If I Only Knew Then (Feature Narrative) | Recognize Grizzly Behavior | Save Yourself in Whitewater | First Aid Emergencies | Unsafe Snow Conditions | Unexpected Accidents | Make Good Judgment Calls
 Going on a long trek or to a remote location far from medical help? Talk to your family doc about getting a versatile antibiotic to treat infections. Example: Z-Pack.
 Avoid spreading germs. Dont share water bottles, put hands in the gorp bag, or cook without first cleaning your hands with a sanitizer.
 Cold hands and no gloves? Use a spare pair of socks or pull your hands inside your jacket sleeves; or let your sleeves hang empty and pull your hands and arms inside, close to your torso.
There’s considerable machismo that gilds outdoor pursuits—I’ve certainly been accused of having more brawn than brains myself. And while I gratefully acknowledge that being tough is useful now and again, being smart is surprisingly valuable. 
I remember telling a fellow climber high in the Himalayas that I didn’t bother with sunscreen; a week later my lower lip had split open down to my chin. I remember bragging to a buddy in the Congo that I didn’t use deet because insects didn’t bother me; a week later my hands were swollen like baked bread from a billion bug bites, my face puffy with sweat bee stings, my *** full of African ticks. In Switzerland, I mocked a hiker with trekking poles, then immediately hyperextended my knee for my blasphemy, and have used poles ever since. Once in Siberia, I failed to bring personal antibiotics and got a staph infection , which ballooned into full-body sepsis that almost killed me (no hyperbole; I had kankles, and the Russian doc said I was less than 24 hours from buying the farm). I’ve been known to boast that I have an iron stomach, and can eat and drink anything. I’ve also had it coming out both ends so explosively I was a fountain of filth.
Having gone 73 days without bathing, I know for a fact you can get by with bad hygiene. However, I’ve been on several expeditions where one person has spread his ghastly germs to everyone else. Wash your goddamn hands when you take a crap! Alas, since some people won’t or don’t. Bringing along a bottle of hand disinfectant isn’t a bad idea, as well as a course of antibiotics. (Beware of Cipro; side effects include a heightened risk of torn tendons.) Two months ago, I tore my calf muscle off my Achilles tendon when I used Cipro on an expedition to Xinjiang province, in northwestern China.
Disease is often spread by unclean hands handling unclean cutlery and dishware , so I carry my own large titanium cup with lid, and titanium spoon (plastic is pointless; it breaks and melts). No one touches these utensils but me. I don’t use communal dishes. Even in a Tibetan’s black-hair hut, I’ll pull out my own cup so the boiling yak butter tea goes straight from the cauldron to my clean cup to my gut. Often simply looking after little things will prevent big problems. While caving in Vietnam with a team of Yorkshire madmen, they delighted in showing me macabre pictures of trench foot before we went underground for a week. And it worked. I dried my feet every chance I got, kept them powdered with antimicrobial talc, and put on clean socks at night. My feet escaped unscathed from the bowels of Southeast Asia.
When your fingers start to get cold, don’t ignore it . Stop. Put them on your neck, on your stomach, against your genitals; windmill your arms, whatever it takes to get blood flowing again. Too many mountain climbers older than 50 are missing digits. At least among my friends.
Eat. As an experiment, I once climbed a mountain in Tibet on half rations: one package of hot cocoa and one package of oatmeal for breakfast; half a candy bar and half a can of sardines for lunch; half a two-person freeze-dried meal for dinner. We summited, but on the hike out, it seemed like I bonked every hour all the way back to the road.
Drink. It was three in the morning when I jackknifed in bed. I got up and began pacing around the room bent in half. It was excruciating, but I thought it would go away. When I started puking from the pain, Sue had had enough and drove me to the ER. We were living in Spain, so she translated while I roiled about.
“The doctor says you have a kidney stone,” Sue said to me, speaking slowly and close to my face, like I didn’t understand English.
It was sometime during my delirium when the doctor spoke to me directly:“So, I hear you are a mountain climber. Not very bright.”
Turns out if you desperately deplete your body of water too many times, you’re gifted with little pearls of wisdom for the rest of your life: kidney stones, gall stones, bladder stones.