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On Thursday, June 13th, 2019, at around 7 PM local time, I was walking across a bridge spanning the Mississippi river, in the middle of downtown Minneapolis, on my way back to the hotel I was staying in. It was a perfect early summer evening, the sky was a clear deep blue, and the temperature was pleasant. It was the last night of a two-day business trip, and I was in a great mood. My meetings had gone as well as could have been expected. I was going home the next morning. I was both relieved to be done as well as happy to be taking a nice peaceful walk through a city I had never explored before. I walked lightly, I think I probably smiled a few times. It was triumphant and celebratory. Less than an hour later I had a dramatic allergy attack. I passed out on the floor of the hotel elevator, in a small puddle of my own blood, struggling confusedly to find my glasses, wallet, and phone, while the ambulance that would take me to the hospital was on its way.
I started working at the job that took me on this trip in 2007. A difficult set of circumstances including a family relocation, and a financial-crisis-era bank failure followed, but by 2019 I had begrudgingly settled into my career. I found the work itself sadly unfulfilling but there were bills to be paid, all the normal life responsibilities to look after, and if nothing else, this work I was doing let me address those. I was working in IT, a second act for me, after having studied Chemistry for many years and not being able to find suitable work in that field. I moved to IT simply because of the job market, but it turned out I was pretty good at it. However, after 12 years, and another 12 preceding it in other IT jobs, I was tired. I no longer had the motivation of making money to raise children and send them to college propelling me forward. I had done that already and the kids were grown. With that work’s only meaning removed, sucked out of it, all that remained in my work life was an empty hole. A soul-crushing tedium, dreading every workday, a deep sense of not just hopelessness, but indifference to the outcome of what I was doing. At that point in my life, my evolution, I could not overcome the fear of change, my only view of the future consisted of a narrow tunnel where I only saw what I was currently doing, what I knew how to do. Everything else was darkness. I was trapped in that routine. This changed for me later, my view became much more expansive over time.
Part of the routine of that work involved the occasional need to travel to another office location to meet with the teams I advised. I typically spent a few days locked in a windowless conference room discussing some “critical” initiative. My job role was that of a technology strategist and an advisor. The team described a complex problem requiring a technology solution, and I was largely responsible for coming up with a solution and sounding credible. Attendees of these meetings varied, a few were interested, but most were distracted and inattentive working heads down on their laptops and attending to other matters. I believe some were there because free lunch was always provided. This trip was no different.
I got off to an inauspicious start. I said goodbye to my wife and drove myself to Charlotte airport for my mid-day flight, as I had done numerous times in the past. While I was waiting in the parking lot for a shuttle bus to take me to the airport. I suddenly had the feeling that I was traveling very lightly. Light and fast, that was the way to do it, as I looked down at my small carry-on bag. It was at this point I realized why I felt so unencumbered, I had left the very heavy backpack I always carry on these trips, the one with my laptop, chargers, and notebooks, at home. I could not work without it. But I was at the airport early enough, after a panicked call to my annoyed wife and a short but tense wait, I had my bag just in time and was on the plane, off to Minneapolis.
My meetings over the next two days played out as they almost always did. Almost. Problems were discussed, and debated, and a proposed strategy to resolve them (that would never be implemented) was agreed upon. Firm plans were made to hold some more meetings, by phone this time. All of that is exactly what always occurred, and there were no surprises there.
Having successfully made it to the end of my second day, with the worst of it behind me, a bit of a celebration was in order. I am profoundly introverted, and after having spent two full days in a conference room full of people, I needed a nice long walk alone. The thought of it was liberating. During breaks in the discussion, I would search google maps for a local brewery, someplace I could walk to after work, a place that sold food as well, that would be perfect. By the end of the day, I had a route carefully planned out. It was a 4-mile walk that would take me to the other side of the Mississippi river over the Stone Arch Bridge, to a craft brewery that featured a food truck, then back across the river over a different bridge in a loop. As the meeting adjourned, I was very much looking forward to dropping off my bag at the hotel, changing into comfortable clothes and sneakers for walking, and enjoying my adventure.
