“Pia Grazdani,” Pia said, not willing to rise to the obvious bait. “Beats me what’s wrong with him, but I’m telling you, as far as I was able to see, he was in full cardiopulmonary arrest when I found him. I thought about heat stroke because he felt so hot, with no perspiration. There was also a question of a seizure. I also thought of septic shock. But none of those goes along with the other thing I noticed: he had hives on his forearms, so maybe it was an allergic reaction of some sort.”

“Well, the best part is he seems to be doing quite well,” Paul said. “Let’s just run some tests on this fellow if we can.”

Paul then tried to talk to the man, but he stayed silent, glaring at Paul as if to dare him to come closer. Paul took an ear thermometer out of his pocket and found a cover for the probe. The only positive finding on the nascent chart was the elevated temperature.

“I just want to . . . wow, easy there, friend!” As Paul had lent over the man to take his temperature, the man angrily swatted Caldwell’s hand away.

“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?”