all security!" the emergency room physician ordered a nearby nurse. "I'm not about to wrestle with a 17-year-old autistic boy."

Within seconds, doors swung open and three bouncer-size men in dark uniforms and beige surgical gloves appeared, ready to pounce on my son.

"Let him walk," I said, knowing the guards would make a bad situation worse. They backed off. It was 4 a.m., and my husband and I had spent the last 17 hours watching helplessly as Jonah, the eldest of my three children, bruised and bloodied himself by hurling his thin body to the ground.

"Unexplained panic" was how we described his behavior to those at the hospital sign-in desk. He showed them what we meant by belly-flopping onto the scuffed emergency room floor, flailing, writhing and resisting everyone's confused attempts to help him to his feet.

Frantic 24-hour days were common in our home, but this was different. No longer a boy we could distract or redirect, Jonah was on the brink of manhood, with all the strength and size that implies. "You need to get up, J-man," I whispered. "We'll walk," I promised, even though we had been instructed to sit in the waiting area.

An unshaven, red-eyed doctor in his 20's found us wandering the hallways, and introduced himself as "the fellow on call." The words "autism" and "anxiety" stood out in bold capital letters on the form on his clipboard. "What seems to be the problem?" he asked, without acknowledging my son.

His private demons, I wanted to say. Instead I explained how the spontaneous flick of some inaccessible internal switch caused my normally docile autistic son to go berserk every few months.

"Have there been changes in his medication?"

"None," I said.

"Does he seem to be in pain?"

I shook my head no, saddened by the reminder of my son's inability to express even the most basic discomfort.

"Is he allergic to anything?"

I said yes, and listed what we knew.

"Allergic," he wrote, another bold, capital A-word at the top of the page.

Jonah began lunging, impatient with the questions.

"He's too agitated for a physical exam," the fellow observed nervously.

"We need something to calm him, so he doesn't hurt himself, something we can administer ourselves," I said.

"Ativan," he said, writing it beside autism, anxiety and allergic.

I was handed a cup with small white pills. "It can take a while for the drug to kick in, if it works at all," the fellow cautioned, as we fed Jonah spoonfuls of drug- laced applesauce.

We would wait to see if the drug helped. My husband and I were sore, sleepless and feeling terribly alone, and although we were aching to sit, Jonah was compelled to move. The pulse in his neck was visible, outpacing the beeping monitors in nearby rooms. We walked in circles, past empty gurneys, people dozing and arriving shift workers. Some people smiled as they passed, but others seemed chagrined by two middle-age people holding hands with what appeared to be a normal teenage boy.

An hour later we returned to the emergency room, where an old magazine caught Jonah's eye. He sat as long as we allowed him to flip frenziedly through the already overworked pages. A nurse offered us coffee.

"No hot drinks around him," I said, "but thanks."

"Are you hungry?" she asked Jonah.

He was scanning an advertisement for Reese's peanut butter cups, banging the page with sluggish excitement.

"Let me bring him something," she insisted, then delivered cereal, milk and cookies.

"You're very nice," I said, searching in vain for a ID badge.

Jonah ate and continued to fade, his head tilting forward, cookie-laced saliva dribbling to his lap. Over the next hour he fought off sleep. Finally, I told the nurse that a car ride might help lull him. She paged the fellow and brought us a wet washcloth and towel. The fellow signed the chart, handed us a prescription and left before I could thank him.

As we gathered our belongings, the nurse approached us with a package of Reese's peanut butter cups. Jonah swiped drunkenly at her hand.

"This is for you," she said, giving him the candy. "I love chocolate, too."

My eyes stung. I glanced at the discharge sheet. Her name was Noreen. Her unexpected gift made our long night easier to bear.

We settled Jonah into a wheelchair, and by the time we reached our car, he was fast asleep.