Cherie Kephart, a young woman who longed for adventure, traveled the world from the remote villages of Central Africa to the majestic coastlines of New Zealand until a mysterious illness thrust her to the precipice of death. The persistent health challenges led to years of suffering, during which her symptoms time and again were undiagnosed by well-meaning medical doctors and healers who were sometimes competent, sometimes careless, sometimes absurd, and always baffled. The anguish, the uncertainty, and the relentless pain would have caused many people to simply give up and end their lives—and Cherie came close. Told with brutal honesty, astonishing wit, and a haunting vulnerability, A Few Minor Adjustments is an unforgettable memoir that will move you with its fiercely inspirational account of one woman’s incredible journey to find life-saving answers. In the end, she finds much more than a diagnosis.
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About the Author
Her memoir has won several awards and received an outpouring of heartfelt responses, motivating Cherie to write a companion book, The Healing 100: A Practical Guide to Transforming Your Body, Mind, and Spirit.
Cherie has earned a Masters in Medical and Cultural Anthropology and has been celebrated for her holistic approach to healing and her willingness to examine her life lessons in her writing.
Stay connected at: CherieKephart.com
Read an Excerpt
Entering the Unknown
April 2004, Part I – San Diego
Hard water hit my breasts. The musty odor of old pipes filled my nostrils. I coughed and turned in circles in my shower, observing the cracked tiles beneath my feet, stepping carefully around them because I had been cut before. I avoided the large patches of mold covering the rusty handles and walls. No matter how much I scrubbed, this cottage was run-down and full of spores.
Damn landlord never fixes a thing.
I lathered my skin with soap, breathing in the scent of citrus as I scoured the crevices that had collected sand from playing beach volleyball earlier that evening. The image of Alex entered my mind; his short brown hair, crystal-blue eyes, full ruby lips, and olive skin. I envisioned his tall, lean, and muscular body pressing up against me as we made love. I had only known him for a few months, but we were enamored with one another. We met while I was working as a technical writer at a software company. We became friends, sharing our adoration for animals, love for exercise, thirst for intellectual conversation, and desire to spend quiet time in nature. My thirty-third birthday was in a few weeks and I wondered what we would do to celebrate.
I turned to rinse the soap from my back and felt a sharp biting pain in my neck. I dropped to the hard tile floor. Water pounded over my head. I tried to stand, to move my neck, but the pain intensified like a saw ripping my flesh and muscles apart, causing me to scream.
I crawled out of the shower and across the floor.
Focus. Get to the phone. Call for help.
I inched across the living room floor, one arm limp by my side, the other forcing me along like an oar wading through sand. I reached the phone and dialed.
Pick up. Please.
"Alex?" My voice felt shallow. My wet hand gripped the receiver.
"Cherie. You all right?"
"No." I strained to speak. "Intense pain. I collapsed." I forced words into the air between breaths. "My neck feels — broken. I don't know how, but I can't feel my left arm. I'm scared, Alex."
"Hang on, CK, I'll come right over."
I dropped the phone. I had suffered chronic throbbing neck pain for years from a car accident when I was twenty-one, but this felt as if a lion had ripped apart my neck with its teeth. I inched from the kitchen back to the bathroom. Heard the water still running from the shower. I pushed along the rough hardwood floor. Long, sopping hair covered my face.
My concentration weakened. Heat radiated from my neck into my limbs. My legs burned.
Just get to the bathroom.
My arms and legs quivered. I pushed myself up using both sides of the door jamb. I entered the cramped, steamy shower. Turned the handle enough to halt most of the flowing water. The shower head continued to drip, but I didn't care.
I groaned, forcing myself down the corridor to my bedroom. Holding my neck with my right hand, I climbed wet and naked onto the mattress. My neck stiffened as if my muscles were filled with cement. From the corner of my eye I saw my digital alarm clock on the nightstand, but the numbers looked hazy: 8, 4, 5. 8:45 p.m. The drive from Alex's studio apartment would be at least thirty minutes. Would I make it that long?
