Cusco 1, KP 0: Frustration, Hospitalization, and Near-Total Dejection Edition
This is the first post I’ve ever penned from inside a hospital.
I’m currently in a private hospital in Cusco called Oxygen Medical Network Clinic. Last night, I came here in an ambulance—the drama of it all!—and was deposited first into a wheelchair, then into an elevator, and then into room 401, where I woke up this morning, having successfully managed to dislodge neither the cannula supplying me oxygen nor the IV supplying me antibiotics.
I’m here to get treated for a strong but mild (we’ll get to that oxymoronic phrase in a second) case of altitude sickness, which was complicated by three different bacterial infections, one of which is salmonella.
The fact that I’m here right now, watching the window-washers eke their way down the building in front of the most glorious view of this city I’ll likely get, is frustrating in ways both immediate and, dangerously, creepingly, cripplingly long-term. Immediately, I’ve wasted the hundreds of dollars already put down for my 4-day trek to Machu Picchu, which I likely can’t go on under these conditions, and let down Maddie, who flew from New York to do the trek with me. Our night camping under the stars in eco-domes and whispering ghost stories: gone. The chance to hike to the Sun Gate at dawn and experience what the Incas felt entering their capital city for worship: gone.
Looking forward, I’m feeling a little dejected, disillusioned, and disappointed about my trip in general, and this is the first time I’m feeling this way, so I’m trying to listen to myself and work out what it means and where it’s coming from.
Peru is just so different from everywhere I’ve been so far. Chile, Argentina, and Uruguay all felt comfortable. Not in a way that meant I wasn’t pushing myself, or getting out of my comfort zone, or taking risks—just in a way that meant I didn’t constantly feel on edge or on display.
The on edge part: Peru has the worst public health, public safety, and social services of anywhere I’ve been so far. That’s not to say any of it terrible, but it is to say I’ve needed to be much more careful about what taxis I take (lots operate without licenses and the government doesn’t really regulate them), what food I eat (which I thought I had been, making the salmonella diagnosis so frustrating), where I buy my water, et cetera. After three full months of largely worry-free travel—I could drink the tap water in Puerto Natales, I could eat food from any restaurant in Punta del Este, I could navigate the subway system of Buenos Aires with ease—the extra responsibility of constantly considering all of those basic variables is new and exhausting.
The on display part: I have never felt so obviously an outsider. It’s so easy for me to identify Peruvians and for them to identify me as not one. That’s partially because (and this is a good thing) the indigenous populations in Peru (those descended from Amazonian tribes, or Incas, or other groups) have survived in much greater numbers than the native people of Chile, Argentina, or Uruguay, who were by and large systematically slaughtered and who had their land resettled with European immigrants. Many Peruvians have a distinct look to them—dark hair, dark eyes, planed cheeks, which meansthat everyone knows I’m not from here, which has mostly resulted in them using that to their advantage, whether that means upselling me on a sweater or following me around a square, shoving wares in my face and telling me that they know I have money and should spend it with them. True, I’ve only been in a few cities so far, and all of them tourist hotspots, so it’s no more than is expected from a country where tourism-as-percentage-of-GDP is in the top quartile of all countries in the world1. But I feel uncomfortable and, perhaps ridiculously and unrealistically, unwanted here. It’s clear that Peru would appreciate my tourism dollars, and my patronage at historical sites, but it doesn’t feel like a place I could come to feel at home in, which I think I’ve come to look for in my long-term travel life.
But let’s return to this discontent and what it means for the rest of my trip in a bit. First, let me tell you a bit more about how we got here.
Maddie and I arrived in Cusco from Lima two days ago, on Saturday afternoon. I was in a terrible mood when we got off the plane—we’d taken VivaAir, which must be the Spirit of Latin American airlines and is staffed by schadenfreude-exuding demons of anti-hospitality who refused to stray from arcane and pointless rules like “electronic boarding passes aren’t acceptable and you must pay $16USD”—this for a $40 flight!—“to get a paper boarding pass” or “you may not move seats to sit with your friend even if you are both in empty rows where clearly no other human has or wants a seat”—and sulked over to baggage claim while Maddie ran to the bathrooms (the medicine we were taking to prevent altitude sickness had the unfortunate side effect of making us constantly need to pee). I begrudgingly sidled up to two French girls and asked if they wanted to split a taxi into town with us. They did, we got our luggage, and went to negotiate with the only licensed taxi counter, dodging the dozen men in too-tight pants and brocade vests trying to jostle us into their unlicensed cars.
