I had my first panic attack when I was fifteen, in the middle of January, while I was sitting in geometry class. Winter in Illinois, flesh comes off the boneswhat did we need geometry for? We could look at the naked angles of the trees, the circles in the sky at night. At noon we could look at our own faces. All the basic shapes were there, in bone. Bright winter sun turns kids skinless. Skins them. But there we were in geometry class. The teacher also taught physics. He was grotesquely tall. Thin. Hed demonstrate the angles with his bones.

This was Catholic school. The blackboard was useless. A gray swamp dense with half-drowned numbers. Mr.Streeling would bend a leg in midair: 90 degrees, cleaner than a protractor. Hed stand and tilt his impossibly flat torso: 45 degrees. He could lift his pant leg, unbundle new levels of bone like a spider: 15 degrees, 55, 100.

I was sitting under the fluorescence when it happened. The first time, technically. Though I could tell it was the first time only in retrospect, looking back from the third time. My right hand on my desk, my left hand fiddling with a pencil in the air.

Mr.Streelings voice booms: Open the textbook, page 96. The textbook lies next to my hand on the desk. Next to the textbook is a large blue rubber eraser. Hand, textbook, eraser. Desktop bright in the fake light.

My hand, I realize slowly, its a... thing.

My hand is a thing. Hand, textbook, eraser. Three things.

Oh.

Thats when I forgot how to breathe. Ty saw it happen. He was sitting across the room. But he saw me, and he gave me a look like what the hell. Watching me trying to remember how to breathe. It wasnt going well. I was sucking in too much air, or I wasnt breathing enough out. The rhythm was all wrong.

Darkness at the edge of vision...

Two seconds blotted out. When I came back my lungs had picked up the tune. The old in-and-out, the tune you hear all the time. If it ever stops, try to remember it. You cant. Breathe in, breathe out, breathe in, breathe out. It never stops. But if it does, its hard to remember how it goes. Ask dead people. Ask me. I gave Ty a weak smile, like Id been joking, my face probably red or maybe white or even a little blue. Ty turned slowly back to his textbook, shaking his head like I was crazy.

The second time it happened was in a movie theater. My dad had taken me to see The Godfather Part III. It was a Tuesday night. Late January. The theater was basically deserted. Kind of depressing, this father-son outing on a school night. Kind of cool too. Like we didnt give a fuck about school nights.

I think the show started around 10pm. Everything was fine. The film was pretty good. Until halfway through, when the Al Pacino character says he has diabetes. As he said that word, diabetes, I could feel gas rising in my blood. The gas started to rise maybe a minute before diabetes. Like I knew he was going to say it. Like I prophesized it.

This time what I forgot was how to move blood through my body. My blood stopped. When your blood stops, the gas rises. Thats my experience. Gas rising in the blood. Dad snored beside me. I woke him up, said we have to go. He looked at me. Okay.

As soon as we got up my blood started to move again. I was still in shock or something. Walking like I was about to fall over. When we got to the car I lay back in the passenger seat and pressed my forehead to the cold glass and Dad asked me if I was okay and I said yes, which he knew was a lie, but there was nothing else I could say.

I couldnt tell him that my blood had stopped. I couldnt tell him about the gas in my blood. Those were inside symptoms, not outside symptoms. I knew on some intuitive level that my blood stopping at the word diabetes wasnt a symptom Dad could work with. Thered be questions. Plus my blood actually stopped about a minute before the word. Hard to explain.

In fact there was nothing that could be said between myself and Dad about what had happened to me in the theater. So it was the same as nothing happening. That was the second time.

The third time was two weeks later. A Sunday night in February. I climbed into my narrow bed in my narrow room at Dads place. I was reading Ivanhoe. The old Signet Classic paperback. There was a painting of a joust on the cover. A lot of red in the painting, I remember that. But not from bleeding knights like youd expect. The knights were whole. The red was in the atmosphere. I sat up in my bed with my pillow propped against the wall and opened the book and started to read. It was probably 10:15 or so. I usually read for a little while before falling asleep.