Goose bumps prickled across my arms and legs. I wrapped myself in a golden throw that hung over the edge of the bed. The dampness of my skin made me tremble. I swayed back and forth in tiny movements and started to cry.
A tidal wave of tension rushed through me. I grimaced and turned toward the clock. 8:52. Please hurry, Alex echoed in my head like a mantra.
I thought back to my visit to the hospital two weeks earlier. The ER smelled like bleach and fear. Fluorescent lights shone brightly overhead. I sat on a gurney in a busy hallway and watched the flurry of activity. My knee ached and my heart pounded like an elephant stampeding after too much Red Bull and cocaine. Something was wrong with me and I trusted that the medical system would agree and offer me an efficient way to heal.
A red-haired doctor with bushy eyebrows rushed up to me. "What did you find?" I asked him.
He paused, shaking his head. "Your EKG's a bit, well, unusual," said Dr. Unsure, as I had come to think of him.
Just say it, I can take it.
"It's your heart. Your EKG readings are reversed." He fiddled with his stethoscope.
"What's that mean?"
"I'm not sure," said Dr. Unsure. "Very unusual." He scratched his head, thought for a moment. "I've never seen this before, but I don't believe there's anything to worry about right now."
So, the time to worry would be when?
"I need you to do a follow-up with your primary doctor, a cardiologist, and a neurologist. You seem stable enough for now."
I drove home with fifty less dollars in my checking account and a thousand more worries.
Sharp stinging sensations crept up my neck to the base of my head, bringing me back to the moment. Still in my cottage. 9:01. My hands shook as I propped myself up. The wet blanket fell to the floor. I stumbled toward my closet, panting as I shoved clothes aside with my right arm, searching for a loose T-shirt and sweatpants. I situated the shirt around my neck and torso; the cotton fabric stuck to my damp breasts. I struggled, pulling down the shirt, still crying, still shaking.
I bent over to lift my sweatpants, fumbled with my left leg, then dropped my right leg gingerly into the hole, and finally pulled the pants up around my waist.
Shoes. Easy shoes. I slid my feet into my sandy flip flops.
What else? ID. Insurance card. Purse.
I turned toward the hallway, and a bolt of pain sledgehammered my neck. I grabbed my head and fell to the floor.
Red numbers glowed out of the corner of my eye. 9:15. The clock mocked me. I dragged myself toward the living room. My purse dangled on the edge of a chair. I stretched out toward the bag, grabbed it, and crumpled onto the carpet. I tried to inhale but could only produce curt, shallow breaths.
Please, someone help me!
I heard a car door slam. Harnessing strength, I pushed myself up from the floor and limped to the door.
Alex's voice sounded muffled through the thick wooden door. "Cherie. Open up."
I wanted to scream out to him, but my voice was a breathless rasp. I cried as I unlocked and pulled the door open.
Alex towered over me. His luminous blue eyes sparkled between his thick eyelashes, and a hazy white cloud highlighted his body. He looked like a savior. He stretched out his arms and gently wrapped them around me. I shook and sobbed. "What happened?" he asked.
"I don't know."
"I've got you, CK. Hang on." He lifted me into his arms and carried me to the car.
In the waiting room, Alex held me close and consoled me. The masculine aroma of perspiration and shampoo filled my nostrils as I nestled in his arms. I could feel the compassion in his touch. A serious man, Alex was a software engineer who had worked his way up to vice-president of a Fortune 500 company. A self-proclaimed "unforgiving bastard," but I had come to know his softer side. He often spent weekends volunteering at animal shelters, rescuing stray cats and finding them homes.
The emergency room bustled with activity. Nurses scurried from one side of the waiting area to the other. I surveyed the people around me and noticed a faint scent of blood. A disheveled, burly man with a stab wound sat alone staring at the floor, holding a blood-soaked wash cloth on the side of his stomach. Was it a bar fight, gang related, or some form of fatal attraction?
