San Jose is not typically on the backpackers travel itinerary. Like other Central American capital cities it’s big, sprawling, boasts a large population, traffic-clogged roads, crime and pollution. Travelers tend to limit their exposure to these big cities to passing through the international airports that are entry or exit points to their respective countries. Unfortunately, our recent visit to San Jose wasn’t to reach the airport. It was to visit one of the cities hospitals for a surgical repair of the broken bone in Heather’s left foot.

As we finished our two week visit to the Osa peninsula with a three-night stay in an ecolodge just outside of Corcovado National Park, Heather had an unfortunate misstep shortly after our arrival to our cabin in Dos Brazos. She forgot about the step down from the rear of the cabin to the lower kitchen/living area and landed on her bare left foot with a resounding crack on the tile floor. Upon inspection there wasn’t any crack in the tile itself, leaving her to realize it was her foot that had made the sound. Not ideal, considering we were in the midst of the jungle on a remote peninsula, without internet or phone service, and over three and a half hours drive to the nearest clinic. We did have our travel first-aid kit, so she swallowed some ibuprofen for the pain, wrapped her foot in an Ace bandage to combat the swelling, then settled into a hammock with a glass of red wine (yes, our first-aid kit includes that, along with white wine for emergencies before 4 pm). She was able to tolerate the pain and toughed it out over the next three days, and even felt improvement in the foot, and we held out hope that the injury wasn’t as severe as we had originally thought. But we did decide to get an x-ray to give us clarity on the extent of the injury. Finding a radiology clinic close to Dominical, where we had landed after our trip down to the Osa, wasn’t difficult, and with our guesthouse owners assistance, were able to get an appointment for the following day. We made the drive over the mountains to San Isidro the next morning and found the clinic without difficulty. Heather had a series of x-rays taken and the pictures left no doubt – a complete break of one of the metatarsal bones. As disturbing as this was, it was also apparent that the broken bone was ‘displaced’, meaning the two pieces weren’t aligned correctly and probably wouldn’t heal properly. This meant we needed an orthopedic surgeon’s opinion on whether surgery was indicated. Disheartened by this news, we left the clinic and walked across the street to our car to return to Dominical, only to discover a parking ticket on the windshield! Upon our return to Dominical we decided we had to make the two and a half hour trip to a hospital in San Jose in order to consult with an orthopedic specialist. We loaded up the car and headed north along the coast. An hour into the trip the car started to act up – without warning it would accelerate on its own – gaining speed without any pressure on the gas pedal. Unnerved, we left the highway at Jaco and found a spot to pull off the road and call the rental company. After hearing our report and my insistence that we wouldn’t continue to drive the unsafe car, they agreed to bring a replacement car to us. We waited under the mid-day sun in the 90+ degree temperatures for two hours for the replacement car to arrive. Excited to get back on the road when it did, we were further disheartened to find the new car already had a flat tire. Another half hour passed as the driver took it to a service station for repair. Finally we were able to hit the highway again – just in time to get bogged down in the slow-moving traffic approaching San Jose. If it wasn’t merging lanes through construction zones, getting caught behind slow-moving trucks going up long, winding stretches of highway or creeping past broken-down vehicles, we lost another hour, turning the two+ hour trip from Dominical into a five and a half hour slog.

When we arrived at the hospital, we were met outside the emergency entrance and Heather was placed in a wheelchair and taken in for examination. I hadn’t even completed the check-in process at the reception desk when the doctor came out and asked me to join them. Holding the x-rays, he told us that surgery was indeed necessary and would take place the following evening – Christmas Eve.

The next afternoon, as directed, we arrived at the hospital to go through the check-in process, which included a COVID test (surprise!) before the one-hour procedure to insert a metal plate and six screws into her foot. Now the recovery process begins – six weeks, non-weight bearing, in a boot and crutches. I’m going to have to restock the travel first-aid kit – a lot.