It was a perfect early summer evening in Minneapolis. I left the hotel and was soon walking across the Mississippi river over the Stone Arch Bridge. I was mildly surprised at first by the fact that the Mississippi was here at all, this far north, who knew? The Stone Arch Bridge is a former railroad bridge that spans the river. As the name implies, it is constructed of a series of stone arches, making it one of a kind, as far as Mississippi river crossings go. It is very old, completed in 1883, and still standing. These days, there are no trains, and the bridge is used only by bicycles and pedestrians. The walk was extremely pleasant. There was a crowd of people out walking, jogging, and cycling. It felt like this was one of the first warm days of early summer in this part of the world. A great many pale-skinned young mid-westerners were taking their colorful new tattoos out for perhaps the first time. It felt like an awakening from hibernation.
Minneapolis, like any major city with a long history, has had to change, and reinvent itself over the years, to stay alive and relevant. The origins of the city’s first boom date back to the mid-19th century, when it became a large center of commerce for flour milling. Rail lines from all over the plains of the US carried trainloads of wheat to the mills, and the finished wheat was sent back out on other trains for distribution and export. This business reached its peak in the early part of the 20th century, after which various market forces moved flour milling to other locations, resulting in its decline and eventual end altogether in 2003. In its place, today’s Minneapolis hosts other businesses and industries that continue to sustain it, such as banking and finance (the reason I was there). The 19th-century residents of Minneapolis, living and working in the flour milling capital of the US, probably could not have envisioned a future so different. Nor could the railroad engineers in 1883 who built the Stone Arch Bridge ever have conceived that their masterpiece would one day serve only bicycles and electric scooters. That kind of drastic change would have seemed impossible, perhaps scary, yet it is exactly what happened. The building that housed the Pillsbury A-Mill remains today prominently in place on the banks of the river, now being converted into loft space. A reminder of the past, and also a reminder that change is possible, not just possible, but necessary for survival. In May of 2020 a few months following the events I am describing, the tragic killing of George Floyd by Minneapolis police would cause another upheaval, this one more of a revolution than an evolution, that requires the city again to change, evolve, and reemerge if it is to survive.
After crossing the river on the bridge, I was in a small park, and then I was walking through what looked like a pleasant little residential neighborhood. There were rows of small (by current standards) older bungalows and cottage-type homes, neatly painted and maintained, set on wide tree-lined avenues. These older homes seemed to fit well across the river from downtown Minneapolis, which has an equally old feel as many buildings remain from the city’s beginnings when it was a busy commercial center back in the 19th century. I was at ease. I envisioned owning one of these little houses, across the river from work. A neat little cottage with flowers in the front, I’d ride a bicycle to the office every day like I used to. I eventually arrived at a crowded brewery, a big open space with long communal tables. I ordered a burrito from a food truck in the parking lot and a beer inside. Seeking out a relatively isolated spot to sit down, I was uncomfortable being the weird alone old guy in a brewery full of millennials. I got out of there pretty quickly and immediately felt better. I was nearing completion of my planned walk now, nearing the hotel in the middle of town on busy 7th street. As I walked over the last bridge, I felt great. I was in a celebratory mood. I was thinking about a nightcap, maybe a martini at the hotel bar. It had been a successful trip and it was still early. It was exactly at that point that my wrists started itching.
The Mayo Clinic1 describes anaphylaxis as the following. “Anaphylaxis is a severe, potentially life-threatening allergic reaction. It can occur within seconds or minutes of exposure to something you’re allergic to, such as peanuts or bee stings”. I was certainly familiar with the term at that point in my life, but I did not need to be particularly aware or concerned. By then I had made it to age 53 without any occurrence of an allergic reaction in my life. Sure, every once in a while I would get some hives on my face and neck, usually when out on a walk, but it was a very infrequent occurrence and they went away quickly. It was never anything more than a minor nuisance. The website goes on to describe the symptoms.
- Skin reactions, including hives and itching and flushed or pale skin
- Low blood pressure (hypotension)
- Constriction of the airways and a swollen tongue or throat, which can cause wheezing and trouble breathing
- A weak and rapid pulse
- Nausea, vomiting or diarrhea
- Dizziness or fainting
It goes on further to recommend an immediate injection of epinephrine, and an urgent trip to the emergency room of the hospital, if left untreated, the condition can be fatal.
