Gross Anatomy

“Don’t worry,” he said.

“But. There. Were. Lice. In. Our. Apartment,” I said for the eighth time.

I imagined the little insects were exactly like criminals, but instead of wanting to hurt or steal from us, they wanted to eat our heads.

“We’ll be okay,” Dave said.

That night, I felt tingling on my scalp. The sensations seemed real, yet then again maybe they weren’t. I nudged Dave awake and asked him to investigate. He rolled his eyes, but humored me nonetheless, because we took vows, dammit.

As Dave positioned me under a lightbulb and parted my hair, I was reminded of lice-check days in elementary school. The first time was in kindergarten. The nurse came in with latex gloves and told us all to sit cross-legged on the carpet. She directed us to lower our chins to our chest and wait patiently until she got around to each and every one of us. I was terrified about what she was going to do until she stood behind me and laid those virtuosic hands onto my head. My eyes rolled back and my arms got gooseflesh as she parted my hair into tiny chunks and looked through each nook and cranny of my scalp. Lice check, I thought, should last forever. Parasite detection felt so good.

From that day forward, I got excited whenever a nurse appeared with latex gloves (an impulse that would eventually fail me).

In the meantime, my friends and I began to play “lice check” during slumber parties. We would take turns being the nurse and the potential parasitic host. I cannot quite imagine what my parents must have thought if they overheard our conversations. “But now it’s my turn—you have to check me for lice!” They probably thought I wanted to become a nurse when in actuality I wanted to grow up and get massages.

As I got older, I experienced a new kind of hair caress—the kind attempted by boyfriends. I always wanted to tell them that they weren’t doing it quite right. Hair caressing should have direction, a point of view. Their method, I realized, lacked purpose. I wished I wasn’t so shy and could have just told them exactly how I wanted it: “Do it to me like you’re checking for blood-sucking insects!”

What I’m saying is, I totally understand how childhood can influence the development of sexual fetishes.

“I don’t see anything,” Dave said, turning off the light.

I spent the next two weeks under orange alert. I didn’t necessarily think I was going to get lice, but I wasn’t going to be stupid and ignore the fact that lice-infested children had been in my home. I took precautions. The aqua-colored velvet chair was under quarantine as a potential hot zone. I didn’t care that science says that it’s highly unlikely to contract lice in any other way than direct head-to-head contact.

I started out learning novice stuff—a louse can lay six eggs a day, it can survive underwater for several hours, and infestations occur most often at schools in September (and September it was) because children come back after a long summer break and immediately mingle their head fauna—but I eventually got into mating practices. I dug way too deep. This info wouldn’t help me, but I couldn’t stop. It was ghastly stuff. If a louse dies while copulating, then the pair can’t separate. The one that survives has to carry around the other’s dead body, connected via the genitals, for the rest of its life. I didn’t know whether to think it was tragic or beautiful—surely dying in each other’s orifices was more romantic than in each other’s arms, but still.

I kept going down the information black hole. When a louse needs to eat, your head becomes a real-life nightmare. A small tube with teeth on the end protrudes from its mouth and pierces the scalp. As if that weren’t obscene enough, the tiny menace then spits on the wound. The spit is what makes some people itch, but it’s also magical and keeps the cut from clotting, so the louse can endlessly consume the blood through the two pumps in its head as if it were standing under a never-ending soda fountain. Lice take four to five meals a day, during which they consume the equivalent—if they were our size—of ten gallons of blood, and even with all that liquid, they don’t pee. Their urine evaporates through their respiratory system while their excrement, tiny dry pellets, goes through the more traditional anal route.

I later spoke to Kim Søholt Larsen, an entomologist from Denmark with a PhD in fleas and a specialization in lice and ticks, about this behavior. “If they urinated, your hair would stick together and you would immediately figure out that you have lice,” said Larsen. “This is how they hide themselves.”

They’ve had a lot of time to hone their terror techniques, because they’ve been hunting our plasma for millennia. The only good thing I found out about head lice was that they aren’t body lice: Body lice carry disease.