A New Zealand girl I’d come off the plane with had warned me not to spend more than 20 soles (about $7) on the ride, so my best Spanish haggling came out for the first time all trip. The taxi man and I were at an impasse at 40 soles, but I felt my mood ballooning like an oil drum that’d taint everything around it were it to be pushed just a tiny bit more to the tipping point, so I accepted the fare and we trudged out to the airport, laden with backpacks.
Figuring that the best short-term cure for a bad mood was to do something nice for someone else, I saw the New Zealander again, in the parking lot, struggling to negotiate with a black-market taxi driver, and asked if she’d like to come with us. She looked at me, green eyes brimming, nodded her head, and burst into tears.
I hung back from the rest of the group and put my arm around her, waiting to see if she’d speak.
“You’re my guardian angel,” she got out between sobs, “I don’t know what I would have done if you didn’t come find me right now. My boyfriend just broke up with me before I got on this flight. I feel so alone.”
I kissed her on the cheek and told her not to worry, that I’d cover her taxi fare to town and help her find somewhere to stay if she needed it. The five of us squeezed into the sedan, to the chagrin of the driver, who then tried to charge us another 10 soles for an extra passenger and yet another 15 soles to pay his airport parking ticket; I firmly refused both requests, feeling renewed, imbued with responsibility. (I write this not to laud how charitable I am—first, I’m not, really, and second, my thirteen years of Catholic school firmly implanted the whole “do not let your left hand know what your right hand is doing” thing with regards to what counts as actual charity. Though, as our taxi driver pulled up to the middle of town to drop us off and before we each scattered to our respective lodgings, Karla the Kiwi asked for my WhatsApp number and warned me not be taken aback when she messaged me, as she works as a stripper and her profile picture is of her breasts, bare but for bedazzled nipple tassels—so she would make a good Mary Magdalene, were we to turn this into a whole parable thing.)
I strapped on my backpacks and took off with Maddie. I’ve carried the full weight of my bags many times before, and for distances much larger than the three blocks that lay between the main plaza and our hostel, but when we arrived at reception I could barely breathe. Reviewing the space from the bean bag chair I sunk into to regain my breath, I saw it was filled with almost everything I hate about hostels: smoke on smoke on smoke, bickering European preteens who think they are the kings and queens of the known universe, loud music, and already-drunk Americans, which was especially concerning as alcohol, which seemed to be free-flowing at our hostel, is especially bad for those acclimating to high altitude.
Chalking up some of my discomfort to hunger—after all, we’d taken the altitude meds, stayed hydrated, and gulped down coca tea as soon as we checked into our dorm; I couldn’t possibly be already sick from the elevation—we left to find food and explore the city a little bit.
Though some of the street meat looked tempting, Maddie and I settled for a chicken dinner at a little place off the Plaza del Armas, where for 12 soles, or $4, we were each served with a hunk of chicken, a bowl of rice, and a plate of fries, and given access to the salad bar, which we resolutely avoided as we couldn’t vouch for the cleanliness of the scraggly beets or sliced tomatoes.
Looking back now, I think it was likely the chicken that did me in. My doctor assures me it could’ve been the eggs I had for breakfast in Lima, or unwashed fruit in the crepe Maddie and I had for dessert, or any number of other things I’d eaten, but somehow my gut (which I’m feeling especially familiar with, after two days of intimate communication with it) says it was the chicken.
After dinner, Maddie and I went back to our hostel and tried our best to sleep over the din of reggaeton blaring and ping pong paddles a-slapping. I woke up still not feeling great, but figured maybe some fresh air would help, so we went for a walk through Cusco.
Fresh air did not help. I was still dizzy, with a lightly pounding headache and a nauseous stomach that neither comfort foods (a delicious piece of chocolate cake Maddie and I split on a cafe terrace) or bland foods (the rice and potatoes under a bed of lomo saltado) could make happy. We returned to our hostel, where I folded myself into bed and tried to get warm, as my fingers and toes, despite layers of gloves and socks, remained freezing to the touch.
