Ebola Survivor: The Best Word For The Virus Is 'Aggression'
When Dr. Ian Crozier arrived in West Africa this past summer, he was stepping into the epicenter of the Ebola hot zone. The American doctor was working in the Ebola ward of a large, public hospital in Sierra Leone's dusty city of Kenema.
The trip nearly cost him his life. First came a fever, then a severe headache. "My first thought was, 'Oh, I must have missed a few days of my malaria prophylaxis,' " Crozier recalls.
A day and a half later, Crozier was medevaced to Atlanta and admitted to Emory University Hospital's isolation unit. He had come down with Ebola. And although he had enough strength to walk into Emory, his condition went downhill fast — to the point where he needed life support.
Crozier had landed at the Kenema Government Hospital at a time when the facility was on the verge of collapse. The lead doctor had just died of Ebola. Several nurses had also succumbed.
The Ebola ward was overflowing with sick, dying and dead patients. Patients were throwing up on the floor. Bed pans couldn't get emptied fast enough. The number of new patients was increasing by the day, but many staff members were too afraid to show up for work.
"I think most of us who've spent time on the isolation wards anywhere in the region will tell you that nothing really prepares you for the realities of treating patients back there," Crozier says.
He says the virus behaved unlike any other he'd seen before: "The best word I can think of is 'aggression.' "
The disease comes on with a fever spike and then doubles the patient over with vomiting and diarrhea. Ebola robs people of their dignity, Crozier says. Patients become so weak that they can't lift themselves out of bed; they're left lying in their own stool and vomit.
"Then shortly after that particularly ominous predictor of death — at least in my experience — patients become somewhat vacant," he says. "This can range from mild confusion to delirium."
"Many patients on the ward are out of their minds in a sense," he adds.
Soon after Crozier's arrival at Kenema, Ebola struck head nurse Nancy Yoko.
"She was the glue that kept the nurses, many of whom were struggling to deal with the deaths of many of their colleagues, together," Crozier says. "She was a remarkable woman. And she was exhausted. She'd been there for months and months."
After having relied on her to help keep the ward running, Crozier then had to admit Yoko to the ward. He cared for her as she deteriorated. Not long after, he was mourning with the rest of the staff when she died.
Things got so bad on the ward that eventually it was shut down. The government would start a new Ebola isolation unit in tents outside the hospital. But not before Crozier also got infected.
Crozier remembers making rounds in the ward one morning in September when the symptoms of Ebola began. He aborted his rounds, notified the team and isolated himself in his hotel room.
He was eventually sent to Emory, but Crozier doesn't remember what happened after stepping through the hospital doors.
"When Ian arrived at Emory, he sort of seemed to ... think he was still in Sierra Leone," says Dr. Colleen Kraft, who was part of the Emory team that treated Crozier.
Crozier was the third Ebola patient treated at Emory, and he would become the sickest. Within five days, he was on life support, and Kraft says it was unclear whether he'd make it.
"He was on dialysis; his kidneys had failed. He was on mechanical ventilation," Kraft says. "And because of his confusion early on we weren't sure about his neurologic status."
He also had severe hepatitis. "So right there you have many organs that had failed," adds Kraft.
Crozier knows that if he hadn't been evacuated, he would have been dead a week later. "That's obviously a difficult thing for me to think and talk about," he says.
The doctors at Emory managed to keep him alive even as Ebola wreaked havoc inside his body. He was given an experimental Ebola drug and a blood plasma transfusion from an Ebola survivor.
While he was on life support, his illness finally turned the corner. His immune system started making antibodies to kill the virus. Rather than going up, his viral load started to go down. And 40 days after he walked into Emory, Ian Crozier walked out Ebola-free.
He's incredibly thankful to the staff at Emory who cared for him, and to the U.S. State Department for jetting him out of West Africa. But he also is very aware that he was lucky and that many of his patients back in Sierra Leone aren't as fortunate.
"Do I wish my patients that I'd been with just a few days before had access to that type of critical care?" he says. "Absolutely. Absolutely."
Crozier was released from Emory on Oct. 19.He's still recuperating from the near fatal illness but hopes to eventually go back to West Africa and treat Ebola patients.
"I think I have a new understanding of what it's like to be an Ebola patient," he says. "That will be a gift in not just in thinking about the technical aspects of people's care but how to lend them some dignity in those isolation wards."
Like many other Ebola survivors, Crozier still suffers from extreme fatigue and has some swelling that's causing eye problems. His doctors at Emory say they simply don't know how long it will take for him to make a full recovery, but they're confident he will.
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Transcript
ERIC WESTERVELT, HOST:
This summer, American Dr. Ian Crozier volunteered to help treat Ebola patients in Sierra Leone. The decision nearly cost him his life. He was medevaced to Emory Hospital in Atlanta in September. Doctors there say he was the sickest Ebola patient they treated. Crozier survived and was eventually released from Emory hospital. NPR's Jason Beaubien shares his story.
