The Atlantic Monthly | January/February 2003
The Louse is in the House
A malady that does
not speak its name
by P. J. O'Rourke
America gives every appearance of being a nation
besotted with trashiness, divorce, illegitimacy, casual Fridays. The murder
rate in the cities is rising again. Anna Nicole Smith is back for a second
season on cable TV. But recent experience argues that this love for the
dirty and the vulgar is only skin deep, so to speak. Social critics
shouldn't nitpick, at least not figuratively.
Our country has an
enormous stockpile of bourgeois propriety, highly refined bourgeois
propriety. In fact, it is weapons-grade, as verified by the detonation of
me at our house when our five-year-old daughter was sent home from pre-K
because she had head lice.
"How could my daughter get
lice?" I shouted (out of daughter's earshot, of course, for propriety's
sake). "It's a private school!"
"They let us in," my
wife said. And possibly our head lice, too. On inspection our two-year-old
daughter-who does not go to school-proved to be even more populated than
her older sister.
"Where would my baby get lice?" I
"At the country club?" my wife said.
"They let us in," my wife said.
I felt a blush of shame creep across my face, not to mention what
I felt creep across my scalp. None of the six motor vehicles in our yard
is actually up on blocks. We have a huge satellite dish, but that's from a
couple of marriages ago. I defy anyone to call the O'Rourkes trashy, now
that my nephew is out of prison. And my wife's family was on the Mayflower
(Van Lines). The piano was always moved in a well-bred fashion.
"Oh, hush and quit clawing at yourself," said my wife, who was
consulting The AMA Home Medical Encyclopedia. "'Children,'" she
read aloud, "'are most affected, women occasionally, and ...'it
figures' men rarely.'"
The head louse, Pediculus humanus
capitis, is a cousin of the body and pubic lice that truly are
indicative of trash. The former live in filthy clothing, and the latter
are the result of reading Kahlil Gibran by lava lamp and cavorting on a
waterbed. But the head louse is different. The American Academy of
Pediatrics, The Merck Manual of Diagnosis and Therapy, the New
England Journal of Medicine, and the Harvard School of Public Health
say, respectively, "All socioeconomic groups are affected"; "It is common
among school children, without regard to social status"; "[It] affects
persons of all ... socio-economic backgrounds"; and "Head lice ... do not
respect socio-economic class distinctions." One need not scratch one's
head about the repeated mentions of status. The New England Journal of
Medicine notes, "Most children get them at some point, including
The adult head louse is usually described as
being the size of a sesame seed. But a sesame seed stuck between teeth is
visible at ten yards, whereas to my bifocaled eyes lice are ...
think I have lice all over my shoes."
"Those are the holes in your
wing-tips," my wife said.
The female louse lays one to six nits a
day, according to the NEJM. She lays ten nits a day, according to
the American Academy of Pediatrics. The nits hatch in three to fourteen
days, claims The Merck Manual; in ten to fourteen days, maintains
the Academy of Pediatrics; in about a week, declares the Centers for
Disease Control. The CDC states that the louse nymphs (a Nabokovian, and
not very proper, image) mature in about another week. The Harvard School
of Public Health avers maturation in nine to twelve days. A louse that's
been separated from its host dies in a day or so, says Harvard; within
forty-eight hours, asserts the CDC; in fifty-five hours, opines the
NEJM. That journal postulates head-lice-infestation rates of one to
three percent in industrialized countries. This would give the United
States 2.8 to 8.4 million cases a year. The CDC estimates only 6 to 12
million cases worldwide. The AAP thinks there are that many cases among
three-to-twelve-year-olds in the United States alone.
researchers don't know much about head lice because they don't much care.
The reason that they don't much care is, paradoxically, that they know a
lot. That is, they know one important thing: there is no evidence that
head lice transmit disease. Body lice can carry deadly typhus, and pubic
lice breed fatal excuses. All that head lice cause is a vibrant pizzicato
on the skull and an occasional secondary infection from fingernail raking.
The Merck Manual, however, does say, "Moderate discrete posterior
cervical adenopathy is frequent." I was halfway through calling an
ambulance for the girls when my wife slammed my hand with the
Merriam-Webster. That means "swollen glands."
