The Best Medicine

The taxi meandered through the urban sprawl of San Jose. Corrugated steel roofs and weather-beaten store fronts lined our route while our driver cranked up "Center Field" by John Fogerty. As I hummed, "I'm ready to play...Today!" we pulled up to an antiseptic blue and white building that couldn't have been more than ten years old. "Hospital Clinica Biblica," stated the driver matter-of-factly. He helped unload the bags while Katie dashed across the drop-off area to grab me a wheelchair. The guard by the entrance seemed a little confused by the sudden explosion of backpacks and Americans. As Katie wheeled me up he asked her, "Appointment?" "No, um, Emergency?" "Ah." He seized the handles and Katie slung one backpack to her chest and the other to her back and took off in pursuit.

Katie's method for hauling our luggage. She's in there somewhere.

I've always wanted to have an excuse to ride in a wheelchair. I feel there was some early idea of being able to pop wheelies and speed down ramps that drove this childish longing. Now I hope I never reside in one permanently. I like to be in control of where I'm headed. In a wheelchair it's far too easy to be scooped up and rolled to a destination without being consulted. Okay, maybe I'm a bit of a control fan (I wouldn't say freak) but I didn't like not taking in my surroundings as I was whisked to the ER's waiting room.

Katie unloaded our grimy luggage on the immaculate linoleum floor and walked from desk to desk, searching for the right place to start. With my passport in hand she had me in the system and could even ask questions in English. Soon I would be talking to a doctor. Soon we would know what was wrong with me.

"Robert...Bort-heh-es." I looked around for my father before realizing they were calling for me. This became a trend, everyone addressing me by my middle name. My food would arrive with a label for "Robert" and nurses would confirm my name when taking my pulse. It became routine to hear, "Robert?" and simply respond, "Si." I almost told them to just call me Rob. Maybe I would have expected this if I'd known a little more about Latin American culture. But I didn't.

Behind door number one they took my pulse and blood pressure, listened to my story briefly and sent me back to the waiting room. Behind door number two the doctor pretended he didn't understand English just to mess with me. I started speaking in German just to mess with him. Then he told me he was the wrong guy to see about infections. Finally, behind door number three we were confronted by the hobbit version of Fred Savage, Dr. Arias. His English was tentative, but functional, and his accent slight. He took a look at my oozing toe, grapefruit-sized knee, and the map of the Soviet Union spreading across my thigh. "This does not look good. You will need to stay in the hospital...some days. I will give you antibiotics and draw blood for the laboratory." Those were the magic words.

Because the internet needed a picture of my inner-thigh.

I felt myself relax, releasing a tension that I hadn't noticed I'd been carrying for the previous two days. He gripped my chair and wheeled me through massive swinging doors to a small alcove off the main traumatic care lobby. Katie was then swept off to billing to show them my insurance card, my credit card, and fill out a massive packet (ugh) of forms. Even given the stress of the previous 48 hours she managed to recall my father's middle name. In a world without HIPPA there were no questions asked about who this person was. Katie came in with me, so she must have some reason to care about my health and well-being.

As soon as the insurance cleared, a nurse arrived to trick me out with an IV. It was placed in the back of my left hand and basically left me unable to extend my fingers for the subsequent six days. I always wondered what and IV felt like. Now I know it's uncomfy and you can feel the needle rubbing against the tendons of the hand, but the antibiotics it was delivering along with the painkillers left me relaxed, happy, and safe. Katie returned with a short, nervous man who was predestined for a life in accounting. He bowed slightly, asked for my signature andexplained, "you dial nine to call outside the hospital," then left us alone with my drugs.

For the previous 40 hours Katie had expertly hidden her fear, offering well-reasoned advice while taking care of my infected body and the details of getting it fixed. But now it was someone else's turn, and Katie could finally release her anxiety. She leaned into my shoulder. I wrapped my right arm around her, cursing my clutched left and felt her back heave in a deep sob. I held her close, the two of us perfectly fitting onto the hospital bed. I knew this was bad, that this could get worse and we didn't even have a name for it, yet. We were scared, but it was my turn to hold and console. I couldn't carry two backpacks, but I could hold her.

A nurse came with a new packet of antibiotics. She politely allowed us to separate, then offered a tube of white gunk. "Here, you should put this on your upper leg." Turning to Katie, "Or maybe you can." Katie snapped to attention. "No, he can rub his inner thigh all by himself." Back to business.

