I Survived the “Destroying Angel”

This memoir of a near-fatal mushroom poisoning was written by our most fortunate guest, Richard Eshelman. Happy Thanksgiving, all.

I. That Fateful day – July 18th, 2006

Tuesday, July 18th, 2006. It was a balmy day in Ithaca, New York. I went for a walk after work to sit and meditate at my favorite spot near a waterfall in Upper Buttermilk State Park. It’s really nice to have such a huge backyard cared for by the public like Upper Buttermilk. I feel privileged.

Before I left my private meditation area I did a standing STARS (Somatics Transformation and Restorative Systems) exercise called “Aligning the Three Tan Tiens.” Something inside me made me feel invincible. You know that feeling you have when you are young and feel invincible? Well, as I walked out of the wooded area I was in, I found some young mushrooms. Their caps were hanging down like closed umbrellas. I mistook them for inky caps (Coprinus spp.) even though I spotted an Amanita nearby–its cap was fully open, and not hanging down. Thinking back, I should have been more suspicious as mushrooms do grow in colonies.

I took three home with me. I couldn’t find my Mushroom book, was in a hurry, so I trusted my judgment, fried them up in olive oil, and ate them as a side dish. I should have recognized then that they weren’t inky caps, because inky caps exude a black substance when you fry them.

They honestly did not taste that good, rather bland in my opinion. I thought to myself, “Gee, I don’t think I’ll ever pick and eat these again.” (Little did I know the truth of my thought at the time).

I went dancing afterward, and bragged to my friends that I had picked and eaten some wild mushrooms for dinner. A friend asked me “Were they all white?”
I said “Yes.”
She scolded me, saying, “My mother told me never to eat an all white mushroom.”
At that point, I got concerned. I covered it up by saying, “I’m OK, I know what I’m doing and I don’t feel sick.”

I got home. I was hungry, so I ate some nachos and humus and drank some apple juice before going to bed around 11 p.m. I still felt fine, so I wasn’t worried.

The crack of dawn that time of year is early, sometime between 4:30 and 5:00. It’s a really neat time if you’ve never experienced it–the silence is almost unbearable. To most busy people it is unbearable. There is nothing to drown out the chatter in the head. City folks usually find it uncomfortable in contrast to the noise of the city. I’ve become accustomed to awakening with the light. This morning I woke a little earlier than usual. I couldn’t quite tell whether it was still night or just breaking into the day.

I felt queasy. It was the same feeling I had when I had food poisoning. Before I had any more time to assess my state, I realized I needed to get to the bathroom. I barely made it to the royal throne when I started heaving my guts out. The vomiting reflex was strong. The pressure of the strong contractions forced stuff out both ends of the GI tract, uncontrollably. I had a severe case of vomiting and diarrhea. At that point, deep down I knew I had made the big mistake: I HAD EATEN AMANITA VIROSA, AKA, “THE DESTROYING ANGEL”. ¹

For the next three hours, I was making trips constantly from my bed to the bathroom. I was still in denial. My housemate asked me the first time I was up “Are you OK?” I said “Yes, I was just sick.” By the time 7:30 had rolled around, I had talked to my girlfriend, called in sick to work and still had not mentioned that I thought it was Amanita poisoning. Finally, my housemate again asked me what was going on. I responded saying “I think I accidentally poisoned myself with some bad mushrooms last night.”

He said “Maybe you should go get checked out at the local “Convenient Care Center.”
I silently thought to myself, “Yeah, If I go there, I’ll be sitting and waiting and by the time someones sees me, I’ll be dead.”

I found my mushroom book and looked up the symptoms for Amanita poisoning: vomiting and diarrhea or severe constipation 6-8 hrs after consumption.² Oh, and by the way, it’s now destroying your liver and 50 to 80 percent of the people who ingest Amanita DO NOT SURVIVE! At that point, I knew I was in deep, deep doo doo and in for the biggest fight of my life, for my life.

I called the Poison Control Center – 800-222-1222.

They suggested I go back to the area where I had picked the mushrooms and get one to take with me for identification, then get myself to the local emergency room. I went back to the area and picked the one mushroom I had left because I thought it was Amanita. I also took a piece of stem I had thrown into the garbage the night before.

