Culture

Is It 'Unjust' for Doctors to Die from Ebola?

16107791

When I visited the John F. Kennedy hospital in Monrovia during the long Liberian Civil War, it had been destroyed by a kind of conscientious vandalism. Every last piece of hospital furniture and equipment had been disabled, the wheels sawn off trolleys and gurneys, the electronics smashed. This was not just the result of bombardment during the war but of willful and thorough dismantlement.

There were no patients and no staff in the hospital; it was a ghost establishment, completely deserted. I was severely criticized for suggesting in a book that the painstaking destruction of the hospital, which shortly before had performed open heart surgery, was of symbolic significance.

I was pleased to see from an article in a recent edition of the New England Journal of Medicine that it had re-opened, but saddened to see that its problems were now of an even more terrifying nature than those it encountered during the civil war: for the hospital is at the center of the epidemic of Ebola virus disease, and two of its senior physicians, Sam Brisbane and Abraham Borbor, have recently died of it. The article in the journal lamented their passing and praised them for their bravery in not deserting their posts; they both knew of the dangers of refusing to do so.

shutterstock_208246078

Pictures of those treating the disease put me in mind of mediaeval plague doctors, but more hi-tech, with helmets instead of beaks and dressed in white instead of black; they look like terrestrial astronauts. As for the epidemic itself and the terror it creates, it resembles something dreamed up by Hollywood. What must it be like for a person suspected to have contracted the disease to be approached by a health worker in an entire spacesuit, as if the slightest normal contact with him were an immediate sentence of death?  Not very good for the morale. It must be all the more terrifying for a population ignorant of the germ theory of disease. To the terror of the disease will be added  terror of the doctor.

I was once myself treated by doctors and nurses in space suits. I had just returned from Haiti, where I contracted a viral fever of great intensity, to England, and was admitted to hospital. It so happened that it was at the time when the mode of spread of AIDS was still not fully known, though Haiti was thought to be one of the main sources of the disease. I was therefore a prime “suspect” to have it, and it was then so terrifying, its exact mode of transmission being still unknown, that everyone approached me in space suits. When I had recovered enough to look around me, I found it amusing: I knew that I didn’t have AIDS. But terror of the patient and a space suit are not the best aids to bedside manner.

The article suggests that, horrible as their deaths were, those of the two doctors in Monrovia were good in the sense that the ancients meant: deaths, in other words, consciously faced and to some higher purpose. One can indeed admire their bravery, their devotion to duty. But I think it hyperbole to say, as do the authors, that “Dr Sam Brisbane’s death diminishes us a people.”

This is John Donne recycled as humbug. And the authors refer to the death of Dr. Brisbane as not only horrible but “unjust,” which seems to me a failed effort at heightening the reader’s emotion, a straining after effect. It is necessary to distinguish between injustice and unfairness, even in the face of tragedy, perhaps especially then; untune that string, and hark what discord follows!

****

image illustration via shutterstock / pixfly