A lab tech appeared to get some swabs and samples from my oozing toe. While he poked and prodded, Katie pinched and poked me to distract my attention from the knife by my digit. We had each found release and a more stable peace-of-mind...until the doctors came in.

Dr. Arias entered with a taller, thinner doctor. They bent over my toe, then followed the bruising and swelling up my leg to the massive pooling bruise around my lymph nodes. Their brows furrowed as they whispered and consulted. Then they noticed the book on my lap, "Your Inner Fish" by Neil Shubin, a birthday gift from Katie. "Is this about a fish?" "It's about how our bodies evolved." "So, is the fish inside you causing these problems?" "Maybe he's just upset I decided to grow this leg in the first place." "You study evolution?" Uh-oh.

That question has lead to some tense moments before, and I wasn't sure I wanted to have a tense moment be part of an early interaction with my doctor. I braced to discuss the separate paradigms of faith and science. The tall doctor started in, "Then you must have enjoyed the movie 'Avatar.'" Oh. "Yeah, I thought it was awesome, and the hexapod animals were really cool." "Yes, this was a wonderful movie." Thank you Mr. Cameron and Dr. Shubin, for facilitating international nerding. The doctors switched back to Spanish and exited.

Dr. Arias returned. "This is a very strange, very aggressive infection. We must wait on the results of our tests, but first we will take you for an ultrasound." I never thought I would find myself lying on a hospital bed, smeared in Vaseline, looking at a pizza-wedge image of my body's inner workings, but then I never thought I would land in a Costa Rican hospital, either. While a particularly awkward computer guy cataloged the images, the radiologist followed the main veins and arteries of my leg, from the toe that looked more like a cocktail weenie, to my ankle and all the way to my abdomen. As he traced the path he entered words that I hoped to ignore for a few more weeks: "Popliteal fossa," "Anterior tibial vein," "Femoral Vein." He confirmed my vessels and organs were all normally sized and, after the abdomen scan, that I am not pregnant. That's a relief.

I was wheeled upstairs and through a lovely blue door. Katie was waiting for me on the other side with the backpacks propped against each other in exhaustion. The massive room would have accommodated my entire Long Island apartment.

A lone hospital bed sat in the middle of the expanse and against the wall was a couch that looked suspiciously like a futon. I lifted myself onto the crisply tucked sheets. I was plugged into another round of antibiotics as the sun set over San Jose and the doctor appeared again, "I will see you in the morning with the test results. We will watch you tonight." Looking at Katie, "You are welcome to stay here. We make that couch into a bed. This is easier than finding a hotel, I think." Perfect.

Katie had a bed, but didn't consistently have a pillow. Fortunately she's a woman who can improvise.

We weren't exactly in the best neighborhood for a young, woman to be wandering around alone with a massive backpack and a wad of cash. He disappeared and I saw the phone next to the bed. Time to check in with the folks.

I rehearsed how I would reveal what had happened. Do you lead with, "Hi Mom! Just so you know, I'm fine. Well, not fine. We're waiting for a diagnosis. I'm in a hospital in San Jose, so I'm safe. The jungle kicked my ass, but I'm fine."? That didn't seem right. I dialed nine and punched in my home phone number. Weird beeping. Dialed again; something in Spanish. Dialed Mom's cell phone. It went through but straight to voice-mail. Then I called my dad. No one. In desperation I called my brother, never far my his cell phone. No one. Okay, back to the home number. I managed to leave a voice-mail. "Hi Mom, I'm fine. Here's the hospital's number." So much for instantaneous, universal communication. There would be some stress in Cincinnati tonight.

It had gotten late and my stomach was starting to make noises. But it really wasn't rumbling for hospital food. A nurse came in sporting a bright blue top and an antiquated folded white hat like all the female nurses at the hospital. We tentatively asked about the dinner schedule. In moments there were two trays of food. And what food it was. Every meal at Hospital Clinica Biblica was gourmet, from the traditional pinto beans with eggs and tomatoes that arrived for breakfast to the grilled fish for dinner or the fresh guava juice...I never want to be holed up in a hospital again, I would just be disappointed by the food options.

Then the phone rang. I braced for the conversation I was about to have. How to explain the situation and ensure her that I was in good hands. Well, I needed to to pick it up. The voice I heard on the other end of the line was shockingly calm and even. Like a good journalist's son I gave her the whos, whats, and wheres as concisely as I could between heartfelt apologies. "Matt, you don't need to say you're sorry. There are some risks in what you do. We're lucky this hasn't happened earlier, and that you're doing so well. Hang in there. I'll call tomorrow to hear what the doctor tells you about the lab results."