Maddie convinced me to take some oxygen from the reception desk, so I crawled out and explained my symptoms to the receptionists. They swabbed a mask with rubbing alcohol, instructed me to sit on the stool next to the oxygen tank, and told me to breathe deeply for four minutes.
It didn’t help much, but sitting there quietly, with all the staff and the guests gawking at me, I started to think that maybe what I was feeling wasn’t normal first-day acclimation issues. I tried to gameplan what my next steps should be—my go-to response to any new situation—but could feel my thoughts slushing around inside my brain. I’m used to being able to call up ideas and logic trees and come up with fully-formed, crisp evaluations and it felt like my thoughts were struggling through honey on their way to my consciousness.
That scared me more than anything, so like any grown woman in a crisis, I called my dad and asked for his advice.
We decided on a game plan: rest up that night, and if I felt as bad or worse in the morning, immediately go see a doctor.
I was all set to follow the plan—with a slight addition of changing lodging from the cheap-but-loud hostel to a nicer, three-star hotel in a quiet neighborhood, which was Maddie’s idea and a wonderful one—but that evening, as we were walking up the two flights of stairs to our new room, I felt so dizzy I thought I was fainting. So I decided to have the doctor come check on me that night—a Sunday evening house call that, in one of the pros of being in a less developed country, would only cost me $50.
I walked down slowly to the hotel lobby, wearing a white alpaca sweater I’d bought that day and my favorite black flowy pants, clothes that gave me comfort and, I imagined, strength, and shook hands with Dr. Frank, whose serious face was brightened only by his light eyes, made bigger by his fan of dark lashes. We started off speaking Spanish, but when I had trouble explaining my symptoms en español, he switched to relatively fluent English.
I say relatively because after checking my heart, lungs, stomach, blood pressure, and oxygen levels—which he clucked at, seeing them come in at 85% instead of the bare-minimum 90% for healthy respiration and blood flow—he declared that my case was an acute one. I started crying again, imagining the worst-case complications of altitude sickness I’d read about: fluid in the lungs, swelling of the brain, heart murmurs, et cetera.
“Why you cry?” he asked. “Not so serious!”
“You just said I have an acute case!” I said.
“Yes, yes, acute!” he confirmed.
Maddie, who was watching the proceedings from an armchair behind us, jumped in to help: “Yeah, and acute means it’s not a big deal, like it’s small, like an acute angle.”
My own Íñigo Montoya moment: I do not think that word means what you think it means. I held up a hand to pause them both, typed quickly, and then lifted my phone screen.
“Present or experienced to a severe degree,” I read pedantically. “Are you saying my case is serious? Or not serious? And Maddie, this is acceptable from him, with English as a second language. You, not so much.”
Dr. Frank apologized and explained that my case was not so serious. No pulmonary or cardiac complications meant it was in the mild classification of altitude sickness. But it was as drastically mild as it could be, as my oxygen levels were so low that simply taking an hour or two of oxygen wouldn’t get them back up. I’d need at least eight hours, and I’d also probably need some tests for my stomach pain, since my digestive issues were more complicated than those expected from altitude sickness-related nausea and might mean infection or, in the worst case, a parasite.
Parasites! As Maddie and I packed to spend the night in the hospital, I started flashing through everything I’d eaten over the last few months. Most recently: guinea pig, alpaca, plates on plates on plates of raw fish. In general: fruits, veggies, and meat from all sorts of places—Michelin-starred restaurants, hostel kitchens, unlicensed restaurants in Mendoza serving food out of their houses, airport hot plates, fishermen’s shacks, fruit markets, friends’ homes, grocery stores. Could I, at some point, have picked up something that was eating me from the inside? Possibly. Vamos a ver—let’s see.
That takes us to last night, where I checked in and immediately gave blood, urine, and stool for them to test (asking my nurse to please, please be careful about putting in the needle for the blood test as I didn’t want to stain my white alpaca sweater; she smiled my at vanity). A few hours later, the results came back: no parasite (joy of joys!), but yes to a few different bacterial infections, the most serious one being salmonella, which they’d like to treat with a dual regimen of antibiotics and probiotics, along with some other medicines to lower the fever caused by the infection and to treat my altitude sickness. I got hooked up with oxygen and a saline drip and was given the remote to the smart TV, where I navigated to Netflix and then to La Casa del Papel, a Spanish-language heist drama set in Madrid that Maxi had turned me onto in Uruguay.
