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blinked, so I did get some reaction. I ordered a CT scan to rule out a brain tumor or hemorrhage.
    Her low-grade temperature could mean an infection, but she lacked the neck rigidity that was typical of meningitis. Her complaints about the heat and her nudity suggested possible heat intolerance due to an overactive thyroid, which the blood-screening tests would rule out. We needed a urine sample for a toxicology screen, but no way was she going to pee in a cup. She would have to be catheterized. To spare her the humiliation of two burly security guards holding her down, Judy shuffled us guys out of the room and enlisted the help of two female interns to catheterize her. She also drew blood for screening laboratory tests to make sure the patient didn’t have anemia, a thyroid disorder, or some other chemical imbalance that might be altering her mental state.
    As I waited for the lab results, I decided to take another stab at an interview. The guards and I walked back into room 6, and I could tell that Joe and Carl were looking forward to seeing me get nowhere again. I tried to be casual with the patient and offered her a cup of orange juice. She finally seemed to respond to me. She slowly raised her hand for the cup. She took a small sip at first, then quickly gulped it all down.
    “It looks like you were pretty thirsty,” I said. The staff smirked, anticipating yet another useless round of questions, but the patient’s demeanorseemed to change—her blank stare was replaced by an inquisitive look. She scanned the room; her body tensed; her brow furrowed.
    I felt like maybe we were getting somewhere, so I continued in my light tone, “Maybe we can talk now.”
    Ms. Doe suddenly sat straight up and became aware of her scant attire. She wrapped her hospital gown tightly around her body and asked, “Where am I? Who are you? What the hell?”
    I could sense that the team was impressed. I should have felt cocky that my astute, relentless, and well-timed interview skills had finally cracked this obstinate naked-lady case. I should have been proud that in my role as a psychiatrist, something I had said had actually gotten this delirious, mute woman to talk like a normal person. I mean, sure I had gone to school and read some books and aced some tests, but here I was in the real world, playing doctor, and I actually fixed somebody. Unfortunately, I had no idea what I had said that worked.
    The patient held out her cup and said, “More.”
    In an instant I realized it was nothing I’d said but something I’d done that got her to talk. More precisely, it was the orange juice. And that cup of OJ was also the key to what caused her bizarre behavior. Her blood sugar had obviously crashed, and she had been suffering from acute hypoglycemia.
    Responding to the patient’s anxiety about her skimpy hospital gown, I asked Judy to get her a pair of scrubs to put on and escorted the security guards out of the room while Judy helped her change. I returned with another cup of orange juice and sat in the chair next to her gurney while she drank it. She was calmer now.
    Again I told her I was Dr. Small and asked her about herself. Her name was Katie Genaro. She was nineteen and lived with her parents above their popular family bakery in the North End. She worked part-time as a waitress while taking acting classes and doing Equity theater whenever she could get a part.
    I moved the conversation along to find out more about the cause of her delirium. “Katie, do you have any medical illnesses?” I asked.
    “Why do you want to know?”
    “Because you were brought to the hospital tonight, delirious. You’d been walking in the street babbling, and you only just now came out of your delirium when you drank some orange juice.”
    “Shit. It’s my stupid diabetes again. I probably didn’t eat enough breakfast before taking my insulin shot.”
    “So this has happened before?”
    “Once or twice. I don’t always get my insulin right, so