At this point, as long as I didn’t eat or drink anything I could get around. I had pretty much eliminated everything from my GI tract.

I got in my car to drive myself to the emergency room. Three thoughts went through my head as I prepared to leave:

1. Should I go back into the house and say goodbye to my cats? My response: “No you idiot, you don’t have time for that!”
2. If I didn’t have health insurance, would I go to the emergency room knowing I was just about to wipe out my cash reserve? Luckily I didn’t have to ponder that question as I had insurance and felt very fortunate. But what about someone who didn’t? Would they deny their symptoms and just consider it food poisoning? What would have been the end result? They probably would just start to feel better and then keel over from liver failure. Amanita will fool you that way.
3. My last thought was “Take one last look around you, because you may never be back here again.” I did, and left without telling anyone where I was going.

II. The Emergency Room

Wednesday, July 19th. I arrived at the ER of Cayuga Medical Center about 9:15 a.m. I went in and walked straight up to the receptionist. She was on the phone with someone. She obviously was in a discussion with someone about some problem and it wasn’t going to be anytime soon that she could get off the phone. I waited patiently thinking, “I don’t want to make a scene.” Nevertheless, I didn’t understand why she couldn’t put the person on hold while she addressed a new emergency room client.Finally, around 9:30, she got off the phone and asked “What can I do for you?” I explained to her that I felt I had accidentally poisoned myself with some poisonous mushrooms. She asked whether my records were at the hospital. I said “yes.” She checked my name and found I indeed was registered and my insurance information was current. She asked me to be seated and informed me that someone would be with me shortly.

I expected that someone would be out to see me within a minute or so since I had informed them that I suspected mushroom poisoning. Instead, time dragged on. I kept thinking, just stay calm and collected. Finally, after waiting another 20 minutes, someone came to get me.

It’s amazing to me. Most people when they know they are dying think of what they didn’t do or what they should have done. In this case, all I could do was watch and monitor time like a hawk. My concern was I needed help NOW! ASAP! But, I also knew I needed to stay calm so as not to create a panic situation.

I don’t remember much once I was admitted other than them taking vital signs and getting the info they needed regarding the poisoning and making sure that I was the only one involved. They kept me comfortable while someone took the mushroom to Cornell for identification. They started an IV to replenish my fluids.

While waiting, I finally took the time to write down some phone numbers for people to call in case I didn’t make it. I also made a few more trips to the restroom.

The Emergency room staff came back saying a Cornell Mycologist (Kathie Hodge) had identified it. It was definitely Amanita virosa mushroom poisoning.¹

The first thing they did was make me drink a milk shake size container of charcoal. Have you ever seen a charcoal drink? It is as black as you can imagine. I often practice the Bates “palming” eye improvement exercise. During this exercise you rub your palms together, then place them over your eyes, and imagine the blackest black you can imagine. This was the blackest black I had ever seen! It was really hard to get past the thought and just drink it. It had a chalky flavor.

About a half hour later. The ER staff informed me they had called Bang’s Ambulance and they were present, waiting to transport me to Strong Memorial Hospital in Rochester, New York.

Needless to say, the charcoal drink did not stay down long. It would be at least another half hour before we left because I had to first go to the restroom to honor the vomiting reflex. My body was still reacting to anything put into my stomach and was rejecting the charcoal drink. It’s probably a good thing I made the ambulance crew wait and went to the bathroom when I did or I would have been upchucking in the ambulance all the way to Rochester.

Before leaving, I also made a few phone calls; to work, letting them know what was going on and that I probably wasn’t going to be available to work the weekend, to my housemate, and to my girlfriend Julie. Then I was strapped in a gurney, loaded in the ambulance and on my to Rochester.

The trip to Rochester from Ithaca was uneventful. The attending ambulance technician comforted me all the way. What I do remember the most was watching the clock above the rear doors. We left Ithaca around 3:00 p.m. in the afternoon and arrived at Strong Memorial in Rochester around 5:37 p.m.

I was being sent to Strong Memorial because they had the only liver transplant unit in upstate New York. The treatment of choice is often liver transplantation. With early diagnosis, another experimental treatment includes massive doses of penicillin to stimulate the liver’s defenses. This was the treatment I would receive with the option to transplant if my liver failed.

