September 20, 2017

Willard R. Leonard, MD
233 North Smith Avenue
St. Paul, MN 55102

Dear Dr. Leonard:

Re: Tim Morcom

I saw Mr. Tim Morcom, your patient, in my office yesterday afternoon.

As you will recall, Mr. Morcom is a 49-year-old professional gardener, most recently working in
San Diego, who came to see you with a chronic cough and a history of expectoration of a
whitish material. He brought the x-rays from your office with him, and I noted a fossa on the
superficial surface of his lung. He was afebrile today and stated that he had been so since the
onset of his symptoms. He did not complain of pain but did experience some dyspnea on
exertion and some shortness of breath.

I did not carry out a physical examination, but I did skin test him for both tuberculosis and
coccidioidomycosis. I did not give him a prescription for any medication and will wait until we
get the results of his skin tests. It seems to me that your diagnosis of his problem is correct, so
we will proceed with that in mind.

As you probably know, valley fever is endemic to San Diego; and since Mr. Morcom was born
and raised in Minnesota, he could be very susceptible. You may tell his employer that if he
does have valley fever, he will have to convalesce for a month to six weeks, after which time he
should be fully able to return to his normal duties.

I will keep you posted on the results of his tests. Thank you very much for letting me help you
with Mr. Morcoms problem.

Sincerely,

Steven A. Flores, MD
Pulmonology
jb