Don't Kill the Birthday Girl (5 page)

If there's one thing becoming more and more obvious, it's that teachers need the means and the permission to pull the trigger on epinephrine. I know that's scary. An injection necessitates a trip to the emergency room, whereas the alternate plan is to let the Benadryl-dosed child (who will protest violently that she is
fine
, as she puffs on her inhaler) sleep it off in the clinic. But the side effects of an EpiPen's worth of epinephrine are usually no worse than tremor, nausea, and a mild headache. The side effect of anaphylaxis is death.

Even my mother, with all of her experience, sighs over the countless times she should have used my EpiPen and did not.

“You were so lucky,” she says. “We were so lucky.”

•  •  •

By the time I got to high school, I had become increasingly aware of foods that made no conceptual sense. Cheesecake, for example. Cake should not be cheesy. Cheese should not be caked. Admittedly, I had never tasted cheese. Nor had I ever eaten anything like the spongy, frosting-rich, boxed-mix-plus-egg cakes that populated the parties of my friends. But curdled milk served at room temperature? With cherries on top? This is what dessert would look like on the island of Doctor Moreau.

So when I found myself being herded with a crowd of friends into a restaurant known for its all-cheesecake menu, I knew I was in trouble. We were on a choir trip to New York, where we were booked to sing at Carnegie Hall. My mother's instructions echoed in my head:
Watch for pickpockets. Don't walk over sidewalk grates in a skirt. Keep those medicines on you at all times
.

She should have added
Avoid restaurants with a fifteen-dollar-per-person minimum
. There wasn't a single menu item I could eat. I asked for a root beer.

“A root beer float, you mean,” the waiter said.

“No, I can't have ice cream. Can I just get a root beer? And what brand is it?”

“A and W.”

“Oh.” I was pretty sure A&W's recipe included egg whites, to make the head frothier. “Just a Coke, then.”

The waiter glared at me over his notepad. “That's not enough.”

“Lay off her,” Liz said. “Everyone else is ordering.”

“Jeez, mister,” someone else muttered. “You'll get your money.”

We had the swagger of fifteen-year-olds out on the town. At the Empire State Building, a junior-year tenor had announced that an object dropped from the Observation Deck would gain so much momentum that if it hit a person walking below, it would punch into his skull. We'd pitched our pennies anyway, little Lincoln bombs plummeting toward the sidewalk. We were renegades.

After taking the other ten orders, the waiter jabbed his Bic pen behind his ear and stalked off. I scuffed my shoes back and forth against the checkerboard linoleum. I was the only one who had already changed into the prescribed stage costume of a white button-down shirt, black skirt, and black tights. My purse was stuffed with an EpiPen, an inhaler, Kleenex, and six Benadryl. I had chosen the black purse, hoping the conductor wouldn't notice it onstage. The odds of a Parmesan ambush at Carnegie Hall were low, but I'd promised my mother.

The waiter came back with ten plates, ten forks, and one Coke with watery ice. When he slammed my glass down, soda slopped onto the table.

“Can I have a napkin?” I asked.

“Get one from your friends,” he said, turning away. “Only plates come out with napkins.”

Once he was gone, my friends fumed at his rudeness. Someone suggested we dine and dash. Someone suggested we talk to the manager. Drunk with power and engorged on cheesecake, my friends decided his punishment: they would stiff him on the tip.

By now it was six o'clock, and we were due back at the hotel
in our stage outfits. The two Jens put their money down. “Gotta run and change.” One girl had to go meet her mother, who was chaperoning. The three altos sharing a room headed out. Then the other sopranos followed them. I was the last one at the table.

Our waiter swooped down on the pile of cash. He eyed me, counting out each bill.

“Where's my tip?”

“Um …” I froze. “I don't think they wanted to give you one.”

With a loud clatter he swept ten dirty plates into a plastic dish tub. Then he picked up the tub and stormed through the double-hinged doors, cursing in an unidentifiable language. From the kitchen I heard the crash of the tub being thrown to the floor. Only then did I do what I should have done ten minutes before: I ran.

