Travel Confession: I Thought I was Dying in Costa Rica

My most memorable birthday was the one where I threw up blood in a small town in Costa Rica. My girlfriend and her sister were in the middle of a three-month backpacking trip through Central America, and I met up with them for the week of my 26th birthday. We decided on the Caribbean coast because friends and guidebooks touted it as the last authentic region of the country. We wanted to avoid the tourism hot spots partially because we felt better equipped with conversational Spanish than the standard tourist and partially because we didn't have any money.

Cahuita guaranteed us an experience rather than a vacation. The town featured a bus station, a cemetery and three restaurants with no glass in the windows. Dogs that belonged to no one sat in the street and licked the air as we walked by. The three of us shared a cabin at the end of a rutted road, overlooking the beach. My girlfriend and her sister selected it because it offered hot water, but after a near emergency in which we couldn't shut off the shower, the enthusiasm faded. The whole cabin was roughly the size of a dorm room; for $15 a night with hammocks instead of beds and a cockroach we tried anxiously to account for every morning. That's where I got sick.
How it Started

After a few idyllic days on the beach, we celebrated my birthday in Miss Edith's restaurant on the north end of town. I ate a bowl of Gallo Pinto and immediately felt full. Then I felt too full and politely excused myself to throw up in the street. Outside, I assured my girlfriend and her sister--along with the kids who had appeared from nowhere to watch--that it was a one-time thing, that everyone gets sick when they travel, that I was actually feeling much better. Then I threw up again. On the vast hierarchy of shame, I put vomiting while strangers gather somewhere between walking into a glass door and accidental nudity.

We stumbled back to the cabin and I spent the rest of the evening in the darkness of the bathroom, afraid to turn on the bare bulb because it attracted swarms of mosquitoes through the open window. With my head hung over the toilet and my eyes closed, my girlfriend kept her hand moving across my back and smiled encouragingly. "At least you got everything out," she said.

"Yeah, I hope," I hoped.

How it Ended

The fever didn't hit until after we had gone to bed. I woke up freezing and nauseous. The other two hammocks were still so I bypassed the bathroom, walked directly outside and doubled over. I caught glimpses of what I was egesting between the tears and the flickering porch light, and I could taste the iron. I was throwing up blood. I'd dealt with abrasions and blisters before, I knew how to stop a bleeding cut, but an internal problem was beyond my realm of expertise and I was genuinely frightened. The dogs started barking and I scared myself into believing they could smell my blood like sharks, now riling up for an attack. I kicked dust over it and hurried back inside.

"Are you ok?" my girlfriend asked through the bathroom door.

I wasn't ok at all, was in a foreign country throwing up my insides. I knew that telling her would incite panic, a potential trip to a sleeping doctor's house and a lot of Spanish. On the other hand I wasn't going to power through this. I wasn't strong enough to kill it and salvage the rest of the trip by myself. I weighed my options, opened the door and told her.

It was a humbling reveal. Admitting I was truly sick meant that I was just another tourist, helpless and unassimilated ; I was everything I tried to avoid by coming to Cahuita. There was no surprise in her face or panic as I had expected there to be. She left the cabin, went to the owner's house and pounded on the door until he answered. She brought back bottled water and the address for a doctor. We visited him the next morning and managed to communicate my symptoms and he managed to communicate, through the help of a diagram, that I had tiny tears in my esophagus from the stress of vomiting. He told me the tears could be very dangerous if they don't heal properly but that it was a good sign I hadn't thrown up for hours.

We had to abandon our plans for the next two days while I swayed in the hammock with medication and juice. My girlfriend brought me crackers and read next to me while her sister went to the beach.

"I'm sorry," I told her.

"Don't be sorry," she said. "Just, you should always tell me if something like this happens. Ok?"

"Ok."

"Good. Happy birthday."

While it was hardly happy, it was an important birthday. I had assumed for a long time that I existed outside the realm of the fragile traveler who wanders haplessly through a foreign country, wondering why the comforts of home weren't accounted for. I thought I was capable of pulling myself through any inconvenience, and only growing stronger for it. But laid up in bed, I was forced to admit that I needed help. Over the next two days, my shame shifted focus from ruining the trip to believing I could save it alone. I still don't know all my limitations, but now I'm old enough to question them.

Destination Dossier

Destination: Cahuita, Costa Rica
Month: July
Time Spent: 6 days
How I got Around: On foot and by bus.
Memorable Moment: Renting surf boards on an empty black sand beach and teaching ourselves to surf.
Biggest Regret: Snorkeling on a windy day. The water was choppy and cloudy; we couldn't see a thing.
Must-Pack Item: Potable Aqua or a water purifier for emergencies.

Soren Bowie has led hiking and camping trips across the White River National Forest in Colorado. He was a competitive snowboarder and rock climber from 1998 to 2000 and has extensive knowledge in outdoor survival skills, from avalanche safety to orienteering. He currently makes a living in Los Angeles, California as a writer and an editor for numerous online publications.