I was approximately a half mile away from the hotel at the point when my wrists started itching. I picked up the pace, feeling more annoyed than nervous. I thought mosquitos had bitten me, but I didn’t see any insects anywhere. Another block or two closer to the hotel. The itching was spreading very quickly, from my wrists to my face and neck, then to my chest and back. In the next few minutes I was within sight of the hotel, it was a relief. By now the itching had turned into more of a burning feeling, and it was everywhere, all over my body. As my legs moved they burned and stung as they rubbed against the fabric of my pants, I had to resist the urge to stop walking and just scratch everything. I had no idea what was happening or why, but I sped up and made it into the hotel elevator. I pressed the button for floor 25. Someone got in the elevator and said something to me, I am not exactly sure what it was, I believe it was a reference to a sporting event occurring that night. I wasn’t paying attention. It was at that moment that I first got a look at myself, in the reflection of the shiny polished metal interior of the elevator. This looked bad, and my stomach dropped. I was covered in bright red hives, my face, neck, hands, and all the exposed skin that could be seen was nearly completely covered. The burning and itching I was feeling everywhere else told me that the rest of me was likely to look the same. Back in my hotel room, still feeling more confused than scared, I decided that I must have been exposed to something outside, something in the air maybe that was wafting around while I walked by, that was causing my whole body to react like this. I decided I needed a cold shower to get whatever it was off of me, and to get me some relief from the burning feeling. Having a look at all of me now, in the hotel bathroom, in that giant mirror that is always directly over the sink across from the shower, my growing fears were confirmed. I was covered from head to toe in bright patches of red, hives everywhere. I got in the shower hoping for the best, and that I could just manage this on my own, wash it all away. When I tried to step out of the shower to dry off, I lost my balance and nearly fell down. I was dizzy, and the room was starting to spin, it was the feeling you had when you were young and you drank way too much for your own good and laid down in bed. Dizzy, nauseous, and confused. I was having a hard time taking a deep breath. I looked again in the mirror, this time after the shower. It was worse than when I went in, now, there were no red patches. Just red everywhere, like a giant swollen overripe tomato. Writing this now, three years after it occurred, I feel like my skin is crawling and I can feel the shortness of breath all over again.
I had been around death before. I had lost both of my parents by that point in my life. But I never really thought seriously about my own mortality. But then, standing in the bathroom of the Marriott in downtown Minneapolis, looking at myself in the mirror and thinking about my rapidly deteriorating condition, I had my first confrontation with mortality. It wasn’t a desperate or even sad moment, it was just the realization of how foolish this whole situation was. This was my only clear thought: This is bad, I might not make it, if I don’t, this would be the stupidest, most meaningless death imaginable. I was alone in a hotel room in a strange city attending a series of meetings I wasn’t interested in while performing a job I didn’t enjoy.
With my equilibrium gone, and clear thought difficult, I decided to just lie down on the bed and consider my next move. The shower didn’t help. It might have made it worse. Breathing was shallow, the burning feeling was only getting more intense. I thought briefly about just calling 911, in hindsight, that would have been the correct move, but for some reason, I didn’t do it. I remember sending a text or two to my wife letting her know I wasn’t feeling well, and that I was having some sort of allergy attack. Something inside must have said that I could take care of this on my own. I don’t know why, but I recalled at that moment there was a drug store on the street right next to the hotel. I could just throw some clothes on and hop on down there, get a box of Benadryl, take about half of it, and everything would be fine. Strengthened by the hope of a plan and a resolution, I staggered a bit but managed to put on a minimum of clothes, grabbed my phone and wallet, and headed out of the room to the elevator. Once again, in this present moment, I have to walk away from my computer and this story, as the shortness of breath is almost as strong right now as it was that night.
In the months and years that followed this event, I worked with my therapist to change my life. This event causing me to finally seek out therapy was a tremendous positive. I was trapped in a career that no longer served me, I knew that well enough, but I was unable to free myself of it. She helped me understand that when I looked forward, to my future, at the options available to me, my perspective was shrunken and constrained by fear and uncertainty. I was in this state for so long, that my anxiety caused me to have tunnel vision, I could only see a narrow view of the world, a single point of clarity in my field of view that corresponded to exactly what I had always been doing. Everything outside of the tunnel was in darkness. Unfortunately for me, at the time, the whole universe of possibilities was outside my vision. It took me some time to conquer my fears and learn to expand my view of the world.