A quiet middle-aged Hispanic couple sat across from me. I couldn't discern the reason for their visit to the ER, or which one of them was sick. They watched me periodically, perhaps wondering what pathogen I had, and what, if anything, I infected their air with.
Was I contagious?
Alex kept his eyes on me, occasionally running his hand along my back or across my leg. His presence kept me sane.
We sat for hours in our awkward plastic waiting-room chairs. I focused on wanting to live, yet the pangs radiating from my neck and head raged as if a savage battle were being fought over my every muscle, sinew, and bone.
"Why's it taking so long? I can't stand this anymore."
"I know. This is awful. I'll ask the nurse again. You've got to hang on, CK."
Although Alex sat next to me, I somehow felt alone. He knew about the two other times I'd endured pain so overpowering that, unlike this day when I fought to live, I asked to die.
My heart rate accelerated as I recalled those times of despair and what I had survived. Did those two episodes give me the strength to overcome this new trial, or had they depleted my reservoir of endurance? Had they contributed to my current unknown condition?
I didn't know.
Pioneering for Peace
January 1994 – Zambia
I was twenty-three years old the first time I wished for death. I was serving as a Peace Corps volunteer in Zambia. Twelve of us became the first group of volunteers. We would learn to speak the Bantu language, Bemba. We called ourselves the Kalapashi, meaning "the pioneers."
Before traveling to Africa, I absorbed the Peace Corps medical spokesperson's lecture on a multitude of precautions, preventive measures, consequences, and statistics. She described several diseases, emergencies, injuries, and accidents we were bound to encounter throughout our two-year service.
Each year millions of people around the world were infected with malaria. Between one and three million people died from this parasitic infection. Ninety percent of these deaths occurred in Africa. Besides the high risk of contracting malaria, HIV was prevalent. Statistics showed that approximately eighty-five percent of Peace Corps volunteers had sexual relations while in their host country. Heterosexual transmission of HIV in the United States represented eight percent. In Africa, it was eighty percent. There were thirteen million cases of HIV in the world. Eight million of those were in Africa. Fifty percent of hospital patients there had HIV. Hospitals and medical clinics commonly reused needles for immunizations and blood drawing because supplies were low. Instead of sterilizing, they washed the needles in hot water.
Aside from warning us about venomous snakes, crocodiles, and spiders, they warned us about dysentery, giardia, hepatitis, and a wide variety of water-borne diseases like schistosomiasis. Equipped with all of this staggering information, I assured myself that for the duration of my service I would always boil and treat my drinking water (even before brushing my teeth), consistently take my prophylactic medications, sleep in a chemically treated mosquito net, stay current on my immunizations, abstain from sex, keep out of hospitals and medical clinics, and avoid swimming in any body of water.
Being young, unhampered, and idealistic, I decided I would remain healthy by adhering to the rules and guidelines and remain conscious of everything I did. My young mind propelled me forward without fear. I joined the Peace Corps because I aspired to make my life mean something. I needed to believe I was imperishable. I kept thinking of a quote from Margaret Mead: "Never doubt that a group of thoughtful, committed citizens can change the world. Indeed, it's the only thing that ever has."
I wanted to be a part of that change. Never did I imagine that most of the change would be within me.
My first three months, from January to April, were with my eleven fellow volunteers in the south of Zambia, participating in language, technical, and cultural training. Each of us lived with a host family. Since Zambia had been a British colony, many of the locals in the larger cities spoke English. At the end of our three-month training we would be relocated to remote villages where almost only Bemba would be spoken.
During our training, we lived in Kabwe, an old zinc and lead mining town. Home to 200,000 residents, it offered few amenities. The middle of town had a large marketplace where hundreds of local vendors sold their agricultural and homemade goods. It smelled like charcoal and dust, surrounded by a steady stream of flies constantly circling and landing on the makeshift tables, food, and people. The training site, where we studied and gathered for Peace Corps events, was on the outskirts.
