BOUT WITH PLAGUE PUT A MAN ON THE BRINK
07 Feb 2003
Source: New York Times, February 7, 2003
Bout With Plague Put a Man on the Brink, and New York on Edge
By ANTHONY DePALMA
John Tull raised his right arm the other day. Nurses cheered. It was a big deal.
Mr. Tull's corner of the intensive-care unit at Beth Israel Medical Center has been keeping the staff members entertained quite a bit lately. Mr. Tull — variously known as J.H.T., the Tullster or just plain Tull — has wowed them with his tenacious fight against plague, a word still so scary that the mere mention of it cleared half a million people out of a city in India in 1994.
Plague has claimed more than 30 million lives through its black history. It seemed eager to claim two more in November, when city officials said that Mr. Tull, 53, and his wife, Lucinda Marker, 47, probably had the first cases of bubonic plague in New York City in 100 years.
"My theory is that if my jig is up there's nothing I can do, but this obviously wasn't my time," Mr. Tull said yesterday in his first public comments since being hospitalized.
He is not overly religious, but considers his survival a miracle. He has learned patience, he said, and intends to live his life with what he calls "aggressive hopefulness."
There was not much hope back in early November, when Mr. Tull and Ms. Marker were hospitalized. With modern antibiotics, Ms. Marker soon returned to good health.
But within a day of being admitted, Mr. Tull became so sick that he was given no more than a 10 percent chance of surviving; he was "a wreck," according to one doctor.
Plague had caused an infection that spread quickly through Mr. Tull's body, weakening his liver and shutting down his kidneys and lungs. His circulatory system went haywire. Clots formed too rapidly in his feet and toes; he hemorrhaged elsewhere.
All that from the unnoticed bite of an infected flea he had probably picked up while hiking on his five-acre spread on the outskirts of Santa Fe, N.M.
Mr. Tull had to be put on life support and sedated into unconsciousness. In the end, extreme measures had to be taken.
His wife remained by his side every day for almost three months while he was unconscious, and dreaded the moment when he would awaken and she would have to explain what had happened.
"I planned to have doctors, therapists and psychologists with me when he woke up, but it didn't happen," Ms. Marker said. "The last thing he said to me before he had lost consciousness was, 'Rub my feet.' "
The clots in his feet had blocked circulation. Infection set in. Doctors feared that it would spread.
"When he came to, he couldn't speak, but he mouthed a few words that I understood," Ms. Marker said. "This time, too, he said, `Rub my feet.'
"I looked at him and told him he had been very, very ill," she continued. "That he'd been through a lot. I said that in order to save his life the doctors had to amputate." Doctors amputated from the middle of his shins down.
"He couldn't speak, but I could read his lips," Ms. Marker said. " 'What? My feet. That's unbelievable.' "
The Tullster was a big man when he arrived in New York on Nov. 1 for five days, a combination business trip and vacation. He was a curly-haired cyclist, cross-country skier and mountaineer who was having the time of his life. Just a few months before, he had quit his job as director of the Insurance Fraud Bureau of the New Mexico Department of Insurance so that he and his wife could start their own firm helping people manage their resources and their futures. He is a lawyer; she is a financial planner.
They celebrated with a big dinner and drinks at the Plaza Hotel. The following morning, both felt queasy. "We figured we overdid it," Ms. Marker said.
They had planned to watch the New York City Marathon but instead spent a miserable weekend fighting fevers and body aches. At one point in the hotel room, Mr. Tull said something that really upset Ms. Marker: "I hope we don't have the plague." She said she responded, "Don't be ridiculous."
They both knew plague the way New Yorkers know the flu. Northwestern New Mexico is one of just a few places in the United States where plague occurs naturally. Mr. Tull knew what he was up against when he decided to build his dream house outside Santa Fe a little over two years ago. He cleared all the brush from around the house. He kept his woodpile off the ground so that pack rats could not nest there. He kept Chica and Puck, his dogs, flea-free.
But last summer he found a dead pack rat in the backyard and notified the authorities. It tested positive for plague. Health officials put out hundreds of traps and found more fleas that carried the bacterium. Mr. Tull and Ms. Marker were told to be careful.
Lying in a bed that now seems far too big for him, Mr. Tull — who has lost 70 pounds and much of his muscle tone — said he knew of only one person in New Mexico who had ever gotten plague. "It was some hippie who invited a mangy old dog into his sleeping bag," he said.
He and his wife were careful, but somehow they were bitten — neither felt it — just before they left for New York. It can take up to six days for symptoms to develop.
In a jittery city, a city on edge, mentioning plague can cause an epidemic of fear. One New York television station ran a "Black Death" banner on the screen when reporting that two tourists had come down with bubonic plague. Health officials who had been primed by the anthrax scare of 2001 were concerned about bioterrorism, worrying that the couple with the disease were either the first two victims of an attack or, perhaps, terrorists who deliberately carried plague to New York.
Dr. Ronald J. Lis of Beth Israel was one of the first doctors to care for the couple. All possibilities had to be considered. When he remarked at an early staff meeting that this was a terrible thing to happen to a couple from New Mexico, a colleague interrupted. "Ron, don't be so naVve," the other doctor said.
Because Mr. Tull came from a place well known for having a few cases of plague each year, city health officials could pretty quickly rule out bioterrorism. But the thought that he had been considered a terrorist for even a minute strikes Mr. Tull as insanity.
"I'm just a lawyer from New Mexico who doesn't even know how to spell bioterrorism," he said.
Little by little, Mr. Tull has been regaining strength and mobility. He is already dreaming of his first solid meal (double cheeseburger with a side of Krispy Kreme doughnuts) and doctors say he might be able to go to a rehabilitation center in Albuquerque next week for physical therapy that could last six months or more.
Mr. Tull says he is not angry about what happened to his legs. How could he be when he is so glad just to be alive?
"I'm sorry that my feet are gone, but it's a challenge that's been given to me," he said. He says he cannot wait to get back to his house, his dogs, the magical New Mexico sky and a "grandbaby that's coming in three weeks."
Doctors have already made preparations for his new prosthetics. And he is eager to try them on. "As I understand it, prosthetics now are almost as good as real legs," he said.
Just before coming to New York in November, he and Ms. Marker climbed Deception Peak in the Sangre de Cristo Mountains — 12,000 feet, he reminded her. "My goal is to be able to do the same thing before the end of the summer," he said.
Ms. Marker, who must wear a surgical gown, mask and gloves while visiting her husband, smiled — you could see it in her eyes.