Commenting on these allegations, Seth Jacobs wrote that although Dooley "may have exaggerated or fabricated", this was not done to make his book more sensational. Instead, these atrocity stories grew out of a period of immersion in the refugee drama, from September 1954 to May 1955, a period during which he drove himself so mercilessly that he went from 180 to 120 pounds, "nearly died of malarial fever, acquired four types of intestinal worms, and suffered so acutely from sleep deprivation that he frequently hallucinated." Jacobs speculated that something more than careerism or sentimentality, a "growing empathy", was motivating him, because before he had always avoided responsibility but now "he could not get enough of it": he was in charge of a network of clinics that treated up to 500 people per day; he regularly performed major surgery; he lobbied pharmaceutical companies for antibiotics; and, "in large part due to his vigilance, not a single epidemic broke out in Haiphong or on the ships leaving for Saigon."