III. Strong Memorial Hospital

Upon our arrival at the Emergency Room, I was surprised to find they were ready to accept me without any paperwork. All the information about me had already been transmitted to them and I was admitted directly to the Emergency Room.The ER room there is impressive. It has a semicircular console area facing individual double occupancy booths. I was in the first one upon entering the ER room. I called Julie on my cell to let her know what had happened. She wanted to come up then, but, I insisted she wait till the next day. She insisted on letting my family know.

I was having blood drawn every 2 hours to monitor the buildup of toxins in my liver and kidneys. They hooked me up to a transfusion stand and monitors. They were preparing to run me through all the tests they needed in order to prepare me for a transplant in case my liver failed. They were giving me huge dose of penicillin plus fluids to rehydrate me.

Being sick as a dog with constant vomiting and diarrhea is no fun! I had a diaper on. I felt helpless. I felt humbled.

I was given a bed in the transplant unit. Taken for x-rays. Back to the room. Given a drink in order to do a CAT scan. It was a liter of pink liquid. I drank it in small amounts and even though they had given me something to shut down the vomiting, it just wasn’t working. Shortly after getting it all down, it came right back up. They gave me another liter. Again, I slowly started sipping an 8 oz glass every 15-20 minutes. Eventually, I almost got it all down and felt I could not drink another glass without vomiting again. They wheeled me down to the CAT scan machine and transferred me onto the bed that slides into the large instrument. As they started to roll me in, I yelled “Back me out, back me out! I’m going to throw up again!”

They pulled me out of the cylinder and got me a bedpan just in time. I’m glad I didn’t ruin their large instrument puking inside it.

After the CAT scan, I was taken back to my room in the transplant unit. There was a constant droning sound that I couldn’t figure out and constant announcements over the PA system. It was really difficult sleeping with the noise and being awakened all the time for blood work. (They were drawing blood every 4 hours to monitor my liver and kidneys). It’s not a place conducive to good sleep. I just couldn’t get a decent nights sleep.

My girlfriend Julie and my housemate Mark visited the next day. Julie had sent out an email to the dance community informing them of my situation, and had let my family know of my happenstance. Everyone was praying for me. My sister even had a bus load of kids praying for me while on their way to a youth conference in Colorado. All were worried about me. The focus was on me. I felt embarrassed. I had made a critical error in judgment and everyone knew about it.

Eileen, my friend who had first alerted me to my possible dilemma, saw the email and discussed it with her friends. One of them had just read about an alternative treatment. She went home at lunch and brought it to Eileen, who faxed it to the Doctors in Rochester. The doctors say they never received it.

The treatment uses Lipoic Acid.³ It has also been shown to be useful in the treatment of liver problems such as hepatitis B and C, autoimmune hepatitis, primary biliary cirrhosis, and primary sclerosing cholagitis. The article is from Dr Whitaker’s health newsletter Vol.16, No.7, p6.

By now the doctors were coming around asking me questions in order to assess my mental capacity. If my liver went into failure, I would not be lucid. Without sleep, I found it hard to remember what day it was as everything seemed to blend into one long event.

I work as an accelerator operator in high energy physics and am an avid amateur dancer, a certified massage therapist and Hanna Somatic Educator. When they asked me about this and I told them, they thought I had lost my sanity. They had to ask Julie and Mark if I was telling them the truth. How many people do you know that earn their living as an accelerator operator?

At one point a doctor came in and asked me “What is Pi?” I wasn’t quite sure how to respond as I didn’t know if he was asking about Pi, or pie. My question to him was “Which pi/pie, pi the mathematical term or pie the thing you eat?”

His response, “Pi the mathematical term.” I proceeded to tell him about its relationship to a circle and its origins. I stumbled a little and thought maybe I really was losing my sanity.

Thursday, Julie was with me most of the day. I was taken for tests of my cardiovascular system. The stress test. They had to do it chemically as I was unable to do it physically on the treadmill. A friend from my mediation group visited, who ironically worked with the wife of the transplant surgeon, Dr. Peter Abt.

