On weekends, my husband and I are in a house near a lake, surrounded by woods. We are miles away from everything. When we wake up there, it is to silence, and for some time on those mornings we lie still, letting the day gather around us, listening to each other breathe.

When we get up, we start the day separately. My husband drives off to get the paper at a gas station. This is seven miles away, on country roads, so he’s gone for twenty minutes or half an hour. I go downstairs and make myself breakfast. I eat it alone in the kitchen, then I take my coffee to my desk to work.

But that morning, while I was still upstairs, I had the vague sense that my husband hadn’t left. Usually he calls the gas station to make sure the paper is in, so maybe it hadn’t come yet. Maybe he was downstairs in the kitchen, or upstairs. I couldn’t have said what creakings or murmurs, what soft distant sounds or their absences—his voice on the phone, his step on the stairs, the clang of a pan in the kitchen, the closing of the front door, his car starting up out by the garage—what barely acknowledged, minimally perceived scraps of information had formed my opinion. But that morning I thought he was still in the house.

In the bathroom, I washed my face and brushed my teeth, then opened the medicine cabinet. I take Synthroid, for a thyroid condition, and a lot of vitamins and supplements: omega-3 and some others. I took the Synthroid, and then started on the rest. A few days earlier, I’d run out of the omega-3 and I’d bought a bottle of a different brand, at a strange pharmacy. This was in New York. We’d been invited to dinner at a friend’s house, and somehow we’d arrived too early. To pass the time, we walked around the block, and when we saw a drugstore I remembered the omega-3. The pharmacist was a pleasant man; he held up the bottle. “This is the best for omega-3,” he said. “The very best brand.” The bottle was dark brown, so I couldn’t see the size of the pills. I’d once had a bad time taking a pill, so now I’m careful about sizes. But the pill I’d had trouble with was hard, and omega-3 is fish oil, so it would be soft. And this was the very best brand.

That morning, I took the Synthroid, with a little gulp of water. Then I opened the new bottle of omega-3 and tore off the protective layer that sealed the mouth. I took out a capsule and held it between my finger and thumb. It was a soft oblong, golden and translucent, somehow radiant. It was solid. It seemed very big. Not just long, which doesn’t matter to your throat, but also thick, which does. It seemed squat and intractable. I squeezed it. It barely yielded. But the pharmacist had said it was the best brand. It was not much bigger than the pills from my other brand. Or, anyway, I hoped it wasn’t.

Thought makes swallowing nearly impossible. Once anxiety enters in, the pill becomes the enemy of your body. You can drink glass after glass of water, hoping to conceal the pill in a tidal wash, to no avail. Your tongue becomes a goalkeeper—agile, muscular, vigilant. Whenever the pill is swept toward the goal of the open throat, no matter what your brain urges, your mutinous tongue sweeps it to one side.

That morning, I decided to avoid the struggle altogether. I took the pill in two fingers and thrust it neatly down my throat, beyond the swallowing place. It was in.

At once, I knew how bad it was.

It was like a cork in a bottle.

My throat was plugged tight. I couldn’t swallow. I couldn’t talk. I couldn’t breathe. Before my mind understood this, my body knew. Nothing had happened yet, I wasn’t in pain, I was clear-headed and upright, but my body set off an alarm of extreme peril. Panic flooded through me, cascading terror.

I found myself leaning over and I began convulsing. My chest heaved and bucked, the torso muscles clenching as my lungs strove for air. I felt myself going into spasms, hunched, helpless, jerking. I heard myself making strange, urgent sounds, from deep in my center.