JASON BEAUBIEN, BYLINE: When Dr. Ian Crozier arrived in Sierra Leone this past summer, he was stepping into the epicenter of the Ebola hot zone. He was working on the Ebola ward of a large public hospital in the dusty city of Kenema.
DR. IAN CROZIER: I think most of us who have spent any time on the isolation wards behind the curtain anywhere in the region would say that nothing really prepares you for the realities of treating patients back there.
BEAUBIEN: The Ebola ward was overflowing with sick, dying and dead patients. At the same time, staff were getting infected at an alarming rate. Patients were throwing up on the floor, bedpans couldn't get emptied fast enough and Crozier says the virus behaved unlike any other he'd seen before.
CROZIER: The best word I can think of is aggression.
BEAUBIEN: The disease comes on with a fever spike and then doubles the patient over with vomiting and diarrhea. And he says Ebola robs people of their dignity. Patients become so weak that they can't lift themselves out of the bed and they're left lying in their own stool and vomit.
CROZIER: And then often shortly after that - a particularly ominous predictor of death, at least in my experience, is that patients become somewhat vacant. And this is - can range from mild confusion all the way to delirium. And so many patients on the ward are out of their minds in a sense.
BEAUBIEN: Crozier landed at the Kenema Government Hospital at a time when the facility was on the verge of collapse. The lead doctor at the hospital had just died of Ebola. Several nurses had also succumbed to the disease. The number of new patients was increasing by the day, but many staff were too afraid to show up for work. Soon after Crozier's arrival, Ebola struck the head nurse, Nancy Yoko.
CROZIER: She really was the glue that kept a group of nurses who were struggling to deal with the deaths of many of their colleagues together and she was exhausted. She been there for months and months.
BEAUBIEN: After having relied on her to help keep the ward running, Crozier then had to admit Yoko to the ward.
CROZIER: And cared for her as she deteriorated. And then mourned with the rest of our staff when she died.
BEAUBIEN: Things got so bad on that ward that eventually it was completely shut down. The government would start a new Ebola isolation unit in tents outside the Kenema Hospital, not before Crozier also got infected. He still doesn't know how that happened. He just remembers the onset of the symptoms.
CROZIER: I was on the wards rounding that morning, I developed fever and a severe headache. And my first thought was I must have missed a few days in my malaria prophylaxis and I sort of locked on to that. But obviously, quickly, I aborted my rounds and I notified the team and then quickly isolated myself in my hotel room.
BEAUBIEN: A day and a half later, he was medevaced to Atlanta and admitted to Emory University Hospital's isolation unit. Although he walked into Emory, Crozier's condition went downhill fast. He doesn't remember what happened after stepping through the doors of that hospital.
DR. COLLEEN KRAFT: When he arrived at Emory, he sort of seemed to still be in Sierra Leone and think he was still in Sierra Leone.
BEAUBIEN: Dr. Colleen Kraft was part of the team at Emory that treated Corzier. Crozier was the third Ebola patient ever treated at Emory and he would become the sickest. Within five days, he was on life support, and Dr. Kraft says it was unclear even if he was going to make.
KRAFT: He was on dialysis, his kidneys had failed. He was on mechanical ventilation. And because of his confusion early on, we weren't sure about his neurologic status. He also had a very severe hepatitis, so right there you have many organs that have failed.
CROZIER: That's obviously a difficult thing for me to think and to talk about. The reality is had I not been evacuated, I would've been dead a week later.
BEAUBIEN: The doctors at Emory, however, did manage to keep him alive, even as Ebola wreaked havoc inside his body. He was given an experimental Ebola drug and a blood plasma transfusion from an Ebola survivor. It was while he was on life support that his illness finally turned the corner. His immune system started making antibodies to kill the virus. Rather than going up, his viral load started to go down. And 40 days after he walked into Emory, Ian Crozier walked out Ebola-free. He's incredibly thankful to the staff at Emory who cared for him and the State Department for jetting him out of Africa. But he also is very aware that he was lucky and many of his patients back in Sierra Leone - well, they aren't so lucky.
CROZIER: Do I wish that my patients that I'd been with just a few days before had access to that type of critical care? Absolutely. Absolutely.
BEAUBIEN: Crozier was released from Emory on October 19. He's still recuperating from the near fatal illness, but he hopes that eventually to go back to West Africa and to treat Ebola patients.
CROZIER: I think I have a new understanding of what it's like to be an Ebola patient. And that - that'll be a gift in thinking about not just the technical aspects of peoples' care, but how to lend them some dignity in those isolation wards.
BEAUBIEN: Like many other Ebola survivors, Crozier still suffers from extreme fatigue and he has some swelling that's causing some ongoing eye problems. His doctors at Emory say they simply don't know how long it will take for him to make a full recovery, but they're confident that he will. Jason Beaubien, NPR News. Transcript provided by NPR, Copyright NPR.
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