Fever of Unknown Origin (FUO) is a term that continues to be redefined. In 1961 Petersdorf and Beeson (Medicine 1961:40:1) defined FUO as a fever of more than three weeks, continuously or intermittently, which remains undiagnosed after 1 week of investigation. The term is often used during the early phases of an epidemiological examination. Fevers can be caused by unknown bacterial or viral agents, neoplasms, or environmental toxins. Patients suffering from autoimmune syndromes are at particular risk for FUO's.
Dateline: Los Angeles
The plan was to see if we could ride our bikes along the river to the sea. The three of us – Turpentine, Candlepower, and yours truly, were all in training for the California AIDS ride, an event where you were provided the opportunity to ride your bike from San Francisco to Los Angeles. The ride was supposedly a real sweetheart deal, fully supported – hot showers, hot meals, medical staff, etc. You were cleared to ride after raising at least twenty-five hundred dollars for an organization known as Pallota TeamWorks. The better part of these proceeds ostensibly went to California AIDS charities and services, with the remainder going to underwrite the logistics and operations of the ride. I say 'ostensibly' because it seems that Pallota TeamWorks dropped significantly below the 65¢ per dollar ($) efficiency rating recommended by most charity watchdog groups. Since my ride the LA-based AIDS services, apparently quite unhappy with some shady bookkeeping on the part of PTW, have created their own AIDS charity ride called "Lifecycle." Keep in mind that PTW will still be holding the California AIDS ride, thus creating a situation under which dueling philanthropic rides of several thousand cyclists each will presumably clash against each other somewhere out in the Central Valley, in something similar to the final scenes of Braveheart, but with more cross-dressing.
Which brings me back to my initial point: Five hundred and seventy five miles by bike is a lot of riding, and though I was a strong rider, I was worried about being in good enough condition to do the ride with ease. So Candlepower and I did long rides up Mt. Wilson to build our hill climbing. We did loop rides around Griffith Park. But I also knew we needed to put in road miles, and the traffic in LA was driving me nuts. I wanted someplace we could put in some serious miles. Miles where we wouldn't be hassled by drivers that apparently went for the "bike filter" option when they got their car windows tinted against the authority of the California sun.
This is where I got the idea about the river. The Los Angeles River is completely channelized, which is to say the entirety of its 52 mile length is paved in concrete. "Armored," to use the parlance of the Army Corps of Engineers. This was done as a flood control measure after the disaster of 1933. You know the river – Hollywood has used it as the scene of several high speed car chases. You may have enjoyed it in films such as Repo Man and Terminator 2. Yes, that's the "river." It only flows enough to fill its engineered course a couple of months a year. One of these days, a five-hundred-year flood will come to the LA Basin, and everyone along the bottomland will be in for a big surprise. The big flood of 1936 was supposedly only a "century event" – so bigger things await. But again, that's another story.
A helpful map from the LA County Bicycle Office offered hope. There was a thirty-five mile stretch of paved bike trail along the top of the river's embankment, starting just south of Downtown and spooling out to the sea at Long Beach. I drove down to the start of the trail to scout things out. It was black ice blacktop, complete with a dotted yellow line down the middle, a smooth-as-glass bike freeway to the Pacific. Thirty five miles down, a ride along the beach, pick up the river trail along the Rio Hondo, ride back to the car and go home. A seventy mile bike ride along a river with NO CARS. As I gazed down the arrow straight bike path, I had to pat myself on the back – this was one of my better ideas.
Saturday morning finds Candlepower, Turpentine and I down at the River, in full road biker geek mode. Ass grabbing, package bulging spandex shorts. Shoulder clinging shrinkwrap jerseys in bright eurofag colors. Egg helmet. Bug glasses. Turpentine had shaved his legs, "for speed." Our spindly roadies with razor thin 110 psi tires trembled in anticipation. The hour was upon us.
