Every eye in the room is on me now. Naima's cool assessment, Jonah's sympathetic wince, Harper's barely concealed amusement, and Sebastian's penetrating stare that seems to see right through me.
"No need," I say, straightening my shoulders and meeting his gaze directly. "Thirty-two-year-old male, unexplained seizures, respiratory distress. I've got it."
Sebastian's eyebrow lifts slightly, the only indication that he's surprised I caught that much. "Good. I expect a preliminary differential by this afternoon."
Relief floods through me that I managed to grasp enough details to not completely humiliate myself. As Sebastian moves on to the next case, I force myself to focus, taking detailed notes and asking relevant questions. By the end of the meeting, I've almost convinced myself that I've recovered from my momentary lapse.
Almost.
"Well, partner," Harper says as we gather our materials after the meeting. "Shall we go meet our patient?"
I nod, grateful for the chance to throw myself into work and away from my inappropriate thoughts about Sebastian. "Lead the way."
Marcus Ellis lies propped up in his hospital bed, his skin carrying the gray undertone of someone whose body is fighting a losing battle. He's thirty-two but looks older, exhaustion etching lines around his eyes and mouth. As Harper reviews the chart at the foot of the bed, I notice Marcus's phone on the bedside table. Its lock screen shows a gap-toothed little girl with pigtails, maybe five years old. Must be his daughter. I see the way his eyes keep drifting to the photo, and something twists in my chest, a feeling I know too well.
"Mr. Ellis, I'm Dr. Phillips and this is Dr. Langston," I say, stepping closer to the bed. "We're going to be taking over your case. Can you tell us how you're feeling today?"
"Like shit," he says, then offers a tired smile. "Sorry. Not your fault. The breathing's worse today. Feels like someone's sitting on my chest."
Harper continues his review of the chart with the detached efficiency that seems to be his trademark, barely looking upas he asks, "Any changes to the seizure activity? Frequency or duration?"
"Had one this morning," Marcus says, his fingers fidgeting with the edge of his blanket. "The nurse said it lasted about two minutes. I don't remember it, just waking up afterward feeling like I'd been hit by a truck."
I reach for my stethoscope, moving to the side of the bed. "Mind if I listen to your lungs?"
He nods, sitting forward slightly as I place the cool metal against his back. The raspy crackle I hear isn't promising; fluid’s building up where it shouldn't be. This isn't good.
"Any other symptoms you've noticed?" I ask, moving the stethoscope to different points on his back. "Anything new, even if it seems unrelated?"
"My hands shake sometimes," he says. "And I get these headaches that make it hard to see. That's why I had to call my sister to take Emma for a while. Couldn't trust myself to take care of her properly, you know?"
The mention of his daughter makes his voice crack slightly. I know that tone, the fear of a parent who might not be there for their child. Dad had the same tremor in his voice when he finally admitted he needed to go to the hospital, when he looked at me and said, "I don't think I can fix this one, Mimi."
Pushing the memory away, I force myself to focus on the present. "We're going to run some additional tests," I tell Marcus. "And adjust your medication to help with the breathing. Dr. Langston and I will be monitoring you closely."
Harper and I step out into the hallway to discuss our approach. His assessment is all science and no soul as he rattles off potential diagnoses.
"The fluid in his lungs has increased since yesterday's X-ray," I point out. "And the tremors in his extremities suggestperipheral nervous system involvement too. What about an atypical presentation of Guillain-Barré?"
Harper gives me a look that's just short of an eye-roll. "Guillain-Barré doesn't typically present with seizures."
"I said atypical," I counter. "And we should test for mycoplasma pneumonia. The respiratory symptoms could be primary, with the neurological symptoms secondary to—"
My argument is cut short by the sharp wail of a monitor alarm from Marcus's room. We both whip around, rushing back through the door to find him gasping for breath. The oxygen saturation monitor plummets as his lips take on a bluish tinge.
"Get a crash cart in here," Harper shouts to a nurse passing by.
I'm already at Marcus's side, elevating the head of his bed further as he struggles to breathe. "Mr. Ellis—Marcus—try to stay calm. We're going to help you."
His eyes are wide with panic, his fingers clutching at the front of his hospital gown. The monitor shows his heart rate spiking and his oxygen levels dropping dangerously low. A nurse rushes in with the crash cart as another calls a code over the intercom.
"Let's get him intubated," I say, already reaching for the laryngoscope. "His airway's compromised."
Harper moves to the other side of the bed as we work in tandem, the choreographed urgency of emergency medicine taking over. The room fills with medical staff—a respiratory therapist, more nurses, and an anesthesiologist who takes over the intubation as I step back to assess what else might be happening.
That's when Marcus's body goes rigid, his back arches off the bed in a seizure more violent than any documented in his chart.
"He's seizing!" I call out.