The night was punctuated by visits from the nurses taking my pulse, drawing blood, switching out my antibiotics and asking, "Pain?" They would often helpfully produce the international pain index with the little smiley face that grades into distress. I would point or give a number and go back to trying to sleep while tethered to my IV. Early the next morning I asked if I could take a shower with a tube-plug sticking out of my hand. The middle-aged nurse nodded and disappeared. Just then the phone rang. Mom asking if the doctor had been in. As I tried to answer, the nurse reappeared with a wheelchair. She indicated I should hop in. I passed off the phone to Katie who was quizzed on my, uh, intestinal functionality.

As we rolled down the hall I felt a building anxiety. Were we going to some kind of massive bath or shower? Was this woman going to scrub me clean? I was mortified. As long as I have control over my extremities, I am taking care of suds-ing up. Luckily, I recognized the route. Another round of ultrasounds where I got to check out my own kidneys, gallbladder, and pancreas. Again, we determined there were not little Borthses on the way.

Soon after crawling back into my bed the doctor returned. Diagnosis time. He perched on the edge of a plastic-upholstered arm-chair, awkwardly propping his ankle on his knee. He gripped his foot to keep it from sliding off and took a deep breath. I braced for the worst. "We're looked at your test results. Your coagulation numbers, these should be at one. These are at 1.9 when you arrive. Your blood has been thinned." He breathed again. "There is only one thing that causes this. This is a snake. There are many kinds of dangerous snakes in Costa Rica. I think this is a biper (Note: "V" is pronounced like a "B" in Spanish)." Whew.

"You seem much less worried than I thought you might be with this news." "Oh, I'm just glad to know what it was...that and a snake makes for a better story than a thorn." "This is true. We do not administer anti-venom more than 24 hours after the bite. There are several kinds of snakes, um," He struggled for the English names of the animals. Katie produced our field guide and opened to the section on reptiles. I had originally hoped to turn to that section to identify a weird lizard, but now Katie thumbed straight to the section where every animal was labeled "venomous."

We established it was a good thing my foot didn't find a coral snake or bushmaster, two of the most deadly snakes in Central America. Coral snake venom is neurotoxic and has a nasty habit of quickly paralyzing the diaphragm. Rescue breathing is the way to keep a person alive. What my foot likely found was a kind of small pitviper.

I was correct in assuring Katie that snakes are diurnal predators...in places where there aren't pitvipers. The group has a special organ between the eye and nostril that creates their eponymous pit. The organ is heat sensitive, allowing the snake to hunt warm-blooded prey at night. Since most furry, warm-blooded animals need a drink eventually, many vipers will simply set-up along a riverbank and wait to ambush an unfortunate rodent. This nocturnal adaptation has the added bonus of giving the snake protection from birds who are primarily day-time killers.

The critter I found probably wasn't even paying attention to my foot as it descended from on-high. He was keeping his pits and eyes low, looking for rats and opossums. I scared him as I tried to cross the river, he gave a desperate lunge, and slithered off in to the grass along the riverbank only to become a creature of my frustrated nightmares. The bloody nose was a reaction to suddenly thinned blood compromised capillaries and the bruising on my left foot was a reaction to the suddenly venom-compromised veins of my extremities. If I had taken a hard fall soon after being bitten, I could have caused a vessel to pop in my head, essentially triggering a stroke. Lucky. I was incredibly lucky.

As the swelling went away, my leg and foot were left a very attractive shade of iodine-stained yellow.

I propped up my foot, was injected with vitamin K to help lower that coagulation number and left to watch CNN's coverage of the Haitian earthquake. If I ever started to feel sorry for myself or rage at the unfairness of it all, all I had to do was remember there were people dealing with true tragedy not too far from my massive cell.

The next few days were a monotonous blur. I would read or write, chat with my Mom and Katie, then watch my swelling dissipate some more. I would look forward to delicious Costa Rican coffee in the afternoon served by the gracious food staff. Katie and I would watch a movie or TV show in the evening. And so on. In the afternoons Katie would be tasked with exploring the city. I may have only been capable of shuffling to and from the restroom, but that didn't mean she was doomed to stare at me, the blank walls, or Anderson Cooper all day. She went to the markets, keeping an eye out for snake figures. Turns out no one in Costa Rica wants a serpent on their dresser.