In the meantime, I still had Dave check me at the slightest provocation. If I felt anything, I’d turn on the bright overhead lights, flip my head over, and have him gander at my scalp. We were searching for insects that looked like black sesame seeds; irritated red skin near the ears and neck; and tiny white dots—lice eggs or nits—that informational lice blogs described as looking like “dandruff that won’t move” near the base of my hair.

I did not moan from pleasure during these encounters. It wasn’t that Dave was bad at lice checking, but I found that the practice didn’t feel as hedonistic when it wasn’t recreational—nothing like a real fire to take all the fun out of a fire drill. Dave would toss a couple of strands here and there and tell me that everything was going to be okay.

“There’s a very low possibility that you got it,” he said, over and over again. “The kids were here for like two minutes.”

During that time, I got so invested in looking for lice that I forgot about my usual terror of tumors. In some ways, it was kind of nice to mix up my concerns. Tumor hunting gets very one-note after a while.

Life continued. If I felt an itch, I made Dave look. Otherwise, I was content just to have a valid reason never to let anyone ever sit in my aqua-colored velvet sofa chair again.

By the time ten days rolled around—which was the amount of time it would have taken any new eggs to hatch—I’d probably had Dave check my hair about fourteen times and we hadn’t found one louse. Finally, I felt confident that we had eluded the little bastards and that we were in the clear. It was perfect timing, too, because we had only two days to prepare to take off for our honeymoon.

Dave had had a hard time getting time off work, so we had waited two and a half years after our wedding to take the Japan honeymoon of our dreams. I had spent three months planning the affair. Over eleven days, we would be visiting four bustling cities. We began busying ourselves with packing and plans of what we’d eat.

We arrived giddy and exhausted at Narita airport. Over the next few days, the stresses of the last couple of weeks completely disappeared. I even eased up on the idea of an elective hysterectomy. We became fully engrossed in our new surroundings. We went early in the morning to Tokyo’s Tsukiji fish market, and we visited Shinto shrines and Zen rock gardens.

After a few days, we took a train to Hakone, a small mountain town renowned for its hot springs. We stayed in a ryokan, which is a traditional Japanese inn. Our room was beautiful and highly flammable. The whole thing was made of wood and bamboo tatami mats. In fact, tatami mats are how they measure the size of rooms in Japan. They don’t say a room is twenty by thirty-five feet; they will say something like “It’s seven tatamis.” (In the United States, we don’t have a form of measurement that’s nearly as charming. If we tried, it would turn into something awful like “My house is three cement trucks and a granite countertop that caused four people to lose their fingers in a Brazilian quarry.”)

A soaking tub was on our balcony. Dense green foliage gave us privacy. We wore robes at all times of the day, because they even brought us our dinner.

Soon we were taking bullet trains, regular trains, and a ferry to find our way to Naoshima, a small island with a phenomenal hotel inside a modern art gallery. In the morning, the seventh of our trip, I went for a walk by myself to admire the magnificent sculptures on the grounds, such as the massive polka-dotted pumpkin by the artist Yayoi Kusama. I continued walking along the shore, ankle-deep in water. I looked out over the serene and vast horizon and felt so much gratitude.

I then noticed that I was scratching the back of my head. How long had that been happening?

After taking a shower, I roused Dave and we went to breakfast. “I think I’m having a reaction to the shampoo,” I told him over eggs and miso soup. I figured that using all the different shampoos at the different hotels was making my scalp feel irritated.

“Yeah, probably,” he said. He also mentioned that it was unusually humid for us so it’s possible that I was having a heat rash.

“Yeah, you’re right,” I said. “The climate really is different here.”

He told me that the psoriasis on his scalp was acting up, too.

“That makes sense,” I said. He always had more trouble with his psoriasis when we traveled.

Later that afternoon, we made our way via bullet train to Kyoto, where we would spend our final three days. After that, we would have one night in Tokyo before heading back to New York.

