“Let me try,” said Pia. She took the thermometer from Paul, showed it to the man, and put it in her own ear. She then let the man look at the display. After switching out the probe cover, all the time smiling at the man, she took his temperature. She was surprised. Just like her own temperature, the man’s had fallen to normal: 98.7 degrees.

“That’s incredible,” Pia said. His temperature had been 105. Such a precipitous drop called into question the veracity of the initial reading.

“Can you do a quick basic neurological exam?” Paul asked. He was as surprised as Pia about the apparent sudden dramatic fall in the victim’s core body temperature.

“I can try,” Pia said, not too sure of herself. She took the flashlight he offered and shone it in each of the runner’s eyes. The pupils constricted equally. She proceeded with a neurological exam, and although it was difficult to perform many of the basic tests because of the lack of communication, it seemed to Pia that his general brain function was normal. She was able to get the man to touch her finger with his finger and then touch his nose while Pia moved her finger into various locations. That tested cerebellar function. Whether he was oriented to time, place, and person was just a guess, but he seemed to be.

“I’m impressed with your technique,” Paul said with a smile. He was enjoying Pia’s company as well as her help with the difficult patient. He was surprised she was doing as well as she was without any residency experience. “I think you have demonstrated that there doesn’t seem to be any apparent neurological deficit. What about trying to get an EKG?”

With the runner far calmer than he had been since he’d awakened, Pia was able to attach the leads, and the patient left them in place. Paul turned on the machine, and it kicked out an entirely normal EKG.

“This is amazing,” Paul admitted. He studied the printout more closely. “Are you sure he was in total cardiac arrest when you came upon him? I don’t see any abnormalities.”

Pia shrugged. “I was reasonably sure he had no pulse, and he wasn’t breathing. So I’d have to say yes.”

“And you say you saw some hives on his arms?”

“I did.” She pointed to the man’s forearms.

“I don’t see any now,” Paul remarked, and Pia agreed. Whatever it was, it was now gone.

Paul motioned for the runner to take off his sweatshirt, but the man vociferously refused, shaking his head in the process.

“Okay,” Paul said. He wasn’t going to force the issue, at least not yet. He wanted, at a minimum, to listen to the man’s chest, but he decided to wait until the man was more amenable. “We need to take some blood,” said Paul. “Maybe I should do that.”

Pia glanced at him. The patient had not let Paul do anything. Why did he think he could draw blood, a far more invasive activity than taking a temperature or attaching EKG leads? “Maybe I should try.”