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A Piece of My Mind
September 8, 2004

In Memoriam

Author Affiliations

A Piece of My Mind Section Editor: Roxanne K. Young, Associate Editor.

JAMA. 2004;292(10):1153-1154. doi:10.1001/jama.292.10.1153

The cops bring her here after she collapses in Customs at O'Hare. They don't know much about her. She has only the one small bag, not even a change of clothes, just a 30-day visa from Nigeria, a one-way ticket from Lagos, and a dog-eared copy of the Koran. No, she hasn't said anything, the cops say. They seem bored, leave quickly.

In the ED, her temp is 105 but she is cold, her lips and fingers purple. Dopamine is running when the blood smear returns: no trophozoites or gametocytes but severe pancytopenia. And bacilli. Gram-positive bacilli. On the blood smear.