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“Just so you know, I have an allergy to milk,” Sandra Beasley tells the Thip Khao server when she arrives to take our order.

“OK.”

“I have an allergy to chicken egg,” Beasley adds.

“Chicken egg,” the server recites back.

“Beef, shrimp…”

At this point the smiley young woman taking our order realizes this is no ordinary list and pulls out a little notepad to write everything down. She re-recites the ingredients. “That’s it?” she asks.

“Cucumber and mango,” Beasley says.

Beasley, a 35-year-old author and poet, has already scoped out the menu online in advance, as she always does. (Thip Khao was her suggestion for our dinner.) She sees it as a good sign that the Columbia Heights Laotian restaurant makes a point to say “vegetarian” means no fish sauce or shrimp paste. It signifies someone is paying attention to the ingredients.

But this is just the starting point. Beasley will need to ask the kitchen some questions before she can decide what to order: What makes the pork “sour pork”? Does the coconut curry use shrimp paste? Can it be made without shrimp paste? Are those egg noodles or rice noodles? Is the catfish fried in an egg batter?

Beasley thanks the server, who heads back to the kitchen to check on some answers. Although she didn’t mention it, many of her allergies are potentially fatal—something she’s written about in her memoir Don’t Kill the Birthday Girl. Even a slight exposure to dairy could result in swollen eyelids and lips, shortness of breath, itchy throat, and vomiting. At Italian restaurants, she might ask her dining companions to skip the Parmesan cheese sprinkled on their dish tableside. “When you have that much free-floating cheese to your immediate right and left, it creates a scenario that is unnecessarily stressful. Literally if any of that lands on my plate, we have to start over,” she explains.

Beasley carries an EpiPen, Benadryl, and an inhaler with her at all times.

While her allergies are extreme, Beasley is part of a growing group of people who dine out in spite of dietary restrictions. Allergies in general are on the rise: The number of children with them increased 50 percent between 1997 and 2011, according to a 2013 study from the Centers for Disease Control and Prevention. Plus, people are now more comfortable bringing their dietary restrictions to the attention of the restaurant rather than silently navigating the menus themselves. Restaurants, for their part, are doing far more to accommodate them.

“Maybe 20 years ago it was a much stricter, rigid system in which the chef is always right,” says chef Haidar Karoum of Proof, Estadio, and Doi Moi. That’s less so the case today. He says he’s personally become more accommodating as he’s gotten older. “When you’re young, you have this thing in your head that there’s a certain integrity to a dish and you can’t change this… As you mature, you start to realize that you’re a cook, and I’m here to feed people. If somebody came to my house and had dinner and asked for something, I would certainly do anything.”

Estadio and Doi Moi now offer special vegan, vegetarian, and gluten-free menus. For people with severe allergies, their restrictions are not only printed on a ticket but also brought directly to the attention of chef, who will then evaluate every possible contamination point. The kitchen will then use all new utensils, cutting boards, and saucepans to prepare the food. When reasonable, Karoum will make a dish that’s not on the menu to accommodate restrictions.

Some people with extreme allergies will hand their server a card—sometimes with their photo on it—that lists ingredients that will make them ill or could kill them. These days, Karoum says he gets a card like this at least once a week.

Beasley doesn’t use such a card unless she’s traveling abroad, in which case she’ll have it translated into the native language. “For me personally, I’ve had a better experience where you’re working with the kitchen,” she says. The cards are a “borderline aggressive gesture, which some people will welcome and some people will not.”

Elizabeth Parker, manager at Crane & Turtle, recalls one woman who gave her a card with a long list of deadly allergies at a previous job at Kapnos. “It’s scary,” she admits. “It’s a lot of pressure on the kitchen. It’s a lot of pressure on everyone to make sure nothing goes wrong.”

Crane & Turtle asks diners about allergies three times: when the reservation is made, when the reservation is confirmed, and when the diner sits down at the table. Parker says sometimes people don’t volunteer the information without being asked directly.

It’s a relatively new phenomenon that servers automatically even ask about allergies. Parker says it wasn’t until she began working at Cleveland Park’s Ripple in 2011 that it became a habit for her. “Knowing that it wasn’t a nuisance for that kitchen for me to come tell them about allergies, that they didn’t always roll their eyes at me, that they wanted to hear about it… that’s when I started always asking people about allergies.” Now, she says, that’s the norm at many restaurants.

Within the past month or so, Crane & Turtle has gone a step beyond with seven specialty menus printed out each day for various restrictions: gluten-free, vegetarian, vegan, pescatarian, no pork, no shellfish, no dairy. If someone can’t eat shellfish or dairy, for example, sometimes Parker will print out a special menu just for them with enough advance notice. “It reduces a lot of the margin for error for everybody,” she says.

