Rachel Cole (DOD: 11/11/2015)
Rachel Cole was 18 and a freshman in college when she passed away from her food allergy. She was diagnosed with a peanut allergy after, at age 2, she ate a peanut butter cookie and developed hives. Until her fatal reaction, she had never required use of an epinephrine auto-injector. Her rare reactions had been managed with Benadryl alone. In addition to a food allergy, she had well controlled asthma, requiring albuterol as needed.
On the day of her fatal reaction, she and a friend ordered take-out from a Chinese restaurant. Normally, Rachel was very careful about reading labels and talking to restaurant staff about her allergy to peanuts but it is not clear if she did so on this day. She ordered sweet and sour chicken, something she had before but not from this restaurant. They went back to her friend's house to sit down, eat and watch TV.
Within a few minutes after starting her meal, she called her mom and said, 'I think I messed up'. She said she could breath fine but that her throat was itchy. She did not have her epinephrine auto-injector with her. Her mom directed her to take Benadryl. She called about 3 minutes later, 'screaming, saying that she couldn't breath and, while she was screaming, she passed out'. Her mom reports calling her phone back, over and over. 911 was called. It took EMS 4 minutes to arrive. She was in cardiac arrest. CPR was initiated and epinephrine was given but it was too late. She sustained a fatal anoxic brain injury and never returned to consciousness.
Rachel loved to write. She'd had poems published. In her writing, her mom found 'If I survive a day and I helped at least one person, then it is worth it'. Importantly, her mom said, 'I can talk about her because I guess I feel bad that I am a respiratory therapist and my child died of a food allergy. And, that shouldn't have happened. I should have known better because I know what happens. It is so important to understand, if it could happen to me, it could happen to anybody'. 'All the education and experience I have had, it could still happen. Because she was an 18 year old, on her own, trying to figure it out'. In her passing, her tissues were donated. These tissues were given to 4 other individuals.
From Her Mom
We were blessed with 18 years with Rachel. Not nearly long enough but the impact she had on us and many others will be felt for a lifetime. Rachel was in her first semester of college and loved it. She was a beautiful, smart, strong-willed teenager who led and was loved by her family and friends. Rachel loved writing. She wrote poems and short stories. Several poems had been published. She won The Young Writes of America award for the best short story. She was working on a novel and had several chapters. She loved music, concerts, driving her car, going out to eat, and football especially Tim Tebow. Her obsession with him was known by everyone who knew her. She was convinced he would ride into our little town and sweep her off her feet. When Rachel was 16 she went on a mission trip to Costa Rica to help with a church there. It changed her life. She returned from the trip a changed person. She started the trip not even knowing how to wash dishes or clothes (they just magically were cleaned overnight) and she came home with a new appreciation for all that she had. From then on she was completely self-sufficient washing clothes, fixing food, walking herself up for school. The change was amazing. Rachel was allergic to peanuts. Over the years it became automatic for us and her to read labels, ask questions, and avoid anything that could be a danger. She ordered take-out and was accidentally exposed to peanuts. She died from a severe anaphylactic reaction. We will continue to spread Rachel's message of the dangers of food allergies and help teach others about food allergies. In one of Rachel's many books containing her writings she wrote 'if I die and my name remains unknown and unsaid to a lot of people but I make a change in one person's life, then it's ok'.
The following interview transcript was generated during an interview between Stacy Dorris (represented by "S" in the interview transcript) and Melissa Mooney (Rachel's Aunt and represented by "M" in the interview transcript) on May 22, 2017. The interview took place for approximately 22 minutes via the phone.
M - Hello
S - Hi Melissa. This is Stacy Dorris
M - Hi.
S - How are you?
M - OK
S - Well, good. Well, thank you so much for taking the time to talk with me about your daughter.
M - Oh, your welcome.
S - As you know, I'm a physician at Vanderbilt and I see children only at this point. I am really interested in food allergies & how people perish from that & I know that is a really hard subject matter.
M - Yeah.
S - But, I'd love to know more about her. And, today, at some point, I'll have to send over my consent form just to sort of see what my intentions are. Then, you can decide from there what you want & don't want. Typically, what I do, well, the website should be up tomorrow. I had my last meeting, I hope, today about it and what I will do will be to have a transcript of what we talked about & some basic information like what it was and where she was & that kind of thing. Do you want to tell me about her or...
