Like many people over a certain age, vomiting no longer disgusts me. I’m not proud to admit it, but on occasion, I throw up after poisoning my body with too much alcohol. As a result, I’ve developed a handful of techniques that take me from retching to flushing without too much discomfort. Sometimes, when the first pangs of rusty saliva leak down my throat, I like to pretend that I’m an angry dragon, hurriedly flapping my wings to spray an unsuspecting porcelain city with waves of bilious puke-fire. It’s pretty awesome.
“Nausea and vomiting can be at the end of a whole buildup of things,” said Charles Horn, a neuroscientist who specializes in emesis, the clinical term for blowing chunks. “But the truth is, when you vomit, you feel better, almost every time.”
In fact, vomiting makes some people feel so good that they’ve devoted their lives to studying it. This year, along with another neuroscientist named Bill Yates, Charles co-hosted a two-day, single-track academic conference at the University of Pittsburgh, officially known as Biology and Control of Nausea and Vomiting 2013—the International Vomiting Conference for short. In attendance were 62 prominent doctors who share the goal of advancing research on the biological mechanisms that cause nausea and vomiting. Their ultimate goal is to answer the questions: Why do people blow their grits, and what are we to do about it? The answers are more complicated than one might think.
When Charles accepted my request to report on the conference, I could barely contain my excitement: I am downright fascinated by vomit. There’s a glint of the rarest purity in the act of puking, a black-and-white reality in a world of nauseating, amorphous gray (or green, depending on what’s coming back up). For instance, the most expressive art on the planet can often feel, look, or sound like puke—think Jackson Pollock or punk rock—automatic expulsions of parasitic elements that preempt a sense of therapeutic completion. The primal discharge of a pathogen. Nothing left but stomach lining and bile. In other words, despite its messy downsides, vomiting is a relatively impressive reflexive evolutionary defense mechanism, so what better place to find my people than at the International Vomiting Conference? Unfortunately, it was not all fun and games and research subjects sticking their fingers down their throats, as I hoped it might be, but I still learned a whole lot about ralphing.
I stumbled bleary-eyed into the conference at 7 AM, working off a night of very little sleep that was entirely my own doing. The previous evening, I had taken the bus from New York City to Pittsburgh, birthplace of both the Big Mac and the polio vaccine, and the city cradled me in its boozy arms shortly after my arrival. I felt suitably nauseated for the event.
The conference was held at the University Club, an elegantly restored 1923 social center encased in floral white, classically styled limestone. Across the street, students bustled around a lawn outside the Soldiers and Sailors Memorial Hall. Due to my research, I recognized it as the set for the Memphis courthouse scene in The Silence of the Lambs, where Dr. Hannibal Lecter cuts off a cop’s face and wears it to escape jail time. Totally puke-worthy, I thought.
Before the conference, I came to the realization that even though I was on board with puking as a conceptual phenomenon, I had no idea what vomiting entailed, at least scientifically speaking. Before my trip to Pittsburgh, I had arranged a call with Charles to become more familiar with his research, which was sparked by the realization that the majority of animals on earth—like rats—are physically incapable of vomiting: they lack the neural connections to synchronize the brain stem with the various muscles needed for a proper puke. It sorted me out on a rudimentary level, while solidifying my standing as a vomit novice.
As I choked down some doughnuts and milky coffee in a ground-level conference room full of bespectacled men with briefcases and pocket protectors, I realized that, besides the administrative staff and various caterers, I was the only person there who wasn’t a member of the scientific establishment. My presence seemed to be weirding everyone out. “I heard VICE does a lot of undercover work,” one researcher snidely told me. “Is that what the tucked-in shirt is about?” I wondered what would happen if I threw up all over his shoes. Would he be disgusted or quickly swab up my fresh spew? The former, I decided, but figured I’d probably be asked to leave either way.
Later on Dr. Yates, one of the co-founders of the International Vomit Conference, gave a lecture entitled “Integration of Vestibular and Gastrointestinal Signals by Brainstem Pathways That Produce Nausea and Vomiting,” where I learned that ejecting partially digested food from your stomach is merely a strange form of breathing.
“What happens is this: the skeletal muscle contracts, and the normal respiratory patterns during breathing are interrupted,” Bill lectured. “During breathing, you contract your diaphragm. During vomiting, you co-contract your diaphragm and your abdominal muscles, squeezing the stomach between the two muscles.” Then the muscles go through a series of co-contractions, usually referred to as retching. Finally, the diaphragm stops contracting, thus unblocking the esophagus while the abdominal muscle continues to contract, forcing food through your throat and out of your mouth. Breathing is momentarily suspended via a process called apnea, which allows you to get all the bad stuff out without the threat of asphyxiation.
At another lecture, I was surprised to learn that humans are the sole species with the ability to consciously will our bodies into puking. Certain activities like pedophilia and incest induce a sense of moral disgust, and if you think about them deeply, with regard to your own life and experience, some people can actually induce vomiting. In the science-puke world this is known as “conscious vomiting,” and it’s actually recommended by certain yogis, who refer to it as a component of dhauti, the purification of the esophagus and stomach. I attempted this during the preliminary research for this article and found—to my amazement—that I could consistently make myself puke by concentrating hard on a particularly nauseating scenario involving my beloved cat, Niko.
Leading up to the conference, I’d had a shaky Skype call with Dr. Val Curtis, the director of the Hygiene Center at the London School of Hygiene and Tropical Medicine. She refers to herself a “disgustologist,” so you know she really means business. Dr. Curtis told me the feelings of disgust that can lead to nausea and vomiting are actually part of an evolved adaptive system linked to our primal fear of death. The reasons you recoil from nasty situations are instinctual, if not primordial. According to Dr. Curtis, we are all the offspring of primeval ancestors who “tended to avoid feces, nasal mucus, and bad-smelling food. They were healthier, mated more often, brought up more children to sexual maturity, and hence had more grandchildren. And these grandchildren, the descendants of the disgusted, were more disgust-able themselves—and so on, till the present day, and us.”
Dr. Curtis said disgust can stem from anything, but the root cause is usually the reflexive avoidance of a parasite. According to her logic: If spiders and bugs make you puke, this could be because vermin carry disease. If seaweed grosses you out, it’s because it can carry things like cholera. Evolutionary biologists refer to this as Parasite Avoidance theory. According to this theory, vomit is disgusting because it also carries disease. Weight was added to this theory as recently as this past July, when the Hunday Manor Country House Hotel on the west coast of England was closed after a norovirus outbreak was spread by vomit.