After a trip to the National Museum of History where she found Costa Rica's first printing press (and took a picture knowing how special such an artifact would be to my family):

the worst set of taxidermied animals ever put on display:

Theoretically a capuchin monkey.

and a modest collection of Costa Rican fossils:

she returned to find a strange woman sitting in the chair next to my bed. She started to worry there was a problem in billing and my credit card wouldn't cover our stay.

"Hey, Katie, meet Adrianne." Adrianne promptly jumped up to give a still-worried Katie a hug and offered the backstory, "We did theater together then I was his brother's romantic interest in a bunch of shows. I'm studying abroad in San Jose and heard about the bite from my mom." Welcome to the interconnected internet age. Adrianne was warned to keep close-toed shoes on at all times and sent off to explore the jungles and waterfalls that I hope to visit upon my eventual return.

Katie also managed to smuggle in one symbol of the tropics that we'd planned on enjoying on some remote Pacific beach: a coconut. Instead we enjoyed it snuggled up on a hospital bed in land-locked San Jose. Not the planned adventure, but an adventure nonetheless:

After a couple of days of sitting and eating, my knee returned to a more manageable size and I found I could straighten my leg when I walked. I still did some shuffling and my ankle was only reluctantly revealing skeletal structure, but I was on the mend. It was time to go home. After a long discussion with Dr. Arias - they were always long discussions that ranged form his Star Wars fandom, to his trilobite collecting days - he decided he was through with me and it was time to fly back to the United States. He told the travel insurers that I should keep my leg up, so I was bumped to first class. I may have been bitten by a snake, but I would eat sirloin at 40,000 feet.

Saying goodbye to the sliver of volcano visible from my bed.

At the airport I watched the tanned and the exhausted stroll by, wearing the exact same sandals that had landed me in the hospital. I felt a slight jealousy for them, and pity for Katie whose vacation was ruined by my foot. But really I felt lucky. Lucky to be alive. Lucky to have my leg. Lucky that I had Katie to help me get to the jungle then help get me out. Lucky to have a parents who understand the risks posed by the woods. Lucky to have a story to tell.

Lucky. Lucky and wiser. Wiser about next time...

Stay tuned for the lessons learned, the arrival home, and images of Costa Rica sans serpents!

Let's Fly Away

Note: For some reason the formatting of these posts is getting screwy. If you enjoy spaces between paragraphs and slightly smaller text, click on the post title to view the entry in isolation with correct formatting.

The next morning I tentatively wiggled my toes and inspected my bruises. I desperately willed my foot to reveal an ankle bone or two. Nothing. Just an amorphous blob of flesh at the end of my tibia and a Technicolor bruise that smeared my entire inner leg. The antibiotics were as ineffective as Katie had feared.

I was able to straighten my leg a little more than I had the previous day, so the prospect of shuffling to the airstrip seemed a little less daunting. It was time to get to a hospital and a laboratory. Katie loaded up our packs and moved me and our equipment to the beach outside the window. I sat at a picnic table, listening to the waves gently lap the break wall and contemplated a return. If this was a virulent infection brought on by an aggressive reaction to getting damp feet, I wouldn’t return to this country or even the jungle. Sitting on that beach, my heart may have broken a little.

While I sat near the beach and emoted, Katie was taking care of business, directing a taxi to my spot and eliciting his help loading the gear. I stretched my right leg as far as I could manage and climbed into the back seat of the pick-up truck. We traced an arch along the coastline of Puerto Jimenez, past beach-side cafes and the mangrove swamp where Katie had seen a pair of scarlet macaws raising a ruckus the day before. Someday, maybe, I’ll come back. But first I needed to make sure I could save all my digits.

The cab driver dropped us off at the “airport,” an open-air pavilion with an office for Nature Air. The scattered plastic lawn furniture was occupied by four other couples, all middle-aged. I was wearing board shorts so I could keep an eye on my bruises and a wrinkled t-shirt. They were wearing polo shirts and Panama hats. While Katie left in search of something for lunch, I got to feel like a skuzzy shlub.

After my self-consciousness wore off, I was left with my journal and watch. Katie had been gone a long time. She had said something about going to the pizza joint around the corner. Geeze, it had been a half-hour. Now forty minutes! What if she'd been snatched up by one of the beat-up trucks we'd seen tooling around the main road? What if she'd twisted her ankle, or had been gored by a toucan? The minutes ticked by and I started testing my weight on my foot. This was the longest I'd gone without seeing Katie in a week. Anything could have happened and I had no way to contact her besides wandering and yelling.