At a certain point early in the first chapter I became aware that I was having or was about to have a heart attack. As long as I kept reading I didnt have to think about this too much. When youre reading, the words of the book borrow the voice in your head. Words need a voice. The voice they use when you read is your voice. Its the voice your thoughts talk in. So if you give the voice to the book, your thoughts have no voice. They have to wait for paragraphs to end. They have to hold their breath until the chapter breaks.

So the lords and ladies went to the joust, and the Saxon guy threw meat to his dog in his hall, and the other Saxon guy ran away, and the Jewish guy spoke to his daughter, and I was having a heart attack, and the Knight Templar looked down from atop his war horse. He had an evil look in his eye.

I read at a medium pace. Too fast and the voice in your head cant keep up with the words. Thats what your thoughts are waiting for. They catch the voice and flood your head with news of the catastrophe unfolding in your body.

But if you read too slow then its not just the chapter breaks you have to watch out for. Now youve got holes and gaps between the words. Maybe in some situations thats a good thing. You can savor the words. The words come swaddled with silence, like expensive truffles, each one separate, while cheap chocolates are packed next to one another with their sides touching.

In a reading situation like mine you want the words packed together with their sides touching. Because silence isnt delicate truffle-swaddling in that situation. Its heart-attack holes. Its not even silence. Every second the book isnt talking your thoughts are talking, urgently, telling you about this heart attack youre either having or about to have.

So I read at a medium pace. A constant, medium pace. I developed a technique where Id read over the chapter breaks, and run the paragraphs together. I didnt pause. Sometimes Id feel myself speeding upthe voice in my head began slipping on words. But I didnt lose it. I slowed down. Not too much. I kept the pace medium.

By chapter three I had it down cold. I was a genius at reading Ivanhoe by chapter three. I doubt its ever been read so well. It had a voice all to itself, with no interruptions, and no breaks, for the entire length of the book. How often has that happened in the history of Ivanhoe? The whole time I was reading I never even found out whether I was actually having the heart attack or just about to have it. Thats how good an Ivanhoe reader I got to be. The very next thought would have told me. But the next thought never came.

I suspended the heart attack in Ivanhoe. Like when you shake a solution of oil and vinegar. As long as you shake it, the oil and vinegar are suspended in one another. When you stop, they separate. So long as I read Ivanhoe my heart attack stayed suspended in the story.

I didnt stop reading. I didnt go to the bathroom. I didnt change my position. I didnt look at the clock. We went through the hours like that. Me, the Saxon lord, the Jewish guy, the heart attack, and the Knight Templar. We moved through 11pm like that. In suspension. Midnight. 1am. 2am. 3am. And then the legendary, unseen hour. 4am.

I heard Dad get up. The end of the story was very close now. Richard Coeur-de-Lion has come home. The news of his return spreads. Dad moves behind the thin wall that separates my room from his. Ivanhoe, Rowena. The sound of the shower. Rebecca! Rebecca... Dad goes down the stairs and I can hear the clink of silverware. The sound of the fridge opening.

Ivanhoe distinguished himself in the service of Richard, and was graced with farther marks of the royal favour. He might have risen still higher but for the premature death of the heroic Coeur-de-Lion, before the Castle of Chaluz, near Limoges.

At 4:35 am Ivanhoe ended. I put down the book. I put on my pants and pulled on my sweater. Then I walked downstairs and told Dad that I was having a heart attack.

At the emergency room they told me what I was actually having was a panic attack.

A panic attack? I repeated.

The bright fluorescence of the hospital room shone on red and black medical devices. Shone on my hands, which were crossed on my lap. They looked more like things than ever.

Dad welcomed the news.

A panic attack, he said. Nothing to worry about, thank God.

The emergency room doctor nodded.

People often think theyre having a heart attack when they first have a panic attack.

Actually it was the third time, I realized. It took three tries for it to learn how to mimic recognizable symptoms, to make itself public.

What am I panicking about? I asked.

They didnt find it easy to answer that question. To tell the truth they didnt find it a very compelling question. In the emergency room they deal with organ failure, stab wounds. Things of that nature. Philosophical questions about quasi-diseases give way to the urgency of actual vivid outside-the-body blood, in large amounts. Pulseless wrists, severed legs. Prestigious, respectable conditions with absolutely unfakeable symptoms.

Probably nothing, Dad ventured after a few seconds, looking hesitantly at the doctor.

