The man’s agitation increased when the ambulance arrived at the hospital and backed up to the unloading bay. He began babbling to himself and looked around continually, as if he were a caged wild animal. The man barely allowed himself to be wheeled into the ER, where he was sequestered in a room separated from the main emergency area because his high fever suggested he might be infectious. But at that point the man had had enough, and he started to undo the buckle restraining him. When he was prevented from doing this, he let loose a rapid flow of angry Chinese. He wouldn’t let any of the nurses near him. It wasn’t until Pia stepped up to him from the periphery, where she had been standing, that the man calmed down a degree.

One of the nurses took pity on a shivering Pia and gave her a white coat to cover up her jogging outfit. The ER was air-conditioned to a temperature well below seventy degrees. The nurse also told Pia that a request for a Mandarin interpreter had been placed, but unfortunately the only one available was off duty and wouldn’t be arriving for perhaps an hour.

Pia was standing next to the man’s bed, keeping him relatively calm, when the head ER doctor on the shift entered. One of the nurses told Pia that he had been called in because of his standing order that he be notified whenever anything out of the ordinary occurred. In this case it was the communication problem. He had been briefed by the EMTs even before they made it to the hospital.

Pia did a double take. From her medical school experience back at Columbia in New York, she was accustomed to seeing harried ER doctors looking like something the cat dragged in. In her experience they were always beset with dark circles under their eyes, always dressed in soiled scrubs that looked as if they had been slept in, always sporting one or two days’ growth of a beard if they were male, and always with hair in a state suggesting they had just arrived in an open convertible if they were female. In the few minutes she’d been at the busy Boulder Memorial ER, Pia had already seen several doctors scurrying around who met this description.