aspect of the project. You will not be permitted to ask work-specific questions.â
Crane wheeled back. âYou canâtââ he began. Then he stopped, forcing down anger with effort. Whoever this Korolis was, he clearly wielded authority. Or thought he did. Why all this need for secrecy, Crane wondered, at a scientific establishment?
Then he paused, reminding himself he was the newcomer here. He didnât yet know the rulesâovert or covert. It seemed likely this was a battle he couldnât win. But heâd sure as hell bring it up with Asher later. For the moment, heâd just have to diagnose this patient as best he could.
He stepped back into the hospital room. Dr. Bishop was still beside the bed, her expression studiously neutral.
âIâm sorry for the interruption, Ms. Philips,â Crane said. âLetâs proceed.â
Over the next fifteen minutes, he performed a detailed physical and neurological examination. Gradually, he forgot the watchful presence of Commander Korolis as he grew absorbed in the womanâs condition.
It was an intriguing case. The bilateral weakness to both the upper and lower facial muscles was marked. When tested for pinprick sensation, the woman demonstrated significant impairment in the trigeminal distribution. Neck flexion was intact, as was neck extension. But he noticed that the sensation of temperature was greatly reduced across both the neck and upper trunk. There was alsoâsurprisinglyânoticeable, and apparently quite recent, wasting of the hand muscles. As he checked the deep tendon reflexes, then the plantar responses, a suspicion began to take root in his mind.
Every physician dreams of stumbling across a particularly rare or interesting case, the kind one reads about in the medical literature. It rarely happened. And yet, in all observations so far, Mary Philips was presenting with precisely such a condition. And Crane, who often stayed up late catching up on medical journals, thought perhapsâjust perhapsâhe had just identified such a case.
Maybe there is a special reason Iâm here, after all
.
On a hunch, he examined her tonsils: markedly large, yellowish, and lobulated.
Very interesting.
Thanking the woman for her patience, he stepped away, picked up the clipboard, and glanced at the blood work:
White-cell count (per mm)
3,100
Hematocrit (%)
34.6
Platelet count (per mm)
104,000
Glucose (mg/dl)
79
Triglycerides (mg/dl)
119
Erythrocyte sedimentation rate (mm/hr)
48.21
He withdrew to speak with Dr. Bishop. âWhat do you think?â he asked.
âI was hoping you could tell me,â she replied. âYouâre the expert.â
âIâm no expert. Just a fellow doctor looking for a little cooperation.â
Bishop simply looked back at him. Crane felt the anger returning, stronger now: anger at all the inexplicable secrecy, anger at the meddling Commander Korolis, and particularly anger at the unhelpful, resentful Dr. Bishop. Heâd take her down a peg, show her how much he
did
know.
He closed the clipboard sharply. âDid you think to do any antibody tests, Doctor?â
She nodded. âViral hepatitis A and C, sulfatide IgM. All negative.â
âMotor-conduction studies?â
âNormal bilaterally.â
âRheumatoid factor?â
âPositive. Eighty-eight units per milliliter.â
Crane paused. These were, in fact, the tests he would have performed next.
âThere was no history of arthralgia, anorexia, or Raynaudâs phenomenon, for that matter,â she offered.
Crane looked at her in surprise. It wasnât possible the same exotic conclusion had occurred to her as well. Was it?
He decided to call her bluff. âThe incipient wasting of the hand muscles would seem to suggest syringomyelia. So would the loss of sensation in the upper trunk.â
âBut thereâs an absence of leg stiffiness,â she replied immediately, âand
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