The call came at 3:47 a.m. on a Friday morning while I was sitting alone in my home office, reading through surgical schedules for the upcoming week. The house was quiet in the particular way only a house at that hour can be quiet, with the refrigerator humming in the kitchen and the soft ticking of an old brass clock on the bookshelf behind me sounding louder than it ever did during the day. I remember the exact minute because I looked at the phone before answering and felt my chest tighten the instant I saw the name on the screen. Ethan. My son was twenty-two years old, a graduate student at State University three hours away, and he never called me in the middle of the night unless something was seriously wrong. Ethan was many things—bright, independent, stubborn in the way young men often are when they are trying to prove to the world they can manage on their own—but he was not dramatic, and he was not the sort of person who reached for help lightly. By the time I swiped the screen to answer, some primitive part of my brain already knew the night had just split into a before and an after.