Hospitalization in the Age of Ebola

The 24-year-old who fixed my IV may find herself on the front lines of battling the spread of the disease.

A hospital is a thrumming organism of people and procedures. All day long, monitors summon doctors, blood pressure cuffs do their boa constrictor thing, stretchers get jostled into elevators. This is all set against the cacophony of TV judges and Fox blowhards holding forth from the ubiquitous monitors above the foot of every bed.

It never completely stops, but in the middle of the night, it slows down. It was during one of those periods of almost enchanted quiet, two nights ago, that I noticed that my arm was quite swollen at the point of my IV.

I was mildly alarmed. I had been admitted through the ER for a bowel obstruction — a painful and serious failure of my body’s plumbing — but was past the crisis. After two days of sleeping off Dilaudid, I had insomnia. And that’s when I noticed the swollen arm. I wasn’t terrified, but concerned. Hospitals are notoriously dangerous places.

I called my nurse, whom I’ll call M., a 24-year-old who’d been ministering to me, with Florence Nightingale-like selflessness, all night. That’s what nurses do. They perform hundreds of mundane and often physically-repulsive tasks for weak people tethered to poles. Many of these tasks, I could not help noticing, in the age of Ebola, involved bodily fluids.

First M. reassured me that this wasn’t going to be something fatal. Then she got her IV kit and started palpating my arm for veins. This would be my third IV insertion in two days, and I felt bad for her. The good veins had already been taken. It felt like a lot of responsibility for a young girl to take on alone in the middle of the night.

Sticking people in the arm is an art. Not everyone is good at it. M. was. She checked both arms, talked with me about the alternatives, felt for the springiness of various veins, and finally found her spot.

I looked in her eyes as she concentrated on the side of my left wrist. She had the wide, molten, guileless eyes of the young. There was intelligence there and kindness. This was going on, as I mentioned, during a moment of almost eery hospital quiet — like something in a movie.

So it seemed the right time to blurt the question that had been on my mind since I’d gotten beyond my initial pain.

“Is everybody freaking out about Ebola?” I asked.

Just that day, news had come out that a Dallas nurse treating the first Ebola victim in America had tested positive for the disease. It was perfectly clear that hospitals were going to become a battlefield and nurses would be on the front line. As a seasoned journalist, I also knew it was likely that hospital employees had been instructed not to talk about it. But in the quiet of the moment, this was not the case.

“Oh yes,” she said. “Everybody is.” She talked openly and frankly about the training, the fear, the hospital’s preparations. Isolation rooms in the ER and the ICU had been prepared. And in fact the very ward we were on, the pulmonary unit, would likely also be a placement for Ebola victims, because of its supply of ventilators. [corrected]

In other words, she’d been conscripted.

I know nothing of what drives a person to become a nurse. It’s a less egotistical world than the one I usually travel in. People don’t become nurses to build a big platform and get thousands of Facebook followers. I assume it has something to do with a basic disposition for caring about people, and the job market. We’re not talking about Navy Seals, who know that danger is in the job description.

M. was distressed about the fact that the nurse in Dallas — at that point, there was only one — had protective gear and had followed hospital procedures.

I told her I’d heard a story on NPR about how much danger there was in taking off the elaborate protective gear. “Oh yes, degowning,” she said. “That’s always the tricky part.”

For those of us who work only in the digital world, the physicality of a hospital comes as a surprise. Yes, there are screens, but the core business of a hospital, after all, is dealing with ailing flesh. Doctors want to feel your belly, and nurses need to feel your veins. Potties sit aside hospital beds so that urine output can be monitored. Vomit, blood, feces, phlegm — things mostly absent from polite society — are a commonplace. In other words, there are a lot of tricky parts.

After two nurses have contracted Ebola, nurses across the country are terrified and angry. I don’t blame them. The protocols have to get better—immediately. The shifts have to get shorter, and the pay should be increased exponentially for the commensurate increase in risk.

M., at 24, is awfully young. She’s taken on more responsibility than most people her age, and from what I can see she handles it beautifully. Lets keep her — let’s keep all of them — safe.

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