The menus have become particularly important to Parker because she recently developed her own seafood allergy, which she discovered after a seafood platter sent her to the hospital a couple months ago. Now, she’s “coming out” to restaurant industry friends. Their responses? “It’s been somewhere on the range of death in the family to terminal disease or just pointing and laughing,” Parker says. She also finds herself apologizing profusely to servers when she mentions her allergy. “I definitely have the allergy shame, I won’t lie.”

Cate Elmore, a pastry cook for America Eats Tavern, has likewise been on both sides of the equation. She was diagnosed with allergies to wheat, corn, barley, rye, peanuts, and melons less than a year ago. She had previously been feeling crummy and making excuses for it until a birthday dinner at The Inn at Little Washington. The meal began with popcorn with truffle shavings, and by the fourth course, Elmore was so sick she had to stop eating.

Now that Elmore has cut her allergens out of her diet, her reactions have intensified. If she’s working with flour in the kitchen, she has to wear sleeves and gloves to avoid hives and a mask to prevent an asthma attack. She relies on her colleagues to taste test her cooking. While Elmore used to find diners like herself a pain to deal with, she’s become much more understanding. And as a diner, she’s been pleasantly surprised to find how accommodating restaurant staff are.

Kimberly Galeone, a bookkeeper for Sligo Cafe in Silver Spring and other small businesses, says the gluten-free movement in particular has made restaurants more aware of special diets. As a vegan with bovine dairy, soy, and gluten allergies, Galeone says about a quarter of the time she eats out, the kitchen will go out of its way for her. Half the time, the staff wants to help but isn’t sure what to do, and the remaining quarter of the time, she gets a negative response like an eye roll or annoyed look.

Sometimes, the response is somewhat hostile: For New Year’s Eve, Galeone says she and her husband made reservations for a $70 tasting menu at one local restaurant, which she didn’t want to name. She called two weeks in advance to make sure the restaurant could accommodate her. “For my appetizer, I got a salad with cold beets. And for my dinner, I got a salad with warm beets,” Galeone says. She claims the meal took more than an hour to arrive. “The owner actually came over and said, ‘If your wife wasn’t so difficult to feed, we would have had better service.’”

There’s certainly a camp that asks why someone with extreme dietary restrictions would even bother to dine out. Aside from any potential strain on the restaurant, diners could be risking their lives.

To that, Beasley has a straight-forward answer: “I am probably there primarily because I am celebrating something with a loved one, and I am not out to make your life hard. I am out to honor this larger purpose, and I just want to work with you to have something safe.”

At Thip Khao, just being safe means a lot to consider. Beasley is not allergic to pork, but she’s wary that pig’s ear could be brushed with egg or breaded. Similarly, she won’t order pork sausage because the casing is a wild card. Anything with tofu is out of the question because she’s also allergic to soy. Then there are foods that Beasley isn’t 100 percent sure she can eat, like quail or papaya. If she’s going to try a new food, she’ll sample it at home first to see how she reacts. Often, she has to try something a few times to know if she’s truly allergic. People with food allergies might not always get sick the first couple of times they try something.

Depending on the place, even ordering a cocktail can be a risk for Beasley. Just because a restaurant is allergy-aware in the kitchen, doesn’t mean it is at the bar. If Beasley were at a restaurant that served martinis with blue cheese-stuffed olives, even a trace contamination could make her ill. “Someone knows not to reuse a spoon, but people don’t know not to reuse a shaker, so I always have to weigh the risk and whether what I want to try is worth the risk.”

Beasley and I ultimately order red coconut curry with chicken, salmon head soup, and crispy rice salad with sour pork to share. When the rice salad arrives, Beasley examines it closely for any colors or textures that she might be unsure of. “If there’s a nut in it, I always want to look to make sure it’s recognizably the nut that I thought it was.” She’s allergic to cashews, macadamias, and pistachios, but not peanuts.

Later the curry arrives with a white cream on top. Beasley asks the server what it is. “Coconut.” At this point, Beasley must make a mental calculation. She’s already made it clear that she has a severe dairy allergy, and canned cream of coconut can sometimes contain dairy. At the same time, we’re both drinking out of whole coconuts, so she knows the kitchen uses fresh ingredients. “My instinct is to trust,” she says.

With each dish, Beasley will take one bite then sip her drink or wait for a few minutes before moving on to the next thing. Eating out can be stressful to a certain degree, but “it’s just the reality of how I live. I’ve never known anything different,” she says. “I guess in a way I will always think of it somewhat as a joyful luxury experience because it represents a small victory.”

And just because she can’t eat more than half of the menu doesn’t mean she’s not an adventurous eater.

“Am I going to really gross you out if I eat this eyeball?” Beasley asks as she spoons through the salmon head soup and slurps up the odd bit.

“How is it?” I ask.

“Good. You have this really tasty goo, but the very center is as if the eyeball had an eyeball bone in it. The center is hard,” she says. “You can’t eat that part.”

Photos of Sandra Beasley by Darrow Montgomery