When we reached Kyoto, we were exhausted, so we grabbed a quick dinner at a tonkatsu place before going straight to bed. When we woke the next morning, we both had a cough and runny nose. Nonetheless, we explored Ninomaru Palace and Kinkaku-ji temple and attended a kimono fashion show.

By that point, Dave and I were both having coughing fits, but my back also itched painfully. It was an odd symptom for a cold. I got onto the internet and typed in, “Why does my back itch …” And then the search engine autocompleted “… when I cough?”

That was comforting. I obviously wasn’t the only one. The explanation I found said that when we cough, the nerve fibers in the diaphragm can become irritated by overstimulation. Because there aren’t a lot of nerves in our organs, the brain gets confused—there is a crossed signal of sorts—and makes you feel like your back is itchy when it’s actually not.

The takeaway: My itchiness was clearly an illusion.

That evening, we were so bad off that we went to a pharmacy. The two-story shop was floor-to-ceiling packed with fluorescent boxes. No one spoke English and none of the medicines had English translations. They weren’t even in Roman letters. If they were in Spanish or Italian, I could have at least tried to pronounce the words and then pretended that I knew what they meant. But with Japanese symbols, I was so hopeless that I might as well have been trying to read a pile of pick-up sticks.

After a half hour, we gave up and bought two mystery boxes of drugs. For all we knew, they could have been to treat a dog’s case of heartworm and to give me an erection for twelve months. We brought the medicine back to our hotel, knocked back a couple of gel caps, and sat watching the news in Japanese. An hour later, I was still scratching. During a commercial that depicted a woman having an intense flirtation with what looked like a fried chicken cutlet, I looked over at Dave.

I stared at him until he said, “What?”

“Do you think it’s possible that the itching is from lice?” I said.

“I doubt it,” he said.

It did seem unlikely. It had been almost a whole month since we’d seen his niece and nephew. If I’d had lice, wouldn’t they have made themselves known weeks earlier?

I asked if he’d check just to be sure. The light wasn’t great in the room, so I sidled up to the bedside table lamp. I turned my head upside down as he looked through my hair.

“I don’t see anything,” he said.

I was pleased with that answer, so I turned over and went to sleep.

The next day we had a cooking class and then switched from our hotel to a ryokan in town. We wanted to get a little more of that traditional Japanese feeling. Despite being ill, we went for the multicourse kaiseki dinner. Between the pickled vegetable course and the fish stew course, a small brown bug fell onto Dave’s arm. He immediately flicked it off.

“Where did that come from?” I asked.

“I don’t know,” he said.

It almost looked like it had dropped from his head. There were a lot of quirky things in Japan. A raccoon dog, called a tanuki and known for its colossal scrotum, is supposed to bring good fortune. Replicas of the big-balled animal greet you at the front door of many restaurants. In a country that adores a rodent with gigantic testicles, why wouldn’t a bug appear out of nowhere?

After our final day in Kyoto, we headed back to Tokyo. We had dinner at a sushi joint in the Ginza district. I itched so badly that I couldn’t keep my hands out of my hair for more than one slice of fish. That night, I couldn’t sleep, so I went to the swimming pool as soon as it opened. For the first few moments, the water put out the bonfire of pain on my back and head. When I got back to the room, I had to ask Dave to check for lice again.

He still didn’t see anything, which was actually a huge relief, because if I had lice, it would be somewhat of a cataclysmic event for Japan. I had been up and down the country using the bullet train. I used blankets, pillows, towels, taxies, ferries, and small Jacuzzis. I laid on tatami mats and rubbed up against restaurant booths. I had leaned against walls, tried on yukatas (thin cotton kimonos), and wrapped cute scarves from expensive shops around my head.

“It’s probably an allergy,” Dave said, which sounded entirely plausible even though I’d never once experienced an allergy.

“Yeah, we’ll figure it out when we get back,” I said.

By this point, we were ready to get home. The same man who’d picked us up at the airport eleven days earlier drove us back. I noticed how he’d decorated his car headrests with intricately woven lace doilies. So many people in Japan went the extra mile to make everyday objects more comfortable and aesthetically pleasing. I was impressed. I laid my head back onto those beautiful covers as I watched the city go past.