We were trained to orchestrate water and sanitation/health education projects; to build wells and latrines; and to educate the locals about good health practices to prevent disease. When I arrived, people bathed in, drank out of, urinated, and defecated near and in the same slow moving river that ran through the village. The degree of illness and death from contaminated water sources was alarming. Combined with deaths from malaria, HIV, and other causes, the average life expectancy of Zambians was around thirty-two years.
Despite my cautious intentions, illness managed to find me in interesting ways. In addition to changes in diet, such as fried caterpillars that tasted similar to burnt French fries, and newly found bowel functions that all of the volunteers enjoyed, I noticed three red sores, one on the inside of my right arm and two on my behind. At first they looked like pimples, so I ignored them, but after a few weeks, they grew bigger, darker red, and became so piercing it was difficult to sit.
The Peace Corps medical staff, a doctor and nurse who were both in Zambia for the first time, brought me into a small unused dorm room on the Peace Corps training campus to investigate the sores. The room smelled musty, had cold concrete floors and one window that was painted shut.
"Cherie, lie down on that cot and we'll take a look at you," Dr. Enthusiasm said, pointing to a child-sized mattress in the corner. He was a brown-haired Jerry Garcia look-a-like from Alabama. I wondered if he had ever been to a Grateful Dead concert. The nurse, a petite and naturally beautiful dark-haired woman from Alaska, smiled at me.
I positioned myself on the bed, lying backside up, and lowered my pants and underwear so they could see the two bright red sores on my butt. The two medical professionals rubbed, poked, and picked at the sores, chatting back and forth while I kept from fidgeting.
"We aren't certain, but we think you've contracted a Putzi fly or Tumbu fly infection. This is exciting." The doctor's voice cracked. "I've never seen it before, but I just read about it. It's native to Africa. The flies lay eggs in damp clothes hanging outside to dry. Once the clothes come into contact with human skin, the eggs hatch. The larvae burrow into the skin and, if left untreated, morph into adult maggots."
"Whoa. Did you say maggots?"
The muscles in my stomach tightened. "I have maggots in my butt?"
"It's been a few weeks since you first noticed them, correct?"
"Yes. But, oh gosh, how do we get them out?"
"We'll have to cut them out. It may be a little painful. You'll have to remain quite still, all right?"
I reached my arms up to grasp the thin metal frame of the bed. I shut my eyes. "Okay."
While the doctor rubbed the areas with a cold, wet antiseptic wipe, I braced myself. They used an X-Acto blade and a pair of tweezers, medical instruments resembling those included with the board game Operation.
I could feel the sharp blade cut into my flesh. Lying face down, I couldn't see what they were doing with these elementary tools, but it sounded like an archaeological investigation being conducted on my butt cheeks.
"That's interesting. Wait, I have it. Nope, I lost it. Wait, I have it. No, it burrowed back in again. We've got to cut a little more. Okay, now dig." Their less than comforting dialogue, coupled with their probing and cutting, continued for almost forty-five minutes, during which I thought so many things. What was I doing here? Maybe I made a mistake? Who was I kidding? Get these things out of me! Was I strong enough for this? Was I prepared? How does one prepare for getting maggots in her butt? I knew that the Peace Corps experience was not for the weak hearted, but I didn't know it was going to be this tough. I was not in a hospital or a medical clinic (which I wanted to avoid, so how could I complain?), but in a random, non-sterile room with no pain medication in sight. Just me, two perplexed medical staff with tools from their portable first-aid kit, and three determined worms.
"We've got it!" they exclaimed when they finally extracted the first maggot from my aching ass. "Do you want to see it?"
I was not in the mood for show and tell. But they showed me a cream-colored worm about a half an inch long wriggling on the end of the tweezers before I had a chance to respond. It looked about as happy as I did.
"Do you need to take a break or should we continue?"
My glute muscles ached as if they had been stung by a swarm of wasps. "No break, let's get the other two out of me." I closed my eyes and waited for the cold, sharp blade to once again cut into the fatty flesh on my behind.
