Several current and former officials blame intense pressure from the White House.

Acting head of Immigration and Customs Enforcement Todd Lyons has been hospitalized at least twice for stress-related issues as he has carried out Donald Trump’s aggressive immigration agenda — strain that has caused him to struggle to make key decisions for the agency, according to two current and two former administration officials.

During these episodes, the current and former officials said they saw Lyons break out into a full sweat, with his face turning deep red. They also attributed the source of the pressure to ramp up deportations to the White House and top adviser Stephen Miller, who yelled at Lyons during morning phone calls with administration officials, according to four people who were on the calls. Other officials disputed that Miller yelled at Lyons, with one saying the deputy chief of staff was merely “passionate.”

Miller didn’t respond to a request for comment. But the attempt to blame Miller is the latest example of continued infighting among administration figures over immigration policy — even after former DHS Secretary Kristi Noem and some of her aides have departed the agency.