I knew that I was going to be facing trouble when I came around after the first seizure. This would have been around 2003 or 2004.

I was on a bike. My then husband and I, who had been married since 1994, were leaving after a several-day nightmare—what was supposed to be a vacation. I went on vacation because I had to, really. He knew I was self medicating—legally by the way, but as an RN, it would not be tolerated, and he would have reported me to the board out of spite if I hadn’t gone along with his wishes.

There was no TV in the rooms of the B&B we stayed at, which I didn’t mind. But without TV we had to talk. And he could talk a lot. It was more like interrogation, really. About my past relationships with other men. About where I was and what I had been doing. At home, it was odometer checks and other controlling behaviors, such as reading every email I sent or received. My ex was in control. He knew it. And I was the breadwinner. We had two children, and I was the only one who wanted out of the marriage. I was deeply depressed and trapped.

During this vacation, he asked one evening if he could share in some of the books I enjoyed. I recommended the short story “The Short, Happy Life of Francis Macomber.” It was the last story in the Hemingway short-story collection “The Snows of Kilimanjaro.” It involved the eventual shooting death of a cuckolded husband. He finished it, but it threw him into a rage. To him, this story was my way of making a mockery of him, since he was certain I was cheating on him. Since I never had, it didn’t occur to me that I shouldn’t choose this story. We fought about it, and the next morning, we were looking at about seven hours or so together for our trip home. I was sick with dread.

I ran my seven miles after taking about four pills of tramadol first thing after awakening. By breakfast I had taken another three. It was my drug of choice and considered safe and non-addictive at the time. I could obtain it easily, cheaply and legally over the Internet. I had gone in and out of withdrawal from it several times. I finally opted to stay on.

It did not make me feel high. It made me feel normal, functional. I ignored the warnings not to take more than four pills a day. It was a fine day. We were running late, but I was packed and ready to ride the six or seven miles to return the rented bikes and board our ferry. I was seated on the bike, not moving, thank God. And that’s the last thing I remember.

Witnesses tell me that I went blank and did not respond to questions. Then I apparently had a seizure—the kind commonly referred to as “grand mal,” but medically known as tonic clonic. They can and do kill. My ex and others did all they could to keep me safe, considering the circumstances, and they did it well. I only had bad bruising and cuts. But I was unaware of all this.

Such seizures are terrifying to watch. I have witnessed several. There is nothing to be done but protect the patient from injury. Afterward, I came to, fuzzily. It’s like slowly coming out of a dream, or drifting up from underwater. I just wanted to go home, but was not given that option. I was disoriented and could not answer all the first responders’ questions, although I knew I should. Worst of all was what to say. I had never had a seizure, and a primary seizure coming from a very healthy 35-year-old woman is alarming. I sat there in the ER either staring blankly or in tears.

I know tramadol does not show up in a routine urine tox screen. My CT and other results were normal. The physician felt that I needed to be airlifted to the mainland to be seen by a neurologist. After some discussion with my ex, he went out and told the physician the truth for me. I knew I never could have. To me it was OK to have secrets, but admitting to them just wasn’t done.

The physician was very kind. She said their job was not to judge me, and she never would. From there it was a quick discharge. We spent one more night on the island. My ex made the call to my parents, and I really don’t know what he told them. But I knew this was the beginning of the end of something. I didn’t know what.