Down in the drops, in an aerodynamic profile, big ring leg strokes jam our bikes along the near perfect surface. There is no one out, we have the entire river to ourselves. The river is wide, maybe 100 meters across at the bottom, a broad artificial declivity between two sloping concrete levees that bank in at a 30 degree angle. The water is in its "low" channel – a trench some three feet wide and ten wide in the very center of the watershed. It's East LA, and we're shooting along the path at the top of the levee with a privacy wall on our right and the steep grade down to the river on our left. The sun is high in the sky and the air is bright from moisture. I look down at the speedometer on my bike computer, twenty one miles an hour, and we aren't really trying that hard. The smell of frying eggs and tortillas is in the air, floating over from the homes on the other side of the barrier wall to our right. This is bike heaven. I can see something up ahead, a change in the trail surface.
Wait! There is no trail surface! "Stop! Stop!" I was out in front, and I swing my bike across the trail so that the guys behind me can see that something's up. Directly in front of me, the trail abruptly terminates in a two foot drop off, down to red earth. The trail is gone. In fact, as far as we can see ahead, the trail has been ripped up, even its bedding removed. We've come about five miles. We could turn around, ride back to the car, and go get a stack of pancakes. Or…
The whole bottom of the river is concrete! The river is a bike path. The river has been down for more than a month. I'm thinking that they've only ripped up a section of some miles for maintenance. We could portage. We could hike-a-bike down the steep embankment and then ride along the bed of the river until we've bypassed the work area and reached open trail. This end run would save the ride and add an element of adventure.
My cycling companions were dubious. Turpentine offered to buy us all breakfast if we would only turn back. He was born and raised in LA, and right now his every Angelino instinct was crying out, "Listen, it's already fucked up that you're on a bike. But I'd like to point out that you are a white boy in EAST LOS ANGELES and now your hick buddy from Virginia (of all places) is proposing to RIDE YOUR BIKE IN THE RIVER! No good can come of this." Candlepower, on the other hand, was raised by hippies who had never even owned a car. He was a monster on the bike and furthermore felt my reasoning seemed solid. Of course, this is a fellow bumpkin from North Carolina, who ate stuffed pumpkin for thanksgiving.
Allow me a momentary aside here to explain a thing or two about the pedals on a road bike. All three of us were using the LOOK system of pedals and shoes, arguably the most efficient on the market. These pedals, somewhat misnomically referred to as "clipless," are nothing like what you had on your Huffy or Schwinn as a kid. The pedal looks like an enlarged bottle opener. You wear very stiff plastic soled shoes that strap tightly to your feet. On the bottom of these shoes is a cleat. This cleat bears no similarity to soccer or football cleats. Instead, imagine screwing a hockey puck to the bottom a shoe, just under the ball of the foot. When the rider steps down on the pedal with this cleat, a spring loaded clip levers over the cleat and locks the rider's foot to the pedal. The rider's feet are now mechanically interlocked to the bike.
The reason for this is that road racers need to transmit every watt of power they can to the drivetrain of their bike. Running shoes, with their gel, foam, and air pocket inserts, are designed to mechanically deform, "squish," under foot as you step on them. This mechanical deformation absorbs the shock and energy of your entire body landing on your foot at speed. This is a good thing, and running shoes have gotten progressively better at absorbing this energy over the years, to the extent that some of them actually redirect this absorbed energy into motive force, helping to further propel you down the road.
On a bike, this is the exact opposite of what you want happening between your foot and the pedal. You want all the downward force you generate going towards moving the pedal around the crank. Biking with running shoes on is like trying to push a grand piano across carpet with a beach ball between you and the piano. So, the engineers of the cycling industry created shoes with a very stiff sole, a kind of latter day inflexible plastic clog. Some shoes, like the Shimano system, use a recessed cleat to interface with the pedal. This means you can walk around with relative ease, albeit clattering about like a little dutch girl with clogs fabricated from aerospace spinoff composite. This Japanese recessed cleat system is less than optimally efficient. In reply to this missed opportunity, the fine French engineers at LOOK invented the LOOK system. It is fantastically efficient, and an exemplar of French engineering.
