(If you missed the first three parts of this story, click here, then here , and then here.)

The scene: a small road off of a two-lane state highway in the woods. The cell phone coverage: first none, then a single bar. My panic state: full blown.

I was laying down in my car, following the EMT-in-training’s instructions to avoid sitting up or moving around, and I was scared nearly to death. I shook, I gasped for air, and I palpitated.

I hated every single second that slowly and dreadfully crawled by. No matter how hard I tried, I couldn’t even conjure up the energy or the clarity of mind to reach for my Ten Rules for Coping With Panic worksheet that lives in my wallet. I was in the middle of nowhere, I was stuck, and I couldn’t escape without help. Not only was I about to receive medical help, but I’d had to call my husband and ask him to drive 40 miles to be with me.

Ugh. Failure.

The word kept repeating in my head: failure failure failure.

Maybe I am having a legitimate medical problem instead of a panic attack. Maybe there’s a problem with my heart or my blood pressure. Maybe there’s a problem with my brain. Did I have a stroke? Maybe I’m having a stroke RIGHT NOW OH GOD WHAT THE HELL.

When your limbs are shaking uncontrollably, the gas pedal is a nightmare to control. My car heaved in fits and starts, thanks to my spasmodic right foot, but I didn’t make it far before I started to feel very cold and prickly.

Twenty minutes in: rocking out to Modest Mouse and eating a peanut butter cup. Thirty minutes into the drive: nausea, a racing heart, and a vivid expectation of death.

There are so many variables in any given day that can effect my physiological arousal — not just caffeine, but sleep, weather, exercise, and so on — that it’s pretty difficult to detect when coffee alone is the culprit.

Karl, the coffee shop owner, said that I wouldn’t be able to tell the difference between half-decaf and fully-caffeinated Americano. The difference, he said, was so slight. GAME ON, KARL.

Six cups of Americano. Six different days. Six different opportunities for me to blindly guess the caffeine content of each drink.

That’s my ultimate goal: to be able to manage panic by myself, without outside help, be it human or pharmaceutical. The power is inside of me, somewhere. I just need to find it.

Should I be paying attention to my body or trying to dismiss its faulty signals? I had no idea. This is the greatest struggle for us panickers: separating the signal from the noise.

When all the tests came back with the medical equivalent of academic straight A’s, I was dumbfounded. I asked my doctor why I felt such strange sensations when others did not.