Sixth and final in a series.
On arriving in Geneva to wait out his required 21-day, self-monitored quarantine, Dr. Darin Portnoy says he was looking forward to a few runs—he hadn’t had time to work out on his Ebola mission, and there was no easy path for a jog between his living quarters and the Ebola treatment center—and was hoping he might find a Thanksgiving dinner. He found one listing quickly, at the American International Club, but along with turkey and fixings, a James Brown impersonator was to MC, and Portnoy says he couldn’t face going from four weeks of treating Ebola to a room full of ex-pats lip-synching to “I feel good … and I knew that I would now.”
Overall, Portnoy says, reentry after his time in the Ebola zone was going well enough. His first stop after Monrovia, in Liberia, had been Brussels, where Portnoy spent a long day at the Médecins Sans Frontières/Doctors without Borders office. With those leading MSF’s response to the epidemic, which has now claimed 5,444 lives in Guinea, Liberia, and Sierra Leone, the Bronx family physician discussed what’s been working (cheap cell phones so patients who arrive at the clinics without them can stay in touch with family, more aggressive intravenous hydration at critical stages) as well as what can still be improved in the field (more rapid response teams that can travel to new clusters of cases as they’re reported). He also sat for some mandatory counseling with a “psychosocial” team.
“It’s always been offered, but it was voluntary, and on previous missions I didn’t do it,” Portnoy says of the counseling. With Ebola, “now everyone has to go through it, because in the early months of the outbreak, when the centers were at capacity, and they had to turn people away—it was very traumatic.” Although he’s feeling OK, he says he found it valuable to speak first “with people who know what you’ve been dealing with before trying to explain it to others.” It was good to be reminded that it’s OK to be suddenly down or have uncharitable, judgmental feelings toward others who complain about seemingly trivial matters. The hardest part for Portnoy, he says, was not being able to do more to save children. He’d learned via e-mail that a teenage girl he’d been treating had died soon after he left.
The Brussels MSF office has been in overdrive since April, and, while a six-hour flight from the Ebola zone, it feels close to the epidemic. MSF currently employs 3,077 national/local staff on Ebola and has sent 263 international workers to West Africa. On a floor below street level, a large shared office acts as something of a situation room for the Ebola response. On the door, gallows humor: Keep Calm It’s Only Ebola Alert. When I visited in October for a feature story, one recent returnee told me that the MSF health-care workers who’d contracted Ebola could all recall the moment they’d been exposed. Did such a moment come to mind for Portnoy?
“No, fortunately, I didn’t have an obvious moment when something went wrong—no [personal protection equipment] malfunction or clear breach,” he says. There was no avoiding a bit of hypochondria, though. “The onset symptoms are so similar to so many other things.” He might take a dry swallow and become anxious about a sore throat. Any infection that elevates his temperature above 100.7 (he’s checking twice a day) requires that he check into a hospital. He has a preapproved hospital to go to if need be. (The other protocols he must follow are here.) The possibility of a “false positive”—a fever that wasn’t Ebola—made him glad he’d decided to stay in Switzerland and not put his family through similar anxiety. All the same, he was missing Thanksgiving.
He was reminded of another time he’d missed Thanksgiving while working for MSF. It was 1998, before he had a family of his own. A doctor and nurses at a tuberculosis hospital in Uzbekistan decided to surprise him with a turkey after learning from him about the American holiday. “Only they boiled the bird,” Portnoy says. “And it was this mass of grey meat. It was truly disgusting: The texture was indescribable, and it made me even sadder on the inside.” Boiled turkey and vodka made him miss home more. For that, he says, “you really have to put your game face on.”
In Liberia, he’d been spared such an epicurean adventure and received as a thank-you the garments of a tribal chief. Portnoy says it made for a stirring farewell but left him more grateful, still, for those who would carry on the work. He wanted to thank them.
