Tuesday, September 23, 2014


It was too good to be true.  SDA Cooper is the only hospital in Monrovia to be
open during the whole Ebola epidemic thus far.  And we were the only hospital
without Ebola casualties among its staff.

This morning, I get called into a meeting in Mrs. Carter’s office.  Dr. Martin,
Dr. Sonii, Steve, Gillian, the Chaplain and Mrs. Carter are all there.

I find out that Arabi, the ER nurse’s aide who took herself to JFK Hospital last
week to get tested for Ebola has been confirmed as positive.  She has had early
treatment, but the ongoing treatment is dependent on Steve taking money,
medicines and supplies over there every day and bribing the hospital staff to
take care of Arabi.  She’s conscious, but has bloody diarrhea.

No one has heard from Aaron either.  He’s one of the cleaning guys.  He’s been
sick for over a week, taking malaria medicines at home and refusing to come in,
go get tested for Ebola or even let anyone see him.  He’s been having rectal
bleeding which he’s been claiming is his hemorrhoids, but he won’t let anyone
examine him.  He lives by himself.  Steve went to visit him yesterday and the
door was locked and no one answered his loud banging.  Gillian had told me
earlier that the rumor is circulating that someone found him dead with his
pupils fixed and dilated.  This apparently hasn’t been confirmed.

As a result, yesterday, no midwives or nurses showed up during the day and only
one nurse at night.  Today, there’s one nurse and one midwife on as well as the
Outpatient Department staff.  Steve confirms that many nurses and midwives have
called him to say they’re not coming in, they’re too afraid.  Many of them had
contact with Arabi or with the same patients she did and so they are frightened
and don’t want to come in.  Steve recommends that we temporarily close the
hospital.  Everyone seems to be in agreement and after a brief discussion, we
decide to close for three weeks, as a sort of quarantine since that is the
incubation period for Ebola.

As of tomorrow, we aren’t seeing patients.  If you’re pregnant and need to
deliver?  Malaria, anemic and need a blood transfusion?  Surgical emergency?
Sorry, find someplace else…if you can.  Gillian and I and whatever nurses are
willing to help will take care of the inpatients until they are discharged.  We
only have six left after Gillian discharged many today.  Tomorrow, we’ll do the
last operation on Titus to close his colostomy and then he’ll go home in 2-3
days.  By Friday, the SDA Cooper Hospital will be closed.

Meanwhile, later in the morning, Bendu calls me to go see Mr. Wennie.  Mrs.
Wennie is helping him stumble into his office.  I follow them and see Mr. Wennie
sitting in a chair.  He has an obvious right facial droop and is complaining of
his left arm “not feeling raht.”

“His preshuh 150 ower 100, doctuh,” says Bendu.

“Did he take his pressure medicine this morning?” I ask Mrs. Wennie.

“No, he did uhnt take it.”

I have her bring his meds and we give them to him along with four baby aspirins.
He can barely swallow, on pill rests on his outer lip and he chokes on the
water.  All signs of a stroke.  I go get a thing of yoghurt from my fridge and
bring it to him.  He swallows that fine with the rest of his tablets.  We lay
him down on a mattress behind his desk.  I call for oxygen.  We’ll see what

Mrs. Wennie comes back a half hour later to tell me Mr. Wennie has refused his
oxygen. I go into his office.  His facial droop is gone and he’s sitting at his
desk without oxygen.  He’s talking better but says his left arm still doesn’t
feel right. I speak firmly with him about the need for oxygen and he finally
lays down again and lets us put the oxygen on.

I go back to my office.

I get a call to come see another “emuhguhncy in de cah’.”  A woman with a stroke
three weeks ago who went to a clinic, was diagnosed with “presshuh” and given a
water tablet which she took for a few days and stopped.  Then she went to a
Chinese medical clinic.  She shows me a bag filled with bottles labeled in
Chinese and baggies of black pellets.  Now since yesterday evening she has been
having right sided seizures.  I tell them there’s nothing we can really do and
except comfort care so I send them home with some meds.

As I take off my gloves and wash my hands in chlorine water before going back
into the hospital, a man comes up holding sick seven year old girl in his arms.
She is semi-conscious, but otherwise looks healthy.  Her temperature is normal.
The man explains that she had a headache last night with fever and then
convulsed this morning.  I admit her for treatment of cerebral malaria.

I realize suddenly, this may be the last patient I ever admit here in Liberia…I
can’t tell if I’m relieved or sad...

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