"I'm sitting in a Dunkin' Donuts and I know I'm going to die tonight..."

Part 1 in a series on anxiety.

A true story:

I'm sitting at a table in a Dunkin’ Donuts, the only customer in the place on the Saturday night before Halloween. I’m surprised it’s empty in here, as the donut shop is located on a strip near the university I’ll soon drop out of.

It's a few weeks shy of my 21st birthday and I know I'm going to die tonight. I'm gasping for air so badly that the attendant behind the counter, obviously weirded-out, is staring over at me.

I manage to heave the words “Don't worry” between breaths and between bites of my strawberry frosted donut with sprinkles. “I'm not drunk,” I assure the attendant, “I'm just going to die tonight, so I'm having one last meal.”

I can tell that the guy doesn’t know what to make of either what I’m saying or the state I’m in. He looks concerned, but he makes the mental calculation to just leave me be. The Dunkin’ Donuts is located about 200 paces from the hospital that’s affiliated with the university, so I figure I’ll at least make it to the emergency room down the block before the inevitable happens…

At the time I made this decision — i.e: “I think I’m dying, so lemme go get a donut first” — it honestly seemed like a good idea. I’d been at a Halloween party that was literally across the street from the ER when I suddenly found myself unable to breath. Oddly, instead of just high-tailing it for the door, I made it a point to say several goodbyes first. I did my best to give the appearance that all was well because I didn’t want to worry anyone.

I should mention: I was also high as fuck. I didn’t yet have enough experience with marijuana to grasp in the moment just how distorted and out-of-scale my perceptions were. As it turns out, though, what I’d just been feeling wasn’t all in my head.

“I smoked marijuana tonight,” I tell the doctor straight-up, without flinching. I’m intentionally being direct, and I don’t feel self-conscious about coming clean. As the son of an RN and an MD, I know that you’re supposed to be up-front with doctors in case they give you a medication that interacts in a dangerous way with whatever you've ingested. The doctor places an oxygen mask over my mouth, and I sober-up almost instantly.

Everything comes back into proper focus, at which point the absurdity of my train of thought up to this point becomes clear, crystallizing right there for me to see in all its comic glory. I’m not, I realize, in the process of dying at all. And as it sinks in that I drastically over-estimated the danger I was in, the doctor explains that I’ve just had an asthma episode brought-on by breathing-in marijuana smoke and then immediately thereafter exposing my throat and lungs to the cold, crisp air of a late-October night. Naturally, the doctor continues in a very matter-of-fact, non-judgmental tone of voice, because of the way marijuana affects the brain, I became hyper-aware of what was going on physically, and the sense of alarm was amplified.

Not only did I feel absolutely fine just then, but I also felt clear-headed and free of any embarrassment. I hadn’t suffered any serious effects from asthma since childhood, so I wouldn’t have understood what was happening even if I’d been sober. I’d always known that I had asthma, and I’d always had to avoid exerting myself past a certain point in cold air, but I had never felt like I was fighting to breathe. My level of alarm made perfect sense.

In any case, what had just happened was fairly routine. All I had to do, I was told, was take moderate precautions and be aware of my asthma “triggers” — a term I was just hearing for the first time — and it would be a piece of cake to manage this.

So I was okay — at least for the moment. I had been brought safely back to earth with the same kind of reassuring confidence that we see in airline pilots. The doctor on duty that night ended up being right: my asthma issue is quite mild. Nevertheless, that trip to the ER was my maiden voyage into a galaxy of fear that I’ve traversed countless times in the three decades since.

In truth, I’ve never needed medical attention for asthma-related issues again. But that experience was like a placeholder for something else that had been awakened unbeknownst to me — an ailment far more difficult to define yet way more debilitating and scary.

That “something else” was an anxiety disorder of epic proportions, and it would soon make its entrance as a semi-permanent feature of my existence in a big way. Meanwhile, I didn’t know it yet but I’d just gotten hooked on the feeling of convincing reassurance from the doctor. Seeing the evidence that nothing was actually wrong would leave the door ajar for me develop an insatiable craving for more of the same.

If I’m being precise, the re-emergence of my asthma had nothing do with anxiety. But together, the asthma and marijuana heralded a recurring pattern that would unfold in almost the exact same sequence every time: my body would give off some kind of signal, I would feel like I was in danger, my fear would spiral out of my control and, if I couldn’t calm myself back down, I’d end up in the emergency room or calling an ambulance.

Looking back all these years later, it’s obvious to me that that evening was like a simulation drill before asthma politely moved out of the way for something else that was about to hit me like a ton of bricks.

I leave the hospital feeling both elated and settled. I now know that I wasn’t dying, and that I wasn’t in any real danger to speak of but it’s still, in a sense, as if my life has been saved. I feel like I’ve been rescued from a burning building somehow. It would be inaccurate to say that I feel like I’ve had a near-death experience, but I do feel like I brushed up against mortality, having just been convinced that I wasn’t going to live through the night.

The party had quieted down by the time I was discharged. So I walked over a mile in a light snow to the safe haven of my bed.

I had no idea what was coming, or how difficult things were about to get.

I was, in so many ways, a sitting duck…