I had always been a careful, obedient child, figuring that my allergies didn't give me much of a choice. In high school, I was ready to rebel. Teenage rebellion usually involves a sip of beer or a surreptitious make-out session during
Days of Thunder
. My coup took the form of a spoonful of peas.

I was sitting on the far left end of the L-shaped sectional that anchored our downstairs. For years my regular seat had been the prime real estate on the far right end of the couch. Bigger end table. Close to the window. But my kid sister's macaroni-and-cheese habit had contaminated that section of furniture; the ghosts of countless fumbled pasta bears past haunted the armrest, residual dairy causing my eyes to water whenever I sat there. I had been forced to relocate.

“I've spent years facing the TV from a different angle,” I whined to my mom. “Now my neck feels strained.”

Dinner that night was one of the usual combinations of baked chicken breast, wild rice, and boiled peas. No sauces, no garnishes, Sandra-friendly. As I lifted the obligatory vegetable to my mouth, it occurred to me that I didn't particularly like peas.

In fact, I hated peas.

I could hate peas!

It was the first time I could remember articulating a dislike of something I'd eaten. I'd grown up thinking of food in terms of two categories—deadly and safe. I had a few favorites, sure (bacon, French fries, artichokes in chicken broth). But outright “dislikes” were a luxury only others could afford.

On the secure shores of my family's tan shag carpet, I decided I deserved to have dislikes like anyone else. The moratorium on peas would last seven years. Later in life, I'd take to turning down okra,
uni
, Israeli couscous, and red onions. I admit that cavalierly saying no to something on a menu still thrills me a little.

If only all my problems could have been solved by swapping peas for lima beans. In the course of three years, I had gone from being a cute, eager-to-please kid to being a moody lump of greasy hair and sweaty armpits. I rolled my jean shorts up so high that the pocket linings showed. I chewed gum just so I could snap it in sullen comment.

Fifteen was the year we discontinued my allergy shots, after a new round of testing revealed they'd had little impact on my sensitivities. Just what every teenager craves: incontrovertible evidence that she's been duped by The Man.

“Fourteen goddamn years of goddamn injections and they didn't do a goddamn thing,” I reported to my friends. Actually,
the shots probably kept my environmental allergies from worsening, but such subtleties were lost on me. I had just discovered cynicism, which required modifying sentences with “goddamn” whenever possible.

I turned rude toward any and all doctors. I “forgot” to use my daily inhalers. When chided, I muttered, “It's my body.”

My mother would pick me up for dentist appointments and ask if I'd brushed my teeth. The answer was always a principled “No.” I figured that if the dentist really needed to know what my teeth looked like, he should see them in their natural state. No playing nice with Crest and Scope.

I was insufferable. I was a teenager.

Life-or-death decisions fall into the hands of a food-allergic adolescent. As when you hand your Volvo keys over to a sixteen-year-old, it's invariable that accidents, even tragedies, are going to happen. A survey of one registry of food-induced anaphylaxis indicated that 69 percent of fatalities in a given year were victims between the ages of thirteen and twenty-one.

Say a teenager is heading out for a basketball game. He's wearing mesh shorts and a T-shirt, with his wallet and keys on a chain. He figures,
Where would I keep an EpiPen? Besides, I won't be eating anyway
. Then the players get swept along to a postgame pizza party. He's starved for carbs and surrounded by his buddies, and he doesn't want to be the weird guy asking if someone made absolutely sure there are no anchovies on the pie. So he thinks,
To hell with it, I've had pizza before
. He takes a bite.

In one study sponsored by the Food Allergy and Anaphylaxis Network, 54 percent of a pool of teenagers with severe allergies indicated purposefully ingesting a food known to contain
at least a tiny amount of an allergen. Nearly half of those kids cited the rationale “It looked good and I wanted to eat it.”

Most parents know to expect Superman Syndrome from their kids. According to that study, the good news is that teenagers with allergies, unlike most, know they're vulnerable. The bad news is, many don't care—at least, not enough to sit at the peanut-free lunch table or teach their friends how to use an EpiPen or wear jeans with pockets roomy enough for an inhaler. In an earlier study, the same team of doctors found that teenagers said that the hardest part of living with food allergies was “social isolation.” Their parents cited the most difficult issue as “fear of death.”

