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Doctors Without Borders

Doctor treating Ebola: 'I've been given a gift'

Liz Szabo
USA TODAY
Daniel Lucey, an adjunct professor of microbiology and immunology at Georgetown University Medical Center, treated Ebola patients at the ELWA3 hospital in Monrovia, Liberia, run by Doctors Without Borders.  He offered this stuffed bear to "Baby Ben," who survived Ebola.

The baby boy had exactly one person to look after him, and she had Ebola.

The baby, only about 15 months old, was also sick with Ebola. He and his grandmother arrived together at the ELWA 3 hospital in Monrovia, the capital of Liberia. His parents, also sick, weren't with them.

The hospital looked nothing like American hospitals, says Daniel Lucey, a physician at Georgetown University Medical Center who cared for "Baby Ben," as he was called. First of all, it was a tent. In place of beds, patients slept on mattresses on the floor. Each patient had three buckets, one for each type of bodily waste.

Lucey had little to offer patients like Ben. No intravenous fluids to prevent dehydration. No X-rays. No lab tests other than ones to diagnose Ebola.

Lucey could spend only a couple of minutes each day with a patient. Rules set by Doctors Without Borders, which ran the hospital, allowed medical staff to make no more than two visits per day to patients — wearing personal protective equipment, the white-hooded "moon suits" covered by long yellow aprons seen in so many photos from West Africa.

Each visit can last no more than 45 minutes. Yet Lucey had 46 patients when he arrived in Monrovia on Oct. 3.

Maintaining proper protocols is a matter of life and death, Lucey says. At least 678 health workers have contracted Ebola in West Africa, and 382 have died, according to the World Health Organization. In all, more than 20,380 people have been infected and nearly 8,000 have died.

Lucey learned to spot some some patients with Ebola just by looking at them. About 40% developed tell-tale red eyes. The sickest developed "the Ebola stare" — staring wide-eyed, as if tracking something only they could see.

Only one of Lucey's patients with the Ebola stare survived.

"This has to get better," Lucey, 59, told himself. "I can't live with it. And I can't leave."

Liberian deaths from Ebola have fallen markedly in recent weeks due to a number of key measures. The country has banned traditional burials, which can spread Ebola when mourners touch the bodies of the dead, and now requires that all corpses be cremated.

At ELWA 3, Lucey struggled to find ways to save lives.

On his first day off — his eighth day in Liberia — Lucey took a walk to the beach. The ocean was close enough to hear the waves from the hospital, but he'd been working 12-hour days "at a sprint," with no time to even glance up at the Atlantic. His walk did him good, and the sea air helped clear his mind.

Lucey began thinking of ways to help his patients survive.

Ben's grandmother had been providing the sort of care that nurses would have provided in a better-equipped hospital, including feeding and bathing him. Replenishing fluids is vital for patients who suffer from heavy diarrhea and vomiting. Because patients often can't hold down more than a small sip, their caregivers need to give them liquids throughout the day — a task that requires great patience and persistence, Lucey says.

Eventually, Ben's grandmother became too sick to help anyone.

"Without an adult, a small child has a very high risk of dying" in an Ebola treatment center, says Lucey, who returned from Liberia last month.

So Lucey asked the patient next to Ben to help make sure that he got enough to drink.

A few weeks earlier, there might not have been any patients to help, because so few were surviving. In the summer, patients were being turned away from hospitals in Liberia because there were no beds.

By early October, however, the ELWA 3 hospital had at least a handful of "pre-survivors" — those who were well enough to walk again but who couldn't leave the hospital until their blood tested negative for Ebola, Lucey says.

The patient next to Ben was taking care of his own 3-year-old daughter, who was also hospitalized. He agreed to take care of Ben, too, along with an 8-month-old named Daniel and a 7-year-old girl named Princess, Lucey says.

Stronger patients were spending much of their days in the hospital courtyard, which was considerably cooler than inside the stifling tents. Lucey soon decided that every patient should spend at least a little time in the shade of the courtyard.

Cooling the patients could help save their lives, Lucey thought, given that they were sweating so heavily in the sweltering tent.

If patients were too sick to walk, others carried them. The staff set up a small area where hospitalized children could sit together in the shade of a black tarp. Soon, the children were helping each other, too.

Daniel Lucey, center, volunteered at an Ebola treatment center in Monrovia, Liberia from October to November. He's seen here with other medical staff.

Ben survived. So did his grandmother.

Lucey was determined to find a way to spend more time with patients. Wearing his moon suit for more than 45 minutes wasn't an option. If he tried to push the limits, he became so drenched that sweat would pool up in his boots, his sleeves, even his face mask.

He decided to begin his rounds with the sickest patients.

He moved recovering patients to another area, where he could sit and talk to them at a distance of a few feet, without his personal protective equipment.

A little boy named Cheemoh gave him another idea. Cheemoh, a 5-year-old who had lost both his parents and his sister to Ebola, was severely dehydrated, with painful blisters on his mouth and lips. When staff offered Cheemoh a rehydration solution, he wouldn't take it. Lucey assumed that Cheemoh had lost the will to live. When someone happened to offer Cheemoh a juice box, however, the boy quickly sucked down its contents with a straw. Something as simple as a straw, Lucey says, saved Cheemoh's life.

"The will to live was there. We had to help the boy survive," Lucey says, turning away, his voice catching and growing faint. "We had to to help the boy survive."

An 18-year-old offered to take care of Cheemoh, even staying in the hospital after testing negative for Ebola, to make sure the child was all right.

None of the pre-survivors refused to help. After a while, Lucey says, he no longer had to ask. They helped on their own.

Lucey feels the same urge to help.

Even after making two volunteer trips to West Africa, he doesn't feel he has done enough. The outbreak has infected 18,603 people and killed 6,915, according to the WHO.

The epicenter of the outbreak has shifted from Liberia to Sierra Leone, where Lucey worked in an Ebola testing center. His colleagues from West Africa are still fighting the virus.

"People like me come and go," Lucey says. "They're always there. Unless they die."

Lucey has battled outbreaks before.

He worked in a Toronto hospital when SARS, Severe Acute Respiratory Syndrome, broke out. He treated patients with H5N1 bird flu in Indonesia, Vietnam, Thailand and Egypt.

He treated AIDS patients at the University of California-San Francisco hospital in the early 1980s. He also treated AIDS patients in Boston and San Antonio, where he worked on a military base.

Lucey, who grew up in a military family and spent four years on active duty in the Air Force, often uses the word "duty" to describe why he feels compelled to fight Ebola, when he could be so much more comfortable on Georgetown's campus in Washington, D.C.

He's far from the only volunteer to return to West Africa again and again. British nurse William Pooley, who survived Ebola, also returned to Sierra Leone. Ebola survivor Richard Sacra, an American physician, has announced plans to return to Liberia in January.

To Lucey, being able to save lives from Ebola is a privilege. "I feel I've been given a gift," Lucey says. "If I could, I would go back tomorrow."

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