Doctor recalls his near-death experience with Ebola

Tom Wilemon | The (Nashville) Tennessean

NASHVILLE -- Dr. Ian Crozier, the Vanderbilt University-trained infectious disease specialist who contracted Ebola in Sierra Leone, was living in Uganda last summer, training doctors at a medical college, when he answered the call from the World Health Organization to respond to the Ebola epidemic in West Africa. He kept working through its darkest days.

After falling sick with the virus, he was evacuated to the United States, where he spent 40 days at Emory University Hospital in Atlanta. He almost died.

He recalled, before he became ill, looking at patients who had survived the virus. They were waiting until blood tests would clear them to leave the hospital in Kenema, Sierra Leone.

"I stood on a little hill and looked over the fence at them, expecting them to say, 'Dr. Ian,' " Crozier said. "They didn't recognize me. They had no idea who I was."

The patients he treated had never seen his face because of the protective personal equipment he wore.

"When they heard my voice, they were amazed," he said. "I remember that was such a poignant moment, realizing all they see is my eyes and they hear my voice. I love that side of medicine, to be part of that human drama that happens at a bedside. It was quite interesting later to wake up in the other unit and to be on a different side of that coin in which I could only see the eyes of my caregiver."

Q. Why did you go to Sierra Leone to treat Ebola patients?

A. My skills fit the need, and I contacted both the WHO and Médecins Sans Frontières. An old friend and colleague who was already on the ground in Kenema called me, expressed their need for help and within a week I was on the ground in Sierra Leone. Of course, I would never script my particular outcome, but I was grateful for the chance to be able to put my training and skills to use in the Ebola treatment unit.

Q. During your time working there can you tell me about your darkest days?

A. A really close colleague of mine was the head nurse (Nancy Yoko), who died under my care. She was a really remarkable woman. ... That was one of the darkest days. I had been working there for some time. Over time, you get deprived of sleep. You get overwhelmed by what you're seeing on a daily basis. Some of the things we never talk about. Her death was this huge blow to the community there.

Q. Your brightest days?

A. One was a day we discharged nine survivors. ... People were singing. They had all been through their personal hells, especially in the villages. Multiple family members had died. Parents died. Siblings died. Then they go through a lonelier hell in the Ebola treatment unit itself. The joy of when people are finally getting out is amazing.

Q. Other bright moments?

A. As children came back to life and would be running around, we spent time singing with them and joking with them and dancing with them. I'm sure it sounds strange in such a grim setting. ... There was a pair of brothers named Courage and Success. What amazing names! Earlier when they were really sick, I remember turning to my colleague as we were sort of trying to sing a song to get them calm, trying to ease them and then making comments to each other how awkward those names were, given the way they were. Then, later, they survived. Those names were incredibly apt for those brothers.

Q. What is your last memory from when you were sick?

A. Walking with assistance in personal protection equipment from the ambulance through the back door into the Emory Serious Communicable Diseases Unit. I was evidently somewhat lucid for the first few days but rapidly became confused and delirious, and really have no memory of any of that time from walking through the doors until I woke three weeks later in late September.

Q. Your first memory upon recovery?

A. I woke confused, disoriented, almost childlike. It took a few days for the fog to clear and to realize where I was and what had happened. My sister recognized this somehow and spoke to me, almost cooing through her phone to the speaker at my bedside, in much the same way she had spoken years earlier to her infant boys. I'll never forget her expression through the window and the safety in her tone.

Q. Do you have any idea how much the investigational drug or the blood plasma transfusion from Will Pooley, a nurse you worked with who had also contracted Ebola, played into your recovery?

A. Clinical trials ongoing in West Africa will hopefully tell us of the impact of the experimental treatments I received. The evidence at this point is either anecdotal or comes from animal modeling. So my first and correct answer is "I don't know." My viral load was orders of magnitude higher than other U.S. patients. It began to fall shortly after the first three liters of Will Pooley's plasma. My second answer: I will always be convinced his gift to me was lifesaving.

Q. You were the sickest of any American who has contracted Ebola in this epidemic thus far, yet managed to recover. Your thoughts about surviving?

A. The level of care provided me at Emory was really ground breaking on so many fronts. So, I am of course incredibly grateful to WHO and to the State Department for facilitating my evacuation and to be provided that level of care. At the same time, I'm haunted by many patients, including some of my colleagues, who didn't have that opportunity. I'm learning to hold these things in tension. Again, I wouldn't script this outcome, but on the other side of it, I see some things with new eyes: family, friends, the chance to be part of this story both before and after I got sick, and now the chance to continue to engage.

Q. What are your plans now?

A. With recent clinical skirmishes in December and January related to complications I developed during my convalescent period, I have not been able yet to formally get back to work, though of course I have been "working" still in many senses. Over the next few weeks, the schedule is pretty full with academic and other opportunities to speak about my case in the context of the larger outbreak. As well, I will be returning to West Africa for the first time in a few weeks to engage some of the survivors' complications on the ground. I hope to be able to return to Africa on a more permanent basis very soon.