Cusco, Altitude, and the Strange Tenderness of Staying Upright

“Coca, Slow Steps, and the City That Makes You Breathe” — The bodily rituals of acclimatization and the small practices that keep you upright.

Cusco greeted me like a beautiful punch to the lungs. I had barely stepped off the plane before my chest tightened in that subtle but unmistakable way asthmatics recognize immediately. The air was cool, deceptively soft, and thin enough to make each inhale feel like trying to drink through a clogged straw. I had prepared, or at least convinced myself I had. I read the blogs, skimmed the medical warnings, packed electrolytes and asthma meds, even rehearsed the “slow steps only” mantra they recommend for newcomers to high altitude. None of it mattered. Cusco simply raised an eyebrow, whispered “we’ll see,” and let the week unfold.

The first afternoon was a blur of charm and breathlessness. I adored the city instantly. It has that layered feeling, ancient stone foundations under Spanish balconies under modern storefront signs that flicker in the afternoon glare. But as much as my eyes were trying to feast, my body was thinking only about oxygen. My appetite vanished. Not faded, not dimmed. Vanished. You could have served me the best lomo saltado on Earth and I would have stared at it like a math equation. My stomach was on strike, my head floated, and every twenty minutes I tore open another electrolyte packet like it was a winning lottery ticket. The irony was that the food was genuinely delicious. I knew it was. I could taste edges of brilliance in little bites before the fullness hit like a wall. But altitude doesn’t care about culinary artistry. It cares about pressure and lungs and how willing you are to surrender your pride.

The nights were the trickiest. Lying down felt like someone had quietly lowered the oxygen settings in the room. I found myself doing the oddest things, like sitting up mid-sleep to “reset” my breathing or leaning forward with my elbows on my knees just to convince my lungs to keep participating. More than once I caught myself wondering whether these were the early signs of HAPE, the high altitude pulmonary edema everyone warns you about. The line between caution and paranoia bends easily at 11,000 feet when your chest already sounds like a slowly deflating balloon. I checked the symptoms compulsively. Extreme shortness of breath at rest? Not quite. Coughing up frothy sputum? Thankfully no. But the possibility lingered in the background like a shadow. Enough to keep me hydrated, slow, and embarrassingly attentive to how many stairs I climbed in a day. The short answer: very few.

Cusco, though, has a way of rewarding slowness. When you move carefully, the city reveals itself with a kind of patience that feels old and generous. I noticed more than I would have if I’d been sprinting through an itinerary. The way the morning light spills down narrow alleys. The way locals greet each other with that soft, almost musical cadence. The way you can hear history in the footsteps on the Plaza de Armas. Even the coca tea, which every hotel seems to offer with quiet confidence, became part of my rhythm. It didn’t cure anything, but it gave me something warm to hold while my lungs negotiated with the altitude like two stubborn diplomats.

By midweek I settled into a strange equilibrium. Not quite comfortable, not quite miserable. Just… aware. Aware of my breathing, my limits, my stubbornness. Aware of the privilege of even being in a place that demands respect from your body. The city is high enough to humble anyone, and I needed the humility. It forced me to move at a pace that fit the environment instead of pretending I was made of sea level air and optimism.

The food continued to taunt me in the best way. Every restaurant had something fragrant and promising. I’d read the menu carefully, pick something exciting, and then manage a few careful bites before the altitude reminded me it was still in charge. But even those small bites tasted like stories: earthy quinoa soups, herb-laced chicken, bright citrus notes in ceviche. I kept wishing I had a second stomach or a stronger set of lungs, but I made peace with the fact that sometimes travel is about tasting what you can, not conquering the whole plate.

By the time the week ended, I had learned a few things that weren’t in the guidebooks, at least not in the tone I needed. Drink water like it’s your new religion, yes, but also drink it before you feel thirsty. Add electrolytes often. Overdo it if you must. If you have asthma, triple-check your inhaler before you leave the hotel. If your heart rate spikes on a staircase, stop. No pride, no shame. Just stop. And if anything feels wrong or escalating, get help immediately because HAPE is real and doesn’t care how adventurous you feel.

What surprised me most was how much I loved the city despite the physical wrestling match. Cusco is stunning, but it’s also tender in a way I didn’t expect. It rewards effort. It forgives slowness. It lets you fall behind in your plans and offers small, quiet moments instead: a sunset turning the rooftops gold, a street vendor laughing as a gust of wind tries to steal her napkins, a child kicking a deflated soccer ball down a centuries-old street with absolute joy.

I left still a little short of breath but filled with that warm afterglow that only comes from places that challenge you and charm you at the same time. Cusco taught me to listen to my body even when I’d rather pretend it’s fine, to savor food even when hunger is absent, and to let the altitude set the tempo instead of fighting it.

Next time, I’ll acclimatize longer. I’ll bring more electrolytes. I’ll respect the height from the start. And yes, I’ll still chase every bite of Peruvian food I can handle.

Even if it’s only one careful forkful at a time.