Head-lice infestation is a Protestant work ethic of a
malady. It causes effort, attention, and planning instead of excusing you
from these. There are arguments that head lice cannot be communicated by
anything other than live lice going for a power walk during head-to-head
contact. But the arguments aren't strong enough to keep my wife from
soaking barrettes, pigtail ribbons, doll brushes, and Barbie coifs in
alcohol; laundering everything, including the mittens on my three wood and
driver; vacuuming the ceiling; and buying the local dry cleaner a summer
house in the Hamptons. What couldn't be shoved into the Maytag had to be
sealed in plastic garbage bags for two weeks. Fortunately, pets do not
harbor head licea good thing, because the puppy was getting restless
inside the Hefty Sak.
Is the head louse new to America's
prosperous burghers? Is it part of the contemporary "cheese burgher"
phenomenonthe lumpenproletariat migrating into our well-ordered lives,
bringing with them their social problems? Maybe not: propriety incarnate
George Washington apparently was infested; in the "Rules of Civility" he
wrote out for himself at age fifteen, he avowed, "Kill no Vermin as Fleas,
lice ticks &c in the Sight of Others." Or maybe so: the American
Academy of Pediatrics claims that lice in an individual infestation may
number a hundred or more among members of what the academy calls "cultures
with different grooming practices"which I nominate for euphemism of the
The NEJM says that head-lice occurrence "is probably
increasing in the United States." The Harvard School of Public Health
hedges: "The perception that lice are more prevalent today than in past
decades may, perhaps, reflect societal changes in candor in discussing
such issues." The more candid lower orders seem to have been discussing
such issues for a while. A look into The American Thesaurus of
Slang, compiled sixty years ago by Lester V. Berrey and Melvin Van Den
Bark, reveals a trove of louse terminology: "seam squirrels," "shimmy
lizards," "pants rabbits," "circus bees," "having the hootchy-cootchy,"
"on the cootie trail," "louse-cage" (hat), "lousewalk" (hair part), "louse
ladder" (run in a stocking), and "Lousy-Anna" (the state).
Anecdotal evidence for the recent spread of lice to the better-off
is overwhelming, according to my speed-dial: I called some parents. People
whose children are over the age of twenty-five were baffled by my inquiry.
When I told them that my kids have head lice, they made a kind of phone
noise indicating that my entire family tree derives from those "cultures
with different grooming practices." But everyone with a child under
twenty-five seemed to have had a Go-unto-Pharaoh, Exodus 8:17 experience:
"All the dust of the land became lice ..."
Theories about the
suburban sprawl of head lice abound, many involving things that are or
have become bourgeois proprieties. Feminism, for instance: with mothers
working, children spend more time tête-à-tête in extended school hours,
day care, and play groups. ("Plague groups," one male informant
said.) Or cleanliness: the NEJM says head lice "like clean hair."
Or comfort: schools of yore were furnished in polished linoleum and oak,
and everyone was expected to stay in his or her own slick, hard seat. Now
young educatees loll about on acres of cozy carpet and plush upholstery
where, perhaps, nits lurk and lice nestle. Then there's the national
epidemic of hugging. But bad news for liberals who think that head lice
may be a by-product of meaningful progress in classroom diversity:
"African-Americans rarely get head lice," the CDC says. The cultures with
different grooming practices are those with unwashed Klan bed sheets.
To get rid of head lice you simply buy a bottle of
over-the-counter pediculicide shampoo, apply, wait a week or ten days, and
repeat. The various brands contain either pyrethrins, which are natural
extracts of the chrysanthemum plant, or permethrin, an almost identical
chemical synthetic. Stuff from mums can't be too bad, or prom night and
Mother's Day would be even more toxic than they are. These shampoos can be
used with safety on adults or children. The only problem is they don't
The prescription medications approved by the FDA for
head-lice treatment contain either lindane or malathion. Lindane is a
neurotoxin. I would as soon put lindane on my daughters as put my
daughters unaccompanied on a commercial flight to Baghdad. Also, to
briefly summarize research from the Department of Dermatology and
Cutaneous Surgery at the University of Miami School of Medicine, lindane
doesn't work. And malathion is bug spray. I wear a bandanna over my mouth,
and gloves and a hat, to use it on the lace bugs in the azaleas.
The actual answer to head lice, once the chrysanthemum sap has
been rinsed from the children's hair, is mechanical removal of surviving
lice and nits. The Harvard School of Public Health tries to make the best
of this: "A few lice on the head ... present an opportunity for parents to
spend the needed time with their children." And Harvard goes on to
recommend that treatment be "combined with perseverance and a bit of
levity." I welcome any Crimson grads who care to come to my house and
amuse my wife and daughters with Harvard-type jests. "A fellow with
wingless insects on his head walks into the Fly Club ..."
cannotbless my golf-buddy opticiansee well enough to do the necessary
grooming. The lice are elusive. The nits are the size of telecom-stock
dividends. My wife is furious. She walks around the house muttering, "Men
rarely!" Domestic relations are deteriorating, owing in part to a
head-lice folk remedy that calls for smothering the creatures day and
night with olive oil. The whole house smells of salad. And sincewith
hours spent on the cootie traillittle cooking has been done for the past
month, all three women might be in danger of really getting their heads
bitten, if I could find the balsamic vinegar.
