Four minutes felt like forty. Daniel's convulsions showed no signs of stopping, and if anything, they seemed to be getting more intense. His muscles were locked so tight that Sarah was afraid something was going to snap. The groaning sound from his throat had gotten louder, more desperate, like he was trying to scream but couldn't.
And he was still burning up. Sarah had soaked a washcloth in cold water from the sink and was trying to cool his forehead, but the cloth dried out almost immediately. It was like his body was a furnace, burning through energy at an impossible rate.
What the hell did he take?
She'd searched his room before, looking for drugs to throw away, but she'd never found anything more serious than marijuana. Either he'd gotten very good at hiding his stash, or he'd moved on to something much more dangerous.
The sound of sirens echoed through the thin walls of their building, getting closer. Sarah had never been so grateful to hear anything in her life.
"They're here," she told the 911 operator.
"Good. Stay with your brother until they take over. You've done everything right."
Sarah wanted to laugh at that. Nothing about this situation was right. Nothing about their lives had been right since Mom died, leaving her to take care of a drug-addicted teenager while working two jobs just to keep them from getting evicted.
I should have seen this coming. I should have done something.
Heavy footsteps thundered up the stairs, and within seconds, two paramedics were crowding into the tiny bathroom. Sarah scrambled backward to give them room, still clutching her phone.
"Seventeen-year-old male, seizure activity for approximately..." the first paramedic, a middle-aged woman with graying hair, looked at her watch, "...twelve minutes now. Suspected drug overdose."
"Temperature?" asked her partner, a younger man who was already pulling equipment from their kit.
The woman pressed a digital thermometer to Daniel's forehead and frowned at the reading. "Jesus. 106.8. That can't be right." She tried again. "Still 106.8."
106.8? Sarah felt the blood drain from her face. She wasn't a doctor, but she knew that was dangerously high. Potentially fatal.
"We need to cool him down fast," the male paramedic said, pulling out IV equipment. "Suspected hyperthermia secondary to stimulant overdose. This seizure activity isn't stopping."
They worked with practiced efficiency, but Sarah could see the concern on their faces. This wasn't routine. Daniel's temperature was climbing—107.1 when they checked again—and his body was burning through fluids faster than they could replace them.
"What kind of drugs was he using?" the female paramedic asked as her partner struggled to find a vein in Daniel's dehydrated, convulsing arm.
"I don't know," Sarah said miserably. "I mean, I knew he was using something, but I never found anything. He hides it well."
"Any idea what he took today? How much?"
"No, I—" Sarah stopped. Something about today had been different. Daniel had been acting strange even before the seizure started. Not high-strange, but confused-strange. Like he didn't know where he was or who she was.
"He was acting weird this morning," she said slowly. "Not like he was high, but like he was... confused. Like he didn't recognize me at first."
The paramedics exchanged a look that made Sarah's stomach tighten.
"Possible adulterants in the supply," the woman muttered. "Or a bad batch. We're seeing more of that lately."
They managed to get an IV started, pumping cooled saline into Daniel's system while applying ice packs to his neck, armpits, and groin. His convulsions finally began to slow, but his temperature was still dangerously high.
"We need to get him to Metro General now," the male paramedic said. "This level of hyperthermia can cause permanent brain damage."
Brain damage. The words hit Sarah like a physical blow. She'd been so focused on keeping Daniel alive that she hadn't thought about what condition he might survive in.
They loaded him onto a stretcher, still unconscious but no longer convulsing. Sarah grabbed her purse and followed them out of the apartment, not bothering to lock the door behind her. There was nothing worth stealing anyway.
The ride to the hospital was a blur of sirens and medical terminology she didn't understand. The paramedics kept checking Daniel's vital signs and radioing ahead to the emergency room. His temperature had finally started to come down—105.6, then 105.1—but he was still unconscious and burning hot to the touch.
"Is he going to be okay?" Sarah asked, hating how small her voice sounded.
"We're doing everything we can," the female paramedic said, which wasn't really an answer.
Metro General's emergency room was a chaos of fluorescent lights and medical personnel. Daniel was rushed into a trauma bay while Sarah was directed to a waiting area that smelled of disinfectant and despair. She tried to follow him, but a nurse gently but firmly guided her to a plastic chair.
"The doctors need room to work," the nurse explained. "Someone will come talk to you as soon as we know more."
So Sarah sat in that plastic chair and waited. And waited. And waited.
The clock on the wall seemed to move backward. Other patients came and went—a man with a broken arm, a woman having an asthma attack, a drunk teenager who'd gotten into a fight. All of them were seen, treated, and discharged while Daniel remained behind the closed doors of the trauma bay.
This is my fault, Sarah thought for the hundredth time. I should have been watching him more closely. I should have found his stash and thrown it away. I should have made him get clean.
But how? She was barely keeping her own head above water, working eighty-hour weeks just to pay rent on their shitty apartment and buy enough food to keep them both from starving. When was she supposed to find time to stage an intervention for her drug-addicted brother?
Mom would have found a way.
The thought was like a knife between her ribs. Mom had always known how to handle Daniel, even when he was at his most difficult. She'd had infinite patience for his moods and problems, always believing that he would eventually straighten himself out.
But Mom was dead, and Sarah was just a nineteen-year-old girl who worked at a factory and a diner and came home too exhausted to deal with anyone else's problems. She'd failed Daniel just like she'd failed Mom by not being there when the mugger had pulled his gun.
I'm going to lose him too.
"Sarah Fischer?"
Sarah looked up to see a doctor approaching. He was young, maybe early thirties, with dark hair and the kind of serious expression that made her stomach drop.
"I'm Dr. Martinez," he said, sitting in the chair next to her. "I'm treating your brother."
"Is he—is he going to be okay?"
Dr. Martinez was quiet for a long moment, and Sarah felt her world start to collapse.
"Daniel's condition is... unusual," he said finally. "The good news is that we've managed to bring his temperature down to near-normal levels, and his seizure activity has stopped. He's stable for now."
"But?"
"But his brain activity is unlike anything we've seen before. The EEG is showing patterns that are..." He paused, clearly struggling to find the right words. "His neural activity is off the charts. His brain is working at what should be impossible levels."
Sarah stared at him. "What does that mean?"
"We're not entirely sure. Typically, when we see this kind of brain activity, it's associated with severe trauma or certain types of drug toxicity. But Daniel's scans don't show any structural damage, and his blood work is... complicated."
"Complicated how?"
Dr. Martinez pulled out a tablet and showed her a series of charts and graphs that meant nothing to her. "His metabolism is running at approximately three times normal speed. His brain is consuming glucose and oxygen at rates we typically only see in extreme stress situations, but sustained over hours rather than minutes."
"Is that why he had the fever?"
"Partly, yes. His brain was generating so much heat that his body's cooling mechanisms couldn't keep up. It's like his nervous system was overclocked, if you'll forgive the computer analogy."
Sarah didn't really understand the technical details, but the core message was clear: something was seriously wrong with Daniel's brain.
"Did the drugs cause this?" she asked.
"That's what we're trying to figure out. His blood work shows traces of several compounds we can't identify. Either he took something completely synthetic—designer drugs that aren't in our databases—or..."
"Or what?"
Dr. Martinez looked uncomfortable. "Or his body is producing chemicals we don't recognize. Which shouldn't be possible, but the alternative explanations don't make much more sense."
Sarah felt like she was drowning. "Can I see him?"
"Yes, but I need to prepare you for what you're going to see. Daniel is unconscious, and we're not sure when—or if—he'll wake up. His brain is working so hard that we've had to sedate him to prevent further seizures."