Ebola: Why More Hospitals Could Miss the Clues, Too
I now consider myself an expert on United States health care. That’s why I can tell you what went wrong in the first U.S. case of Ebola. No, I didn’t go to medical school; nor do I have a degree in the field. And it’s not because of my first-place award in investigative journalism for my series on health care while working at the Preston County Journal.
It’s because I’m married to a diabetic with heart disease who also ended up with a deadly bone infection earlier this year, resulting in five separate emergency department (ED) visits that kept him hospitalized for 23 days for parts of February, March, and April. And while diabetics are prone to such infections, in this case that disease wasn’t the culprit.
The culprit, quite honestly, was poor medical care at Ruby Memorial Hospital—in the orthopedic and emergency departments; the latter was where we spent 11 hours on Saturday, February 22. Then they sent him home with a foot that looked so much worse an hour after we left that I called the hospital and insisted they recheck the labs and confirm he didn’t have an infection.
Now a disclaimer, of sorts. When I noticed two of his toes were red and wounded early that morning, I insisted we go to the hospital immediately. Never did I dream we would still be there 11 hours later.
I had to work the next day, a Sunday, and I couldn’t call off. Work, for me, meant traveling to Los Angeles, Calif., on a 6 a.m. Sunday flight, in order to be on the Dr. Phil Show. Since I always save my packing until the day before I fly, by 7 or 8 p.m., I was starting to worry about staying up all night to pack, and then driving to the airport on no sleep. You see, I had to be back up and out the door at 3 a.m.—and I had not gathered up a single item for the trip.
So I left my husband at the hospital for about an hour, 90 minutes tops. In the back of my mind, I knew his health history and the way his foot presented meant he would probably be hospitalized. Imagine my surprise when, as I’m throwing clothes into my suitcase, he calls and says, “Come pick me up; I’m ready.”
“They’re letting you go?” I asked, incredulous. “You don’t have an infection?” He assured me the orthopedic resident who trimmed back the cast on his broken leg insisted that he was fine. They didn’t prescribe a single antibiotic.
I know this, for sure: If I had been there, he would not have gone home—because I would have argued what anyone who has taken a basic first-aid course knows: redness and swelling are two signs of infection. But my husband was waiting outside for me when I got there and by then, he was so worn out he just wanted to go home and go to bed. By then I had no energy to argue either, but when I was helping him into bed I saw how much worse his foot looked than it had that morning. That’s when I called the hospital. After a bit of an argument: “We aren’t allowed to give you any information over the phone,” I was put on hold and someone came on the line telling me no, my husband’s foot was not infected. They were positive.
So I flew to LA but by the time I returned home 48 hours later, my husband was so sick he could barely stand; he was lethargic and had difficulty paying attention. Plus, a fever had caused him to soak the bed linens. It was 9 p.m. and I wanted to immediately drive him to the emergency room. He insisted he could wait until the morning, for his follow-up 9 a.m. orthopedic appointment.
Which came and went, while the ortho doc insisted—again—that my husband was fine. “But he has a fever,” I protested. No infection, he assured me before I ran out the door to cover Rachel Shoaf’s sentencing. But later that day, we again returned to the ED—after my stepdaughter, a registered nurse, saw the photos I emailed her. She called from South Carolina and said it looked like the tissue was dying. I honestly believe that had it not been for her professional validation—or perhaps knowing that someone in our family does have medical training—they would have sent him home again.
Here’s why, but this isn’t the only reason: each and every time I have visited the ED over the last year, I have seen medical staff who are on their cell phones, playing on the computer, watching sporting events on TV, and joking around or flirting with each other. In short, unprofessional behavior is going on in a setting that, for many people, is a matter of life and death.
Like it was for Thomas Eric Duncan, the Liberian man who showed up at the doors of Texas Health Presbyterian Hospital in Dallas on Sept. 25 with a fever and abdominal pain. And whom the ED sent home. Duncan returned with much worse symptoms on Sept. 28, but by then it was too late. Nothing could save him from the Ebola the Centers for Disease Control confirmed he had. Duncan died Oct. 8.
We, the public, has been told that Duncan told a nurse—one nurse, sometime during his short Oct. 25 vist—that he had just traveled here from Liberia. We have also been told he neglected to tell any hospital staff that he had carried a pregnant, dying Ebola patient in his arms not long before he boarded a flight to the States.
Call me a skeptic, but having seen the death and devastation that Ebola caused all around him, I seriously doubt Duncan deliberately failed to reveal he had been exposed to Ebola. Why would a man who flew here to marry his beloved want to risk death—or transmitting such a deadly disease to her and her children, if he was infected? I don’t believe he would.
Sadly, we live in a world of people who have been trained to believe it’s more important to CYB (cover your butt) than it is to simply tell the truth and face the consequences. So we may never know the truth.
That’s what I observed over and over at RMH during our 28 days there. To the point that I finally told the orthopedic surgeon in charge that I didn’t want anyone on his team to have any say in the decisions being made for my husband. I later told him, very firmly and respectfully, that I felt he owed my husband an apology, and that I hoped he understood that his actions and those of his team were going to get someone killed. Because by then I had logged into my husband’s “My Chart” file and found that his rate of infection was high enough during the first ED visit that hospital staff should have, at the very least, given him an antibiotic.
We did not get an apology.
Maybe it’s just me. I am, after all, pretty old-fashioned. I guess since I have a superior work ethic, and come from a family of the same, I expect everyone else should, too. But perhaps that’s too much to ask in this day and age, when technology has made our lives easier while simultaneously creating dangerous levels of distraction.
Or when, on Feb. 22, the WVU Men’s Basketball team played Baylor at home, at 1:30 p.m., right smack in the middle of our 11-hour outing at RMH. And I might be wrong—but given that everyone was crowded around what I call “ED central” at Ruby, watching or talking about the game—I don’t think I am.
So, you know, I couldn’t help but wonder what game was playing in Texas, where football reigns as king, the first day Duncan went to the hospital?
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I have four books. My memoir, Sister of Silence, is about overcoming depression from domestic violence; Cheatin’ Ain’t Easy, now in ebook format, is about the life of Preston County native, Eloise Morgan Milne; The Savage Murder of Skylar Neese (a New York Times bestseller, with coauthor Geoff Fuller) and Pretty Little Killers (also with Fuller), released July 8, 2014, and featured in the August 18 issue of People Magazine.
For an in-depth look at the damaging effects of the silence that surrounds abuse, please watch my live TEDx talk, given April 13, 2013, at Connecticut College.
Have a great day and remember, it’s whatever you want to make it!
Editor’s Note: Daleen Berry is a New York Times best-selling author and a recipient of the Pearl Buck Award in Writing for Social Change. She has won several other awards, for investigative journalism and her weekly newspaper columns, and Sister of Silence placed first in the West Virginia Writers’ Competition. Ms. Berry speaks about overcoming abuse through awareness, empowerment and goal attainment at conferences around the country. To read an excerpt of her memoir, please go to the Sister of Silence site. Check out the five-star review from ForeWord Reviews. Or find out why Kirkus Reviews called Ms. Berry “an engaging writer, her style fluid and easy to read, with welcome touches of humor and sustained tension throughout.”