Thursday evening they took me into intensive care. Before wheeling me into intensive care, Dr Abt visited me. I had to sign papers giving Julie power of attorney etc. He informed me they were ready to give me a transplant if I needed it. I remember grabbing the cross on my neck chain and praying silently to myself, “Dear Lord, let me keep my liver. I do not want to live with someone else’s liver the rest of my life and have to deal with the medical expenses to keep my body from rejecting it.”

I had put my fate in the hands of my Lord and Savior Jesus Christ. The 23rd psalm was running through my mind as well. The Sunday morning meditation group I attend had just recited it the previous Sunday.

The thought that these guys might be trying to get my liver for someone else did cross my mind. I let it go. Instead, I did a visualization exercise. I imagined my liver. I saw the color black (it should have been green). My kidneys, ocean blue. I smiled to both of them. (For more info on visualization, I recommend you read “Awaken the Healing Light of the Tao” by Mantak and Maneewan Chia.)

Somehow, in the middle of the night my liver numbers peaked and started coming down. I wasn’t out of the woods yet, but it looked like I was going to recover without a liver transplant. I was wheeled back to my room in the liver transplant unit Friday morning.

Members of my family visited that day: Jim, my oldest brother, Tim and his wife Kim, and my baby sister Betty Sue. They brought flowers and balloons wishing me well and a happy birthday balloon as my birthday was coming up. We all held hands and my sister in law, Kim, prayed for my recovery. I was also receiving prayers and get well wishes from the dance community.

All along, I had hoped to be out of the hospital by Friday to work my weekend shift. All along, the doctors told me I was going to be there for a while. It was clear I wasn’t getting out Friday.

My liver and kidneys had taken a big insult, as had my gastrointestinal tract. Although my liver numbers were coming down, the kidney numbers still hadn’t peaked. I would be in the hospital another week to make sure I would not need kidney dialysis.

They took the tube out of my nose going to my stomach on Friday. It had been quite annoying as it gave me the hiccups. I could almost predict when the next one would come along. It was that periodic. Even after removing the tube, the hiccups lingered for another couple hours.

By Sunday, all the tubes in me had been removed. Julie was there for me as well. She got me out of bed that evening and we took a short walk around the nurses’ station. We did a little salsa together. I was dancing again! The nurses applauded.

I still found it hard to sleep. Now, at least, they were only drawing blood every 4 hours. That night another patient was in my room who was there to receive a transplant. He was constantly yelling out for help from the nurses.

Sunday night/Monday morning I finally fell into a deep dream sleep. I saw a white church glistening in white light. A power cord glowing red was feeding power to keep it lit up. I was riding in a black limo and sparks flew from behind the car as we drove over the power cord. The next thing I knew, I was next to my grandfather’s grave. I was wondering why I was there when I was awakened by the nurse for another blood sample.

When people ask me whether I had any near-death experiences, I usually relay my dream to them. I am here by the grace of God! I feel so lucky and yet fortunate. I found out that of three people admitted in 2006 to Strong Memorial with Amanita poisoning, I am the only one to have survived; 66% died.

Why did I live and the rest not live?
Was it the amount of toxin?
Was it that I knew what had happened to me and sought care and help quickly?
Was it my meditation/visualization and somatic self care/self help practice?
Was it the prayers of my friends and family and my faith?
Was it the doctors’ care? One of them said it was a miracle!

Simply said, I don’t know that it was any individual thing, but a combination of everything.

Monday, July 24th was my birthday. I could not have received a better gift than the gift of life. Throughout my life, I have been traumatized. I was born a blue baby, fell out of a silo at the age of 12, etc. I could go on, but the important thing is, I am a survivor. I love cats–maybe I have nine lives!

How did I get in such a mess? In retrospect, I considered the possibility that I had subconsciously poisoned myself. But in reality, the mistake I made was just not taking the time to positively identify the mushrooms I had picked before ingesting them.

