The End Of The Trifecta: How The Worst Panic Attack Of My Life Ended(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.

After what felt like a million years (read: about 40 minutes), my husband finally pulled up in his car. (I’d never been so relieved to see his car in my life.) He talked briefly with the EMT-in-training and then hopped into the passenger seat of my car and held my hand.

His presence was calming, but it wasn’t enough to quiet the gigantic beast of an overactive sympathetic nervous system inside of me. I still felt panicky. My heart was still racing. I blathered on and on through hurried breaths about how I was sure I was having a heart problem or how I was sure that something was medically wrong with my body.

I tried to cry, but couldn’t. It was too physically stimulating and only added to the “I’m about to die” feeling.

And then, we watched the ambulance pull up.


Before I tell you how the panic ended, I’ll tell you how it got worse. Because it did get worse — all thanks to loose-lipped EMT.

The ambulance parked and a back-country flannel-clad guy, probably in his 50’s but with the wrinkled face of an octogenarian, got out of the driver’s seat. However, there were no EMT’s in sight. The ambulance driver was just that — the ambulance driver.

“Yep, I just drive ’em,” he said to me after the EMT-in-training and my husband helped me up into the back of the ambulance. “But let me try to take your blood pressure and stuff while we wait for the medics.”

Great: more waiting and more shaking. Not only was I anxious, but also cold: the gray clouds outside had begun to sleet. My hair was wet. My jeans were damp. And, of course, I was in an effing ambulance — so, my scary location-within-a-scary-location compounded my fears. Has anyone ever died in this thing? Will I die in this thing?

About fifteen minutes later, after some small talk with the driver about his most recent panic attack (yes, seriously — he tried to distract me from my own panic attack by talking about his own panic attacks), two EMT’s arrived from the nearest major town. Without really acknowledging me, a young man in his early 20’s began hooking me up to some kind of boombox-shaped monitoring device with a screen and multiple cables.

My blood pressure was a little high — what else would you expect? — but the oxygen level in my blood, as read by that little clothespin-esque device they clip onto your pointer finger, was fine.

My heart rate, however, was too high for their liking.

“You’re steady at 103 or so,” said the young EMT, “and we recommend an ER visit for anyone with a steady rate of over 100 beats per minute.”

I didn’t want to go to the hospital. I just wanted to make sure I wasn’t having a bona fide medical problem and I wanted to get the hell home. If I were home, I reasoned, I’d calm down in an instant — like any other friendly neighborhood agoraphobic. Home would comfort me.

So, now beginning to think a bit more rationally, I reached into my proverbial toolbox of CBT tricks.

“Give me a minute,” I asked the young EMT, “and I’ll see if I can lower my heart rate.”

I’d had a lot of experience using deep breathing methods of relaxation, and finally with my husband on one side an a EMT on the other, I felt safe enough to try breathing through my diaphragm. I inhaled for 2 seconds, and exhaled for 5.

“Don’t lower your heart rate too much,” the young EMT said, “or you might pass out.”

Pass out.




What was (probably) meant as a joke caused my heart rate to skyrocket, almost instantaneously, to 135 beats per minute.

Not funny, EMT guy. Not funny.


And then, I started feeling the third Xanax I’d taken just before the ambulance came. My heart rate slowed down after I asked my husband to grab a soda and pretzels out of my car. I noshed on this mini-meal in the ambulance, still hooked up to a few wires, and began to feel safer with every pretzel crunch and soda sip.

Soon, the shakes dissipated and I was steady enough to sign a paper acknowledging that I’d voluntarily refused medical treatment.

“This happens to me all the time,” I remember saying to the EMTs while signing it. It felt like a vague apology for their effort in driving all the way out into Nowhere, PA to take a few vitals on me.

“I’m agoraphobic, so, yeah. These long drives on country roads are hard. Very hard.”

The female EMT, who, until this point, had been standing outside of the ambulance, chimed in and told me that her neighbor is so agoraphobic that she never leaves her house at all. Her limit is the backyard fence.

“I’ve never been that bad, thankfully. Close, but not quite that bad,” I said.

My husband helped me to step out of the ambulance. He parked my car in a safe place near a township maintenance building, and we got into his car for a long, miserable, and (mostly) silent drive home.

My self-esteem?



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