The nurses kept coming back to check my heart rate right as the chase scenes were unfolding, and we had a few laughs together as I explained that I felt fine, but was just concerned for my favorite robber, Nairobi, who seemed near the breaking point and whose sure arrest was making my heart race. I turned off the TV.
I had been in mostly high (if slightly caustic) spirits all evening, joking with Maddie about the fact that we’d eaten all the same things but that I’d been felled by mysterious bacteria instead of her, with her more sensitive stomach, and posing with thumbs up in the photos she snapped in my hostel bed.
But as night fell, and Maddie went downstairs to order pizza and eat it somewhere where the smell wouldn’t make me nauseous, my mood dropped. I knew I was in good hands, and would make it out of this just fine. But I was there, wearing the knitted earwarmer I’d bought for our hike and shivering under a down blanket, with an IV taped down onto my arm and a cannula under my nostrils, and I felt like I was my mother, sitting in a hospital bed near the end of her life, being pumped full of medicines and trying to survive. I felt awash with what I imagine she had to have felt then, as the cancer ate its way through her body: weak, powerless, alone. I looked at myself in my cell phone camera and saw her face: pale skin under freckles, hair covered such that I looked bald, as she did at the end, strong nose casting a shadow on sallow cheeks.
I don’t have cancer, I’m not dying, and I’m not a particularly morbid person. Salmonella and altitude sickness are infinitely get-over-able and I have the money (and hopefully the reimbursing travel insurance) to get the care that I need. I will be fine. But for a few minutes last night, listening to the hiss of my oxygen and the drip of my IV and the muffled communication of the nurses down the hall, I felt so deeply sad and so deeply alone and so throughly like I’d like to be able to call my mom and cry to her, too.
This morning, I woke up tired but feeling positive, and worked on practicing my medical Spanish with the day nurse, whose English is much worse than the night nurse (same goes for the day doctor, unfortunately). I succeeded with questions like “I forgot to lift my arm when I walked to the bathroom, can you help me get the blood out of my IV?” and “I finally feel hungry, can you bring me some toast?” and had to switch to English to clearly articulate, “What do you think my stamina will be like in two days? Will I be healthy enough to go on a 4-day trek through the mountains?”
The answer to those questions, from my nurse and from my doctor, were maybe. With my oxygen levels up on their own—staying steady this morning at 90%, without any supplemental assistance—I would probably be fine at the altitude. But my stomach would continue to be sensitive, and I needed to stay on a strict diet of antibiotics every 12 hours, small meals of simple carbs and fully cooked vegetables between them—no fruit, no juice, no eggs, no dairy, no red meat—for the next week, which would be hard to control while trekking and eating the food prepared by our guides.
Picking up this missive from the next day, from our hotel room:
After passing my final test of having the appetite for my lunch of boiled chicken, white rice, and steamed vegetables and the digestive powers to keep it down, my doctor discharged me. She gave me a plastic bag of medicines and rattled through their different uses and dosing instructions. She couldn’t understand my questions about side effects or timing (and worse, she refused to believe that her English wasn’t good enough to comprehend, so she just gave me prepared speeches about the intended effects of the drugs, which I’d more than mastered at that point), but I have a best friend in medical school so I took what notes I could, then shot Cat a text of the prescriptions and my understanding of what each did and she patiently answered my questions like the rockstar that she is.
I called an Uber (I didn’t think I had the strength to haggle with the taxis or mopeds over fares) and went downstairs to pay my bill.
Bill for 18 hours of medical care, three blood tests, one urine test, four stool tests, four prescriptions, and 10 hours of oxygen: $660.
Final bill after I’d pointed out two redundancies and an incorrect quantity of oxygen with the billing lady, who complained about me in Spanish to her coworker until I calmly leaned over and whispered that I could understand her: $545. Did you not expect me to read the Spanish bill? To care that you’re either incompetently or maliciously overcharging me? Must we haggle over this, too?
