As soon as I’m shown into the clinic, the specialist wants to know why I’m there. She’s had a long letter from my GP, she says, about some half-remembered symptoms I first suffered aged six – I don’t mind if the two medical students sit in, do I? – and she can’t understand why, on a wet April day twenty-four years later, I’ve come to discuss them with her. She lists the symptoms and doesn’t invite comment: mouth this, throat that, a bit of bowels. Then she asks me what I want, with the contempt a waiter might have for a customer who lingers over the set menu. Her hair is strapped back with such tight precision that I suspect it’s a ploy to enhance her raised eyebrows.
It seems utterly in keeping with having a food allergy that an allergy specialist should take such disinterest in it. Indeed, the doctor’s brusque, sceptical attitude corresponds to my experience of allergy as something that, however uncertain, has always felt tediously unremarkable. So unexceptional is it that I’ve avoided making this appointment for a decade: I’m only here now because I’ve come up against a GP who won’t revamp my prescription for an EpiPen – the epinephrine autoinjector that’s supposed to give you a chance against anaphylaxis – until he knows what he’s prescribing it for. It might do more damage than it prevents, he says, before reeling off a cautionary tale about some chap, mildly allergic to cinnamon, who lost a thumb when he plunged the syringe upside down.
I agree to be referred to a specialist, and hold back the irresponsible truth. Which is that, for me, the EpiPen sits somewhere between placebo and memento mori: it’s a reminder that I should be taking my allergy seriously and a justification that I am taking it seriously enough. Arranging the prescription, however tardily, makes me feel accountable to the risk I take when I eat. Then the yellow triangular cardboard wedge – the ‘Pen is packaged like a Toblerone bar for people who’d die if they ate one – gathers dust in a sock drawer, or mould in a wash-bag, until the time comes to sort out another. It’s to deceive myself sufficiently, Doctor!, I want to wink and whisper, I store the last resort where it will always be too late!
It’s a complacent attitude, of course. It’s little excuse to protest that I avoid more hazardous cuisines, whatever they might be, in favour of the food I think I know; besides, the allergy is far more handy as a social pretext to dodge restaurants where I’d rather not eat in favour of the food I know I like. And yet my allergy is no illness, nor even so much as a condition, so protesting anything would be to protest too much. It’s more like a chore, remembered and forgotten so many times each day and, as with so many chores, it tends to seem wholly petty when most maddeningly vital.
I habitually neglect to tell waiters what I can’t eat – then scuttle after them, as if flapping at a departing bus, before they can punch in my order. I am allergic to nuts. I have a nut allergy. I am allergic: the allergy possesses my body, inherent, unflinching. I have an allergy: where I profess ownership, the familiar sham of control. Either way, the kitchen’s answer – and how well that spatial metonymy shrugs the prospect of blame – never fails to catch the charade-like nature of the entire inquiry. There are no nuts in the ingredients… the kitchen can’t guarantee…
Nuts to nuts! My body’s dull, dormant antipathy to a vaguely defined group of foodstuffs – frutta secca, dry fruit, in Italian, is so imprecise as to band withered apples and apricots with the pecans and pistachios – merits my wishful scorn, no more. The boredom of allergy is exacerbated by the niceties it provokes: that slew of hoop-jumping questions that we ask to feign interest in someone else’s digestion. Is it all kinds of nuts or just some nuts? What would happen if I gave you a nut right now? If you ate a cashew would you swell up and die?
It’s wearying to be asked these questions repeatedly. In the right mood though, they hit on the type of latent comedy that banal repetition can foster. After all it is funny, if not exhaustingly so, to be allergic to a playground synonym for testicles: I’ve had food slammed in front of me for ‘Mr No Nuts’ before. Made in a factory that handles nuts: some ball-scratching work-house for Waitrose? Perhaps the structure of allergy is itself comic, if that is the word, for ultimately what else is the body that mutinies against itself? Allergy is one of those unruly surprises that snooze in our physiological make-up. Estragon: what about hanging ourselves? Vladimir: it’d give us an erection!
Eating, when it’s done well, should naturally cousin comedy – which is why Petruchio’s depriving of Kate makes for no more than cold laughter. But eating, for me, is a nervous comedy that could at any mouthful swivel into tragedy. At the allergy clinic, I’m relieved when the specialist doesn’t ask me to retrace my body’s fierce reaction to rogue traces – to the smear of pistachio ice-cream on another scoop, to contaminated buffets, to peanut dust on the rim of a pint glass. Unlike other anecdotes, these stories have no capacity to take flight; they are coarse and flat and grounded. And they are merely illustrative, not diagnostic.
Since I’m now here, I can have some tests. But the specialist thrusts a truism at me: if the tests are positive then I’m no less at risk, and if some tests show negative, I risk thinking I’m no longer at risk. And the only other test, she admits, is to play a kind of nut-loaf roulette. Remember your body is a unity is her adamant, baffling conclusion.
The tests take place in the Respiratory Function Unit. When I enter the room, there’s a woman strapped to a mask, and later a man gets strapped in by her side later – at which point the first strap-on starts to fuss for the toilet. Here too are another clutch of medical students and a chubby young woman with a blotchy red forearm. As soon as I’m seated, the test invigilator, Leonelle, starts to scribble on me in black biro, laddering small words and abbreviations in two columns down my inner arm: DOG, HOM, GRASS, ALT, BIRC, TREE, ASP, CAT, EGGW, EGGY in one, MILK, COD, SOY, WHE, PEA, BRAZ, HAZ, WAL, CAS, ALM in another. A lot of pipetting follows and then, with what looks like a pencil-sharpener’s blade, she punctures my skin to let the fluids seep in.
I soon feel a deep itch at CAT. The sensation’s like the aftermath of a mosquito’s bite – the small poisoning before the flesh starts to puff in new contours. Leonelle is now measuring the woman’s blotches with a school ruler, but every so often peeks at my arm, as if sizing up presents before they’re due to be opened. CAS, cashew, is rising quickly, a big thickened welt the size of a penny-piece. It soon takes on the shape of a heart, colonising the geometry of what it threatens to stop. I am allergic to cashew nuts – as I was aged six.
Before long, HOM, GRASS, ALT, BIRC and TREE come up like a regiment of little pink buttons, trooping my intolerances. And PEA and BRAZ, and HAZ and ALM as their auxiliaries. The medical students have stopped what they’re doing to enjoy my arm, and Leonelle seems genuinely excited. I am allergic to nuts. I am allergic to the outdoors – to birch, tree, grass, and a long-named fungus. I am allergic to the indoors – to dust-mites and domestic animals. And to WHE, which has fissured, doubled, a chain reaction that rises to look like a question mark: am I allergic to wheat?
The specialist sends me away with some photocopies. Which give advice on Oral Allergy Syndrome, since I’ve mentioned that some fruit makes me tingle. Before eating an apple, I’m to rub it on my lips, wait ten minutes, take and spit a bite, wait, bite and swallow and wait: I will need to groom my mouth for almost half an hour if I want a Granny Smith or Pink Lady. An apple a day is about all I’ll have time for.
A week later, I’m copied into a letter to my GP about EpiPens. Thank you very much for asking us to see this 29 year old writer, it opens, before listing some symptoms I never had: there’s a widespread rash that’s sprung from nowhere in my past. The letter runs through my positive results but is inadvertently kind, I like to think, in omitting my brand-new wheat allergy. He clinically fulfils the diagnostic criteria for anaphylaxis. This is likely to be related to nuts… I have now discharged him back to your care.