A little too close to home

I hesitated for awhile to post this due to the sensitivity of the subject, but I think enough time has passed. I’m also not using any names either.

I had just ended the “Night Shift” when I came home to this situation. I was tired, emotionally frayed and running on an hour of sleep in the past 24 hours.

One of our normally more cheerful docs simply said “Hi” when she got to the ETU and looked very distracted. I didn’t think much of it at the time, but it was quite out of character for her.

I headed back to the guest house to hopefully get some sleep and repeat the process the next day. It was a good tired, the exhaustion of a hard days work.

When I got to the guest house, I was quickly pulled into one of the bed rooms by one of the other nurses.

“K’s, sick.” She said a worried look on her face.
“Sick?” I asked. This wasn’t good news, “What happened?”
“K had Diarrhea last night,  been running a fever of 101, and has body aches.”

“Shit” is the only word I can mutter. K has had close contact with Ebola Patients, is running a fever, and has Diarrhea. K fits all the criteria for a an Ebola Patient…. But also for Malaria, Typhoid, and the Flu.

K is also my roommate.

There’s a chair sitting at the threshold of the door.  People are taking turns sitting there and watching K.  It’s also acting as sort of the demilitarized zone between suspect and non suspect.

K was there, but there was an almost ethereal feel to speech. K was obviously in pain, and grimaced when moving.

“Hey, how are you doing?” I asked,
“Been better.” K replied, trying to force a smile.

When health care workers get sick in Liberia, they are not taken to the ETU as a regular Liberian would be. They are transferred to whats called the MMU or Military Medical Unit – It’s located next to the UN airport outside Monrovia. All the doctors and aid workers that were infected and diagnosed in Liberia, then sent back to the US after being treated at the MMU first.

The weekend before we left for Bong, a large portion of our group went and took a tour of the MMU. I didn’t go, I had no intention of ever seeing that place from the inside.  The others had described it as air conditioned and excellent.

But how exactly did one get someone sent to the MMU? We had been told that it would be handled by those over our heads. The Medical directors of respective ETU’s.

The other nurses in the house wanted me to call our medical director right away and let him know while the other doctor in the house wanted us to wait until she brought back reinforcements.

We discussed the problem for a few minutes before the other doctor and a Liberian national doctor arrived. The national crossed into the room, and started examining K, palpating K’s abdomen and feeling K’s pulse.

Which is NOT what you’re supposed to do with a suspected Ebola patient. You never touch a patient with out being in full PPE.

Wanting to help my friend, I went in and pulled K’s thermometer from their toiletry bag and handed it off.  I then quickly stepped out and bathed my hands in enough Alcohol hand sanitizer to drown a toddler. The doctor followed suit.

There was still some debate on rather or not to call our chief medical officer. I grabbed the phone, stepped in the other room and did this. Had this really been Ebola, we had to get K evacuated and treatment started as quickly as we could.

The medical officer was alarmed at the situation and promised to get working on it as fast as he could on his end. He was only a couple hours away and would head this way as quickly as he could.

The MMU has helicopters outside of it – or it did when our plane landed, at least. The other nurses were questioning why they wouldn’t send a bird to get K.

The next hour was mostly waiting, trying to find out what was going on, and nervously pacing the halls. I made a bottle of Oral rehydration salts for K and tried to flavor it the best I could. K had requested some cold coke from the ETU, but they only had pepsi. We tried to slip a little ORS and ice in with it.

The seconds on the clock came slowly, and our patience for some kind of guidance was running thin. We hadn’t received any word on what to do. I remembered that on our table, there had been a card left on the table. A captain, an aid to the general of the 101st airborn had left it. I called it and explained the situation, he understood and gave me direct contact information for the MMU.

We get word finally that they are going to send a team in to draw some blood for a Malaria and Ebola test, and then send him to the MMU by ground transport.

