I crossed the Ponte Vecchio in Florence for the second time that day. The medieval stone bridge was lined with bright jewelry shops, and large archways revealed a dazzling view of the Arno River. Following a long morning tour of the city, my friends and I snapped photos overlooking the river on our way to grab some food.   

My friends proposed a pizzeria for lunch. A pang of anxiety hit my chest as we sat down to an unresearched and unfamiliar restaurant, but I pushed it down. Living a life without food anxiety, I told myself, meant trusting waitstaff to manage serving me allergen-free food. Besides, I was super hungry and needed to eat. 

I confess that I also didn’t want to inconvenience my group by asking to stop at a supermarket later. We were on a tight schedule! I discussed my tree nut allergy with the waiter, and he seemed to understand the severity. 

Why would they have nuts at a pizzeria anyways? I thought of justification after justification, excuse after excuse. I had become complacent and too comfortable after traveling for a week. 

A few moments later, the waiter brought me the most beautiful pizza that I’ve ever seen. It was shaped into a heart with a large assortment of vegetables. It didn’t just look good, it tasted good, too. 

See, I thought to myself, there was nothing to worry about. I only had one rounded corner left of the heart pizza when I took a fateful bite. It tasted like pesto. My stomach sank as I felt my mouth tingle and my throat slightly tighten. I flipped the pizza over and saw on the crust a large streak of green pesto. That could mean one thing: nuts!

Unresearched Costs of Care

I called the waiter over, and asked what type of nuts they used in the pesto. “Cashews!” he responded enthusiastically. Completely oblivious to what was happening, he began extolling the virtues of cashews over pine nuts for creamy pesto.

I began to experience the first anaphylactic reaction I’d ever had traveling overseas. Realizing what was happening, I immediately used my epinephrine auto-injector. Even more than my health, however, I became worried about the costs I was about to rack up.  

How much would an ambulance and emergency room visit cost? Did my insurance in the United States cover international health expenses? For the first time in my life, I didn’t know whether I should go to the hospital. Would I have the money to pay for my visit? Even in my frazzled state, I knew that my life was worth the cost (even if exorbitant). I called 112. 

While in the ambulance, I called my parents to ask whether an ambulance ride in Italy would be covered by our insurance. The EMT laughed and interrupted me, “You aren’t in America anymore. It’s not like that in Italy.”  

Still deep in a medical crisis, I realized that in most developed democracies, the choice between large financial burdens and physical safety isn’t one people really need to make. My hesitation to call an ambulance was a direct result of an American mindset where people don’t always have access to emergency care that could save their lives. How many children and adults lack access to epinephrine auto-injectors or emergency room coverage? This thought is deeply disturbing. 

Lessons from My Heart Pizza

I learned many things on this vacation turned harrowing experience that I will carry with me for many years. They include:

1. Never view your needs as an inconvenience to others when your life is on the line. 

I had this worry that I would annoy my friends while we were traveling together. Especially when they are hungry, and I am hungry, I feel bad asking my group to travel to a grocery store. It adds another stop and decreases the amount of time we have before the next scheduled attraction. I knew that supermarkets in Florence were stocked with affordable and allergy-safe pre-packed breads, cured meats, and fruits. But the pizza shop wasn’t near a supermarket and far from our next scheduled attraction. This line of thinking landed me in the hospital. 

2. Pack extra allergy-safe snacks for when you are hungry, and pack more than you think you will need.

At this point in my week-long trip, I was running out of safe snacks. Boxes of Top 9 allergen-free granola bars and fig bars can only last so long. This shortage meant I was quite hungry as I stepped off the Ponte Vecchio. This led to made poor decision-making and rationalization of the risks in play. You never know when safe food will be available next.  

3. Avoid going to restaurants without researching the menu and protocols beforehand while traveling. 

Florence has a plethora of restaurants, and several are advertised as “allergy-friendly.” Due to their regulations, most European restaurants are better than their U.S. counterparts about labeling the top allergens.  

4. Your life is worth it. Get international travel insurance or check the country’s policies on emergency visits for foreign travelers. 

Please don’t put yourself in the position I found myself in. When traveling, make sure to invest in health insurance and check your policy to see what is covered internationally. Plus, do some basic research on the insurance coverage foreign governments gives to international travelers. 

Suffering a serious reaction in another country can, at a minimum, spoil a few days of travels. That heart-shaped pizza certainly did for me! I’m fortunate it wasn’t worse. 

However, you have the tools to minimize the risk of anaphylaxis. Sure, it means lots of advance planning, and might cause some inconvenience for others. But trust me, it’s worth it. 

Alexa Jordan is a Harvard University graduate and incoming student at Oxford University. She can be found at @alexa.jordan on Instagram. Top photo: Alexa at Ponte Vecchio, shortly before eating the pizza.

Related Reading:
U.K. Trip: A Taste of Better Dining Out with Food Allergies
My First Trip as a Food-Allergic Teen Was an Eye-Opener
Finland is Celiac World HQ, Where Eating Gluten-Free is Easy