An apparent drug reaction gave White House press secretary James S. Brady a 104-degree fever and widespread rash over the weekend, but he was nearly recovered yesterday, doctors said.
The reaction never reached the point of danger, and "he felt well and awake and alert all through it," Dr. Arthur Kobrine of George Washington University Hospital, chief of the team treating Brady for a bullet wound in the brain, reported.
But it will be "another week or two before we can stop worrying about other possible problems," especially infection, Kobrine said.
At first doctors thought Brady might be suffering an infection, which would have meant a grave threat to his life, when he started running a fever and getting a rash around 1 a.m. Saturday. By that night the fever reached 104, a serious worry in itself had it continued.
But by then the doctors had decided Brady probably was having a drug reaction, and had taken him off two drugs -- one to prevent seizures, a possible aftermath of brain injury, and the other to control Brady's occasional, mild high blood pressure. His doctors also gave him an antibiotic in case the problem was an infection.
Cultures and a spinal fluid study showed no evidence of infection, and Saturday night the fever broke. It continued going down Sunday.
"This morning it was barely elevated, the Kobrine said yesterday.
Brady "remains alert and in good spirits" and has been placed on different drugs, a White House statement added.
Brady still faces perhaps as little as three weeks but perhaps as long as three months in the hospital, Kobrine estimated, plus up to a year of sessions for physical therapy and rehabilitation.
"Remember," the neurosurgeon said, "of 10 people with the same kind of brain inury" -- with loss, in Brady's case, of 20 percent of the right side of his brain -- "eight or nine die" almost immediately. "Now," Kobrine said, "his recovery depends on how much brain tissue revives and how much was irrevocably injured." Finding that out "just takes time," he said.
Kobrine repeated there is a "good chance" that in time Brady will be normal or "very close to normal" mentally and emotionally and able to go back to the same kind of work.
Physically, however, he still cannot move the fingers or toes on the left side, and has only what Kobrine called "some voluntary movement" of his left hip and thigh. The right side of the brain execrises main control over movement on the left side of the body, and vice versa.
Using his hip muscles, Brady has been able to pull his left knee toward his chest after his doctor or therapist lifts his leg off his bed.
"And he has reflex movement in his left ankle and toe and some in his fingers," Kobrine said. "That is, if you pinch his toe or finger, he pulls it away, but if you ask him to move them, he can't. The reflex movement means there are intact nerve patterns. This is a good sign, potentially."
Here, too, only time will tell how much motion will return, the surgeon said, put in Brady's leg, if not in his arm, the ultimate defict "could be minor." His arm may be more seriously affected, Kobrine concluded, but "I can foresse him essentially normal in mental status and walking with only a cane."
Larry Speakes, White House depty press secretary, said he did not know of Brady's fever until he got a doctors' report yesterday morning. He said he has made it clear "in no uncertain terms" that the White House should be informed immediately of any changes in Brady's condition.