Tim Swarens

tim.swarens@indystar.com

Kent Brantly has a word to describe his first encounter with an Ebola patient — surreal.

For two months, Brantly and other staff, from doctors to janitors, at a small mission hospital in Monrovia, Liberia, had drilled on how to respond to this moment. All around them in West Africa a horrific epidemic had been festering and spreading.

Now the epidemic was at their door.

An ambulance had arrived with two desperately ill patients. And Brantly, an Indianapolis native and Indiana University Medical School graduate, joined a team of stretcher bearers assigned to carry the patients to an isolation unit, set up in the hospital's chapel.

One patient, the team learned, had died en route. The second, a woman, had been placed on the ground, away from the body of her now dead uncle.

Brantly, covered in protective gear, approached her.

"I held my hand out to her and said, "Hi, my name is Dr. Brantly,''' he said. "'We're going to take good care of you here."

It was June 11, day one for Brantly and his colleagues in the center of a brutal storm — the world's worst recorded outbreak of Ebola. He would work amid that storm day after day for seven weeks.

Until the disease almost took his life.

"Then I heard the voice of the Lord saying, 'Whom shall I send? And who will go for us?' And I said, 'Here am I. Send me!'" Isaiah 6:8.

To understand anything about the 33-year-old doctor, who captured the world's attention after falling ill and who has twice visited the White House to speak with President Obama, testified before a U.S. Senate committee and fielded questions on cable talk shows, you need to know something about his heritage and faith.

As a child growing up in Indianapolis, Brantly was surrounded by witnesses to a life of service. His father was a doctor. Aunts and uncles served as medical missionaries in Africa. The expectation from an early age was to share one's blessings with others.

"I am the son of godly parents," he said in an interview this week. "Faith has always been at the center of our lives."

That faith, strengthened as a student at Heritage Christian School on Indy's Northeastside, pulled him toward a radical choice as an undergraduate at Abilene Christian University in Texas. While serving on a short-term mission trip in Tanzania, Brantly decided he would step forward — if called — to serve as a full-time missionary.

It was a "scary idea" at the time, he recalls, but he knew his faith was growing deeper roots. He also knew he would need a vocation, and medicine was a family trade.

By the time Brantly arrived at IU in 2005, others were starting to notice his keen sense of purpose and determination.

"I remember him as a serious, thoughtful student who was unusually clear about his vocation — not just in terms of the career choice of whether to become a primary care physician or a specialist, but in terms of a larger life calling," Dr. Richard Gunderman, one of his instructors at IU, said this week.

In 2012, with medical school completed and nearing the end of residency, Brantly and his wife, Amber, signed on for a two-year stint with Samaritan's Purse, a ministry led by Franklin Graham, son of the famed evangelist Billy Graham.

Their assignment? Liberia, a nation where 64 percent of the population lives in poverty and per-capita income is about $400 a year.

It's also a nation where life-threatening diseases are common and high-quality medical care is scarce.

Kent and Amber and their two children landed in Liberia in October 2013. In the days before Ebola, Brantly said, life was good for the young American family. They found a small beach house on the Atlantic Ocean and developed a close network of friends and colleagues.

Yet, even in those days, work at the hospital was, in Brantly's words, "very difficult."

It was about to get much worse.

"Yea, though I walk through the valley of the shadow of death, I will fear no evil..." Psalm 23:4.

Brantly calls Ebola a humiliating disease. Patients, hit with severe bouts of vomiting and diarrhea, are sapped of strength. The pain can be excruciating. The sense of isolation overwhelming.

"You can't take care of your own needs," Brantly said. "You can't feed yourself, you can't get yourself out of bed, you can't wipe your bottom."

It's also humbling for doctors and nurses. Despite their expertise and extraordinary efforts, there's often little they can do to halt death's march.

By late July, Brantly and his colleagues had admitted 36 suspected Ebola patients to the isolation ward. Of those, 20 tested positive for the disease. Sixteen had died. Three were still in treatment.

One of the 20 had beaten Ebola.

The medical team's days were long and exhausting, physically, emotionally, spiritually. Still, Brantly said, the work also had its rewards.

"We went to Liberia to serve people in need," he said. "I was able to sit with patients and hold their hand, sing to them, pray with them, and give them some respect and dignity amid the tragedy they were experiencing. I was able to show them compassion, and that was why we were there."

Then came the morning of July 23. Amber and the children had returned to the U.S. to attend a wedding. Brantly was to follow a few days later. It would be respite from the storm.

He woke that day, however, with a fever.

He hoped it was malaria. When those tests came back negative, his hope turned to dengue fever.

Then came the diagnosis: Brantly had Ebola.

"For I consider that the sufferings of this present time are not worth comparing with the glory that is to be revealed to us." Romans 8:18

More than three months after that diagnosis, it still seems difficult for Brantly to explain what he was thinking and feeling in the early days of his illness.

