Springer was suddenly overcome with fatigue. Talking with Pia Grazdani was frustrating, and he had more people he was going to have to deal with that afternoon who were going to be even more of a burden. There would be the inevitable press and the patients’ families. It was not going to be a good day, since ultimately, it was the patients he cared about.

“Do you think perhaps there could have been yet another bacteria involved besides salmonella, a bacteria or a virus that was being covered or camouflaged by the salmonella? And maybe it was this bacteria that was totally resistant to chloramphenicol and was the real killer?”

There was silence while Springer tried to control his anger. This was simply too much. His eyes drilled into Pia’s while she maintained her composure, waiting for an answer while looking down at her feet. Finally Springer exploded with bottled-up emotion.

“I cannot, for the life of me, imagine a more ridiculous scenario. We made the diagnosis by fulfilling Koch’s hypothesis. The illness was caused by salmonella, whose presence we ascertained in multiple ways, but most convincingly from blood culture. We classified the strain in multiple ways as well, particularly by DNA analysis. The offending organism was, without an ounce of doubt, the alpha strain of salmonella typhi that Rothman himself had had grown in space with the cooperation of NASA. There was no other pathogen, for Christ’s sake. The blood cultures only grew out the salmonella. Nothing else! Nothing at all!”

Undaunted, Pia changed the subject on a dime. “What about the hair loss? Does serious salmonella infection cause hair loss?”

Springer was having difficulty controlling himself, yet the woman seemed completely calm. “The stress of almost any severe illness, particularly one presenting with high fever, can cause hair loss. Anyway, what hair loss are you talking about?”

“I saw hair loss with Rothman before I discovered the rebound tenderness. The resident suggested it could be attributed to the chloramphenicol.”

“That’s not something I am aware of,” he said. And then, suddenly and angrily, “Oh, for God’s sake. You wait here!”

Springer bounded out of his desk chair, pushed past Pia, and disappeared. Pia stood in the room and waited. Within a few minutes, Springer reappeared and sat down, giving Pia a nasty look. Thinking she had probably maximized what she was going to get out of the conversation, Pia eyed the door.

“I told you to wait,” Springer said. “Stay there!” Confused, Pia did as she was told. There was silence except for Springer’s labored breathing. The man’s boiling, she thought. I’m not getting anywhere. Pia eyed the door again.

“Dr. Springer, I sincerely thank you for your time.”

“Stay where you are!” Springer said brusquely.

Pia rolled her eyes, confused. First he can’t wait to get rid of me, now he wants me to stay. . . . Then, bursting through the door came Dr. Helen Bourse, dean of students.