I think this is when the biggest shock came from. All of us were the ones used to being the ones in the space suit, the ones that received the shocked looks from those looking upon the PPE. To be on the other side, to watch the Ebola shock troops head into your house and into your room was something that none of us expected.

The sprayers came in first, coating everything in front of them with a layer of 0.5% solution bleach, They sprayed the door way, the floor leading to our room, the floor in the bed room, and the entire bathroom. They also filled his Coke/ORS with bleach and rendered it undrinkable (Spraying isn’t a precision art)

You could taste it in the air.  I can understand why those in villages around the country were scared. We knew what coming  and it was scary for us. Imagine yourself being from a village deep in the jungle, and these hooded white figured come in, spraying a noxious fluid over your village and taking your loved ones away. Loved ones who sometimes never came back.

Doctors and Nurses taking some Samples from K for testing

The doctor who had examined K earlier was back with a Liberian national nurse, they were in full PPE this time. They drew a blood sample for a Malaria test and Ebola test, and left the room.

We got a call over the phone that K would be transported with one of the International Medical Corps ambulances down the Military Medical Unit.

The pickup truck with the wooden slat for a back window was the transport vehicle used.

The Ambulance backed up to the door, and K slowly walked into the back and lay down on the mattress. K assured us everything would be fine, and the gate was lowered. We all stood and watched as the trucked disappeared behind the turn, unaware if we’d ever see K again.

The sprayers then return to the house, spraying every step that K had made, and returning again to the bed room, where they sprayed K bed, as well as my bed, and bagged the contents into red bio hazard bags (R.I.P Poncho Liner) they also took the mattresses out of the room to be burned as well.  They sprayed the closet as well, a good amount of my clothes are now ruined with bleach stains and have to be thrown away.

That room was locked, and placed off limits for the rest of us while we waited for the results.

It’s around 1300 at this point and I’m near the point of delirium. the past day, from the death during the night shift to K becoming ill had left me drained and exhausted. I collapsed on a very uncomfortable love seat and slept for several hours.

The next three days we were held in isolation in the house.  Since K had only shown the first symptoms during the night,  and Ebola is only spread after a patient becomes symptomatic, we all felt pretty safe. I had worked the night when K’s illness had began so I hadn’t been directly exposed.

I think we were all affected by this. K had been very diligent in the use of PPE. No breeches, no close calls or anything, if K could get it being that careful, whose to say the rest of us couldn’t get it either? K had been feeling tired and lethargic for a couple days prior, had K been symptomatic then? Were we exposed then?  Being isolated in a house for a couple days you tend to have a lot of these conversations.

Word came back the first night that it wasn’t Ebola, and it wasn’t Malaria. The Malaria test was good news, but K’s viral load for Ebola could still be low enough that it didn’t show up on the test. However, we took what good news we could get.

Every step in the process of transferring a potentially infected healthcare worker had been followed as it should have been. Both organizations responded quickly and did exactly as they should have.

We get a call the next day saying that K’s is feeling better, and that the anti-biotics they were giving were working. K thought it might have been typhoid, . However, we still needed another negative test to clear us for leaving the house. The whole ETU during this time was worried, they had some idea of what happened, but had less details then we did. We passed the time by watching movies and reading, I think two of us managed to watch a good 16 hours of game of thrones during that time (Winter is coming).

Finally, on the third day we get word that they’re taking K out of the MMU, the Ebola test came back negative. K would get some well deserved R&R in Monrovia and then head up.  It was a collective sign of relief, and just drove home how scary this virus could really be. I sometimes think what would have happened had it been positive? We were all pretty sure K could beat it, strength and determination had never been short, and K had no intention of letting this thing get them, regardless of the illness. Would we have been pulled out ? Would another one of us had been infected? Me, being is roommate had slept in the same room and used the same bathroom, what if he was infected and symptomatic and didn’t know it?

Luckily, all of these thoughts are just speculation and never came to fruition. K was fine, we were all fine, and we got to enjoy a free freshly cleaned floor and bathroom.

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