M - I'll tell you anything you want to know.
S - Ok. I know a little bit about her. You know, there is some information that is out in the media. There is always a news report. So, I know a little bit about her. Do you want to tell me what you know happened? What you remember?
M - Well, I know what happened. She ate take-out, her and her friend, from a local Chinese restaurant. She has always been real careful about what she ate and asking but she ordered the same thing she always ordered which was sweet and sour chicken. And, she called me a few minutes later and she said, 'I think I messed up', I think there was peanut oil, which we found out later they don't use, but there must have been cross contamination. They must have had - I don't know if they same the used wok. Maybe used it for different dishes but did not clean it. But, it was fast and it was...I mean, in 18 years she has never had a reaction, I mean, she never had to use an epipen. She had just used benadryl. I mean we were real careful.
M - But, like she couldn't eat at Chik-fil-a. So, we knew were to eat and where not to. But, she and her friend wanted Chinese so they just ordered it. She ordered it and then she called me and said, 'I can breath fine, my throat is not scratchy but itching.'
S - OK
M - And, I told her to take some benadryl. But, she called me about 3 minutes later screaming, saying that she couldn't breath and so, while she was screaming, she passed out. And, I kept calling her phone back, over and over. Somebody had stopped to help when she passed out and, so, they had called 911.
S - Good
M - And, she was still breathing...and, she still had a heartbeat.
S - OK.
M - And, they called 911, it took them 4 minutes to get there. And, I'm friends with the paramedics so I had already talked to them at work so I knew exactly how. They thought she, the care wasn't different but they thought she might be having a seizure. So, they would have done the same thing. Because, as soon as they showed up, she went into cardiac arrest.
S - Oh, gosh.
M - So, they immediately performed CPR & got her heart started again. But, they couldn't ventilate her. So, by the time she got to the hospital, her pH was 6.8 and her CO2 was well her 100. So, she wasn't getting any oxygen to her brain. And, that's not conducive with life. To have a blood gas like that.
S - Right
M - We put her on a ventilator but we couldn't ventilate her because her - what happened was she was so hyper-inflated that her heart stopped because of the pressure from her lungs. You know, it took a little while to get enough medication in her to open her back up. But, by the time that happened, she had irreversible brain damage. And, so, it took a little while but it kept getting worse. On about the third day, I went to the CAT scan with her, and I need to because, her brain was swollen to the point that there was no differentiation - there was no discernible anything. And, so that is when we called Life Link. But, it all happened so fast. I don't know how she was exposed to so much.
S - Yeah, was it...
M - That's where..I don't understand. Because, literally, usually she would get some whelps. She had...one time, she was exposed - we went to the hospital just because we were out. But actually they just gave her one dose ofmedicine and by the time we got to the hospital we were fine. We just didn't have, we were in the car across the street from the ambulance so we just did that. But that was the only other time that she was having trouble breathing but she never even - I mean she was just red and splotchy. So, this time, within just minutes, she was gone. so, that is what I don't understand. I mean, I understand the mechanics of it but I don't understand how she could have consumed so much when she ate something that was not cooked in peanut oil and that did not have peanuts in it. And, that was just sweet and sour chicken which was a normal thing she ate on a regular basis.
S - Right.
M - But, she had never eaten at this place.
S - She had never eaten at that restaurant?
M - No
S - OK. And, she had a known peanut allergy?
M - Yes. We found out when she was about 2.
S - 2, OK.
M - The big thing is, then, I didn't know anything. And, the doctor just kind of ... I panicked and said, "what if she quits breathing?" and, he said, "she's not going to quit breathing, just give her some benadryl, she'll be fine." I wish that we had access to what we know now. Because, with the internet now and this being so public there is so much more information. Then again, we kind of got complacent because for 18 years we learned how to deal with it and we never had any problems. And, it just kind of happened. Really fast. And, like I said, between the 1st phone call and the 2nd phone call - it was just a few minutes. And, it was like 4 more minutes after that. So, within 15 minutes of eating it, she was in cardiac arrest.