At the airport, we had a little extra time, so I went into a corner shop. I browsed books and then I began trying on neck pillows. My mom always told me not to try on stuff like that in stores because you never know the hygiene of other people who have tried them on before you, but I’ve never been concerned. The pillows were so soft and came in so many colors.

As I tried them on, I became a little obsessive—it happens periodically—and suddenly felt like as long as I tried on every different color, then somehow that would mean that the plane wouldn’t crash.

Dave was getting antsy, but I managed to finish my mission before he dragged me off to our gate.

When we got home twenty hours later, we went straight to bed. I woke up on a glorious Sunday morning, and the first thing I did was jump into my aqua-colored velvet sofa chair. I could once again enjoy that plush swiveling piece of gluteal glory, because it was finally out of quarantine.

After fully indulging, I started to unpack our bags, piling our dirty clothes onto the other sofa. While I was doing that, Dave woke up and suggested that we go to the farmers’ market. We’d been eating gluttonous meals for the past eleven days and he thought we should get some fresh veggies.

I left our clothes strewn in the middle of the room as we went out into a chilly but sunny New York morning. We walked together in the East Village along Avenue A, up toward St. Mark’s Place. We were talking about what we would make—some kind of soup? No. A roasted chicken? Maybe. Something with black beans? That sounded good.

I remember happy dogs walking by with their owners. The clank of boots on the sidewalk cellar grates. Pulling my sunglasses down over my eyes. The burn at the back of my head. The stinging sensation that occurred each time I touched my scalp.

I stopped in the middle of the sidewalk. The vendors—their piles of gourds and apples—were in sight.

“You have to check my head one more time,” I said.

“Right now?” Dave said.

I didn’t answer him. I didn’t even care about standard pedestrian practices. I stayed put in the middle of the sidewalk, like an obstinate boulder dividing a rushing river, as people walked around me. I dropped my chin to my chest and waited until Dave appeased me.

When I was in Japan, I could easily dismiss the sensations as if they were some kind of awkward travel bug—the customary stomach upset we expect when traveling to a new place—but now that I was back home, I could finally recognize that the shit I was feeling was not even close to normal.

Something had to be wrong.

By this point, playing lice check had lost all its former cachet. Dave was exasperated—he’d probably checked my head at least thirty times—but he did his duty and took his designated position behind me. My hair was in a bun, so I expected him to start rummaging around in there. Instead there was silence and the heat of direct sun.

“Do you see anything?” I said.

“Um,” he said.

“What?” I said.

There was another long pause.

“What?” I said.

He came back around to face me. The corners of his mouth were drawn down. “It must be because there’s better light here,” he said.

Crabs Pubic lice, or Pthirus pubis, are the couch potatoes of the lice kingdom. They are characterized by their sluggish and sedentary lifestyle. I can’t blame them; I’d be that way, too, if my house was a porn set. Each louse is a millimeter, which means it would take twenty-five of them, back to front, to add up to an inch. They have a roundish gray body with six legs. The two in back are capped off with crustacean-looking claws, which is how they got their nickname: crabs.

They are not found in the crotch because they are fools for genitals, but because pubic hair is their method of transportation. Like a train needs tracks to move, crabs need pubes. That’s why they can also be found in other coarse hair like eyelashes, eyebrows, armpit hair, and beards. We originally caught pubic lice from gorillas three or four million years ago. That’s why pubic lice like pubes. Pubes are the closest thing we have to thick and tough gorilla hair. The fine hair found on our scalps does not give them enough purchase to move around.

Crabs don’t do much besides suck our blood and lay eggs—about three a day—for the two to three weeks of their short lives. Like head lice, they can’t jump or fly but can only scuttle from hair to hair. That is why sex—pube to pube—is their best opportunity to colonize a new home. They can also, though extremely rarely, be caught through infested bedding. A myth looms large that crabs can be transmitted via a toilet seat, but if that’s how your boyfriend is telling you he got his, then it might be time to find a new boyfriend or to finally have that talk about opening up the relationship.

