Painful Quandary double trigger
I played a game where my opponent cast Painful Quandary, I targeted it with a spell to remove it, then I was hit with two triggers of Painful Quandary bringing me to 10 life (I don't see how else I could have lost that life, it was the first spell I cast that turn)
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Rezzahan#77802
commented
Were there two triggers? You can easily tell by two instances being put on the stack, if so. But my personal guess is, that you cast your spell on your opponent's turn, and they had a Bloodletter of Aclazotz on the field.