How many of us have been at checkout while booking a flight online, seen the option to purchase some kind of travel health insurance and thought, "Nah, I'm good"? Hawaiian ripper Cliff Kapono usually thinks the same thing, but because he felt uneasy about a particular trip and pulled the trigger on traveler's health insurance, he managed to avoid a financial pummeling after an already brutal beating from a wave that send him headfirst into a reef, to a local hospital and onto a medevac plane. Below, Kapono recounts the kind of surf adventure that most of us would file in the "trip from hell" folder, but was made somewhat easier thanks to a little foresight.

So where were you when this whole thing went down?

I was in the Western Pacific chasing a typhoon swell. It was a last-second strike. Before I left, I'd been longboarding Bowls on Oahu, and one of my friends told me he was going to chase this typhoon and told me I should come with.

Did you just happen to get insurance for this trip?

No, I actually got it for a trip to Indonesia a month before, because we were going on a boat to this outer island where it was really remote. I thought it would be smart to get some insurance, because if I got hurt I knew it would be a mission getting treatment. Funny, because that trip was fine, but the insurance I got from this company called Diver's Alert Network lasts a year, which was really lucky because of what happened on this trip.

Tell me about the wave that you went to. It looks amazing, but clearly very dangerous.

Yeah, I'd seen images of it before on a swell different angle and it was perfect, but on this angle it would pinch and closeout on a lot of them. You definitely had to pick the right one. It still looks perfect, there's no steps or boils or anything, but the angle put a critical bend in the wave, and on some it will stay open and turn into a really wide barrel. On others it won't open up big enough, then the end part will clamp you, and it gets pretty dangerous. When you pull into the barrel, it looks like there's a 4-footer coming at you from the side.

What happened on the wave you got injured on?

The whole trip, I'd been riding smaller boards, but this was the end of the trip and I'd broken one board and sold another and I just had a 6'6" left. I thought that board was going to be overkill, but I took it out anyway and it ended up being perfect. I could paddle and get in way early, make the drops way easier and for a while it was a magic session. I started taking off on the ones that looked like bad ones before, but because I was getting in early and going so fast, I could avoid that end section. I was feeling really confident, but I swung on this insider and didn't really engage the face, so it took a second for me to bottom turn. When I did, the thing was just running and I ended up not making it out. I didn't hit the bottom when I fell at first, but then I got sucked over, and that's when I knew it was going to be bad. I went to put my hands over my face and head and half a second later there was this flash and I felt this crunch—straight into the reef. Headfirst.

Wow, how bad was it?

I didn't know at first. When I finally came up, there was already another set on top of me. I swung around to duck dive, and when I tried to go under the wave I got vertigo, and that's when I realized my eardrum was also busted. I couldn't even push my board down and the wave just smashed me. Eventually I got washed into the lagoon and started yelling for help, but at first no one heard me. I wanted to get an arm up in the air to show that I was in distress if someone saw, but I couldn't get my right arm up and I thought it might be broken, so I was paddling with my bad arm and holding the left one up. It was like a 20-minute paddle in, but the guys from the lineup saw and came in to help. This guy Chris Anderson was the first person who got to me and asked if it was bad. I put my fingers on my head and I could, like, feel my skull. I thought, "Yeah, this seems pretty bad." Eventually we got to the beach, and they held my neck and helped me get to the van so we could drive to the hospital.

I know you were in a remote area. Did they treat you there or just send you to another hospital?

Yeah, they had a neurologist who looked me over and they looked at my head and told me I'd need a bunch of stitches. I got X-rays and a CT scan, and they told me I'd broken my neck in three places, but I had no spinal cord damage. They said I was super lucky, which I was, but I was also immediately thinking about all the people I know who'd had head trauma and spinal injuries and there's so much scary stuff that happens afterwards. I was kind of freaking out. I was also thinking about the chance of infection, because I've studied coral before, doing bacterial isolations, and I know there's gnarly bacteria there. I was just thinking, "This is really bad, I either need to get back to the US, or to the main hospital on the main island." The doctors said, "Yeah, you should go," and then after staying the night in the hospital they opened up the airport—it normally isn't even open—and they loaded me onto a medevac plane and took me to the main island. At the hospital there, they gave me a MRI and they told me they didn't actually see any damage to my spine, so I just needed to take care of the stitches.

That's crazy. It's always weird to hear something from one doctor and the opposite from the next.

Yeah, when you're traveling, sometimes you don't actually know if you're getting the best diagnosis at smaller hospitals on these outer islands. It can be pretty nerve wracking. But when I got back to Hawaii, the doctor told me that I had calcification on my spine from previous neck injuries, so the doctors on my trip might have thought that was a break.

What would this whole thing have cost you if you didn't randomly get that insurance before?

The medevac flight alone would have been $20,000, but I think the whole experience ended up costing me $600 total, and that was for a MRI, CTI, X-rays, two nights in the hospital, an ambulance ride and the medevac flight. It was pretty crazy. Definitely the best-case scenario, all things considered. So often we hear these stories in the surf world where things get so bad for someone on a trip, and people have to set up GoFundMes to handle the medical costs. But this was so cheap, and I feel like people should know about it. If you're going to spend thousands of dollars going to a place like Indo, why not spend a little more just in case something crazy happens? I feel so lucky that I'd been overly cautious that other trip, because it really saved me on this one. Also thanks to Matt Rott, who was surfing with me and left firing waves to stay by my side the entire time. He handled all the doctor conversations and made sure the doctors knew what had happened before they moved me. He’s a hero.