As I walked down the hallway of the 25th floor of the Marriott in downtown Minneapolis, the tunnel vision I was experiencing was not the metaphorical version. I could see the elevator doors, but my vision on the periphery kept shrinking until everything was gray and fuzzy. I pushed the down button, still burning up, short of breath, and sweating. I got on, thankful there was no one else in the elevator, pushed the button for the lobby, and leaned against the back wall for support.
The next thing I remember was the sound of the alarm in the elevator. Do you know that sound the elevator makes when someone is holding the door open, waiting too long to let someone else in? That buzzing sound was the first thing I heard. Now I was very confused, I was lying face down on the floor of the elevator. I could feel the backs of my hands, at my sides, resting on the elevator floor. I could hear voices in the background, sort of off in the distance, yelling in what seemed like a panic. My glasses were knocked off of my face and were bent on the floor next to me, there was some blood, not too much, but enough for me to realize I had fallen, and my metal frame glasses had cut the bridge of my nose on the way down. Unsure of what had happened or how I had gotten there, I had a panic attack and reached for my pockets and realized my phone and wallet were gone. Still on the floor, on my belly, with my bent bloody glasses now back on my face, I was pawing around on the floor for my wallet and phone, which hadn’t traveled far fortunately, I was able to feel them not too far away. That was the first time I looked up at what was going on around me. At that point, I realized the buzzing elevator door alarm was being caused by a man holding the door open. He was also on the phone with the 911 dispatcher and was asking me if I wanted an ambulance. I forgot exactly what I said to him, I hope it was something polite like “Yes please”. But I am not sure, regardless, he told me an ambulance was on its way. With a little help from this man and maybe one or two more people, I can’t remember, I was helped up to a seated position. At that moment I was too confused to be anything other than grateful that I had found my phone and wallet. We rode down to the lobby, as you can’t just sit there with the elevator alarm going off forever. I was practically carried to a nearby sofa in the lobby where I laid down to wait for the EMTs to arrive. As I was waiting I noticed a change, the burning feeling that had consumed me a minute or two ago, that I couldn’t get rid of in the cold shower, was completely gone. In its place now was intense cold. I could not stop shaking. Not shivering, but not quite a convulsion, my whole body in an instant had gone from hot to cold, the waves of shaking would start and stop every few seconds, with short pauses in between. Fortunately, it did not take very long for EMTs to arrive, they gingerly loaded me into the stretcher and wheeled me out of the lobby, past several onlookers into the waiting ambulance.
I had never been inside an ambulance, it was dark, small, and cozy. There were people inside to take care of me. It was at this moment that I knew everything was going to be OK, I was going to be fine. I was still in the middle of some bizarre unexplained reaction, shaking uncontrollably. But now I felt calm, at ease. I felt cared for. There were a lot of questions from the EMTs, and one that I would hear many times that evening, both here and in the hospital, “What are you allergic to?” To which I could only respond, “Nothing that I know of, this has never happened to me before”. The other question the EMT asked me, I thought was a bit strange. “Which hospital do you want to go to?” I was still very confused, I had just hit my face and head pretty hard on the elevator wall and floor, and the only response I could come up with was “A really good one please.” With that medicines were administered, an IV line attached to my arm, and we started on the short drive to the Hennepin County Trauma Center, a few blocks away.
Visiting the emergency room is generally not a pleasant experience. This is self-evident. Any time in my life I was ever in one, it was because something bad had happened, myself or one of my kids had been hurt in one way or another. The story inevitably has a bad origin. After arrival, my general experience there has been one of waiting and overall frustration. The experience I had that evening was completely different. For starters, I learned that when you are wheeled into the emergency room on a stretcher, you immediately are moved to the front of the queue. I am certain I must have been carted past people who had been waiting there a long time, perhaps with crying children, I couldn’t see any of them for sure but I felt like they must have been there. They always had been there before. I felt guilty being taken in ahead of them. While most of the fear was gone by now, the penetrating cold and uncontrollable shaking was still very much present. I was taken into a private room and lifted off the stretcher into a hospital bed, I was helped out of most of my clothes. A small group of doctors and nurses were swirling around me busily, many sensors were stuck all over my body and attached to monitors. The doctors gave me more medications and put something new in the IV bag. Several doctors and nurses asked me many questions. What had happened? What did you eat? What are you allergic to? I had never experienced so many people all around me working so intently, but none of the answers I provided were apparently of much help. What did feel comforting at least, was the mountain of heated blankets that were piled on top of me in an attempt to keep me warm. When that alone failed to stop the shaking, the heat in the room was turned up as high as it could go. Take a load of laundry right out of the dryer and lay down in bed with all the dry warm things on you, this is what it felt like. Though at this point the hives had mysteriously vanished, I still felt weak and short of breath, nauseous, and still cold and shaking. With none of the medications helping I was wheeled down the hall so that a CAT scan could be taken of my head. A male nurse had to hold me down flat on the bed for me to be still enough to get a good picture. I suffered from concussion symptoms for several weeks after this, as is expected when falling face-first onto a hard floor with nothing arresting your descent.
