Ms. Gonzalez Gil, 18, is now a senior at the High School for Health Careers and Sciences in Manhattan. Taking tests gives her anxiety, she said, and she performs better in school with the help of individual coaching from her teachers.

The anxiety started at an early age. When she was 6, her 2-year-old brother, Devin, died. He had a neurodegenerative disorder that was so rare his doctors could not identify it, his parents said. It stunted his cognitive development and led to regular seizures, leaving him bedbound.

Over time her mother and stepfather had two more children, Seth, now 8, and Samuel, 4. Both developed the same complications Devin had. They need to be monitored at all times, in case they have seizures or their heart rates fluctuate. Backup oxygen canisters line the hallway in the family’s apartment in case a power failure causes the boys’ ventilators to turn off.

Ms. Gonzalez Gil tends to her brothers regularly — feeding them, talking to them, giving them medication. When she comes home from school, Ms. Gonzalez Gueits said, she drops her things in her room and immediately checks on them. Whenever new nurses work the night shift, she stays up to watch them and ensure they are fit for the job.

Her brothers’ health issues have undeniably shaped Ms. Gonzalez Gil’s life. “It’s sad to say, but the boys’ situation kind of trumps everything that we want to do,” Ms. Gonzalez Gueits said. “But she never resented them.” In fact, Ms. Gonzalez Gil said Seth and Samuel are her best friends. She looks to them for inspiration as she plans her next steps.

Read more in the New York Times.

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