While chowing down as fast as you can on one of the hottest peppers known to humankind might sound like a good id– wait, no, that pretty much sounds like my nightmare. And it can be dangerous, as one man found out after getting a one-inch hole in his esophagus after he participated in a ghost pepper-eating contest.

A San Francisco Bay area man ate a hamburger slathered with a paste made from ghost peppers, The Journal of Emergency Medicine (h/t CBS San Francisco) noted in a recent case study. He ended up in the emergency room with severe abdominal and chest pains, followed by “violent retching and vomiting.”

The vomiting induced by the ghost pepper puree burned a hole in his esophagus, causing his one of his lungs to collapse. He was hospitalized for 23 days, and left with a gastric tube.

Pepper heat is measured on something called the Scoville scale, with a jalapeño registering at 5,000 units, while a ghost pepper comes in at one million units. Sounds un-fun, right? So why would anyone undertake such a painful endeavor?

A peppers expert and owner of a San Francisco-area farm says it’s not something he would try, but for some, the rush is worth searing hot pain.

“You think you’re gonna die,” he told CBS San Francisco. “Your throat starts to close up so I think part of the endorphin rush is when you realize, ‘Whew! I’m alive still! I survived!’”

Sure, you can survive, but you might end up in the hospital with your innards dotted with holes.

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