Guest blog
Just like you remember those most important days in your life—weddings, births, funerals—I remember the day I first heard of the name Ebola. It was in 1976 when my husband, then a graduate student in a microbiology lab on the East Coast, came home one night for dinner. He told me that he had just heard some scary news—an entire wing at the CDC had been shut down; the staff placed in quarantine with one person already dead. Everyone in the lab unit had been exposed to a set of cultures they knew nothing about. Its name: Ebola.
As a young registered nurse newly married, I was thankful my husband was not working in such a hazardous unit. His cultures belonged to a bunch of cows so without another thought, I forgot about Ebola.
It wasn’t until 10 years later that I began walking into rooms where patients were being diagnosed with FUO—Fever of Unknown Origin—that I remembered Ebola. The patients were young men who had been living in California and were told by doctors there, “Go home. There’s nothing more we can do.” So they did. Showing up in their home states across the Midwest, their families in many cases rejected them, seeing their illness as God’s curse. They ended up coming to our place—the hospital—where they would die rejected and alone.
That was when the war broke out.
Nurses on my unit, each a basically good human being and excellent care giver, suddenly refused to take care of these California patients. “I have to think of my kids and family,” was the most frequent excuse I heard. I understood. By this time, I had two kids at home myself, and it was a good thing that I worked a shift that ended at night. Upon arriving at home, I would go in my back yard in the dark and strip naked before going into my house, where I would put my uniform immediately into a hot wash cycle.
But the problem remained. Who would take care of these poor guys who had fevers so violent at times they shook the entire bed frame?
With my nurses in revolt, my shift supervisor blocked me from placing the patients into isolation on admission. Isolation, with its high dependency on nursing staff, meant more intensive one-on-one nursing care in addition to the cost of the paper protective gowns, masks, and thin, easily punctured latex gloves.
Hospital regulations also got in the way. I could only get one of those isolation carts by a doctor’s order, I was told, and you had to have that order first in order for the hospital to get reimbursed. I ordered it anyway.
After a few weeks, word went out from the hospital administration to every nurse: Anyone refusing to care for these patients would lose their job. I held my breath. Would I be left with a skeleton crew to care for these FUO patients? Fortunately, none of my staff left.
It took well over a year before everyone was finally comfortable in dealing with the strange fever that we eventually came to know as the AIDS epidemic. It wasn’t until 1985 that Universal Precautions began to be talked about as necessary in hospital systems. At first, patients were insulted, complaining as I pulled on a pair of gloves before I touched them. But I explained that I was not only protecting myself from them, but them from me,as well as the 100 other people I had seen in the past and would see in the future.
Now with Ebola, we have come to a moment again when we must reexamine the boundaries of individual freedoms alongside those of the common good. Which takes priority?
Is 21 days of isolation, with a certainty of communal and individual health following, such a bad thing to endure? Should supports and community resources be put into place so that those living in isolation are not left to feel cast off, blamed, alone and without resources?
Combating Ebola will take time—plenty of time and a lot of steady, careful, patient work on the part of health officials and workers everywhere. They are, after all, the ones who place themselves between disease and the rest of us.
Though stumbling in their first efforts, eventually, they'll get it right. It is up to the rest of us to insist that they be given every resource they need.
