I don't know, I think it assumes a lot, to think the email was purely about the physical ailment itself? A person could have medical phobias, a relative who recently passed away after an ambulance trip to the ER, a traumatic experience or loss in the exact same ER, strong/recent fears of one's own mortality, pain which reminded a person of previous pain during a traumatic incident, all manner of things. I don't know rainbow's personal history well at all, but I would not second guess someone's email to their therapist where not much detail has been given, because I assume there might be a lot they haven't shared here. And sometimes we need support at times when we're distraught and we aren't even sure why! Just wanted to chime in and say that.