When Tim Piazza fell down the stairs drunk during a fraternity hazing at Beta Theta Pi at Penn State, his frat brothers did nothing to help until it was far too late. Caitlin Flanagan traces the harrowing story of Piazza’s 12 hours between life and death in The Atlantic, from the incident itself to the attitudes and policies that create perverse incentives not to seek medical attention for injured pledges.

Four of the brothers carry Tim up the stairs. By now he has somehow lost his jacket and tie, and his white shirt has ridden up, revealing a strange, dark bruise on his torso. This is from his lacerated spleen, which has begun spilling blood into his abdomen. The brothers put him on a couch, and Rizzo performs a sternum rub—a test for consciousness used by EMTs—but Tim does not respond. Another brother throws beer in his face, but he does not respond. Someone throws his shoes at him, hard. Someone lifts his arm and it falls back, deadweight, to his chest.

At this point, the brothers have performed a series of tests to determine whether Tim is merely drunk or seriously injured. He has failed all their tests. The next day, Tim’s father will ask the surgeon who delivers the terrible news of Tim’s prognosis whether the outcome would have been different if Tim had gotten help earlier, and the surgeon will say—unequivocally—that yes, it would have been different. That “earlier” is right now, while Tim is lying here, unresponsive to the sternum rub, the beer poured on him, the dropped arm.

Of course, the blame isn’t just on university or fraternity policy — it’s on the brothers themselves and their disregard for the young men they haze.

Even a full day after Tim died, some members were, amazingly, still focused on the consequences that could befall them. “Between you and me,” a member texted Young, “what are the chances the house gets shut down?”

“I think very high,” Young replied. “I just hope none of us get into any lawsuits.”

“You think they are going to sue?” asked the brother, to which Young responded in a way that is chilling and that reveals a sophisticated knowledge of how such events play out: “It depends if they want to go through with it, or just distance themselves from us all together.”

They can maintain this disregard because they know what happens next:

The grieving parents will appear on television. In their anger and sorrow, they will hope to press criminal charges. Usually they will also sue the fraternity, at which point they will discover how thoroughly these organizations have indemnified themselves against culpability in such deaths. The parents will try to turn their grief into meaningful purpose, but they will discover how intractable a system they are up against, and how draining the process of chipping away at it is. They will be worn down by the endless civil case that forces them to relive their son’s passing over and over. The ritual will begin to slow down, but then a brand-new pair of parents—filled with the energy and outrage of early grief—will emerge, and the cycle will begin again.

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