S - Did she actually eat the food in the restaurant?
M - No, they got it to go.
S - OK. She was she at her friend's house then?
M - Yes. They were just having a normal hang out. Watch TV. What you do when you are 18 and in in college.
S - Exactly. I can totally see it. Was she in Georgia at the time?
M - She was in Rome
S - Do you know if she had an Epipen around?
M - No, she did not have one with her. No.
S - Did she have one prescribed to her?
M - Yes, she did. When she was younger, she actually stuck one in her thumb.
S - Oh, goodness!
M - We went to the emergency room and we teased her about it forever because she bruised her bone. Because it stuck it in time. She knew how to use one. And, she knew everything about it. She would go on school trips and say, "I didn't go in the restaurant - I went into the one next door because we went in and they used peanut oil." She was so on top of it.
S - Oh, my gosh.
M - But, it just was a flip. Well, I don't think it was her fault.
S - It sounds like a cross contamination. Did you know if the restaurant uses actually peanuts?
M - They have several dishes that do. We hired an attorney but they cannot prove that they knew about her food allergy before they served her.
S - OK.
M - So, she didn't actually speak to the manager about it. There was no way to prove who was at fault.
S - But, she didn't order something that would typically contain peanuts.
M - No, no, it should not have had anything to do with peanuts. It should not have come into contact with anything that had peanuts. And, they use vegetable oil.
S - And, do you think there was anything else going on like maybe she was sick with an infection or she ran with her friend afterwards - it doesn't sound like there was enough time.
M - She didn't and she had not been sick. She had been diagnosed 6 months earlier with Mono but she didn't have any problems with it. She had asthma.
S - Do you feel like her asthma was under good control?
M - Yes, she didn't have to be on any medications like advair or symbicort or anything.
S - OK. Did she have to do flovent?
M - She had a proventil (albuterol) inhaler - she might use occasionally.
S - OK. Did she have prior skin prick testing?
M - She had no testing.
S - So, just her Pediatrician diagnosed it?
M - She had had a peanut butter cookie and reacted.
S - And, you said it was just hives?
M - Yes, she just got hives, her face would turn red and she would have a little - she never had any airway issues. No throat swelling. But, she couldn't even drink a drink - she had had a coke from Chik-fil-A one time and we immediately had to go to the drug store because I guess it was in the air.
S - Interesting.
M - She was pretty sensitive to it but we were never - I guess she just wasn't exposed so we never. Even her brother, he would eat peanut butter sandwiches in the house but he knew from, like, a young age exactly how to clean everything. So, if he would get a peanut butter sandwich, he would get a paper towel and wipe down the knife and throw that away before he washed the knife. You know, to get the peanut butter off. And, he knew to use soap and water on his hands. He had to stand there in the kitchen and eat it. And, we had, like, procedures for everything.
S - Oh my gosh. That's so scary. Do you guys have allergies in your family?
M - I'm adopted but the other 2 kids don't have any. They have milk allergy but what they have is an intolerance - they are not allergic to anything. They have digestive issues.
S - Oh, OK, like a lactose intolerance?
M - Yeah, not exactly an allergy. So, they eat anything. She was very fair skinned. And, so she would whelp real easily. And, she had some eczema on her arms along with her asthma - it all went along with it. But, she was healthy.
S - I am so sorry that happened.
M - She was 5' 7", she probably weighed about 130 pounds
S - Her pictures are beautiful. By the way. I've seen some pictures of her on the internet and she was so pretty.
M - Yeah. We just want to help other people. I talk about it all the time. I scared some poor kid at Sunny's, with the waitress we were having, because I paid for some people's dinner, which is something we do often. She said 'you need to talk to the cashier because he won't carry an epipen - you need to talk to him'. He said, "I don't need it because we don't have anything with peanuts here.' But I said, 'Yeah, but if someone had it on their hands & touched a credit card and then you take their credit card from them - then you have been exposed'. And he said, 'Oh, I didn't know that.' I mean, you don't know what people touch.
S - I know! You don't know at all - not at all. I don't know. My daughter has a peanut allergy, too, and I amazed that, even my own mother forgot - like, her grandma, put out a bowl of peanuts & was like, 'oh my gosh - I forgot'.