One textbook, Medical Entomology for Students, explains quite insightfully that having lice makes one “feel lousy.” Crabs can cause itching and irritation, but they are also easily exterminated: Wax off your bush or use insecticides.

Though crabs—blood-sucking wingless genital goblins—sound apocalyptical, we actually have them on the defensive. They are becoming endangered because of habitat destruction. In one study, “Did the ‘Brazilian’ Kill the Pubic Louse?” researchers found that the dwindling number of crab infections coincided with the wax-it-all-off trend, which began around 2000. It’s hard to get good data—people often don’t report embarrassing parasites that have staked out their perianal region—but a 2009 study from East Carolina University reported that less than 2 percent of the population harbors papillon d’amour (which is the sexy French name for crabs). “Their forests are disappearing,” Danish lice expert Kim Søholt Larsen told me. “They are endangered because they don’t have anywhere to live.”

“What do you mean?”

He told me that there were so many black sesame seeds moving around that he couldn’t even count. He said it looked like a horror film where bagel toppings came to life.

My first reaction was to laugh. Gosh, isn’t that funny. I have a lice infestation. I went through an entire country spreading a parasite during my honeymoon. LOL!

Uneasily, Dave joined in on the laughter, too.

Then we pretended that whole episode didn’t just happen. We continued walking toward the farmers’ market as if we were different humans—ones who didn’t currently have minuscule animals eating away at their flesh. It was the most acute case of denial I’d experienced since I was twenty and still suspected that I might grow another ten inches.

“So we’re going to get broccoli and what else?” I said.

“I don’t know,” he said. “We’ll have to see what else looks good.”

We were half a block away from the vegetable stalls when we both paused and looked at each other.

“Wait, we can’t go to the farmers’ market right now,” Dave said.

I furrowed my brows as the realization finally dawned on me, too. “Holy shit,” I said, “I have lice!”

An hour later, I was sitting on a chair in our apartment hallway. Dave stood behind me, brushing through each segment of hair with a fine-tooth comb. We had bought just about every lice-murdering product at Duane Reade, and upon getting home, I had doused my hair with the toxic shampoo. There were nontoxic methods, but I wanted poison! I wanted complete decimation! The fumes—strong and searing—were making my eyes sting, and I relished the implications of this particular burn.

Dave sounded bilious as he explained the scene he was confronted with: “It looks like a city was napalmed and the civilians are trying to escape.” Many lice ran down my back. I couldn’t count them all, but I’d guess there were at least a metric shit-ton. On a piece of paper towel, Dave showed me an abnormally large one. “Look familiar?” he said.

It looked exactly like the bug that had fallen on his arm in the Kyoto ryokan.

(To this day, that bug is still inexplicable. I looked it up and there is no such thing as a queen louse. I try not to wonder about that too much. Mostly, the lice were as billed: dark brown and the size of sesame seeds.)

While I sat there, I thought back to all the neck pillows I’d tried on at the Narita airport. I wondered if lice inject you with psychotropic substances that make you think it would be a great idea to rub your head all over everything. (I’m sorry, people of Japan!)

Dave, oddly enough, had only four lice in his hair. When we did some research, we found out that they were repelled by the acidic shampoo he uses for his psoriasis. It was nice for him to realize that there was at least one positive to having a skin disorder.

Even though I didn’t tell him at the time—it was my duty to make him feel guilty for being a subpar lice-checker—committing genocide on my lice population was one of the most romantic things that he’d ever done for me.

I didn’t speak about my parasite to many people, because having lice is stigmatizing and they scare people, as they damn well should: Those suckers hurt and they are immensely contagious from head-to-head contact. Those evil little bastards exploit our love of hugs. That’s how they’ve survived for like a billion years. Nits have been found on Egyptian mummies. Vikings even carried delicately crafted lice combs in their belts alongside their most essential item: their sword. They—muscular masculine marauders from Scandinavia—were so freaked out by the little bugs that they got buried with their combs in case they needed to battle lice in the afterlife.