I got up. I would ask for the blonde (blanca?), American girl (chica?), maybe ask for the next closest food stop in case the pizza hadn't worked out. The four couples looked up from their crossword puzzles and Dan Brown novels to watch me shuffle-hop to the street and around the corner...where I practically ran into Katie.

"Sorry, they took forever, but we have fresh sliced pineapple on this thing. I was waiting in the street in case you came out to see where I was." "There's that foresight again. I'm just glad the toucans didn't get to you. Who knows what they could do with those beaks." "You know you're a goofus, right?" "Acutely aware." "Good."

As we polished off our lunch - with exceptional pineapple toppings - we heard the low whine of our plane. A baggage handler threw our gear onto a hand-truck and we trooped onto the runway. I've never flown without walking through a metal detector and wasn't sure Bernoulli's Principle would hold if I wasn't first stripped of belt and spare change. The pilot didn't seem to share my concern.

On the runway we discovered the airline had overbooked our flight. We would be picking up ten more people in Bahia Drake, an ecotourism hub on the other side of the peninsula (named, incidentally, for Sir Francis Drake who used to park his pirate ship in the cove). Two people needed to stay. I had the sinking feeling they had screwed up their numbers because of our recent reservation and we would be left on the runway. Katie started examining my leg with a little more drama and concern. Our fellow travelers got the message and started to fight amongst themselves for the most urgent schedule. Sometimes it's okay to play the invalid card.

We had plenty of time to hash out who was being left behind since the plane hadn't emptied out, yet. There were two figures still crouched in the passenger section. One was immobile, hunched over in the seat. The other, presumably his girlfriend, would rub his back for a while then climb out, mess with their backpacks and climb back into the plane to console her vomiting significant other. She was wearing a neo-hippie, full-length skirt, wispy halter top and, um, little support. On her feet were leather sandals that laced to her knee. In other words, she was not outfitted for a trip into "the most biologically intense place on Earth." Even if she had more practical equipment, it seemed like poor planning to haul all those bracelets and necklaces for the rest of their trip. Then again, I was bitten by a snake. What do I really know?

Just as I felt my arms beginning to sunburn, the boyfriend managed to unfold himself and stumble down the short stairway to solid ground. This would be a bumpy ride. I hauled myself into the body of the small, two-prop ride that may have been painted by the Muppets and found a seat near the cockpit so I could prop my foot up.

Our plane to San Jose...

And Fozzie's tricked out Studebaker. Clearly Dr. Teeth works for Nature Air's detailing department.

The seats were low padded stools. Everyone managed to squeeze in, including a family that was toting two children in car seats. Knees in chins, we gracefully lifted off over Corcavado National Park to Bahia Drake. My eyes never left the window as we swooped over the forest, a spongy, rolling carpet of lush green jungle laced with enticing streams and rivers. I was leaving my placemat behind.

As we touched down near the coastline to pick up the rest of our passengers, a young traveler sitting behind me noticed an Ohio State t-shirt on one of the new occupants. "Should I give it an O-H?" he asked. "I'd give you the I-O if he gets cold feet." "Buckeye fan?" "Both my parents then me...the brother went to Michigan." "Hey, both my parents when to Ohio State! I grew up in Dublin. Sorry to hear about the Wolverine in the family." I had "It's a Small World" mingling with "Carmen Ohio" looping through my head for the rest of the flight.

After taking on our new charges we were back up in the air, this time gaining enough altitude to dive in and out of the cloud banks. The rising columns of air jostled the little plane and for a few minutes everyone had their eyes sealed shut and taught expressions of extreme focus. I looked straight ahead, then started reading the in-flight magazine, getting a walking tour of San Jose. It made sense to read up since we would be in town for a couple of days. Focusing on the words seemed to settle my vision and my spinning semicircular canals.

When we were through the cloud banks we started our course through the volcanic highlands. The craters were rimmed with verdant forest cover that rolled on, occasionally interrupted by coffee or fruit plantations before the forest took over and climbed another peak.

Banana farms seen from the air. Click to get a closer look at the geometric rows...

Small villages and towns appeared, some rural, some almost suburban, but all sporting a soccer field. If we had to escape to civilization, at least we were getting there via the scenic route.

Cresting a final ridge-line, the city yawned before us, tucked into a wide valley. With a final stomach-dropping lurch we dropped to the tarmac and taxied to the minuscule terminal. While Katie wrestled with our packs, finally hauling one onto her back and dragging the other behind her, I presented the passports to a sour-looking woman who looked like she needed to hear a good joke. Another reason to learn Spanish, I guess. Two of the couples were sprinting for the taxi-stand, hoping to get across town to the international airport to catch a flight that took off in an hour. I may have had a useless limb, but at least I wasn't dealing with that kind of stress.

