When I was seven, I was in the vegetable garden in our back yard with my older brother Nathan. We had been sent out to pull some weeds, or pick some tomatoes for dinner or something, I don’t really remember. What I do remember is Nathan saying “Hey Patrick, eat this,” and handing me something that I think I knew at the time was a jalapeno pepper he had just picked. And I think that I knew that peppers were spicy. But for some reason it did not cross my seven-year-old brain that obeying my wise, mature, cool, and altogether trustworthy older brother (a nine-year-old child), could possibly result in anything unpleasant.

I took a large bite, about half of the pepper.

I hope that when my brother reads this, the memory will come flooding back—the sunny day, the nice moment we were having together in the garden, the innocent, cheerful, unhesitating acceptance of his offer—and then the look on my face, as I chewed a couple of times and swallowed. How my smile faded slightly at the realization of what had just happened. How my eyes looked as the shock and betrayal set in. I hope he remembers this moment, so he can tell me what it’s like to witness the crumbing of a small boy’s safe, simple world in which older people are to be trusted without question.

I ran inside and ate half a head of lettuce, and drank four glasses of milk. Because I had heard that’s what one does. In my memory the trauma lasted for what seemed like hours. It was probably a few minutes.

(Incidentally, I just realized that that was same spot in the garden where my younger brother, several years later, stabbed me in the foot with a pitchfork as we were digging a hole. Note to self: Are my brothers trying to kill me? Look into this)

Jalapeno peppers, which I have since grown to love, have between 2,500 and 5,000 Scoville heat units, a subjective, but popular scale of spiciness. Habaneros, which I have also consumed fresh and do not love, boast 100,000 to 400,000 Scoville units. Eating a habanero is a dare I will not succumb to again. It was not pleasant.

Maybe you’ve heard of ghost peppers. They make habaneros look like sweet tarts.

According to CrazyHotSeeds.com, ghost peppers, called bhut jolokia in Assam, India, their place of origin, are actually only the 7th hottest pepper in the world. At 1,041,420 Scoville units, they are half as spicy as the world’s hottest, the Carolina Reaper, which comes in at a whopping 2,200,000 SUs.

So not the hottest, but really freaking hot. And here is why you should think twice before yielding to peer pressure from friends to eat one:  

A case study in a recent issue of The Journal of Emergency Medicine described a 47-year-old man who ended up in the emergency department after consuming ghost peppers as part of a restaurant-sponsored contest.

He was experiencing severe chest and abdominal pain after a bout of violent gagging and vomiting. A chest x-ray revealed fluid build-up in the chest cavity so he was rushed to the operating room. In the OR they found a 2.5-centimeter tear in his esophagus.

He had barfed so hard, that he split his esophagus open, and burning ghost-pepper vomit leaked into parts of his body where it did not belong.

If it’s not ripping you apart from the inside out, vomiting is actually a really good and amazing thing. When chemoreceptors in your body recognize certain things that shouldn’t be there, your autonomic nervous system kicks into gear. This is the part of the nervous system you have no control over, that oversees your breathing, heart rate, and other vital functions that would be impossible to manage consciously.

Can you imagine if we had to think about that stuff?

Breathe in. Ok, breathe out. Ok, time to breathe in again. Wait—is my heart still beating? Dang, do I need to poop?’

Luckily a lot of things are just taken care of for us. It’s quite beautiful, really. When something bad shows up, your body says ‘We’ll take it from here, we’re getting rid of this stuff!” So when you find yourself puking, remember to say ‘thank you, autonomic nervous system!” between heaves.

Of course, the body doesn’t always get it right. Capsaicin is the chemical in peppers responsible for either a great deal of misery, or making a boring dish palatable. And though it can feel caustic, it’s not actually damaging tissue. It’s just making our brains think it is, and produces a response.

Dr. Annie Arens, the lead author of the case study explained:

“The capsaicin itself targets a particular receptor that actually is interpreted by the brain and the body as heat and pain . . . The reason the capsaicin is there is that the plants that produce it are selecting for the animals they want to spread their seed . . . the animals that they don’t want to eat them will taste and feel the capsaicin so they don’t eat the plants—so they don’t destroy the seeds by chewing them. Birds can eat the seeds whole and carry them far away. It’s just really cool, frankly,” she told me.

I asked Dr. Arens if she’d seen other serious cases as the result of hot pepper ingestion.

“Usually it’s just some discomfort or nausea that’s pretty easy to treat,” she said.

So spicy peppers aren’t actually that dangerous. If you want to play a mean, hot-pepper based joke on your younger siblings, they’ll probably come out of it ok, at least physically. But just to be safe, you might want to stick to things lower down on the Scoville heat scale.

The guy in this case was lucky.  The rare, vomiting-induced esophageal rupturing known as Boerhaave syndrome is no laughing matter. A 2014 article in the Journal of Thoracic Disease put its mortality rate at “20-40 percent with timely treatment, but this rises to virtually 100 percent if treatment is delayed by more than 48 hours.”

So if the laughter has died down, and your buddy is still puking, that twinge of guilt that starts to set in may be worth paying attention to. At that point you might want to think about making your way to the ER.