FORT WORTH, Texas -- At 2 a.m. on a muggy August day, a Cook Children’s Medical Center ambulance speeds down an otherwise deserted Airport Freeway.

Inside lies Ryan Sewell, a 16-year-old high-school junior, a lean and muscular kid and one of the most gifted young rock climbers in the nation.

Attached to a machine forcing air into his fluid-filled lungs and internally cooking with a body temperature close to 104 degrees, Ryan is edging closer to death, even with the intervention of a team of doctors and nurses.

And no one knows why.

Ryan, a junior at Colleyville Heritage High School, has a plane

ticket to Quito, Ecuador, for Aug. 17 and the credentials to compete with the best climbers in the world in a cobblestoned colonial city named Ibarra.

In early July, he finished second in the nation in the 16- and 17-year-old class in a competition at Ann Arbor, Mich. Ecuador would be his third world championship competition in three years.

He scored a trip to Beijing in the summer of 2005 and to Austria in 2006. In the Austrian championships, he had ranked 19^th in the world and looked every bit like he would do better this year.

“He’s pretty much climbing at an adult level,” said his coach, Josh Haynes, a professional climber who lives in Arlington. “He’s only been climbing for four years, and since he started he’s never looked back.”

An elite rock climber who lives in an upper-middle-class subdivision in Colleyville is not quite as odd as it seems.

He competes in a style of rock climbing that is done indoors and is more about engineered difficulty and raw strength than it is about battling nature on the side of a sheer cliff. The indoor climbs are rarely higher than 60 feet.

“You have to be able to read the routes and problem-solve,” Haynes said. “You have to be strong enough to pull the moves. And there’s a mental game involved, too, of staying calm and staying with it. To be at his level, you have to be good at it all.”

In the emergency room

On Wednesday, Aug. 8, Ryan leaves Longmont, Colo., with a friend for an outdoor retailer show in Salt Lake City. He’d gone climbing in Colorado the first two days of the week, probably some of the best climbing he’d ever done, and at some of the highest altitudes, too—close to 12,000 feet.

But this morning, he doesn’t feel well enough to eat before they get into the car and take off.

As the nine-hour drive wears on, Ryan sleeps in the back seat, an exhaustion coming over him that he’s never felt before.

He goes straight to bed at the hotel in Salt Lake City and sleeps all the way through Thursday afternoon. He finally calls his dad, Bob Sewell, a general surgeon who practices in the Hurst-Euless-Bedford area.

“Dad thought I was probably dehydrated, so he told me to drink some Gatorade,” Ryan said.

By Thursday night, Ryan is feeling worse, even after having consumed more than 3 liters of fluid. His dad orders him to go to the emergency room.

University Hospital admits Ryan with a 104-degree fever, lethargy and nausea. The doctors take chest X-rays and tell Ryan they look “strange.”

“The doctor told me that it looked like he had cystic fibrosis,” said Bob Sewell, who is talking to the doctors in Utah.  “I said: ‘There’s no way he has cystic fibrosis. He is in unbelievable physical condition.”’

On Friday morning, Bob Sewell grows alarmed enough at his son’s condition that he wants him home. He has his son sign the hospital’s waiver and asks Ryan’s coach to take him to the airport and put him on the 1:05 p.m. flight to Dallas/Fort Worth Airport.

“When I saw him, he looked like he had the flu, but he was walking,” his dad said.

They immediately drive to Harris Methodist H.E.B. Hospital.

A tick and a mouse

When Ryan finished with the nationals in early July, his mom drove him and some friends to the Red River Gorge, a famous climbing area near Lexington, Ky., for a few days of fun.

One day while the boys were hiking through the woods, Ryan noticed a tick on his calf. A friend pulled it off, and everyone made a joke about Lyme disease, but no one gave it much more thought.

A couple of weeks later, Ryan drove to Boulder, Colo., to train with some of the best climbers in the nation. When he left Boulder, he and a friend detoured to Rifle Mountain State Park, not far from Grand Junction in the far reaches of western Colorado.

One evening eating dinner around the campsite, it started to rain. Ryan and his friend gathered up all the food and sat in the car to finish.

“I look down at my feet, and there’s a mouse,” Ryan said. The boys, after much effort, finally got the mouse out of the car.

It made a funny story when he gets home to Colleyville.

Struggling to survive

It’s Friday night, Aug. 10, and Ryan is slipping from bad to worse.

His temperature spikes to 104.9, and it appears to the doctors that he is developing sepsis, a life-threatening problem probably created by his body’s overwhelming immune response.

His breathing is more labored, and the chest X-rays reveal that the fluid is quickly building up in his lungs.

His lungs look twice as bad as they did just 24 hours before in Salt Lake City.

“All over his lungs, it was cloudy,” his father said.

Ryan, who still has enough energy to protest what he believes is

an overreaction, is admitted into the intensive care unit.

His condition worsens throughout Saturday, and it becomes obvious that the oxygen hose under his nose is no longer adequate.  Ryan can’t get enough air, and he is struggling severely.