French engineering works. It often works great. The Concorde is a fine example of this. It is a fantastically beautiful machine that carries passengers across the Atlantic faster than the speed of sound. This is a marvel. It is engineering with élan. Of course, it is horribly expensive to operate, only carries 100-some people, and is one of the loudest things created by the hand of man. Compare this to the oft-touted Teutonic engineering - Porsche designed the motors on its flip-up headlights with enough torque to open from beneath an inch of ice. This is thinking ahead. This is very German. The French engineer, having just delivered your beautiful French sports coupe would laugh as she handed you the keys and say, "Mon Amis, this is a sports car, not a sled! It was never intended to be driven in the ice and snow! Besides, on such an occasion, one should remain indoors, enjoy a hot chocolate and read some Baudelaire. "
Our French engineered cycling shoes were never intended for walking. What an absurd conceit, my friend! They were intended for riding a high-performance road bike. They were certainly not intended for walking down a 30 degree inclined concrete embankment. I shouldered my bike and began my way down. The surface was actually big rounded arroyo rocks mortared together with concrete.
First glitch in plan – interface between plastic hockey puck soles of shoes and tops of arroyo rocks is nearly frictionless. As with so many things in my life, I was a little overeager. Uneven surface combined with steep grade means feet want to shoot out from under, clattering over rocks like stubby skis! Quick, lean on bike and roll/ski to bottom of hill! Despite some spastic pinwheeling, I made it down the 60 some feet to the bottom without falling. Approaching more carefully, Candle clippity clopped down without incident. Turp took off his shoes and walked down in his stocking feet. After a short break for the mandatory testicle repositioning (If you are a guy who has ever ridden in lycra shorts, you know what I'm talking about), we were under way again.
This was incredible! The sun coming down, running over perfect brown concrete. The depression of the channel kept us out of the onshore breeze. There was so much room! We would ride 3 across and talk. Steering was suddenly effortless – more like flying an airplane in a big sky than winding down a road. We weaved in and out of each others paths at twenty miles an hour. Candle and I immediately realized that this was like the best game of "X-wings and TIE fighters" ever. Instead of Huffy's and little 11-year old legs, it was big adult quads, ultra-machined bikes and the biggest bike playground on the planet. The concrete embankments were smooth here and we experimented with booming up the sidings and the back down, spiking up to 30mph plus, the river a fifty mile velodrome. It was pure bike pleasure.
"Igloo! Let's paceline!" Candlepower locked into his drops. A paceline is where two or more cyclists work as a team to phreak on air resistance to get the speed up. The lead bike "pulls," he's the locomotive. The lead bike acts as the windbreak. The trailing bikes are on "drag." They draft off the lead. Over about 17 miles an hour, more and more of your energy goes to pushing though the standing wave of air in front of you. When riding very close to the bike in front of you, you can "hide" in the wake of the lead rider, and do the same speed for three quarters of the work. You can do big distances at speed by pace-lining and just spelling off the lead biker ever few minutes. The lead biker peels, the second guy in the pack spins up, and the lead moves to the rear of the chain, a maneuver which is referred to as a monkeyfuck (can you tell this is a boys' game?). I jammed out in front of him and we cranked it up to around twenty-five. Candle moved up to about six inches off my back tire and called it. "Position!" I made a little "whirlybird" motion with my right hand and took the speed up to about twenty-seven. Turpentine hung back – drafting was not his thing.
We rocketed under a long underpass, in near total darkness. The concrete was sailing underneath us. It was like one of those Japanese videogame sequences where the same background keeps going past in an endless loop, a low-bit representation of SPEED. We were both in a full profile tuck – torso over top tube, head over stem, ass down, legs cranking. I would scan forward along our path from under my eyebrows.
