting the amoeba while using neti pots. The Centers for Disease Control and Prevention (CDC) has several pages dedicated to N. fowleri infections. N. fowleri is a free-living amoeba commonly found in freshwater lakes, rivers and springs. Normally this amoeba subsists on other microbes, but it's also perfectly capable of eating brain tissue. Simply drinking some water contaminated with the amoeba is harmless, but when introduced into the nasal passages, N. fowleri can enter the brain, resulting in an infection called primary amoebic meningoencephalitis (PAM). PAM has a fatality rate greater than 99 percent, with symptoms similar to bacterial meningitis appearing within a few days and death within two weeks. I read all of this with terror, as just days earlier I had used natural spring water in my neti pot. I was positive that I had contracted the amoeba. It was at this point that I called my mother and listened to her laugh at me.
It had been a few days since I used the neti pot, so I assumed the amoeba was already wreaking havoc on my brain. I found myself questioning every decision I made: I’d skipped breakfast that morning, even though I never skip breakfast. Maybe the amoeba had already consumed the part of my brain that likes breakfast? I was also trying to figure out scenarios in which I might turn out ok. At the time I was in a physics PhD program – perhaps the amoeba would find my knowledge of physics boring and simply exit my skull with my brain left intact? As my anxiety turned into a full-blown panic, one thing became clear: I needed to know for certain whether I was infected. I couldn't just wait around for symptoms to appear, because the anxiety alone might actually kill me – as much as I appreciate irony, that's not how I want things to end.
I considered calling my doctor with my concerns, but I'm pretty sure he knows I'm a hypochondriac and would probably tell me I'm fine and then make fun of me to the nurses after I hung up. My only other option was to research the water bottle I had used to determine whether N. fowleri was present.
The CDC states that N. fowleri infection via nasal irrigation can be prevented by using pre-boiled water, distilled water or water filtered with an absolute pore-size of less than 1 micron. I later found out that this information had been stated explicitly in the neti pot directions that I had discarded. It was a sad moment when I realized that my laziness might result in my dying the most terrifying of deaths. I knew the water wasn't pre-boiled because I never boiled it. I knew the water wasn't distilled because it was spring water. That meant my only hope for survival was that the water was filtered. I checked the label on the water bottle and my heart sank as the word “filtered” was nowhere to be found. This meant that N. fowleri contamination was a real possibility. I wondered to myself: “how is it even legal to just scoop up unfiltered spring water and sell it to people?” Surely there must be some filtration process.
The label on the water bottle also listed a website, which I promptly visited. Nowhere on the bottler's website could I find any amoeba related information. Understandably, it's probably not in a water company's best interest to draw attention to the possible presence of brain-eating organisms. However, I did find a quality report buried deep in the website. After reading through an analysis listing the levels of dozens of obscure organic compounds, I eventually found what I was looking for: filtration information. It turned out that even though the water was advertised as natural spring water, it was, in fact, also filtered. Most importantly, the filters remove particles as small as 0.2 microns, which is smaller than the CDC recommended 1-micron filter pore size. That one number changed my entire outlook. I breathed a huge sigh of relief. I was not going to die.
It's a strange experience to go from a state of panic to a state of relaxation in a single moment. Once I realized there was no danger, my feelings of anxiety disappeared and were instead replaced with feelings of embarrassment. I had done some dumb things during my period of hysteria. I had thrown away my neti pot in anger, and now I had to shamefully retrieve it from the bathroom trashcan. I had also stopped attending classes, as I felt there was no point in gaining new knowledge while my brain was being consumed. I now had to catch up on past due coursework and my excuse was definitely not worthy of a deadline extension. My biggest regret, however, was telling my mother I was going to die. I called her back to bashfully let her know that I was going to be fine. She laughed at me. I’m not sure if she had just resumed laughing or if she never stopped laughing since the first phone call. Either way, a little humiliation is a far better fate than death by brain-eating amoeba.