The second one didn't take as long, perhaps ten minutes total.
"Not too much blood. That wasn't bad," they said to me with mild excitement.
Excerpted from "A Few Minor Adjustments"
Copyright © 2017 Cherie Kephart.
Excerpted by permission of Bazi Publishing.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.
Table of Contents
1 - Entering the Unknown,
2 - Pioneering for Peace,
3 - Living the Dream,
4 - Close Encounters of the Curious Kind,
5 - Digging Myself a Hole,
6 - Not So Young or Invincible,
7 - Almost,
8 - Emergencies Only,
9 - Nobody Loves Raymond (Except Maybe Jack Daniels and Jim Beam),
10 - Pharmawhaticals,
11 - Counseling 101,
12 - Opening Up,
13 - Darkness to Dawn,
14 - Lucky Me,
15 - Do You Smell Something?,
16 - A Thing Called Instinct,
17 - Uprooted,
18 - Heartbroken,
19 - Painfully Sane,
20 - Desperate Times,
21 - A Little Help from My Friends,
22 - A Twist of ...,
23 - To Pee or Not to Pee,
24 - Positively Negative,
25 - Moving On and Moving Up,
26 - A Fond Reunion,
27 - The Power of Numbers,
28 - Once Again,
29 - Table for One,
30 - Starving,
31 - Fading,
32 - Love with Lipstick,
33 - So Much More,
34 - Burn to Live,
About the Author,
Most Helpful Customer Reviews
Cheri Kephart's excruciating years of exploration into the causes of her pain body as well as how to care for so many undiagnosed symptoms is a testimony to pure resilience. I could not put the book down and could not imagine anyone hanging on to life for so long with her challenges. The books language is authentic, full of humor and gratitude even from within a living hell. Her beautifully written descriptions reveal so well the physical, spiritual and emotional landscape of her world for so many years. A Few Minor Adjustments is nothing short of a pilgrims journey, an inspiring account of faith and courage. Thank you.
Author Cherie was a recent speaker at our California Writers Club, High Desert Branch meeting. I was not able to attend, but my 94-year old mother was very impressed, as were members of the club. My mother bought us a copy of this memoir, and I couldn't put it down, even though it was so full of pain, struggle, and suffering. Although blessed with the help of so many who loved her, I don't know how she had the strength to keep pursuing a diagnosis. The reader will feel her pain and her fellow writers will especially tip their hats to her for writing this memoir of healing. Our club is finishing our third year of teaching memoir to high school students and publishing their works. I will include Cherie Kephart's book in the bibliography so others can know of excellent memoirs out there. I can't wait for Cherie's next publication. Wow! What a story that gives renewed courage to those suffering from illnesses and their caretakers.
A well written and inspirational book that keeps pulling you back to read more. The seemingly insurmountable challenges for one individual's lifetime of health struggles makes the reader feel blessed despite all the challenges they are enduring. Cherie Kephart is an inspiration to anyone going through difficult times.
Never has a phrase, 'no tears for the writer, no tears for the reader,' applied more to a book than this one. Kephart holds nothing back in this heartbreakingly beautiful tale that will transport, transfix, and ultimately inspire even the most cynical of readers.” —Alex Sheshunoff
Pure dogged human perseverance! Cherie's memoir of healing is so much more than I would have or could have anticipated. I sat down with my paperback and for the next 5 hours felt as if I were having a private conversation with a best friend. As I read about pain that took my breath away, I experienced every single emotion I've ever had including a humor that had me laughing out loud. I look forward to reading more about Cherie's journey and amazing spirit!
