The first sentence introduces what will be a key symbol throughout Fever Dream. Guiding Amanda through her memories, David says, “We’re looking for worms, something very much like worms, and the exact moment when they touch your body for the first time” (52). By “worms” he is referring to Amanda’s first contact with the poison. As a symbol, the worms bring to mind death, decay, and decomposition. They reflect how the poison eats away at Amanda’s body and slowly kills her. Furthermore, worms come from the natural world, indicating the danger that Amanda faces in the environment. Discussing the toxin as worms instead of describing the poison outright adds to the novel’s mystery. However, this obfuscation also reflects the hidden nature of the threat. Although the effects of pollution can be seen everywhere—in the dead animals, strange sicknesses, and frequent congenital disabilities—the residents of the town don’t address the problem directly. As Carla says, “People come down with things all the time” in the country (95-96), but the cause is never mentioned.