GNT, he is very specific in stating that no matter how much time passes in the past, only 2 minutes passes in the present. And this does seem problematic to me, in terms of Al's illness. The only way he could have been seen (and been given that oxy, too - which didn't exist in 1958) was if he went to an ER. Given Jake's impression of how ill he was, if he'd done that, they likely would've admitted him to the hospital. I didn't get hung up on it, because it is a great book, but the timing does raise some questions.