In Their Own Words: Ebola Clinicians Share Stories

“What was a high point? What was a low point?” Those are the questions we recently asked a half-dozen doctors and nurses working in Ebola Treatment Units (ETUs) in Sierra Leone.

Their answers were surprisingly candid. And they remind us that beneath the flurry of news headlines, plenty of real people are battling a very real virus.

 

Amanda Coyle, assistant professor of nursing, Rochester, NY

My last week, I was working in the community, but Tim and I decided that the last day we were going back to the ETU, because we missed it, as weird as that sounds. We donned and entered and Tim was the Pied Piper, with the children really loving him, while I was just kind of in the background. We had fallen into these roles where he was the fun parent and I was the serious parent.

Anyway, one of the children was Foday, 14 years old. The night he had turned the corner for the better was also the night it was clear his father was going to die. When his father did, I had gone in, held his hand, put a hand on his knee, and said, “I’m so sorry, so sorry.” He had been very stoic. 

So anyway, Tim is doing his clowning thing and I went to Foday, “How are you?” And he just said, “I love you.”

 

Kim Spray, paramedic and nurse, Santa Fe, NM

Say you need to find some supplies. You go from room to room, looking for water or a piece of tape and you can’t find it. And as each little frustration builds, then a patient you’re close to dies. And then it turns out your clinician friends are leaving. All in one day. Whammie. It’s a bad day.

 

Luanne Freer, emergency medicine physician, Bozeman, MT

I’ll never forget just giving this man a drink. He was so parched. Just taking the time to kneel down beside him and put the water to his lips—if you’re a hospice nurse, maybe you do things like this all the time, but not me.

 

Dana Clutter, infectious diseases fellow, Redwood City, CA

We had this girl, Kadiatu. Ridiculously cute. Big bright eyes. Three years old. Even when her tests came back positive for Ebola, she had enough energy to attempt mischievous little “escapes” from the ETU. 

When she cleared her Ebola, she was left with ongoing seizures, and had developed blindness and paralysis on the left side of her body. But a pediatric neurologist arrived with the next cohort of PIHers; her grandmother, who was always there, proved to be a talented physical therapist; and Dr. Farmer secured us a stash of phenobarbital, an anti-seizure medicine. The stars aligned for her.

And she got better. She stopped seizing, began walking, and her sight returned. By the time I left, her only deficit was weakness in her left arm.

Before she got really sick, during one of her “escapes,” she had ended up running through wet cement, in a doffing area they were making. Now all of us love to doff in Lane One because you can see her little footprints there.

 

Musa Sillah, psychiatric nurse, Willow Grove, PA

We’d just started the psycho-social community outreach and were visiting this village. I think it was our first venture out there. It had had 60-something people with Ebola. And 18 survived. And 12 or 13 of the survivors came from our treatment center. So people in the village knew about PIH before we showed up. But still, when we got to the outskirts, the whole town was there. The chief. Everyone. And survivors started talking and talking about our center, and they knew the names of the nurses that cared for them. It was a good meeting.

 

Dana Clutter, infectious diseases fellow, Redwood City, CA

There’s this one guy I felt particularly bad about, maybe because he was young, probably my age, 32.

He looked healthy at first glance, it seemed like he should do well. But as we’re interviewing him, he just started vomiting so much blood. Tons. He just kept vomiting and vomiting. He looked uncomfortable but what was most noticeable was that he looked scared. His eyes were so wide, and he was looking at the blood in the bucket and trying to read our faces. I told him, “Don’t worry, we’re going to give you medications and fluids and help you survive. You’re gonna get better. We’ll help you beat this.” He died the next night.

I think I had mixed feelings. I felt good that I gave him all the care I could, and that I gave him hope—made him hope. But on the other hand, I felt bad that I couldn’t keep my promise.

 

Charles Callahan, professor of pediatrics, Alexandria, VA

The highlight was Aminata. She came in on the evening of December 23rd. It was late, we were working late, and we could not get an IV in her. I fully expected that on Christmas eve morning she would not be alive. But I came in early that day, so I could get there ahead of everyone else, and she was still alive. I got her to drink a tiny bit. A day later, we decided to put in an intraosseous line in—a special IV placed directly into the bone. We put that in on Christmas day, according to my diary. And eventually she was Ebola negative and discharged. It was like a Christmas miracle.

 

Kim Spray, paramedic and nurse, Santa Fe, NM

We try to have dance parties once a week. They often start laughing when I dance. Seeing the patients smile at the funny white woman trying to dance is one of the highpoints.

 

Amanda Coyle, professor of nursing, Rochester, NY

A colleague and me walked into the ward during the last night shift. And there was a man laying on the floor, all curled up in urine and vomit and stool and blood. And he was just out of it. We knew we had to clean him up, put him on a mattress. You want to run screaming from the building but you’ve done it so much, you know what to do.

Paul and I started to clean him up and Paul’s glove broke. He had on three gloves, but it was a big enough break in the outer one that we were worried. And we had some new arrivals, new clinicians, with us, and they were overwhelmed. And you have to be very sensitive to their safety and PPE. So we had to make this incredibly difficult choice--that it was not safe for the healthcare team to be in there at that moment.

We left the man in that state.

While I waited for them to doff, I had time to round in the confirmed ward. That’s when I discovered a corpse, a woman that had been circling the drain. And the awareness that it was 10 at night and she was going to be there until the corpse team arrived in the morning…. And the awareness that next to her was a father with boys and he was probably going to die, too…. As a nurse, to have to leave those people….

 

Musa Sillah, psychiatric nurse, Willow Grove, PA

It was devastating for us. Most of us had fallen in love with this kid. We put an IV in her. We continued to hydrate. We didn’t give up. One day we’re doing rounds, and one of my coworkers is kneeling down to change her diaper. And I look over and she isn’t breathing. And I have to say, “I don’t think she’s breathing.” And my coworker is stunned. I say, “She’s dead.” But it doesn't register. “No, I have to change her diaper,” he says.

 

Charles Callahan, professor of pediatrics, Alexandria, VA

Every time a child died, I’d write down the name. I just thought these kids need to be remembered. I need to carry their names with me. There were a lot. During my time, almost two dozen kids passed away.

 

Luanne Freer, emergency medicine physician, Bozeman, MT

I was sitting with two Sierra Leonean nurses and we started talking about the war in Sierra Leone. I asked, “How did it affect you?” One pulled his foot out and showed me the toe that had been chopped off in front of his mother when he was five. He said, “This is nothing,” and asked if I’d seen the short sleeve people and the long sleeve people. I had, but I didn’t know that’s what they were called. During the war, rebels would ask if you want short sleeves or long sleeves and then either chop off your hand or chop off your arm.

I asked them, “Do you believe in god?” One said, “I do believe in god, I just believe that satan is stronger.” And I had to agree. I don’t know how anyone can deserve this—war and then Ebola, torture on torture.

 

*names have been changed to respect patient privacy