In summer 2017, shortly after releasing her album You Had Me At Goodbye, singer-songwriter Samantha Crain had three car accidents in three months.
The third left her bedridden for a year and a half, and with no feeling in her hands. She doubted she would ever be able to hold a guitar again.
"The loss of my hands left me in a really dark, dark space," says Crain. "I was really depressed and having panic attacks".
She likens the situation to a loss of identity. "Music is the way I deal with the world, the way I process the world, and I felt like everything was being taken away from me.
"I didn't know who I was outside of being a musician, and so there was this time of getting to know myself from scratch again.
"It was kind of like being like a child again."
Before the accidents, Crain was an acclaimed musician, known for her piercing, expressive vocals and profoundly personal lyrics.
A two-time winner of the Native American Music Award, the Choctaw singer defied categorisation, marrying folk music with the sounds of country rock and college indie, while touring with artists as diverse as Neutral Milk Hotel, Brandi Carlile and First Aid Kit.
She stresses she's not "an awful driver that goes recklessly all over the place". But even though she says she wasn't to blame for her crashes, she was left "in a really bad state financially" after having to pay for her medical treatment.
"So it put me in a really sort of debilitating spot in that way too, which is kind of crazy. I think Americans relate to that a lot - they're in a car wreck and then they're in debt for the rest of their life. It's insane."
As she began to rebuild her life mentally and physically, Crain's therapist encouraged her to keep a diary of her recovery.
Unable to hold a pen, she recorded the entries as voice memos on her phone. Over time, they became a comprehensive journal of her attempts to work out her identity, outside of "Samantha Crain the musician".
"I was dealing with a lot of past trauma and my childhood and then my early adulthood," she says. But there was also a "giddiness" to discovering new sides to her personality and shedding the anxieties that had plagued her in her 20s.
"I don't know if this is something that a lot of people do," she says by way of example, "but sometimes I'll be on a train and, all of a sudden, something really embarrassing I did 10 years ago pops up into my head.
"And my reaction is I hum a little tune, 'da d-da d-da da-daaa,' because I feel so uncomfortable all of a sudden. And that's basically because I've allowed myself to be vulnerable for like a split second.
"Now that I'm 33, I'm hoping to have less shame about myself, so that whenever I have one of those embarrassing memories, I'll just be able to laugh."
Eventually, with the aid of therapy and medicine, Crain began to regain some feeling in her hands. She tentatively picked up her acoustic guitar and tried some chords.
Within the first two or three attempts, a song poured out of her.
"I sat down at my kitchen table and, out of curiosity, I popped up one of those audio diaries and listened to some of the words and that's what this song spawned from. So it kind of came out of nowhere, but it was also being written for two and a half years, in a way."
Called An Echo, it's a sparse but urgent ballad that carries all the weight of the last three years, but ultimately conveys the freedom of starting anew.
Fittingly, the song was also a watershed moment in Crain's recovery. Having written An Echo, she resolved to get better so she could record it and put it on an album.
That album was released last week under the title A Small Death - an oxymoron representing Crain's realisation that "everything is always starting over again, all the time".
The title was lifted from a track called Joey, which taps into the album's main theme - the impermanence of life, and the tricks of memory.
"Was it ever real? / I don't even feel like that girl any more," sings Crain, as she reminisces with an old friend. "Was it ever me? / I don't even see through those eyes any more."
"There's plenty of moments in your life where you don't necessarily remember the event, but you remember a picture of it or a video," she explains.
"And that's how I felt, looking back on a lot of the things that I was writing about - I know it was me that lived through that, but I don't really remember it innately, I only remember the memory of it."
The ability to detach memories from the accompanying feelings is a sort of survival mechanism, she reckons.
"You can't walk around in a constant state of anxiety. There's that middle ground where you're resilient enough keep moving and be able to interact with the world in a normal way.
"I think if we were fully feeling the depths of our emotions for all the things that had happened in our life, all the time, we wouldn't be able to function."
That's why A Small Death feels like "a fever dream", she says. It's revisiting the past through the lens of a woman who has moved on and can feel hope again.
While the last few years have been characterised by inertia and hardship, Crain says her convalescence forced her to think differently about music.
"I got this sort of bonus round, this extra chance to make another record, so it deserved extra attention."
She's "never been more thoughtful" about the writing and recording process, producing the entire album by herself, and ensuring that every note and lyric earned their place.
"I've always operated in a creative sphere where I'd put [music] out and move on. With this record, I was really unpacking things like, 'OK, if I'm going to say something in a song, what do I really mean by that?' Or, from a production standpoint, 'If this song is going to have a certain instrument, what is that achieving?'"
That approach is apparent on Pastime - one of the album's standout tracks - which paints Crain's journey of self-discovery as a new romance.
"And with that feeling, you lose track of time - which is why we did monk-like chants in the background. I wanted the song to be trance-like almost. Like, 'Have I been listening to this song for 30 seconds or 30 minutes?'
"In the past, I don't think I would have taken that extra step to think, 'What's the feeling behind the song? And how can I emphasise that in the production?'"
When we speak, in early July, Crain explains that her recovery isn't complete. Her "pain is definitely manageable right now", but "I am still pretty nervous about what touring will actually end up looking like for me".
Zoom gigs and live-streams could be a solution, perhaps, but the singer says she craves interaction with a live audience.
"When you get people in a room, either someone in the audience is going to do something weird or I might get drunk and say something crazy."
A Small Death was originally due to come out on 1 May on Real Kind Records, a new label set up by British singer-songwriter Lucy Rose.
Rose fell in love with the songs after Crain sent her a work-in-progress demo, and calls it "one of the best albums I had heard in years, maybe ever".
Coronavirus prompted them to push the release back, in the hope that Crain might be able to play some gigs to promote the album when the lockdown eased.
"As it turns out, it really didn't matter - but I'm definitely ready for the catharsis to be completely finished," she says.