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her and her friends, pick her up at school, walk her down the aisle, solve her problems when she had any. He wanted her to know how much he loved her. He carefully folded the paper, slipped it into an envelope and placed it on the bedside tray where he took his meals. He did not have to tell the critical-care nurse what he was doing for her to figure it out. “I’m so sorry,” she told him.
Cai hoped the remdesivir might help. The hospital had made its own request. But he knew that getting approval for compassionate use — which required the manufacturer’s approval as well as F.D.A. approval — could take time, and he was worried that it would be too late. That day, Huang reached out to every Gilead representative he knew and called on all his doctor friends to do the same. His former supervising physician at Mount Sinai, Paul Lee, had already written an unsuccessful email to an associate director at the National Institute of Allergy and Infectious Diseases on Cai’s behalf to try to get him access to the drug. Huang posted on a large WeChat group for Chinese and Chinese-American cardiologists: “My name is Yili, great to meet everyone, unfortunately on this occasion,” he introduced himself. “I usually don’t post, but my good friend, only 32, health care provider, became this first case in New Jersey. Please help me with some inputs.” With Cai’s permission, he included a photo of Cai’s CT scan. He also forwarded the scans to another friend, Felix Yang, a cardiac electrophysiologist.
Yang replied with a question: Can I put this up on Twitter to show the severity of the disease? He had been frustrated in the previous days by other doctors’
can breathe and talk through the mouth, the oxygen mixes with the virus in the patient’s nose and windpipe and, especially at highest pressures, can be breathed out into the air. Doctors in the United States have been forced to weigh a medical option that might spare a patient ventilation but could expose medical practitioners to far greater risk. Cai — as the first patient in a hospital that would be, weeks later, flooded by other patients in even more dire circum¬stances, including their own staff members — received the treatment.
Cai was simultaneously reassured and distressed to see how grave the doctors suddenly looked, how quickly their stance toward his condition seemed to change. Later he learned that the results of that blood test was cause for real concern. They informed him that they had established a plan for getting him to the I.C.U. if need be. They also assigned him a dedicated critical-care nurse. He hated having those conversations about an intubation plan, hated that they had to talk about it as a realistic possibility. If the disease continued to progress at that swift rate in the next few days, he would almost certainly be intubated, his odds of recovery dropping precipitously.
Later that day, March 8, he asked the nurse to bring him some paper. He wanted to write a letter to his daughter about all the things he would want her to know about him if he did not survive this virus. Tearing up, he started to write. He said he was sorry he hadn’t been a better father. He wrote that he understood what it was like to grow up without a father present — his lived in Shanghai — and that he was sorry she would suffer the same fate. He wished he could play with