The Truth

Most victims of life-threatening mushroom poisoning in North America are people from Southeast Asia; Laos, Cambodia, Thailand, Viet Nam. They apparently mistake Amanita for edible “Paddy-Straw” (Volvariella volvacea) mushrooms. The two are similar in several ways; cap color, size, and the white “cup” around the base of the stalk, but different in others (for example, the Paddy-Straw has a pink spore print, the Amanita*, a white spore print; and the Amanita* has a partial veil). The Paddy Straw mushroom occurs in tropical and temperate areas worldwide, and is especially common in Southeast Asia; the Amanita, alas, does not occur in Southeast Asia, so folks from that part of the world are unaware of the lethal “look-alike.”

Millions of North Americans pick and eat wild mushrooms every year, without as much as a belly ache.

Are they “experts?” Yes! At least, they are experts on the edible wild mushrooms they know. Either their parents or grandparents taught them how to identify morels, or puffballs, or meadow mushrooms, or they have a good field guide and they read it… or both.

No one with a reasonable understanding of the importance of properly identifying mushrooms – with a serious awareness that some species are fatally toxic – falls victim to the Destroying Angel*. The folks who eat Destroying Angel* do not use field guides: they just pick the damned things and eat them. No trip to the library. No reading. No spore prints. No idea what a “partial veil” is or what “gill attachment” means.

So… Is it really dangerous to eat wild mushrooms?

How dangerous is it to drive a car? If you’re drunk or careless, it is VERY dangerous; if you’re sensible and pay attention, it is reasonably safe.

Consider this: Would you pick and eat an unfamiliar berry simply because it “looked good?” Of course not. Finding, identifying, preparing, and eating wild mushrooms can be a delightful pastime–IF it is done intelligently.

Otherwise, it is a terrible “accident” waiting to happen.

* I took the liberty of changing the name from deathcap to destroying angel or Amanita in the text above. It’s worth noting that Amanita phalloides most closely resembles the paddy-straw mushroom; A. virosa less so.

Excerpted with permission from David Fischer’s American Mushrooms.

Epilogue

It was another week after leaving of the hospital before I felt comfortable eating and not being close to a bathroom. I was back to work within two weeks of being released from the hospital. A month later, I was pretty much back to full strength. My liver numbers normalized early, pretty much by the time I had left the hospital. It would be another month and a half before my kidney numbers normalized.The liver is a remarkable organ. It is the only organ that can regenerate itself. The kidneys are a different story. There is probably some permanent damage there but not sufficient to require any long term care. People often donate and live with just one kidney.

I did have some strange thoughts during my recovery at home. I’m assuming they were just lingering effects of the toxins in my system. In general, I’ve made a complete recovery and expect no long term effects. I am grateful to be alive and feel very lucky. I’m also grateful for my training in Hanna Somatic Education. It felt great to get back home and in the routine of practicing my somatic exercises, exploring, and able to be comfortable in my body again. It was like coming home to my body as well. I encourage everyone to get a copy of Thomas Hanna’s book: “Somatics: Reawakening the Mind’s Control of Movement, Flexibility, and Health” or to visit the Hanna Somatics website.

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Richard Eshelman can be contacted via phone at 607-280-6788, or by email at re16@cornell.edu or upstatehse@aol.com.

A Special Thanks to Kathie Hodge for encouraging me to write this.

1. Editor’s Note: Amanita virosa and Amanita bisporigera are treated as two separate species by most mycologists, but their appearance and effects are quite similar, and the names have sometimes been used interchangeably. The Editor follows the authoritative example of Rod Tulloss and Zhu-liang Yang in treating northeastern North American destroying angels as Amanita bisporigera, whereas Amanita virosa is a strictly European species. There is some satisfaction in this, since A. bisporigera was described from the Ithaca area exactly 100 years ago by my predecessor at Cornell, George F. Atkinson. This is a centennial poisoning!
2. Editor’s Note: For more on Amanita toxicity and recognition please see our Destroying Angels post.
3. Editor’s Note: Alpha-lipoleic acid, also known as thioctic acid, was advocated for treatment of Amanita poisoning in the 1950s and 1960s, but subsequent studies failed to find a therapeutic effect, according to D.R. Benjamin (1995, Mushrooms: Poisons and Panaceas. W.H. Freeman).

Photos: K.T. Hodge (young Amanita), and K.E. Loeffler (the mature Amanita that Richard brought with him to the hospital for identification).

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