“Okay, ceftriaxone . . .” she said. “. . . And the hair loss . . . Right, of course we’ll stop the chloramphenicol.... Okay. I’ll see you soon, and I’ll call Dr. Miller.”

Dr. De Silva turned and saw Pia. She hung up the phone and redialed immediately. She covered the receiver with her left hand and talked to Pia as the phone rang.

“Dr. Springer’s on his way in. He wants to check the rebound tenderness for himself—Oh, hello. I need Dr. Miller. . . . Dr. Miller, this is Dr. De Silva in Infectious Diseases. I’m treating Dr. Rothman and Dr. Yamamoto. Dr. Springer would like a consult. We’re seeing rebound tenderness in Dr. Rothman and may have to remove the infected bowel.... No, just Dr. Rothman at the moment . . . His temperature is up slightly. Other levels—blood pressure, pulse, oxygenation—are the same. Okay, thanks.”

Dr. De Silva hung up the phone and exhaled. She was a small woman of Sri Lankan descent who prided herself on running a tight ship. She was embarrassed that a medical student had picked up an important sign that she’d missed. “I just checked him a few minutes before you two showed up. Temperature was holding steady,” she said, half to Pia, half to herself. She turned to Pia.

“It can come on very quickly. Dr. Miller, the chief surgical resident, is coming in. And Dr. Springer’s on his way over. So, who’s your preceptor? I should at least give you credit for what you found. And how did you know what to look for? I’m impressed.”

“Actually I’m not on internal medicine at the moment.”

“Are you on an infectious disease elective? If you are, I haven’t heard your name.”

“I’m not on an infectious disease elective either.”

George was desperately trying to get Pia to shut up. Out of Dr. De Silva’s line of sight he was frantically making a time-out gesture like a football official.

“Well, what brought you here?” Dr. De Silva asked.

“I just happen to know a lot about salmonella.”

“Really? From whom?”

“Dr. Rothman,” Pia said, as George grabbed her arm and literally pulled her away, angling her toward the elevators.

George felt a sense of relief as they left the hospital. With as busy as Dr. De Silva was, he hoped she wouldn’t say too much about the two mysterious med students, one of whom had been very helpful. Actually he doubted she would. He knew that there hadn’t been any negligence on Dr. De Silva’s part, but he knew that in the competitive atmosphere of the academic center, she was probably chagrined that she’d been, in a fashion, upstaged by a medical student. Pia had detected the change in Dr. Rothman’s condition before she did. But George’s relief was short-lived.