I was worried about both. I rolled my eyes when my mother suggested that I wear a MedicAlert bracelet (“They've gotten much more fashionable!”). But underneath the surliness, I couldn't shake that nutritionist's curse from years earlier. I was tired of eating baked chicken and boiled vegetables, tired of having to be careful all the time, tired of being broken. Shots hadn't fixed me. Was I unfixable? Was I unfit to survive?

This was the mid-1990s. It would be another ten years before a team of American psychologists ran a series of experiments on the neuropsychiatric effects of allergy, with grant support from the National Institute of Mental Health, NARSAD, and the American Foundation for Suicide Prevention. The scientists induced allergies to pollen and chicken egg in rats and mice. The test subjects were placed in an “open arena,” akin to releasing a human onto an empty basketball court, and their motions were tracked. With controls in place for physical activity, an animal's confidence was measured by its willingness to venture into the center space. The allergy-ridden subjects chose to run
along the walls of the arena, while normal creatures ventured out into the open.

“Little Mouse” had been one teacher's nickname for me in middle school, after she'd noticed I always ate bread from the inside out, nibbling my way around potentially egg-brushed crusts. The little mouse had grown into a teenager with an overdeveloped sense of mortality. I was an anxious creature, clinging to the walls of my arena.

High-strung teenagers are no more rare than rebellious ones. But the X factor of my adolescence, the ingredient that threatened to turn the cocktail toxic, was Benadryl. Benadryl was my ostensible savior—the one thing that could stave off a reaction without requiring a trip to the hospital—and so we had it stashed everywhere. At least six pills in my purse; in my mother's purse; in my locker; in the glove compartment of the car.

The maximum safe dosage of Benadryl within a given day is 300 milligrams. More than that can trigger ringing in the ears, dilated pupils, flushing, fever, hallucinations, and seizure. The bright, friendly shade of pink associated with the brand belies its powerful effects. If you've taken one, you should not be driving. Diphenhydramine, after all, is not just the active ingredient in Benadryl. Known for inducing drowsiness, it is the active ingredient in sleeping aids like Nytol, Unisom gels, and Tylenol PM.

Imagine a depressed housewife who is trying to shut out the siren call of sleeping pills. Now imagine she finds sleeping pills tucked in every pocket, every corner of the house, and even the penny dish by the front door. Imagine her husband reminding her before she leaves for the library or the movies or the grocery
store: “Hey, do you have your sleeping pills with you? Do you need extra? Maybe you should pack a few extra.”

Sometimes my friends would joke that if we ever decided to kill ourselves, I had the tastiest options by far. “Death by chocolate!” they exclaimed. “Death by ice cream!” It certainly would be easy. I can walk into any typical kitchen and find at least fifteen things that would kill me if I ate them, and that's without even looking under the sink for the drain cleaner.

Yet to anyone who has ever had a severe allergic reaction—the numb lips, the swollen throat, the frantic swallowing for air, the churning cramps—the idea that you would volunteer for that sensation is idiotic. Forget the allure of something sugary. No one wants to be drowning in their own spit as they die.

Benadryl was different. I knew what it tasted like (nothing at all), how easily one went down, how quickly another four or five could go down, how it made my eyelids sweetly heavy within a half hour. To an anxious and sleep-starved teenager attending a high-pressure high school, that didn't sound like such a bad way to go. At times that sounded like heaven.

One night I was hiding out in my room, moping and listening to Nirvana's
MTV Unplugged
. My parents were fighting. A boy I liked didn't like me back. I had a ten-page paper due the next day that I had not even started. I emptied my purse, rooted through my underwear drawer, reached into the sliding cubby of my headboard, unpeeled each individual blister casing, and lined up every capsule I had: fourteen Benadryl, and I hadn't even raided the upstairs. I looked at them for a long time. Then I burst into tears, hit the stop button on my boom box, and walked out to the living room. My mother, inured to the
teenage temperament at this point, didn't ask questions. We sat on the couch together and watched the eleven o'clock news.