Contagion

11

NEW YORK CITY

“Mr. Lagenthorpe, can you hear me?” Dr. Doyle called to his patient. Donald Lagenthorpe was a thirty-eight-year-old African-American oil engineer who had a chronic problem with asthma. That morning, just after three A.M., he’d awakened with progressive difficulty breathing. His prescribed home remedies had not interrupted the attack, and he’d come into the emergency room of the Manhattan General at four. Dr. Doyle had been called at quarter to five after the usual emergency medications had had no effect.

Donald’s eyes blinked open. He hadn’t been sleeping, just trying to rest. The ordeal had been exhausting and frightening. The feeling of not being able to catch his breath was torture, and this episode had been the worst he’d ever experienced.

“How are you doing?” Dr. Doyle inquired. “I know what you have been through. You must be very tired.” Dr. Doyle was one of those rare physicians who were able to empathize with all his patients with a depth of understanding suggesting he suffered from all the same conditions.

Donald nodded his head, indicating that he was okay. He was breathing through a face mask that made conversation difficult.

“I want you to stay in the hospital for a few days,” Dr. Doyle said. “This was a difficult attack to break.”

Donald nodded again. No one had to tell him that.

“I want to keep you on the IV steroids for a little while longer,” Dr. Doyle explained.

Donald lifted the face mask off his face. “Couldn’t I get the steroids at home?” he suggested. As thankful as he was about the hospital’s having been there in his hour of need, he much preferred the idea of going home now that his breathing had returned to normal. At home he knew he could at least get some work done. As was always the case, this asthma attack had come at a particularly inconvenient time. He was supposed to go back to Texas the following week for more fieldwork.

“I know you don’t want to be in the hospital,” Dr. Doyle said. “I’d feel the same way. But I think it is best under the circumstances. We’ll get you out just as soon as possible. Not only do I want to continue giving you IV steroids, but I want you breathing humidified, clean, nonirritating air. I also want to follow your peak expiratory flow rate carefully. As I explained to you earlier, it is still not completely back to normal.”

“How many days do you estimate I’ll have to be in here?” Donald asked.

“I’m sure it will only be a couple,” Dr. Doyle said.

“I’ve got to go back to Texas,” Donald explained.

“Oh?” Dr. Doyle said. “When were you there last?”

“Just last week,” Donald said.

“Hmm,” Dr. Doyle said while he thought. “Were you exposed to anything abnormal while you were there?”

“Just Tex-Mex cuisine,” Donald said, managing a smile.

“You haven’t gotten any new pets or anything like that, have you?” Dr. Doyle asked. One of the difficulties of managing someone with chronic asthma was determining the factors responsible for triggering attacks. Frequently it was allergenic.

“My girlfriend got a new cat,” Donald said. “It has made me itch a bit the last few times I’ve been over there.”

“When was the last time?” Dr. Doyle asked.

“Last night,” Donald admitted. “But I was home just a little after eleven, and I felt fine. I didn’t have any trouble falling asleep.”

“We’ll have to look into it,” Dr. Doyle said. “Meanwhile I want you in the hospital. What do you say?”

“You’re the doctor,” Donald said reluctantly.

“Thank you,” Dr. Doyle said.