Katie dropped me off with the luggage - really at this point I was beginning to feel like the bulkiest piece of baggage she could have packed - and went to the airport desk to call a cab. A young driver pulled up to the curb and started lifting Katie's bag into the trunk. I hefted mine, started to shuffle it towards the vehicle and was promptly smacked by Katie. "You don't touch anything. No chivalry." "Humph."

Settled into the car, Katie calmly stated the name of the hospital Lonely Planet had guaranteed offered doctors who spoke English, French, and German, "Hospital Clinica Biblica?" The driver looked a little shocked and did a double-take to make sure there weren't any open wounds leaking onto his upholstery. Satisfied we didn't have buboesor rabies, he drove us towards our next adventure. We were out of the jungle and into bureaucracy!

Out of the Woods

Suddenly, I was called back to consciousness by a crunching, then a splash. My heart was pounding somewhere near my throat as I lay in the darkness. The walls of the tent were lit by sweeping headlights and long silhouettes of bull grass traced the length of our shelter.

Someone had found our camp. Should I hail the vehicle? Could they be rangers, or even poachers? Before I could move to warn Katie or wave for their attention the light faded and the vehicle followed the trail into the darkness.

I reached for my watch. 2:30AM. As I moved, I found my right leg was stiff and it was difficult to flex my toes. I began to wonder how far I would be able to haul my pack the next day if that stiffness didn’t go away. Another bloody nose began. Another reach for the now-bloody sock I had ruined earlier that night. Then I drifted back to sleep. Really the perfect way to pass the night.

Again the sound of an engine. Again the silhouettes. This time they went in a circle around our camp and lightly honked the horn. We would have company.

The truck drove off into the night. A few minutes later I saw a lone flashlight beam approaching from the brush. Katie was still sleeping, exhausted from a night of waking every hour to check my pulse and breathing pattern. I nudged her awake. “I don’t think we need to find the ranger station. It found us.” With impeccable timing, as the light flooded our sleeping area, my nose decided to hold forth. How much more blood did I really need to leave in Costa Rica?

The beam launched into a Spanish monologue. We caught the words “Hola” then “Park office” and finally “vamos.” Relieved, Katie asked, “How far to the office? Cuànto kilometers?”

“No kilometers, meters. Two-hundred meters.” So close! Then the beam waited expectantly for us to pack. I started casting around for the compression sack for my sleeping bag. My nose started to gush, blood splashing onto my sleeping pad, shirt, and shorts. “Matt, you need to stop moving, and squeeze.” “I know, I just need to get this stuff in my pack…” “Here, I’ll pack, you need to just, wow…you’re going to hate me for doing this.” With that she grabbed two tampons from her backpack and shoved them up my nostrils with a squelch.

I sat and felt useless as she gathered our things under the ranger’s supervision. With horror she looked back to see blood dripping from the ends of the first tampons to ever touch my body. “Sir, can you maybe take him to the park office?” “Por que?” “His nose is bleeding…a lot.” With each phrase, Katie would throw in a couple gestures in the hopes of breaking through the language barrier. A hand waving under your nose seemed like a universal sign for “Bloody nose.” Apparently our ranger visitor didn’t agree. “Something something…Inglès.” Then he disappeared down the path into the night.

Katie continued getting our gear together, asking where I wanted to stash pieces of equipment while I attempted to stem the flow with baby wipes (packed for field showering) and my dirty socks.

Our ranger reappeared with a companion who had one key skill: English. “Hello, we must take you to the park station. It is not allowed for you to camp here.” “Thank you, yes, we understand. Would you be able to take him to the station? His nose is bleeding pretty badly.” “Well, you must come to the station.” “Right, but can you take him while the other ranger waits for me to get everything into our backpacks?” “Oh, yes, I see. Yes.” Yet again, we vowed to learn Spanish as soon as we got home.

Katie gave me a tender kiss goodbye before I climbed out of the tent. I tried not to stain her clothing or any more of the camping equipment and finally glimpsed our ranger. His bushy mustache and kaki shirt triggered a memory. He was one of the rangers that we passed on patrol in the late afternoon. I wonder if he regretted not stopping to chat earlier. He was ready with a bag of cotton. I pinched off two wads and hoped they wouldn’t soak through too quickly.