I usually don’t read memoirs, but this one completely blew me away! I was taken on a journey and felt like I was there with Cherie every step of the way. Her writing reads much like fiction and I found myself lost in her world, and in the end, I was left inspired to find the beauty in life. And this isn’t a book that you read and forget, either. Even weeks after reading it, I remember Cherie’s story, and her ability to find the humor in the most dire situations. Oh, and anytime I see an egg in the grocery aisle, without fail, I smile and put my hand over my heart. If you want to know why then I guess you have to read it! ☺
I knew I was going to read this book as soon as I saw the cover. I love elephants! Frankly they are my spirit animal. They’re strong, loyal, sweet and kind, but most importantly, they’re egalitarian. From the brief skim-read of the blurb, it’s quick to assume that Kephart had an encounter with elephants during her work with The Peace Corps in Africa, but that’s far from the truth. Choosing an elephant to represent her life story was a bold decision because apart from the brief mention of a relative’s ornaments, they play no real-life part in her story. The journey Kephart documents, however, shows us that she inherited their strength to fight, their wisdom to look further, and their compassion to hold their loved ones near. She never put her pain upon others, and fought long and hard for a diagnosis, let alone a cure. Never before have I encountered such a visceral account of a woman’s struggle to fight. Aggressive battles of the mind and body fill the pages and tug deep on the heart strings of the reader’s soul. Every twinge, jolt and stab is transferred from the pages and into the reader’s own body. I could feel her frustration with each and every visit to a doctor’s office, her disappointment when each investigation led to another dead-end, and her hope when each dead-end led to another opportunity. The chapters during her more healthier years in The Peace Corps are very enjoyable. Being the same age as Kephart when she began her service, I automatically felt connected. Just announcing the dangers of living in Africa and the number of precautions she had to take, I could only imagine the daunting task she took upon herself, and it left me wondering if I could do the same thing. Her first major health scare involved three large flesh-eating maggots living inside her skin, on her butt no-less. Having them forcibly removed without anaesthetic, in a whole different world of infections and dangers, had me wriggling in my chair. When the maggots were gone, she was given a ’simple’ precaution that involved hot-coal ironing all of her clothing. I don’t envy her. I can barely bring myself to pick up an iron for a special occasion; I couldn’t imagine spending a whole day to hot-coal iron every sock, bra and pair of underwear just hoping to kill the eggs of another invader. This book is written with a casual dialect that any reader or non-reader could pick up and enjoy, yet there is an intelligence behind Kephart’s words. What she weaves is relatable, yet, at the same time, from a whole different world than I’m sure 95% of readers are unaware of. I couldn’t imagine feeling so defenceless that I couldn’t do the things I loved. Not having the strength to feed oneself, hold a book or even stay awake is terrifying. For this reason, "A Few Minor Adjustments" is a true lesson of vigilance, offering hope and asking every reader to be grateful for every healthy, happy moment of their short lives.
A Few Minor Adjustments by Cherie Kephart will make you think and wonder how she ever survived especially her Peace Corp experiences. It is a memoir of epic proportion and covers years in her life trying to find answers to her declining health. It is well written, pulls you in on the first page and if time allows is the kind of book you read from cover to cover because you can't put it down. It is the story of an engaging young woman who never gave up hope that she would have her life back again despite all the odds against her. I loved reading this and you will too.
“In her courageous fight to stay alive, Cherie turned to western medical specialists (including cardiologists, neurologists and physiatrists) and to alternative care providers (including acupuncturists, chiropractors and even an energy healer who used fertile chicken eggs to try to cure her). After 1,710 days of her quest for survival, Cherie's illness was still undiagnosed and her out-of-pocket medical expenses were astronomical. A Few Minor Adjustments is an inspirational story of one person's perseverance in the face of the daunting inadequacies of our healthcare community.” —Marlena Fiol, author of Love is Complicated: A Memoir of Healing
Absolutely Powerful! I must warn any future readers that this book may require a box of tissues by your side when reading. It was one of those stories about life's adventure, with a great deal of challenges, and survival. It's a truly powerful work and very gripping. Inspiring journey of spiritual healing. It lends to helping how to look at life in a not-so-serious manner, and how humor and self-discover of light instead of darkness can help one heal, truly heal. Be grateful for life, definitely.