Back in Vancouver, I am comfortably ensconced in my living room listening to alternative music and drinking hot chocolate. I’ve done all the stuff I usually do when I first get back from a mission: I had a good sleep, a long shower, unpacked, went to Tim Horton’s and texted my son, Eddy. I have replenished my fridge, my wine rack and my snack shelf.
My departure from Sierra Leone with 3 other Canadian expats was uneventful. Our Royal Air Maroc plane left on time at 5am Sunday and the 3 hour layover in Casablanca was not too bad. After arriving in Amsterdam late Sunday afternoon, Alex and I visited a coffee shop before we wolfed down pad thai and som tum at a pleasant Thai café that was actually run by Thais. The Monday debriefing at the MSF Holland office was fine. The Ebola medical coordinator seemed interested in my observations on Ebola interventions. The MSF staff health physician concluded that I had had ‘no breaks in PPE’ and that I was, therefore, low risk for infection. She also discussed their expectations for my 21-day self-quarantine period – no surprises. I spent 30 minutes (as required) with the MSF psychosocial counselor. I managed to keep quiet long enough for her to start talking first. She proceeded to tell me about her Masters thesis on arachnophobia. Battle won!
I flew out of Amsterdam Tuesday afternoon and I had a brief layover at Lester B. Pearson Airport in Toronto. There, a public health nurse interviewed me about my Ebola risk. We filled in a few forms, my temperature was taken and she agreed that I was low risk. The official term on the Public Health Agency of Canada form is ‘at risk of developing symptoms’ as opposed to ‘at higher risk of developing symptoms’, or the even worse designation ‘exhibiting symptoms consistent with Ebola virus disease’. I was ordered to check in with the Vancouver Health Department within 24 hours and I flew on to Vancouver in a WestJet Plus seat. That was nice touch.
But, this missive is about Abigail not me. I have struggled with whether it is important to tell Abigail’s story because I don’t want to recount her sad and short tale for self-serving reasons. I decided it is important.
I first saw her, unexpectedly, one afternoon while making ICU rounds. She was lying curled up in bed #14 just beyond the end of the plexiglass corridor that juts three-quarters of the way down the middle of the ICU. The corridor allowed us to monitor patients without being in PPE. We couldn’t do anything ourselves but we could give directions to staff that might already be inside. And, it was reassuring to be able to check on patients. It was about a week before my departure. I had not admitted Abigail so I don’t know her full story, only her last week. Abigail is not even her real name. I misunderstood the response of a national nurse when I asked her first name. But, she will always be Abigail to me.
Abigail was 12 years old but, like so many Sierra Leonean children, she appeared much younger, more like 8 or 9 years old. She was obviously malnourished and stunted even before she got Ebola. Her hair was in braids, her clothes were tattered and she always seemed to be shivering. She was clearly dehydrated and we tried to keep an IV in her but did not always succeed. Abigail had several troubling Ebola symptoms and signs that I won’t list. Suffice it to say, she was very sick. Despite her pain and suffering, she always said “I’m fine” when we asked how she felt. I don’t know if she had been raised not to complain or if she just wanted to left alone.
During my last high-risk entry early Saturday morning, I stopped at Abigail’s bed after seeing the other children. Curled up and shivering, she was more dehydrated than usual and I decided that it was critical for her to receive IV fluids. I wish I could say that I then deftly inserted an intravenous cannula, but it was actually nurse Joseph that did that after I failed twice. Joseph and I stayed by her bedside as long as we could to ensure that she got a bolus of fluid and that her IV was secure.
I left the EMC hoping that she would hold on for a few more days. I always felt that the longer someone stayed alive the better their chances. But that evening at dinner, Dr. Philippe told me that Abigail died after I left. I wish he had stopped there but he proceeded to tell me her last words. In English, Abigail said “help me”.
The end.