Carol Palk was sick and bleeding from an ulcer in her stomach riding in the back of a cab during a five-hour trip through a dangerous Mexican state, so that she and her husband could catch a plane that would eventually fly them back to the United States via Mexico City.

Neither Carol nor her husband, Bertram "Buzz" Palk can speak Spanish, so they could not communicate beyond showing their driver their airline tickets.

Hours earlier, she and her husband were marooned on a foreign shore by the crew of their cruise ship because they could not treat her ulcer.

Carol Palk, a 79-year-old from Whippany, was sailing on the Allure of the Seas, a Royal Caribbean Cruises ship registered in the Bahamas but sailing out of Miami, with her husband and friends from their Rotary Club. The seven-night cruise, which stopped in ports throughout the western Caribbean Sea, was the couple's 16th cruise vacation.

More than 20 million people cruise each year, according to TripSavvy.com. But it is unclear how many people find themselves in a situation in which they are forced from their ship in a foreign country because of a medical emergency.

The ship's crew was following a company policy.

"Our actions depend entirely on the condition and needs of our patients," said Owen Torres, a Royal Caribbean Cruises spokesman. "In this case, our ship’s doctor and medical crew initially treated the guest in our medical facility but required additional and urgent medical attention that could only be provided in a hospital."

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Carnival and Norwegian cruise lines, two other popular cruise ship companies, did not respond when asked if they have similar policies.

During the trip, Palk sought treatment from the ship's doctor when she noticed blood in her stool, a sign of internal bleeding. That's when she got shocking news.

The doctor on board told Palk that he was monitoring her red blood cell count and that if it dropped below a certain level he would be forced to take her off the ship.

"The doctor told me, 'I'm going to kick you off the ship' if the level dropped any further," Palk said.

That's exactly what happened.

After Palk's blood count dropped again the following day, the couple were told to pack their belongings because they were being removed from the ship at the next port-of-call. In a matter of hours, the Palks were left watching the ship sail off from a dock in Puerto Costa Maya in Mexico on Jan. 11, just two days before the ship was scheduled to arrive back in Miami.

"I just had no idea what was going to happen to me or my wife," the 82-year-old Bertram Palk said.

The mistreatment of passengers by a cruise line does not surprise Jim Walker, a maritime lawyer based in Miami. Many cruise ships are registered in foreign countries, just like the Allure of the Seas, so passengers are in a legal "no man's land" when aboard some of these vessels.

"Legally, there is not much people can do in these cases," Walker said. "If the couple were to sue, they'd have to prove injury or negligence to get anywhere."

Instead of going to a hospital, the Palks opted to return to the United States.

So the ship's staff arranged for a $600 taxi to Cancún and two flights: one from Cancún to Mexico City and one from Mexico City to Miami, totaling an additional $1,039. The couple also had to pay $74 for entering Mexico, a fee that was collected at the ship's dock.

"I told them we didn't want a flight to Miami and that we wanted a flight to Newark, but they said it was too late," Bertram Palk said. "They didn't even ask us."

The Palks' journey home took a grueling 24 hours that was so strenuous Carol Palk decided to write an impromptu will on one of her flights.

Ron Francioli, the Whippany mayor, who was part of the Rotary Club group with the Palks, was desperate to get in contact with his friends during their trek home.

"The way Royal Caribbean handled this was a complete disaster," Francioli said. "I was up through the night trying to talk to them."

The more than 200-mile taxi ride from Puerto Costa Maya to Cancún through the Yucatan Peninsula took the couple through the Mexican state of Quintana Roo, where a Level 2 travel warning has been issued by the State Department, on a scale that has four levels.

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The warning calls for increased caution in Quintana Roo due to crime in which bystanders have been injured and killed, the State Department website says. The first level calls for normal precautions, the third level advises citizens to "reconsider travel" and the fourth warns citizens not to travel to the area at all.

Bertram Palk was relieved when the driver asked "bathroom?" a couple of hours into the ride, because his medication forces him to make frequent trips to restrooms. The bathroom was behind a gas station, where a group of men were standing.

"I was using the urinal and looking over my shoulder," Palk said.

The couple were unsure about what to do in the foreign country. They don't speak Spanish and they didn't know where to turn.

The United States has an embassy in Mexico City and nine consulates general and nine consular agencies that act as extensions of the consulates general. There is a consular agency about 9 miles from Mexico City International Airport and a consular agency in Cancún, but the couple did not think to call them.

"When a U.S. citizen needs assistance overseas, the department works to provide all appropriate consular assistance," said Marlo Cross-Durrant, a State Department spokeswoman.

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But she didn't comment on the Palks' situation.

The Palks were exhausted once they arrived in Cancún for their flight to Mexico City. On the flight, Carol Palk said, she wrote a will on a piece of paper despite already having a formal one in place, just so she could explain what had happened in the event of her death.

The Palks were relieved to be back in New Jersey when their flight landed on the morning of Jan. 12 — a day before the cruise was scheduled to return to Miami.

"If we went to Miami, we would have to pay for a hotel while [Carol] was getting looked at, plus another flight to Newark," Bertram Palk said.

Carol Palk's physician told her she will be fine, and the couple have returned to their normal daily lives. However, there is one thing they are asking from Royal Caribbean: an apology.

"We don't want money. All we want is a 'sorry' from them," Bertram Palk said.

The closest thing to an apology the couple received was a voucher for 20 percent off from the customer service department after Carol Palk told a representative what happened over the phone.

"What makes them think we want to go on another cruise after all that?" she said.

The Palks said they are fortunate they were able to fund the $3,400 — almost twice what the cruise cost — in costs to get back home.

"What would have happened to someone who didn't have enough money to cover all of this?" Carol Palk said.

Email: zuritaa@northjersey.com