The translator then came up as I gingerly put my foot into my sandal. “Earlier tonight I cut my toe. Now everything is a little swollen.” He seemed a little perplexed by this new information and led me into the stream that had given me my wound. If this was a water-born infection I was reloading. As we started up the trail on the other side, the light of the other ranger started waving wildly behind us. “Oh, I think he is telling us we are on the wrong path. This did not look right. I haven’t been here for very long.” Great, so if Katie and I had continued on the path, we could have missed the ranger station entirely. My thorn encounter started to feel a little more fortunate and the lack of signage even more dangerous.

I limped along behind him, praying the swelling would be gone by morning. . We passed a camping area with a lone tent and up to a massive wooden shelter. Hobbling up a couple of stairs I beheld the swankiest ranger station south of the Grand Canyon. An expansive deck, one side open to the elements, held a kitchen and TV area. A couple of cushy chairs faced the flat-screen, though their occupants were facing me. My translator sent a couple of them off into the night to help schlep Katie and our gear. The others sat me down, gagged a little when they saw all the blood, and examined my toe.

The Los Patos ranger station in the daylight. The men who live here hold some of the best jobs I am aware of besides Pixar screenwriters and paleontologists. of the best jobs I am aware of besides Pixar screenwriters and paleontologists.

“They say it does not look like a snake. Perhaps a spider, or an infected cut?” I wasn’t sure if I should be relieved, but they certainly seemed calm about the situation. A foam pad appeared and I was told to lay back. The only spot for me was directly in front of the TV, but I continued to face the rangers so I was watching the television upside down.

As I settled my body and tried to breathe regularly I was treated to one of the more surreal moments of my young life. There I was laid out in a remote ranger station in the middle of the Costa Rican rainforest, losing a liter of blood through my nostrils, my foot swelling, and I was watching E!’s Wild and Naked…2. From the forest to my left came the squawks of alien wildlife. From above my head, the squawks of drunk nightlife. The inebriated women of Austin and Las Vegas really are stellar cultural ambassadors to the world.

They shut off the TV as familiar footfalls came crunching along the path. A worried, but smiling Katie appeared over the deck along with an entourage of three rangers carrying our gear. They piled it in the corner, got out another pad for Katie, and called it a night. No monkey poachers that night. Only a stupid, bleeding American and his girlfriend.

I woke up a few hours later to the sounds of macaws chattering along to the morning chorus. I briefly reveled in the living, breathing jungle then tried to flex my toes. Pain. Once again, my nose decided to give me something else to think about. Katie woke up to a growing pile of bloody cotton and wipes. Some people really know how to get the day started on the right foot.

I needed to get up to use the restroom and quickly realized my hike was over. I hobble-hopped across the platform with Katie as my crutch. One of the rangers came out to check on us and started to radio La Palma for a taxi to pick us up. I felt defeated. One day in the forest and I’m already being dragged back to a world of paved roads and iguana-eating pigs.

Katie and I needed to get to the clinic in Puerto Jimenez where I hoped they would shoot me up with antibiotics and I would be back on the trail the next day. And so go the best laid plans of mice and men. But not women. Katie knew there was something serious going on in my right leg, but kept her fears to herself until we were safely back in a world of pain killers and prescriptions.

Around 8:30AM, we heard the sounds of a truck rolling up the hill to the station. The rangers helped haul our packs to the vehicle and said Adios. They had been incredibly helpful and gracious, if a little sketchy on first aid. Our driver walked back to the tailgate and I saw a very familiar mustache and heard a very familiar lisp. I don’t speak Spanish, but his grin very clearly said “I told you so.” Yes, yes he did tell us so, and now he would get the sixty bucks we refused to pay the day before.

I gingerly hauled myself over the tailgate and onto a padded plank in the bed of the truck. As we rolled back through the waking forest, Katie and I felt a little pride in our accomplishments the previous day. We had covered a lot of ground and waded through a lot of water. If it wasn’t for that “thorn,” we would happily be soldiering on. As the wild flowers and towering trees zipped by I just kept thinking, “Next time.”

Our taxi was a convertible.

Our cab driver took us all the way to the clinic at Puerto Jimenez and I paid the most expensive cab fare I have ever handed over, but the $80 was more than worth the peace of mind. We were at the door of a red cross medical clinic.

I hobbled while Katie hauled our packs to the entrance. The guard watched in amusement as the stupid Americans cast around for a desk or an English-speaker. We found the former, but the latter was difficult to come by on the Osa Peninsula.

