Chapter 11 presents, in a short chapter, another point of view change as Cook takes us to Manhattan General hospital, Donald Lagenthorpe and Dr. Doyle. Lagenthorpe is "a thirty-eight-year-old African American oil engineer who had ... awakened with progressive difficulty breathing ... and he'd come into the emergency room" at 4 a.m. This chapter sets up the possibility of another case of plague but a case that may have an origin not remotely related to Manhattan General in New York if it originated in Texas where Lagenthorpe had recently spent time.
Donald Lagenthorpe had been to Texas the previous week and was due to go back. Since Chapter 10 focuses on Jack's further efforts to identify the originating cause of the infection at the hospital, with help from the Center for Disease Control (CDC) ("[CDC] sent someone up here from there plague division"), the fact that we have a suspicious incidence of difficult to interrupt asthma and a remote connection to Texas raise alarms and suspense. Alarms are further heightened because Lagenthorpe is being kept longer at General to administer more intravenous corticosteroid treatment and to monitor the development of his hoped for full recovery.
"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 longer," Dr. Doyle explained.
Donald ... was supposed to go back to Texas the following week.