He says he doesn't remember being afraid, but acknowledges that he expressed fear at times to family members. What he does remember is holding on to hope, and of experiencing peace amid the turmoil.

"I didn't feel overwhelmed or terrified," he said. "It was a solemn moment, but it was a peaceful solemn moment."

Brantly can't pinpoint when and how he contracted the disease, although it likely was through contact with a patient in the hospital's emergency ward. The virus systemically attacks victims' organs and connective tissue. Patients shed fluids — blood, vomit, feces, sweat — by the liter. And doctors, nurses and others fighting to save their patients are surrounded by those highly contagious fluids.

It's often deadly work. More than 400 health-care workers have been infected with Ebola since the outbreak began, and, according to The Advisory Board Company, more than half have died.

Why did Brantly stay in Liberia amid the dangers? His commitment to serve the people of Liberia. "We couldn't abandon them in a time when they had their greatest need," he said.

Ebola tore through Brantly's body with the same savagery it had shown to so many of his patients. Wracked with constant diarrhea, he was shedding fluids and weight at a fast pace, and his life was in danger after he developed an irregular heartbeat, the result of an electrolyte imbalance.

Then came the chance for rescue. His doctors had acquired an experimental drug called ZMapp. But they had only one course of the three-dose treatment, and a colleague, Nancy Writebol, also was fighting to survive. Brantly told his doctors to give Writebol the potentially life-saving medicine.

But as his condition deteriorated, his doctors called an audible: Brantly would get the first dose.

Not long after, his symptoms improved, but with his life still at risk, the decision was made to evacuate him, on an especially equipped plane provided to Samaritan's Purse, to Emory Hospital in Atlanta.

On Aug. 2, Brantly became the first Ebola patient ever to touch down on U.S. soil. Writebol followed soon after. A third colleague in Liberia, Dr. Rick Sacra, who served as Brantly's mentor, also contracted the disease and was later flown to Omaha, Neb., for treatment.

With Amber and his parents at the hospital, Brantly quickly began to recover. And on Aug. 21, a day Brantly described as "miraculous," he walked out of the hospital and into his family's arms.

Now, most people would describe Brantly as a hero. Time and again he has put the needs of others ahead of his own. To the point, that since his release from the hospital, he has donated blood plasma to three other Ebola patients.

But, of course, we live in a world where even heroes must take their hits. Professional agitator Ann Coulter described the doctor's work to help people in Liberia as "idiotic." Donald Trump argued that Brantly and other Americans infected with Ebola shouldn't be allowed back in the country. On a more serious level, medical ethicists questioned the decision to give the experimental ZMapp to Brantly and Writebol.

For his part, Brantly isn't distracted by such talk. He's much more eager to discuss West Africa's vast needs, and to ask others, especially doctors and nurses, to step forward to serve.

"(The epidemic) ought to motivate us to action," he said. "I hope people can overcome their fear and find the courage to get up and go. I hope those who can't go find a way to get involved."

As we talked by phone a child had been playing in the background and Brantly signals that he must go. Time for a final question: Is a return to the mission field, back to Liberia or service in another country, in the plans?

He affirms that it is. The commitment to others' needs remains high.

The call to serve is still strong.

Contact Swarens at tim.swarens@indystar.com. Follow him on Twitter @tswarens.

Facts about Ebola

• The current Ebola outbreak was first reported in Guinea last winter. More than 13,000 confirmed cases have been reported since then, and more than 4,800 people have died from the disease. Most of the victims have been in the West African nations of Guinea, Liberia and Sierra Leone.

• Ebola is caused by infection with one of the Ebola virus strains. Ebola can cause disease in humans and nonhuman primates (monkeys, gorillas, and chimpanzees).

• Ebola was first discovered in 1976 near the Ebola River in what is now the Democratic Republic of the Congo

• Researchers believe that the first patient becomes infected through contact with an infected animal such as a fruit bat or nonhuman primate

• Ebola is spread through direct contact (through broken skin or unprotected mucous membranes in, for example, the eyes, nose, or mouth) with blood or body fluids (including but not limited to feces, saliva, sweat, urine, vomit, breast milk and semen) of a person who is sick with Ebola

• It also can be spread through objects (like needles and syringes) that have been contaminated with the virus

• Ebola is not spread through the air or by water, or in general, by food. However, in Africa, Ebola may be spread as a result of handling "bushmeat" (wild animals hunted for food) and contact with infected bats.

• Health-care providers caring for Ebola patients and the family and friends in close contact with Ebola patients are at the highest risk of getting sick because they may come in contact with infected blood and body fluids of sick patients.

• A person infected with Ebola virus is not contagious until symptoms appear. Signs and symptoms of Ebola include fever, severe headache, fatigue, muscle pain, weakness, diarrhea, vomiting, abdominal pain and unexplained hemorrhage (bleeding or bruising). Symptoms may appear anywhere from two to 21 days after exposure to Ebola virus, but the average is eight to 10 days.

Source: Centers for Disease Control