My Uber almost left me, as I hadn’t baked in time to quibble over medical costs, but it didn’t, and I dragged myself out of it at our hotel entrance, asked the concierge if he’d look into getting us a discount on the room for the night prior since we had been in it for all of 20 minutes before ambulancing our way to the hospital, and settled in to an afternoon of drinking water, watching La Casa del Papel, writing, eating the pretzels that Camilla dropped off (brief aside: how lucky am I that I fell ill during the one week where I have not one, but two, friends from home visiting?), confirming to my dad that I was okay, and apologizing to the couple of friends I’d barked at while frustrated and bedridden in hospital.
I’ve also been thinking about what I wrote about earlier, about feeling a little disillusioned with the wonders of long-term South American travel and not feeling at home in Peru. What I wrote is true: I’m less comfortable here, and part of me is yearning to get out of this country and go somewhere I’ll be happier. But I know that that’s a fairly emotional reaction that’s over indexing on my horrible last few days.
What I have to decide now is this: do I want to stay in Peru and follow my initial idea, to make my way overland to Ecuador, on the far-less-popular northern route? It will mean lots of Spanish- and Quechua-only towns, lots of being the clear foreigner over and over again (though also not being in cities as tourism-obsessed as Cusco, so perhaps feeling less cynical about the experience), lots of bumpy overnight buses and lots of making my own way. More adventurous, less comfortable.
Or do I want to return somewhere I feel more at home? Maybe to Chile, where I can explore the northern part I never got to see, the Atacama desert and its magic?
Or do I want to flash-forward my itinerary and go straight to Ecuador, to start fresh? And if I go, should I keep traveling continuously, or stay put for a little? Shall I go find a good Workaway in Ecuador—ideally, I’m thinking, somewhere on the Galapagos Islands, where I already know I want to spend a solid chunk of time and can’t afford to do it in full vacation mode—and settle in and calm down and have a more relaxing, eco-friendly month instead of a busy one?
I don’t know yet. I need to think. Luckily my brain is back to fully-oxygenated, fully-functioning speed to do it. I plan to make the most of the next few days around Cusco—through from the home base of the Sacred Valley, which is several hundred meters lower than Cusco and where I should be able to recover better—and then head back to Lima (the only big city that flights from here go; I know I won’t make it throughthe 27-hour bus there, up and down through the Andes at high and higher elevation), where I’ll set up shop for a few days of trip planning and reflection. Send any ideas or suggestions my way!
Author’s postscript: I followed the initial plan as laid out above. I decided not to go on the trek, following my doctor’s advice and my gut instinct, and told Maddie, who took it well and is going anyways (which is great—I’d hate for both of us to miss out on such an incredible experience). Today, Tuesday, after 24 hours of straight rest, I took a cab with Camilla and her boyfriend Nino to the first city along the Sacred Valley (a fertile river basin leading up to Machu Picchu, studded with gorgeous ruins and local markets and centuries of history), where I checked into a really nice hotel (figuring that my hospital stay has likely already blown my budget, so why go back to penny-pinching until I feel completely better? May as well make the most of that investment) and then we spent the day exploring the textile market (alpaca vests are SO SOFT and I almost bought one even though I would wear it no more than twice a year and I can’t rationalize spending $200 on a vest, even one that looks damn good on me).
Nino and Camilla were wonderful. We went at my pace as we explored town, which, despite being able to breathe normally again, was still incredibly slow (I’m so glad I decided no on the 100-km hike); we stopped at a veggie-friendly cafe where I ate a boring and delicious quinoa-and-boiled-vegetables-soup; we gawked at the archeological and architectural and agronomic wonders of the Incan civilization and took many, many photos.
It was a lovely day, and I hope to follow it with a few more exploring the valley on my own, taking my medicine on schedule and checking in regularly with my body. As far as travel mishaps go, this one has been relatively minor, but I’m glad to be on the up and up from it and grateful for the privilege I have in being able to afford the healthcare I need and to have the friends and family I do who have taken care of me over the last few days.
More later on all else I have on my mind—book clubs, gastronomy, quarterly check-ins, motherhood—but for now, I’m off to eat plain spaghetti and go to bed.
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