After being checked in by the non-English-speaking orderly, weighed by the non-English-speaking nurse, and made fun of by the non-English-speaking guard, we were finally called in to see the non-English-speaking doctor. He struggled valiantly to cobble together the few English phrases he knew, and we tried to do likewise with our Spanish. Looking at my foot and the swelling that was inflating my leg and bruising my thigh he pronounced it an “infeciòn.” He put me on an IV of antibiotics and sent me to wait on a bench.

The clinic’s facilities were clean, but reflected its remote setting. Boxes of syringes were battered from transport and the IV stand was rusting near the base, clearly brought to the clinic decades before the word “ecotourism” was invented.

Sitting on the other end of the wooden bench was a large, stressed looking woman massaging the shoulder of her teenage daughter who was dressed in a hospital gown and breathing heavily. Katie leaned over to me, “This is probably the closest you’ll ever be to a woman in labor who isn’t cursing you for putting her there.” Despite the obvious pain she was in, she would still look over at Katie and me and smile between contractions. Soon she was whisked away. As my IV infused my immune system with a few final drops of assistance, we heard the piercing cry of a new life entering the world.

The nurse unplugged me, handed off a handful of oral antibiotics, extra-strength Tylenol, and soaking salts for “Mathew Robeath Bartes.” The directions were all in Spanish. But hey, it was free.

Reluctant as I was to leave Osa, Katie convinced me it was time to see an English-speaking doctor. That meant an escape to San Jose. While I sat on my butt watching the extended family of the new baby arrive at the hospital, Katie ran to the airport where she learned the next flight out for two was at noon the next day. She fought with everything she had, including tears to get us a flight out at 9AM the next day, but was ultimately refused. Then she ran across town to the bus station to check our options for leaving on four tires. The bus had left two hours earlier and the next nine-hour ride to San Jose left at 5AM. We would need to stay in Puerto Jimenez for one more stressful night.

Katie then started going from hostel to hotel, looking for a room where I could put up my foot and moan about the unfairness of the universe. She had a tough time even finding a desk clerk at most establishments because it was a Sunday, and the entire town had turned out to watch the local soccer teams face off in on the expansive green in the middle of Port Jim. Finally, she found a room with a view at American owned, English speaking establishment known as The Palms. The sympathetic owner gave us a room with a view of the beach. Now Katie just needed to get me and our gear into the room.

She strapped on one pack and hiked back past the soccer game, enduring curious stares and whispers of “burro.” One down, my butt to go. She put on the other backpack and offered a shoulder to lean on as I awkwardly crouch-shuffled, each step sending a searing pain from my bruised left foot or football-sized right. Sometimes I would switch and just hop on my left foot. Again the stares. Again the whispers. Again a scene.

I collapsed onto the bed and tried to straighten my right leg. I couldn’t. My knee refused to extend, my thigh was a riot of purple and black that I didn’t want to move again. “I don’t want to go to San Jose.” “Matt, we need to get help. We need to be able to ask questions. I don’t think the antibiotics are working the way they should be and a pathologist really needs to look at the material around that toe. That means a real hospital in San Jose.” “I don’t want to move again. I don’t want to walk again. Can’t we just wait here? I just want to sit on a beach. This will go away, soon. The doctor didn’t seem too worried.” “Matt, we’re going to San Jose. If it’s not better, we may need to - you’re not going to like this - we’re going to have to go home.” “Yeah, I don’t like that.”

I sat and prayed my body would somehow drain all the fluid in my leg in the next 24 hours while my stomach prayed I would find something besides Clif bars for sustenance. Fortunately Katie had picked a room maybe thirty feet from a restaurant. I hopped along the walkway attracting the attention of some surfing beach bums getting a drink. “Tough day in paradise, my friend?” “Yeah, but at least it was in paradise.” While we sat and watched the light slowly fade, enjoying blackened fish and stuffed chicken followed by chocolate brownies, we almost looked like a normal couple enjoying their vacation in the jungle. Unless, you looked under the table and saw a purpling foot and hands clenched in stress.

My right foot as it appeared at The Palms. You wouldn't know there were any bones in there.

That night I periodically woke to take my pills and flex my toes. Nothing was changing. I was headed to San Jose no matter how I felt. Something was wrong with my foot, and now my back was starting to get a little sore and stiff. As I dozed, I would feel Katie check in on me, listening to my breathing and checking the swelling of my limb. If I made it through this, I vowed to never put her through this kind of stress again.

But we hadn’t made it through quite yet…

The beach I just wanted to sit on and heal. Turns out making a break for San Jose was a solid plan, even if it meant leaving this view behind...