Something new was coming up. One of the storm drain feeds that dump into the river was bleeding just the barest trickle of water across the riverbed. The water seeped down the embankment and then across fifty meters of concrete to the center channel, no more than a quarter to half an inch deep. The water was probably from a cracked water main leaking into the storm drains, something that had gone unnoticed for years, an inefficiency in the system. We were coming up on this little "surface creek" at around twenty five miles an hour.
My mental model was as follows – garden hose across concrete sidewalk. Surface of water is slick, yes, but concrete below still has good traction for tires. The key to the thing would be to hit it fast and cross it in a twinkling. Don't put any lateral vectors on the forces involved. Get square up on the bike, so that all your weight goes straight down, rooting you to the road. Hit it fast and clean and bang! You're out the other side.
"Candle! Square up, Square up!" I shouted back over my shoulder, over the sound of the air and surface noise. I could see Candle snap his head out into the slipstream and eyeball the obstacle. He gave me a quick nod.
"Got it! Let's do it!" Candle and I had ridden together a lot, and I knew he had already intuited my plan, made a judgment call, and agreed with it. I really stoked the bike, rounding off our ground speed to an even thirty miles an hour, and my front tire kissed the sweet meniscus of the creek's random course.
As the I crossed the air/bike/water/concrete interface, things began to happen very, very quickly. Mental model of garden hose and sidewalk clearly invalid. Proper model: shallow creek over sandstone with plenty of sunshine. Translation is as follows – Down at the New River as a boy, or Little Anthony's Creek, there were stretches where the current swept the bedrock clean. To step into one of these was to land on your ass, because the rock was quite literally slicker than snot. An inopportune attempt at fording a creek over one some of this "slickrock" nearly sent me over a waterfall once (that's another story). Exposed to direct sunlight, warmed by the sun inside the microscopic nooks and crannies of the stone, bacteria and algae thrive, clinging to the living rock and forming what the pros call a "biofilm" – a contiguous colony of unicellular organisms, a kind of photosynthetic party containing untold billions of wee beasties with the uniform consistency of mucus, nature's superlube. A particularly healthy biofilm specimen here in the LA River had created a non-stick skillet coated with K-Y jelly the size of a small parking lot.
My wheels shot out from under me with sufficient speed and force that I was treated to a moment of genuine freefall. I looked up between my legs to see my wheels silhouetted against the sky as I floated through space at thirty miles an hour. For a moment, in defiance of the natural order, I had achieved perfect head-ass inversion. Then, contact. I felt my feet pop loose of the pedals from the shock and I tumbled end over end along the riverbed, spinning with all the violence of a figure skater but none of the control. It was much more akin to a NASCAR wreck, but with 185 pounds of Iglooflesh slamming and spinning against the macadam instead of Detroit iron.
But don't forget Candlepower! Yes, my faithful companion had backed off from our usual six inch "nose in ass" drafting interval, but not by much. Candle hit me like a city bus with the brakes out, caroming off me into his own sickening spin across the nearly frictionless surface. The both of us had skidded across nearly fifty feet of this… stuff.
Turpentine was screeching to a halt. Not his brakes, him. He was emitting a high pitched squeal as he held a white-knuckle, skin-popping death grip on his brake levers. It wasn't going to be enough. He popped out of his pedals and dug in with the composite heels of his one hundred fifty dollar cycling shoes. A fine dust of what may well have been shredded $20 bills flew up from the concrete, but it worked. Turp came to a halt with his front tire touching the boundary line of the creek.
Candlepower and I sat up. I was groaning – feeling a little pukey like I always am after I take a really good ding. And this was a good one. I had road rash all over my knees. The concrete had torn open the left buttcheek of my very expensive biking shorts and given my glute sinister a little taste of loving kindness. And then there was the stuff. I was covered in it, my legs, my ass, my hands and shoulders. I looked over at Candle. We had both just finished our post crash mental inventories: head, OK. Legs, some road rash, OK. Middle parts, OK. Hands, sore, but OK. Green or yellow lights on all self-diagnostics. I was sitting on my ass in sludge, dinged but alive. Now it was time for horror.
