It's a cold winter evening. The ER is chaotic, but your focus narrows to Tyler, a 19-year-old male who looks pale, toxic, and exhausted.

“What brought you to the hospital today, Tyler?” you ask. He opens his mouth to speak, but no sound comes out—he seems to have completely lost his voice. Looking panicked, he turns to his mother standing nervously by his bedside.

“He’s had a terrible sore throat and fever for over a week,” she explains on his behalf, wringing her hands. “But today he started coughing up foul-smelling brown stuff, and he says...” She pauses, her voice trembling slightly.

Tyler weakly gestures toward the right side of his chest with a pained expression.

“...and he says his chest hurts really bad,” his mother finishes. “I don't know what is happening...” she adds, worried. “Can this be smoke-related?”