What Happened When I Underestimated One of the World’s Highest Cities

I thought I was ready for life at 11,000 feet. I was wrong.I should start with a confession: when people warned me about the altitude in Cusco, Peru, I nodded politely, smiled, and instantly ignored everything they said.“I’ll be fine,” I told myself. I’ve been to, like, Denver, and didn’t have any problems. How bad could it really be?Spoiler: very bad.Cusco sits at 11,000 feet–a full two vertical miles above sea level–and more than twice as high as Denver. When I stepped out of the Cusco airport, I took a deep breath, and it felt good–crisp and full. “See,” I reasoned. “Nothing to worry about.”Underestimating the Andes As I checked into the JW Marriott El Convento, a beautifully restored 16th-century convent turned hotel, the front desk clerk asked, “Are you feeling the altitude yet?” Clearly, they get this a lot. “Not at all,” I said. Remember, I’ve been to Denver.“Good,” she replied. “It’s best not to think about it.”She then immediately steered me toward the table next to the front desk, where complimentary remedies for altitude sickness were laid out. Coca tea, made from the same leaves as cocaine, is recommended for the daytime, while muña, or Andean mint tea, is preferred in the evening, as it is caffeine-free. Channeling my best Tony Montana, I grabbed a bag of coca, dropped it into hot water, and assumed I had just made myself bulletproof. Continue Reading Article After Our Video Recommended Fodor’s Video Considered the oldest living city in South America, with structures dating back 3,000 years, Cusco feels a bit otherworldly. Inca engineering, Spanish architecture, and souvenir shops selling kitschy shirts all co-exist as a kind of breathing museum. It also has an aggressive amount of stairs.As I wandered the cobblestone streets, my breathing became noticeably labored. “No worries,” I assured myself, “I’ll just take my time.”Payton Sparks/iStockThe Slow Decline I woke the next day with a low-grade headache and lips so chapped they felt like sandpaper. I was warned that the altitude could cause dehydration, but I wasn’t expecting this. I quickly chugged two bottles of water, slathered on some lip balm, and headed to the lobby for some more coca tea.Still determined to explore, I set out on the streets in search of Inca architecture, ancient ruins, and strong coffee that might cut through the fatigue. I climbed endless stairs and walked along mountain roads to reach Sacsayhuamán, the remains of a 15th-century Inca citadel overlooking the city. The whole time, my body was saying, Why are you doing this to us? But I soldiered on.Denial works…until it doesn’t.The Great Descent Day three arrived with me tired, dried out, and ready to give up, like a Kardashian after that first look in the morning mirror. But today was Machu Picchu day. So I dragged myself out of bed, grabbed my bag, and headed to the station.And here’s where the universe rewarded me. I boarded the Hiram Bingham, the luxury train to Machu Picchu, for an experience so lavishly old-world it felt like stepping into an Agatha Christie novel.Plush seats. Polished brass. A multi-course gourmet brunch. A bar car where a band played Peruvian classics mixed with American rock ‘n’ roll. And outside every window, unspoiled countryside rolled past in long, quiet stretches.And as the train entered the Sacred Valley, something miraculous happened: I felt better. Of course, it wasn’t a miracle, it was simple geography. Machu Picchu sits 3,000 feet below Cusco, so the slow descent into the Andes had unexpectedly cured all that ailed me.Then There Was Machu Picchu Machu Picchu has the rare distinction of being both entirely overhyped and yet still better than advertised. The Incas chose that site with such astronomical precision that the sun, shadows, and stones all align in ways that still baffle. Pictures and pithy writeups can’t do it justice, so I will spare you mine. You just have to go.Rosie BellThe Altitude Strikes BackOn the way back, the train was hoppin’. People crammed into the bar car, hoisted Amazonian-themed cocktails, shared stories of the day’s adventures, and danced to the Peruvian version of “Livin’ on a Prayer.” It was one of the most enchanting travel experiences of my life.And then, as the train started climbing closer to Cusco, my symptoms slowly returned. The headache. The shallow breathing. The fatigue. By the time I stepped off the train—stomach full and several pisco sours deep—I just wanted to curl up into a ball and let the darkness take me.Back at the JW Marriott, I remembered something they told me at check-in: they offered complimentary oxygen for guests struggling with altitude sickness. At the time, I found it amusing, like a quirky gimmick meant to add some local color for the tourists.Now it sounded like salvation.I asked for it at the front desk, expecting them to hand me a little metal canister like you’d find at CVS. Instead, they told me to go to my room, and they would have it sent up straight away.Ten minutes later, a man appeared at my door wheeling a full-sized medical oxygen tank with him.“Good evening, sir,” he said, “I’m a paramedic with the hotel. May I come in?”A paramedic seemed like overkill, but sure come on in. I sat on the bed and slipped on the oxygen mask.“Let’s check your O2 level,” he said, slipping an oximeter on my finger. Eighty-five percent.“Is that bad?” I asked.“It’s low,” is all he said.It wasn’t until I Googled it later that I learned that an O2 level below 90% is considered serious. Levels below 85% enter severe hypoxemia territory, where things can begin affecting your brain. Luckily, after about 10 minutes of sucking down that sweet, sweet oxygen, I was back up to 99%. Crisis averted. For the moment, at least.The Price of AdmissionI woke the next morning feeling sick again, but there wasn’t much I could do other than hydrate, pack, and get myself to the airport. I’d never been more excited to just sit inside a pressurized airplane cabin and breathe that wonderful recycled air.My time in Cusco was not relaxing. It did not leave me refreshed. But that was never the point. Travel, at its best, isn’t clean or controlled. It’s uneven. It’s uncomfortable. It knocks you around a bit.But then there are the moments—sipping a cocktail as the Andes roll past the window, glimpsing Machu Picchu through the mist, singing with a bunch of strangers in a train car—and you realize it’s all part of the price of admission.And sometimes that price is a little oxygen deprivation.