A quick word about the LA River. It carries the "natural" river to the sea, functioning as the watershed for the San Fernando Valley. An augmentation to this natural function was to use the river as a storm drain system for the entire LA basin. This storm drain system has an illicit function as a cheap disposal mechanism for the toxic effluvia of the various factories and manufacturing plants along the river's run. Why bother with all that EPA and OSHA paperwork when you can have your cousin jackhammer down to the storm drain that runs under the shop floor and tap an illegal drain? Thus, several years ago, when they did water quality testing along the river, they discovered hexavalent chromium, the chemical costar to Julia Roberts in Erin Brockovich, also known by the Vonnegutesque moniker Chromium 6. This was along with the usual heavy metals from industry, phosphates from golf course, lawn, and cemetery runoff, and the fecal coliform soup contributed by five million shitting dogs.
Candle and I were covered in this stuff. The algae didn't worry me. A little of the green stuff never hurt anyone. But the water. . . Once the tumbling was over, once I had regained my equilibrium, the realization of what was seeping into my bloodstream hit me. Candle and I tried to stand and walk out, but it was no-go. Too slippery. A four-point exit was in order. We crawled to our bikes and then out to dry concrete. I grabbed a water bottle and began irrigating the road rash on my knees, in hopes that I could keep things clean. I flushed those wounds with two liters of water, every drop of drinking water I had. Candle did the same. The bikes still worked, and we decided we felt good enough to keep going. We finished the ride, getting new water for our bottles in Long Beach. On the way home, we took the wrong fork of the river, and wound up biking up the Rio Hondo until the trail dead-ended in an oil refinery. We were lost as fuck. Only Turpentine's command of the Spanish language saved us. Navigational intel gleaned from four lollypop sucking, espanol hablando skateboarders told us we were twenty miles east of where we should be. The ride wound up being an exhausting 80 plus miles.
The next day, while making an espresso at the office machina, I was suddenly gripped with a powerful, almost convulsive fever. I felt nauseated. A sweat broke out over my entire body. I had ridden my commuter bike to work that morning, feeling a little tired, but fine. Now I was in the teeth of something ferocious. It was the kind of unnamed tropical ague I had always imagined explorers from the Age of Discovery coming down with. A coworker drove me home.
The fever persisted for ten days. I imagined my immune system tracking down the alien proteins in my bloodstream. I imagined the river bacteria running loose in my blood, flowing though my pipes instead of the concrete of the river, feeling my body heat instead of the warmth of the sun. I could see my circulatory system stretched from the mountains to the sea, like a science text metaphor, my vasculature artificially extended into a bacterial velodrome, where uninuclear badasses beholden to nothing as bourgeois as differentiating into tissue ran loose in a long chase sequence, as if I could look outside my window and see my own vessels laid out along the concrete of the river's bed. I imagined my T-cells identifying these new inhabitants, cataloging them. I imagined the B-lymphocytes ginning out antibodies, tagging these unexpected guests for destruction. I was the river now, for ten days I carried that ecosystem inside me, while the macrophages did their assassin's work, a secret police unit for my hematological system, hunting down a foreign influence that I was almost sorry to be free of.
My coworkers at the office, my friends from Los Angeles, they all had a palpable reaction to the news that my fever was from the river. Some were visibly overcome with a sympathetic revulsion. Others unconsciously took a step back, distancing themselves. My boss, R., was troubled by it for days. He kept asking me if I felt well enough to come back to work, if he could drive me to the hospital (he thought I didn't own a car). Every time I mentioned biking afterwards, he would make me promise that I was NOT going to ride in the river, that no one should ever ride in the river.
They call themselves Angelenos, but they all knew the truth - I had shared an intimacy with the city that they would never know, that we knew each other now, like that nasty cold from making out with your new girlfriend.
It's inside me now, like a pocket phrasebook to a foreign language, an index of alien proteins that I can consult when I want to feel speed, concrete, disease, danger, sunlight, and impact.
It was a ten day love song.
It was my favorite fever.