“I’m fighting to stay alive,” he tells his parents.

His father makes the decision to have Ryan intubated Saturday

evening, so a ventilator will force air into his lungs. Ryan is frightened, but not nearly as much as his mom and dad.

“I totally panicked,” Donna Sewell said of the decision. “To me, it was like the end is near.”

Ryan’s dad calls Haynes, Ryan’s coach, in Salt Lake City at the retailer show to give him the news.

“It hit me hard,” Haynes said. “I walked around and gathered his friends. We stood in a circle and said a prayer.”

In the middle of the night, Ryan is transferred to Cook Children’s, where everyone agrees that the expertise in the intensive care unit is better suited for his age.

About 3 a.m., Dr. Britt Nelson calls and wakes Dr. Donald Murphey, a pediatric infectious-disease specialist, and informs him of Ryan.

“We talked about what might be wrong and which antibiotics would be called for,” Murphey said.

So far, Ryan has not responded to antibiotics, including several “big gun” drugs. That convinces everyone that the pneumonia is viral, not bacterial.

Still, they keep pushing antibiotics until they know more.

Doctors at Harris H.E.B. had sent Ryan’s blood to a lab for a

dozen or more possible explanations—Rocky Mountain spotted fever, West Nile virus, Legionnaires’ disease, Lyme disease, Q fever, tuberculosis, adenovirus, hantavirus and more.

“As long as it’s not the hantavirus, we’ll be OK,” Bob tells Donna.

‘As sick as you can be’

Ryan is all but drowning in his own fluids. The nurses at Cook Children’s drain more than 6 liters of fluid out of the pleural cavity, a small space that encloses the lungs. And more seems to come.

Ryan’s kidneys begin to shut down. His blood pressure keeps falling. He needs blood transfusions.

“His chest X-rays got worse until it was essentially a whiteout,” Bob Sewell said.

Murphey’s patient is, in medical terms, “critically ill.”

“He was as sick as you can be and still be alive,” Murphey

said.

On Monday, Murphey talks to Ryan’s parents about using the extracorporeal membrane oxygenation machine, a last-ditch measure to keep the heart and lungs going outside the body.

“That’s not a good sign,” he said.

Bob Sewell finds himself breaking down. He knows too much of

what is going on medically. This scares Donna Sewell even more.

Ryan’s mom looks stricken and exhausted to the dozens of relatives and friends who pour into the hospital to check on Ryan.  She begins to think that she will lose him.

“I have great faith, and I knew he was in God’s hands,” she said. “But just because I was praying for God not to take him, it didn’t mean I would get what I wanted. I knew we could lose him.”

To what, no one is sure.

A diagnosis

For the first time, on the morning of Tuesday, Aug. 14, Ryan doesn’t seem to be getting worse.

That alone is viewed as progress.

A few hours later, Murphey finally receives the faxed lab report

from Ryan’s blood drawn at Harris H.E.B.

There it is, big as day—the hantavirus. Ryan’s body is crawling with antibodies specific to the hantavirus.

“We had never seen a case here,” Murphey said. “My colleagues at Children’s in Dallas have never seen it before.”

No wonder the antibiotics hadn’t done any good. As with most viruses, there is no drug treatment. The body must win, if it can, by itself.

The hospital and the ICU staff continue helping with oxygen, nutrition, blood pressure medication and chest drains. But these are supportive measures only.

The lab report excites Murphey, even though Ryan remains in critical condition.

“There are lots of times you never get an answer for why someone is so sick,” he said.

Bob Sewell is relieved to finally know, too. “At least we had the diagnosis,” he said. “We knew the name of the devil.”

Donna Sewell, though, is devastated. She feels nothing but raw fear.

All she can remember is what her husband told her a few days ago

“As long as it’s not the hantavirus, we’ll be OK.”

Back on his feet

Ryan walked out of the hospital Monday, Aug. 20.

He was thinner and weaker, but he insisted on walking out. His father took a photo of the moment with his phone.

His youth and his peak physical condition probably made a difference. His parents certainly believe that Drs. Murphey, Nelson and Karen Schultz and the nurses at Cook Children’s did. They can’t get over how well they were treated at the hospital.

Still, they have to believe that it was more than that.

“We’re convinced this was a divine intervention,” Bob Sewell

said. “To see how sick he was and how fast he got better was an answer to a lot of people’s prayers.”

On looking back, it is apparent that Ryan turned a corner the day the lab work came back with the hantavirus diagnosis.

Nothing much changed as far as his medical treatment, but his body was starting to beat back the disease. He left the ICU on Friday, then the hospital the next Monday.

“It’s really remarkable to see someone get so sick so quickly, and then get better so quickly,” Murphey said. “But that’s what happens with hantavirus.”

Ryan stayed out of school last week, not because he’s contagious but because he’s so weak. It may take him a few months to regain his physical conditioning, though neither his doctor or his coach is worried about long-term consequences.

“He looks amazing,” Haynes said. “You can tell from his body language that something bad happened, but his humor is good, and his attitude is like nothing happened.”