in sharp focus

This is the hardest thing you will do as a parent. There is nothing harder, nothing that will eclipse the act of telling your child that she is okay, that she will be fine, that the pain is necessary.

When you first arrive at the doctor's office, you sit with your husband and try to make nervous small talk, the kind that neither of you will remember in 30 seconds because you are both looking around, wondering what is coming next, your eyes on your toddler laughing as she turns the rotating display of pamphlets. You read the titles as they spin past: Helping the Allergic Child, Coping with Asthma, What is Anaphylaxis?... they are printed in bright green, cerulean blue, chubby cheeks smiling.

A male nurse leads you back to the exam room. He is a big guy. He seems nice. You hope that he will be a gentle giant. His name is Sam.

As you wait, your daughter pinballs around the room, laughing and pointing at your husband. She is celebrating this daytime excursion with her daddy. You pull out a wad of notes you have brought with you: a pen, print outs from your daughter's pediatrician.

You wait and try to slow your breathing. Despite this, you are holding your breath when the door opens, hoping that this doctor will be as helpful and knowledgeable as his credentials promise.

The doctor is in his late forties, glasses, has reddish hair that seems fuzzy around the top. He does not smile, but you don't need him to. You want him to know that you respect him, that you need answers, that you want to work with him and find good solutions to this vast territory known as SEVERE ALLERGY. He listens to your explanations of the precious few interactions your daughter has had with the dreaded trigger items (seafood-soy-peas-peanuts, you say them with your eyes closed like a prayer). He asks follow-up questions. He is interested. He offers no opinions other than to say Let's see what happens after the allergy pin test.

This is what you needed to hear. You did not want an alarmist. You did not want guesses. You want a game plan. You want answers. The doctor says he'll step out for a while - the nurse will be in shortly with the tests.

You and your husband explode into action as soon as the door shuts. You scramble for your Ipod, an episode of Sesame Street on pause. You instruct your husband to undress your little girl down to her diaper. She grows suspicious as you pull her woobie out of the diaper bag, a paci in hand.

Your husband lets your daughter crawl around on the exam table. He jumps up to join her, hoping he can help her to relax.

You are nervously taking photos when Sam the nurse walks in, his hands full with dozens of little glass vials. There is a glint of metal deep inside each tube. When you ask how many he'll be doing, the nurse gulps his answer, Twenty-five.

He draws a grid on her back with black marker. She's so small, he says.

And then you're in it, watching your husband hold her as the nurse begins to prick her soft white back with the needles. He works fast - at first she is surprised at the pain. You imagine that she is wondering if she accidentally brushed against something sharp. But there it is again. And again. And again.

Four, five, six.

You are counting under your breath as you hold her head and tell her the lie It's okay, It's okay, Things are fine.

Eleven, twelve, thirteen, fourteen.

She is squirming in your husband's strong arms, kicking her legs. You rub her cheeks.

Seventeen, eighteen.

Her chest is slick with the tears, her eyes bloodshot. She is bewildered that you aren't stopping the pain, that it continues.

Twenty, twenty-one, twenty-two.

You can barely see her face through your own tears, and know that your husband is even more upset, his knuckles white around her shoulders. Your daughter's scream is turning into something ugly: breathy and hoarse.

Twenty-three, twenty-four.

And you know you're still repeating those murmured words, It's okay. It's okay. We're here with you. You wonder when she is going to stop believing that everything will be fine because you're here with her. You wonder when she is going to realize that you cannot take the pain from her, as much as you'd like, as much as you try. You wonder when she is going to stop looking to you to make it go away, to make it better. You hope that it's not today.

Twenty-five.

Because as you hold her shaking body in your arms, you recognize that you need her to ask you to make it better. That, as her parent, the only thing you actually can do is offer these words - the words that you need to say as much as she needs to have you say it:

It's okay.

We're here.

You're not alone.

And then the science experiment goes active: you start to watch her back pucker and flare in the grids. As she calms herself, slows her breathing, your husband is riveted to these spots on her back. He can't believe the hives growing there.

Sam peeks and smiles, Oh! That's a good one!

Your husband wonders aloud, So things are looking good?

Oh yes, Sam nods. Very impressive!

You laugh and add, for clarification, I guess it depends on your perspective, huh? You must really like your job.

To this Sam looks at you, wondering if you're being sarcastic - but he reads your face and knows you're sincere. Yeah, I really do.

You are alone in the room again with your husband and daughter. Sam will be back in a few, he says. You try to keep your daughter from rubbing her back, the welts and hives growing red and angry.

As time passes, you begin to guess which area belongs to which allergen. You pray for no surprises, that everything is as expected, that you will be able to handle what is coming.

Now Sam is taking notes on each allergen, hmmming and hmmming as he writes. You point to an area that is raised in a hot pink welt and ask What's that? Oh, it's cats, he says.

Your stomach knots and you sigh, wondering.

When the doctor comes back into the room, you are composing your face, categorizing the questions you want to ask. The doctor starts slow, goes through each allergen that was tested, talks through what your daughter should not consume or touch. He steadily covers the things you already know: No peanuts, No peas. He surprises you with information about soy, that it's okay in small quantities (such as soy flour that is added to most readily-available baked products). He says that she cannot tolerate almonds - that her allergy to them is equivalent to the peanuts. He discusses seafood, says that it is a much more varied category than you previously thought. That your daughter can eat salmon and cod - but needs to stay away from all other seafood. He says words like pure and 100%. He is painting this topic of allergy with steady strokes. Patient strokes. He seems to want you to know that this is a situation that you can deal with, but you need to be careful.

He talks about food processing practices - that because she is allergic to two kinds of nuts she should stay away from all of them, that there are no promises that anything is pure (there's that word again), that anything is (again) 100%.

He tells you she should not eat any seeds, either. That they have seen some cross-over in severe allergy cases such as this. The best thing, he says, is to stay away from all of it.

You nod quickly. Yes. We know. Yes. This is what we're already doing. You stop him for a moment and tell him what he needs to know: We have already made the lifestyle change. We are here for answers, for a gameplan. But we're already in the mindset.

The doctor brightens with this statement, says Great! He offers websites and a green folder of information. He is taking furious notes that Sam will later print out to put inside the green folder.

When you ask about the cat allergy, he is hopeful. Says that the allergy would manifest itself like asthma, that you should watch her closely. He has seen this many times in children who have grown up with cats: they won't actually develop the allergy until they have spent significant time away from them. Until then, he says breezily, you won't need to get rid of the cats.

It's later when you are getting your daughter dressed, putting on her shoes. You sink quietly into the blue chair in the corner, breathing heavy. The tears come then: the exhausted tears, the tears of gratitude and relief. Your husband grabs the diaper bag, your daughter in his arms, and he holds his hand out to help you up: Well, he says, I guess we'll be back here next year then?

Yes. I guess we will.