Could be anything, said the doctor. If it happens again, breathe into a paper bag.

What?

A paper bag, he repeated.

He explained, as best as I could understand him, that what happens when you have a panic attack is you hyperventilate. You breathe more and more quickly. So you have more oxygen than carbon dioxide, and your blood vessels constrict, which causes you to feel lightheaded. You get tingling in the extremities, and other symptoms which can easily mimic an ignorant persons impression of what a heart attack is like.

He looked at me compassionately.

But if you breathe into a paper bag, that will restore the carbon dioxide.

So a paper bag cures panic attacks? Dad asked.

The doctor paused. His beeper started to go off.

Yes, he said. Please excuse me.

On the way back from the hospital, Dad stopped at the grocery store to buy some paper bags. He gave me two to stuff into my backpack. Then he dropped me off at school.

Wait, he yelled from the car as I was walking away.

I hurried back. He thrust something at me through the open window.

Better take one more bag, he said. In case one of them gets wet.

My mouths dry, I said.

What, he said.

Its not wet, I said. Theres no way the bag can get wet.

What, he said.

Okay, I said, taking the bag.

Have a good day, he said, rolling up the window and driving off.

The regular entrance, where the bus dropped us off, was locked. So I had to go in through the main entrance. Id never used it before. Plainly it was designed for adults. The door swung open into a corridor with what looked like a real marble floor. Expensive-looking dark-green tiles on the walls.

I crept through silently. The right side of the wall had about a hundred framed black-and-white photographs hung on it. Priests. All smiling. Facing the camera with the confidence of men who know they wont have faces for long. Now theyd all stepped out of their faces. Thats what black-and-white photographs mean.

The faces hung there like rows of empty sneakers in a shop window. The priests had stepped out. Into the air, I thought. Breathing out, never breathing in. Maybe thats what its like when you step out of your face at the end. Like the opposite of a panic attack. You breathe out more than you breathe in. Then youre out. Free.

I fingered my paper bag. What had the doctor said? A paper bag is a device for breathing out more than you breathe in? Was that it? I wondered if other people used them. I stared at the wall of priests. Huffing their own carbon dioxide in a paper bag right before the shutter clicked. Maybe thats how they practiced for not having a face any more.

I was sweating in my winter coat.

Pull yourself together, I thought. I hurried down the corridor.

When I was about ten feet from the end, the door swung open. A nun Id never seen before stepped through, glaring.

What are you doing here?

I blinked guiltily. Sweating in my coat, still holding the empty paper bag Dad had given me. I hadnt had a shower that morning. Greasy hair plastered my forehead.

Get to class, she said.

She held the door open, pointing. I stuffed the bag in my pocket and shuffled forward. When I got close she stopped me. Put her long white hand on my shoulder.

Whats in your pocket?

I gulped.

Nothing, I said.

Show me.

I dug the bags out.

Just some paper bags, I said.

She squinted down through her spectacles.

Thats trash, she observed. What are you carrying trash around in your pockets for? Throw it out.

She pointed. For a second I didnt realize what she was pointing at. It looked like a model of a space ship. That opening on top... A garbage can! I clutched my bags tighter.

I cant throw them out, I said. The doctor gave them to me. I mean he prescribed them. The nun opened her mouth. She stared at me incredulously. Then she closed her mouth.

Youre planning to steal something, she said at last.

No! I said.

Those bags wont be empty when you leave, she said. Because youre going to steal something to put in them.

No way, I said.

Im right, arent I?

No.

What are you going to steal?

I didnt know how to respond.

Three items, mused the nun. Three items smaller than a paper lunch bag...

They arent lunch bags, I insisted. Theyre medical bags.

She ignored this.

When you leave today, she said, stepping aside, still holding the door open, come this way. I want to see you before you try to leave.

She made a brushing motion with her free hand, moving me along.

I walked through the door.

Actually, she snapped at the last second, dont come this way when you leave. Dont come through here again.

The door swung shut. I looked down at the bags, clutched in my sweating hand.

They were wet. They were soaking wet.

I went into the first bathroom I saw and tried to dry out one of the bags under a hand dryer.

Dry, I thought. Dry, you bastard.

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The Anatomy of Panic, by Michael W. Clune - Harper's Magazine