M - You don't think about it.
S - If it is not your child, I think you don't think about it.
M - I don't know. I bought all 3 kids Easter candy and I bought the same type of chocolate but different colors. Their favorite colors. And, Rachel came out said, "What are you trying to do? Trying to kill me?" She said, "These are the peanut ones." And I said, "I am so sorry, I just got your favorite color - so, we just switched with her brother." And, I felt so bad but she - that shows that she was so good at everything.
S - She was smart
M - All the labels. So, yeah, she was very smart. You know, she had had poems published. She wrote all the time.
S - I would love to see those. I am trying to put a face and a story to these incidents. I know, for years now, it seems my patients have sort of a simple view of those who pass away - maybe they have heard something on the news but they don't know anybody.
M - I was just saying, you got to put a face to it. So people can realize it is not just something that happens. I mean, it's serious.
S - And, I think that people, too, get casual as it goes on...years and years.
M - Yeah, we did.
S - I mean, I am guilty of it to, at times. A story is just so powerful. I mean, if someone read her poem and then saw her picture and read her story - they may think to themselves, 'that's me'. That could happen to me.
M - I mean, I have tons of them.
S - I would love a few and a photograph, too, to put with her story. And, I think what I'll do, is I'll transcribe this & I might summarize the story and any kind of personal details - I would love them. They're the kind of thing that cement it in people's minds.
M - I went to - we had a service in - for organ donors and it was at the Jimmy Carter Library in Atlanta and I spoke about her. So, I wrote a little paragraph about her and it really explains who she was.
S - Oh, that would perfect. If you want to share it.
M - Yeah. I will.
S - That would be lovely - actually that is the exact kind of thing I am trying to do.
M - I put together a book. You know they wanted each person personality.
S - That's great. It sounds like you donated her organs then?
M - We did. So, I've heard back from two of them.
S - Wow.
M - I found something in her writing that said, 'If I survive a day and I helped at least one person, then it is worth it'. And, those are her words. And she helped more than one person because people are still talking about her and more people know about food allergies now, so. And, she saved the lives of four people.
S - That's amazing.
M - I can talk about her because I guess I feel bad that I am a respiratory therapist and my child died of a food allergy. And, that shouldn't have happened. I should have known better because I know what happens. It is so important to understand, if it could happen to me, it could happen to anybody.
S - Right, I hear exactly what your saying.
M - All the education and experience I have had, it could still happen. Because she was an 18 year old, on her own, trying to figure it out.
S - Right, exactly.
M - Yeah, I can get some stuff together and I will email you.
S - OK. I would love that, Melissa, thank you so much.
M - You're welcome
S - Thank you. Thank you for sharing this. And, I'll send you the consent form. And, it is totally up to you what you want to put up there. You know, you are the first mom who has agreed to talk to me. And, I feel like once that happens - once I have one person who wants to share, it gives people an idea of what they could put up there and that might make it easier for other families. So, I really really appreciate it. I owe you a big thank you.
M - You're welcome. I love to talk about her so.
S - Oh, I am so impressed by you! Very inspired by you! That's a real skill.
M - I have a clinical side that I can totally do. You know, I guess when you work with death all the time. But, I am sad every day, every minute. But, I can talk about it and try to teach people about it.
S - That's an amazing gift.
M - Yeah, I guess. One day, I'll see that. But, yeah, I'll get all this together and send it over. I'll get it to you.
S - Oh, cool. You know, I know Rome a little bit - I went to a Finster Fest there - do you know the artist? Who has that kind of crazy...
M - Oh, yeah.
S - We have some friends who live up - not Rome proper but...
M - Probably in Summerville
S - Yes, Summerville. And, I have a friend from high school who married a guy from Georgia and lives in Rome & she is a dental hygienist. I'm not sure what her last name is now.
M - It's a small world.
S - That's all I know about Rome!
M - I've been her 18 years. I still feel kind of like an outsider.
S - Did you move from a different city?
M - We came from Florida. Rachel was born in Jacksonville.
S - Well, alright, thank you again. I'll email you the link and we will go from there.
M - OK
S - Thank you, Melissa.
M - Bye
S - Bye