More and worse folk
remedies are available on the Internetpennyroyal, tea-tree, rosemary, and
eucalyptus oils mixed with the virgin cold-pressed, for a smell like a
koala exploding in an Italian restaurant. Along with the folk remedies
come the politics of head lice. Of course head lice have politics. The
very birds of the air and beasts of the field have politics nowadays. It
is a tenet of bourgeois propriety to be sensitive to such politics. That's
why we're sending our girls over to play with kids whose parents belong to
Head lice have their own animal-rights group, or may as
well. The National Pediculosis Association doesn't exactly advocate
letting lice live with dignity, but it does oppose pediculicidal
treatments. Headlice.org, the NPA's Web site, states, "There are no
safe pesticides, 'natural' or otherwise, scientifically proven to be 100%
effective ... Reliance on head lice treatment products that are
ineffective promotes repeated use of potentially harmful chemicals ..."
Nor does the association recommend Newman's Own. "Manual removal is the
safe alternative ..."
The National Pediculosis Association
urgently demands a no-nits policy: "the temporary dismissal of a child
from a school, camp or child care setting until all head lice, lice eggs
(nits) and egg cases has [sic] been removed." The NEJM says, "Nits
may persist for months after successful treatment." Welcome to fourth
grade, the best three years of your life.
In contrast, the
American Academy of Pediatrics and the Harvard School of Public Health
urgently demand a no no-nits policy. "Of more than six hundred samples of
presumed lice and nits submitted to us for examination," Harvard says,
"fewer than two-thirds contained evidence of any infestation." According
to the AAP,
In a prospective study of 1729 school children screened for
head lice, only 31% of the 91 children with nits had concomitant lice.
Only 18% of those with nits alone converted to an active infestation
over 14 days of observation.
The nits versus no-nits debate
has turned into a major kerfuffle among parents, teachers, school nurses,
andfor all I knowcafeteria workers forced to wear those ugly hairnets.
The AAP is fretful: "No child should be allowed to miss valuable school
time because of head lice." The NEJM is indignant: "Excluding
children from school because of head lice results in anxiety, fear, social
stigma, overtreatment, loss of education, and economic loss if parents
miss work." And the Harvard School of Public Health puts its objections in
terms so strong that one almost wonders if the Harvardians aren't former
members of the National Pediculosis Association who've been deprogrammed:
"These quarantine policies seem a disagreeable vestige of certain
offensive and supposedly health-based anti-ethnic strategies practiced
mainly in Europe earlier this century."
A concerned father,
weighing the evidence in the controversy, can only conclude, "Where were
those head lice when I was stuck learning long division while the weather
outside was beautiful?"
Meanwhile, I still itch. The Harvard School of Public
Health explains why.
A few people remain convinced that their infestation is
real, even though they have been examined by one or more competent
specialists [surely, by now, my wife qualifies] who can find no physical
cause for their discomfort ... Such a person may, indeed, be delusional.
And this gives me an idea, delusional though it may be. Many
Muslim extremists have lots of children and some more than one wife.
Western-style feminism may prove enticing to these women after they've had
to drag all the tents, rugs, and camel saddles 500 miles to the nearest
laundromat. And wait until they discover "men rarely." Then imagine the
chaos when the no-nits dispute becomes enmeshed in sharia. Furthermore,
all the AK-47s, shoulder-fired anti-aircraft missiles, car bombs, and
suicide explosive belts would have to be sealed in plastic garbage bags.
We may have here a form of biological warfare that bourgeois
propriety can countenance. The entire infrastructure of al Qaeda could be
driven, as it were, buggy. And from what I understand of head-lice
epidemiology, all we have to do is fund one day-care center. Dear Osama,
may all your troubles be little ones.
P. J. O'Rourke is an Atlantic
correspondent and the author of several books, including The CEO of the Sofa (2001).
Copyright © 2003 by The Atlantic Monthly Group.
All rights reserved.
Monthly; January/February 2003; The Louse is in the House; Volume
291, No. 1; 44-48.