Last month, The BMJ published a case report about a 34-year-old man admitted to an emergency room in Cooperstown, NY with thunderclap headaches, a particularly painful kind that can be a sign of cerebral haemorrhaging. His symptoms included dry heaving and intense head and neck pain. The man traced his anguish to a chilli eating contest a few days prior where he consumed a single Carolina Reaper, the Guinness World Record holder for the world's hottest chilli.