While in Wellfleet, I learned two very valuable lessons. First, riding a bike is not always as easy as…well…riding a bike. That means it’s a wise choice to wear a helmet if you’re planning to soar down steep hills on sandy pavement. Unfortunately, I’m not so wise. Second, if you’re going to be strapped down on a stretcher and immobilized in a neck brace for several hours, think twice about chugging that second bottle of water before catapulting over your handlebars.

In my case, I was fortunate to suffer more dearly from the second miscalculation than from the first; by some lucky stroke of fate, my left cheekbone and right wrist took most of the impact, shielding my more tender brain matter from permanent breach. As a result, I survived what could have been a life-ending accident with a swollen face, a renewed sense of life’s (and death’s) urgent claim on my soul, and a very dire need to pee. The painful conundrum presented by this last outcome cannot be understated. Trust me: after you’ve beaten the Grim Reaper at a hand of poker, the last thing you want to do is wet yourself on the gurney.

For the record, I didn’t wet myself. I sure did worry about it, though. Never in my life has my bladder screamed so urgently. Politely, I complained first to the EMT, and then to the doctor who evaluated me, and then to the nurse who registered me, all while staring up at a white ceiling, trapped in the very narrow world of stretcher straps and neck braces.

“I understand I might have a spinal injury,” I told them. “But I really need to pee.”

The EMT was the most understanding. During our hour-long ride from Provincetown to Hyannis, he told me he had to pee, too. He and his partner had received the call just when he was about to step into the john, so he understood my pain. Unfortunately, his empathy ended as soon as he rolled me onto the hospital parking deck; gleefully he announced he could finally relieve himself. My own raging bladder would have to wait another two hours.

In the hospital, a nurse told me I could pee into a towel if necessary. I refused. Instead, I let myself panic about the endless minutes left until I would be freed from my trap and allowed to seek asylum in the nearest bathroom. After all, it’s much less maddening to fear the humiliation of soiled underwear than a bad spot on a CAT Scan. If pissing my pants was the worst I had to fear, then it meant I had successfully beaten the odds, won that poker hand, and fulfilled the promise I’d made to Jack when leaving for my ride. I would come home to him. For a while longer, he would enjoy that fundamental delusion so necessary for a child’s development: Mommy will never die.

When I was the age Jack is now, I almost died from the parasite that made its home in my gut. While I was too young to have any conscious concept of death, I have absolutely no doubt that I understood the weight of what I faced back then. The line between life and death is as palpable as any other door; I felt it open then, as I did in Cape Cod. When that door first opened all those years ago, the usual fantasies we all co-create (immortality, eternity) shattered, and I’ve been fleeing death like an escaped convict ever since. It’s been awhile since I saw the movie Final Destination, but its premise still haunts me. Is it really possible to cheat death? And if we do, does it come back to play another round again and again and again?

There are so many opportunities to die and not nearly enough to live. The lessons I learned from that first trip in an ambulance are still brewing like really rich tea. For now, while they steep, I’m concentrating on just one glorious fact: I get to pee.

On Friday, we’ll load up the car with two weeks worth of can’t-live-without essentials and head north to Wellfleet, Massachusetts for our annual Cape Cod pilgrimage. For me, a New Englander by birth, this trip is like returning home. For that reason, it’s always a tricky mix of heaven and hell: half Fountain of Youth serum, half poison.

Last year, the seven-hour drive morphed into a kind of psychological labor much more torturous than my physical delivery of Jack. Early in the trip, I began experiencing panic attacks so intense it felt like my psyche had been drawn and quartered. None of my usual coping mechanisms (yoga, deep breathing, talk therapy) made the smallest dent in my anxiety. My soul hurt. And unlike its physical counterpart, this psychological labor promised no visible end. I couldn’t even beg for an epidural.

A year (and much therapy) later, I finally understand the root of this hurt. To understand it, I’ve had to rewind to one of my earliest childhood traumas: a one-week cross-country trip to Colorado that forever altered the course of my life. When I was 2 ½ years old—the age Jack is now—my otherwise obsessive parents sold their house, packed all of their belongings in storage, and headed west for the fresh start they both desperately needed. They left on a Monday morning and by Saturday arrived back in New Hampshire, homeless, unshowered and crazy-drunk on coffee and fear. They’d spent exactly two hours in Colorado before my dad had swung the car around and headed back east.

If my parents had been able to successfully negotiate the emotional hurdles of that trip, perhaps Colorado could have become a kind of pristine Wellfleet for our family. Instead, my parents fled, and when they did, skewered every last hope and dream. Meanwhile, I returned to my birthplace gestating a parasite I’d picked up in a cup of truck-stop water; for the next year, I slipped in and out of hospitals, where I vomited little chunks of blood and wasted away to my infant weight. For both body and soul, that trip and its aftermath were violent assaults. Lately, Jon and I have become obsessed with Alan Ball’s most recent foray into the dark, True Blood, and whenever Sookie is showered by yet another blood bath, I flash to my toddler self screaming in a car.

Last year, I tried to vacation the way I envision Normal People vacation. I packed up my favorite belongings and in the company of my two favorite people (my husband and my son) headed to a beach I find beautiful and serene. On that soul-rending car ride, I discovered two truths. First, I am not Normal. I am still somewhat blood-covered, and it will likely take awhile yet to wash out all that red. Second (and herein lies my hope): that optimistic, joyful little girl who climbed into a car setting off for Colorado is not dead. She is alive and full and eagerly on standby—so much so, I regressed into her toddler psyche in that seven-hour car ride last year. I felt her desperation, her debilitating helplessness…her despair. I’ve never been very religious, but in feeling her pain, I suddenly understood what it means to feel forsaken by God. On that trip all those years ago, she gave up on life. Three decades later—trapped in the body of an adult, a mother—she wants a second chance.

I’m terrified of this year’s trip. Friday symbolizes both the first day of vacation and the first step back into hell. I’m terrified to feel the return of all that blood. And yet blood—gory and morbid and horrifying—is also the source of life. I want to live. I want that toddler girl to live. My parents never made it to Colorado, but my journey isn’t over. I carry vital tools in my suitcase, and my companions are good and true. One day—soon, I hope—I might just make it all the way to the heavenly side of Wellfleet.