The infection was from 2001. If $380,000 was taken from the house value to cover medical expenses, wouldn't that have started in 2001 rather than 2005?
In my experience, the process of processing hospital and medical bills, and the insurance coverage can take (at least) a year from date of service. Realizing you need to take out a second mortgage and applying for it takes time also, so 2005 sounds about right for an infection contracted in 2001. Another factor: probable loss of income from James Mack (if he was not already retired). Since Sheila and James had already been married 15 years or so and (apparently) living within their means, it seems completely logical to me that their need for the second mortgage came more from unplanned medical expenses than a sudden desire for a more lavish lifestyle after his illness. IMOO