We wheeled into Trauma Two, one of St. Jude’s three identical resuscitation rooms. Nothing architecturally unique about this or any resuscitation bay I’ve ever seen; all big bland rooms filled with medical supplies, lights, X-ray viewing boxes, and, at times like these, people. The place swarmed. Some moved with purpose, others—the usual array of wide-eyed students and ER lookie-loos (staff who find any excuse to turn up whenever something exciting rolls in)—just milled about.

Swaddling her in the ambulance stretcher’s sheet, the two paramedics swung the patient over to the room’s stretcher. Lara Maxwell was oblivious to her new surroundings; her arms and legs never missed a beat of their syncopated contraction.

Anne Bailey, arguably the poster girl for hardened frumpy ER nurses the world over, was the nurse in charge. She had no time for the bustling crowd. “If you don’t serve a purpose, get out!” Anne shouted and, on cue, the room thinned. She turned to the other nurses. “Lucy, two IVs. Jan, get an oral airway into her. Tommy, you record, okay? And where are my vital signs?” Anne turned to me, her lower jaw working side to side as if chewing a gobstopper. “What meds do you want us to give, Ben?” Despite her businesslike tone, her eyes clouded with urgency.

Relieved as I was to see Anne in charge, the rare show of concern on her face concerned me. “Lorazepam 4 mg IV push, now,” I said, referring to the Valium-like drug we use for seizures. “Full lab panel including calcium, magnesium, and phosphate. ECG. Chest X-ray. Blood gas. Urine drug screen ASAP, and—”

The nurse cut in from bedside. “Pulse is 140, pressure 260 on 140, respiratory rate of 28, and temperature of 38.4.” There was a pause as she fiddled with the oxygen saturation probe that kept slipping off Lara’s jerking finger. “Oxygen saturation is sitting at 88 percent.”

Not a normal vital sign in the bunch. “Sugar?” I asked.

“Glucometer was normal at the scene,” the scrawny paramedic piped up.

Damn! Gone was the most rectifiable cause for a seizure: low blood sugar.

I edged closer to my patient. The mingled odors of vomit and urine assaulted me, forcing me to breathe through my mouth. Lara’s hair had fallen back from her face, and I could see beyond the strands of drool and blood. The flickering eyelids and gnashing jaw belonged to the face of a child, someone who had no business near after-hours clubs and their inevitable cache of designer drugs. I felt familiar stirrings. Fucking junk! I wanted to shout.

I glanced at the clock. Five minutes since arrival, twenty-five minute since onset, and the seizure showed no sign of lessening. The drool at her mouth had begun to bubble, and became a rich froth like an exploding soda pop can. Reaching for my stethoscope, my worry meter crept higher.