NEWPORT, R.I. — On a Monday morning in October, Susan King went out to her yard in Newport to pick a mushroom to eat. Growing next to a stump, it looked like a mushroom you’d buy at the grocery store, flat and white and beautiful, although King wasn’t sure exactly what it was. King, who’s been eating mushrooms from her yard for a few years, cooked it with some butter, herbs and garlic, and ate it on sourdough bread.
That night, though, at a get-together at a friend’s home, she didn’t really fancy the champagne, which was unusual for her, she said. That night, she grew extremely ill. And it wasn’t the ripe cheese or the vintage wine. The mushroom she’d eaten, she was later told, turned out to have a name: death cap. It also has a reputation: One of the deadliest mushrooms in the world. Its toxins attacked her organs and caused vomiting and, simultaneously, diarrhea. Her doctor told her her loved ones should come soon, and that she might need a liver transplant to save her life.
A month and a half later, King, 62, is alive to talk about it, crediting the care at Newport Hospital and a combination of treatments, including a non-FDA approved drug made out of milk thistle extract, for saving her life and her liver. This week she’s preparing for Thanksgiving in her New York City apartment. As she counts her blessings, she will be eating turkey.
“But no wild mushrooms,” she said. “No foraging at all.”
Definitive statistics on mushroom poisoning in Rhode Island are hard to come by. But they seem to be relatively uncommon: According to Newport Hospital’s parent company, Lifespan Corp., that hospital has had one mushroom-related poisoning this year, and one last year. The Miriam Hospital also had one both years. The state’s biggest and busiest hospital, Rhode Island Hospital, has had four this year, compared to last year’s two, a doubling of a very small sample size.
But enthusiasts say foraging for mushrooms is becoming more popular, especially as the COVID-19 pandemic forced people to take their hobbies outside. It’s safe, if you take precautions.
“I’m an example of the fact that this can be done well and safely — it’s just so incredibly important to know what you’re doing, and follow rules, and be 100 percent certain of your identification of a mushroom,” said Dr. Victoria Leytin, a Brown Emergency Medicine physician who works at the Miriam and Newport hospitals and has been foraging for mushrooms for a few years. “It’s a fun hobby, but you have to do it so carefully and take it so seriously.”
Leytin has never seen poisoning by mushroom in her medical career, beyond a couple cases of magic mushrooms and one case where someone had general stomach troubles after eating mushrooms without long-lasting effects. Leytin, who was not involved in King’s care, said as a general rule, she doesn’t eat mushrooms with “gills” on the underside. That includes the death cap, and also some edible varieties, but Leytin plays it safe. There’s a saying in the mushroom community: “There are old mushroom hunters, and there are bold mushroom hunters, but there are no bold, old mushroom hunters.”
Walter Sturgeon, the Ohio-based author of multiple field guides to mushrooms who has also consulted for poison centers, said a photograph of the mushroom King ate could have been a death cap, but also could have been a species called a “destroying angel.” They’re similar, and both deadly.
King is originally from Nottinghamshire, England, the land of Robin Hood, who, King noted, probably would have eaten mushrooms himself.
She moved from across the pond to New York City about 30 years ago, and has also had a home in Newport for the past 25 years or so. About six years ago, she bought a house on Bellevue Avenue, with a yard that could accommodate some light foraging. She had attended a lecture at the library about finding and identifying mushrooms, and also had purchased a calendar guide to them. But she missed a guided walk in the Norman Bird Sanctuary because it was sold out.
One of the people who leads talks at the library, Ryan Bouchard of the Rhode Island-based Mushroom Hunting Foundation, said they explicitly mention the death cap as one to avoid.
“Our talk is loaded with warnings,” said Bouchard, who added that he and his fiancee, Emily Schmidt, have taught thousands of people to safely forage. “Mushroom hunting is safe, but you have to identify the species.”
Bouchard says people should never eat a mushroom they can’t identify, much less a wild mushroom with gills, which should only be eaten by experts — as the calendar book he sells instructs people. “When in doubt,” the book says, “throw it out.”
Some people he’s aware of have gotten sick from mildly poisonous mushrooms that cause gastric upset but aren’t deadly, but this is the first case he’s aware of where someone ate a deadly mushroom. But recently, some people’s dogs have died after eating mushrooms, he said.
Over the past few years, King had eaten an edible mushroom called lion’s mane mushrooms from her yard, on a tree stump. When she’s back in the UK, she also forages there, although her husband didn’t partake: He joked that she was trying to poison him with her cooking.
A few mistakes led up to King poisoning herself in October. She acknowledged that they tell you to be careful with mushrooms. But she’d lent the mushroom calendar guide to the person who does her lawn, she said. And she usually asks him for guidance on mushrooms, but he was out of town that day. She texted a friend a photo of it, asking for a consultation, but the friend did not respond.
When she went ahead and ate it anyway, it really didn’t taste all that different from other mushrooms — “It was quite good, I hate to say,” King said — but thankfully she stopped at just one of them. One of them made her sick enough.
As she fought for her life in the hospital, her husband James called around to friends to get some advice. A friend in the pharmaceutical business — the husband of the lady she’d been drinking champagne with the first night, as it happens — helped lead them to the drug made from milk thistle extract, an intravenous drug sold under the brand name Legalon.
It took some doing to get the drug, which prevents the toxins from shutting down the liver. It’s not approved by the U.S. Food and Drug Administration. The manufacturer, Mylan, had to get permission from the FDA to use it as an investigational new drug in this case.
King credits the team of doctors and nurses at Newport Hospital with saving her life. She’s not sure whether the milk thistle made a difference or not, but she believes she got more attentive care there from a team led by Dr. Eric Wright than she might have if she’d been back in New York.
In the meantime, she has eaten mushrooms since her brush with death — but only the ones she’s bought at Stop and Shop.
“People need to know to just be really, really careful,” she said. “I don’t want anybody else to go through it. They may not be as lucky.”
Brian Amaral can be reached at firstname.lastname@example.org. Follow him on Twitter @bamaral44.