Back now in my heated room, under all my blankets, there were more questions from more doctors, my entire medical history, and every specific thing I did in the hours that led up to the attack. All the while, a nurse sat in the room with me. We talked a little in between doctor visits. It seemed strange to me that she never left. I felt a little bad about this, that there was someone stuck there in that hot room with me. The whole experience was remarkable, in terms of how attentive and concerned everyone was, and how well taken care of I felt. I was certainly not out of the woods physically, but I know the care I got helped me greatly in terms of my mood and my outlook.
Unfortunately, we were getting nowhere trying to figure out what could have caused me to react so severely, without any known allergies. The doctor told me they were going to give me an injection of epinephrine. You know the one, the EpiPens that people with allergies carry around with them at all times. The nurse gave me the injection in my right shoulder. I wasn’t paying too much attention, I had had a few injections that night already. This one was different. Within what felt like a very short time, the cold and the shaking started going away. Now, I could respond more coherently with steady hands to text home to let my wife know everything was ok. After a little while longer, the cold was gone completely, and the hot blankets and hot room were no longer necessary. It was now all of a sudden way too hot, and the nurse with me opened up the door to let the heat out. After perhaps another hour or two of monitoring and chatting with the nurse tending to me, I felt well enough to get up and out of bed on my own. The nurse started removing the many sticky probes stuck to my hairy body, but by now, let’s be fair, she had already put in quite a shift, and when she suggested I take the rest off myself I was happy to do so. The epinephrine seemed to work a miracle, and it did so very quickly. I was given instructions on leaving, I was told to seek out an allergist immediately after getting home to try to sort out the cause of this reaction. There was a large stack of papers handed to me, describing the diagnosis (Anaphylaxis) and what I was to do in the days and weeks that followed. I walked downstairs to the pharmacy to pick up my shiny new EpiPen that would become my friend and companion for life, as well as additional medications I needed to take for the next few weeks.
With that, I found myself still a bit dazed outside on the sidewalk with a brown paper bag full of prescription drugs. It was 3 AM. It was a clear and cool night with stars out. My hands were still a bit shaky as I tried to use the Uber app on my phone to fetch a ride back to the hotel, but for some reason, I could not make it work. Unsure if this was a technology problem, or user error, after a few minutes I gave up and had a look at Google Maps to see how far away I was. Fortunately, even in my compromised condition, I was able to look up the hotel and I quickly learned it was only 0.7 miles away, pretty much in a straight line. With no other option available, I walked off into the dark back to the hotel. The events of the evening hadn’t settled in yet, maybe it was all the medication I had been given, but at that moment all I felt was nervous to be walking the dark streets of a big city alone at 3 AM with a paper sack full of prescriptions. I walked as quickly as I could and with great relief found the hotel exactly where my app said it would be.
In the weeks that followed this, back at home, back at work, I knew something had to change. I had a brush with what I thought would have been the most ridiculous, meaningless death ever, and I knew I couldn’t keep doing what I was doing. I needed a change in my life. If bridges and entire cities could change, I could change too. Two weeks later, I got a call from my employer. “We need you in New York for some critical meetings.” I dutifully went. Though I knew I had to change my life, it was going to take more than a hit on the head to make it happen. I was too afraid, and the fear of change trapped me. I only knew how to do what I had been doing. I wasn’t capable of anything else. I didn’t know it then but that day marked the start of the process that ultimately would land me in therapy and eventually change my life for good.
- “Anaphylaxis,” Mayo Clinic (Mayo Foundation for Medical Education and Research, October 2, 2021), https://www.mayoclinic.org/diseases-conditions/anaphylaxis/symptoms-causes/syc-20351468.