This drug could help treat monkeypox. Some patients have struggled to get it

Joseph Cassara decided to head back to the emergency room when the pain made it unbearable to swallow.

"I tried to eat a banana for breakfast," he said, "and it just felt like I was swallowing razor blades."

Cassara, 33, was still waiting on the test results to confirm that he had monkeypox, but was suffering scorching fevers and gruesome lesions on his cheek and chin that felt as if they were on fire. The Fresno, California, resident was taking ibuprofen and Tylenol, but the agony persisted; at one point, he said, he woke at 2 a.m. with his fists and jaw clenched, drenched in sweat, and screamed at the ceiling in pain.

He had been hospitalized and put on an IV, he said, when the doctor told him she was trying to get him Tpoxx, a drug not yet approved by the Food and Drug Administration to treat monkeypox. Cassara read through the paperwork and agreed.

Ten days into his illness, the drug arrived and the result seemed "miraculous," Cassara said. Little lesions that had started to spread to his body seemed to freeze their onward march and then scabbed over, he said. The wounds on his face began to shrink. As Cassara began to recover, he wondered: Why had it taken so