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Anaphylaxis


by Jay Johnson


an-a-phy-lax-is  n.  1. Hypersensitivity especially in animals to a substance, such as foreign protein or a drug, that is caused by exposure to a foreign substance after a preliminary exposure.  2. See anaphylactic shock.  (Grk.; ana-: against; filaxiV: protection)

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            The bee stung Maddy thirty-six miles south-by-southeast of Soweto, as the Steppe Eagle flies. We had parked the Rover along the shoulder of the trail we followed twenty minutes off the main road to Lesotho. The sun blinded us with sweat in the blue January sky and we'd left the Mandela Museum ninety-three minutes ago. She wanted to get out of land-locked Johannesburg; she declared it oppressive, with its new out-lying shopping districts and fast-disappearing forests, compared to the salty wind of Cape Town.

            Maddy was fascinated by the Southern Hemisphere, the idea of summer in January, and convinced me it was splendid and adventurous—never mind potentially irresponsible—to flee the township and take a walk in the low rolling hills to the south.  And it was beautiful and wild where we pulled off: no sign of footprints in the fresh mud that had pooled in the wash, baked into a honeycomb of curling edges. We'd called Maureen from a museum payphone to let her know that we wouldn't be meeting her as planned.

            I lead us through the coarse grass and low shrubbery toward the crest of a not-too-distant ridge, or rand as they say in Afrikaans. I'd later read in the report that it was not an Apis mellifera scuttelata, commonly known to the Western world as the "killer" bee, but instead the Apis mellifera capensis.

 

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ep-i-neph-rine   n.  (Grk.; epi-: pertaining to; nefroV: kidney)

 

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            Believe me, we're always prepared; Maureen and I simulated all the possibilities, studied all the probabilities, since our daughter's first attack. We knew exactly the risk and incidence of attacks in North America (21 in 100,000 in the northern U.S. alone), but those numbers did not apply to South Africa, to Maddy and Mo and me. 

            When I heard the gentle, even "daddy" float from behind me and saw the small pink circle quickly resolving on her pale, freckled triceps, I shrugged off my backpack, felt for the Epi-pen, and passed it to Maddy. She dug her long fingernails, brushed a bright purple, into the yellow plastic cap, unscrewed it, and jammed the black tip into the outside thigh of her olive khaki shorts. All the moves were efficient, well practiced. I was surprised, however, by the rugged strength evident in the violent torque of the downward arch.  My seventeen year-old had grown far more than I realized. 

            Another part of the routine was new, too: the spring-loaded needle that delivered the epinephrine failed to deploy. Maddy studied the smooth black surface and then her thigh, wondering where the metal splinter may be.

 

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his-ta-mine  n.  (Grk.; ‘istoV: tissue)

 

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            I didn't know what else to do, so I lied. “Everything's alright, sweetie.” 

            The reaction had started, the hives and respiratory swelling. Maddy huffed for air, each inhalation rattling her throat louder, more hoarse. I stared at the window on the side of the Epi-pen and willed the red plunger to appear with my wide eyes, praying that both of us somehow missed that the medicine had actually mixed with her blood. 

            We always had a backup, which is why we never switched from the Epi-pen to Twinject. I carried one and Maureen carried one. Somewhere in the heart of Houghton was the other Epi-pen, surrounded by storefronts, cafes, cool fountains, clinics, and hospitals. 

            I helped Maddy to the ground and fluffed my abrasive nylon pack into a pillow.  Her pulse was getting faster, which meant her blood pressure was dropping and the shock was setting in. I knew what was around the corner: anxiety and loss of consciousness.  All three of us had shared a good laugh after her first attack, because the doctor had said “conscience” rather than “consciousness.” I thought it interesting that he explained anxiety to Maddy as an overwhelming sense of doom, without saying who felt it: the child, the parent, or the bee. I'd kept that to myself, though. 

 

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an-gi-o-e-de-ma  n.  (Grk.; angeloV: messenger; oidhn: to swell)

 

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            If there would have been anyone nearby, I could have yelled for help in seventy-three languages. I was in South Africa studying several, the last of which was Northern Sotho, which is spoken in a few provinces, including Gauteng, wherein "Jozi” lies.  Northern Sotho is part of the Niger-Congo family of language and, in descending order, part of the Atlantic-Congo, Volta-Congo, Benue-Congo, and Bantu subdivisions. I had already gained fluency in Southern Sotho, isiZulu, and Xhosa during this sabbatical, which placed me between Jeremiah Curtin and Hans Conon von der Gaelentz in the all-time polyglot rankings, if I were counting.

            The nearest clinic would likely be near Soweto, off the main road, but as I wiped her hair from her bulging eyes and tried to feed her a bit of cold water, I knew that was too far. Down to my last, unavoidable option, I grabbed a fist-sized rock from next to her temple and smashed it into the Epi-pen, trying to free the medicine locked beneath the lettering. 

            It was solid and small, a hard cylinder to crack, but I kept at it, my violence increasing with Maddy's heartbeat and weezing. Ten, fifteen, twenty times I struck that little fucking pen, grunting, trying to break out the secret, until it finally splintered. I cradled it between throbbing palms like a twenty-seven week preemie and cupped the liquid into her mouth, hoping to God that giving a dose five or ten times the norm per os would be enough to stave off cardiac arrest. 

            I washed down the thick, sweet smelling medicine with water, hoping her cramping intestines would absorb it into her bloodstream fast enough to keep her alive until Soweto.  

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