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Reed S. Wilson, MD, FACC, FACP: The “Selfish, Selfless” Health Care Worker November 10, 2014

The “Selfish, Selfless” Health Care Worker

By Reed S. Wilson, MD, FACC, FACP, President of Private Practice Doctors

As a physician, my job includes treating the disease at hand, managing patient expectations and dealing with the psychological aspect of the patient’s illness.  It’s part of the beauty and the burden of taking care of people.  That is why I find it so disconcerting to read about the attitude of three healthcare professionals who have been in West Africa where they treated or reported on Ebola victims.  In spite of this, it should be recognized that going to West Africa and helping this devastated region takes a lot of courage and empathy.  But it should also be noted that one must have the financial wherewithal or backing and not have significant family and patient responsibilities at home to be able to go half way around the globe to volunteer one’s services.

In the first instance, it appears that Dr. Craig Spencer, who ultimately was infected with Ebola, lied to authorities about his self-imposed home quarantine in New York.   Apparently, he stated that he isolated himself in his apartment but neglected to mention he rode subways, took a taxi, visited The High Line and went bowling.  The police discovered his isolation violations when they examined his Metro Card and credit card statements.  Dr. Spencer was in Guinea – he saw firsthand the devastation caused by Ebola.  He traveled back to the US knowing that the incubation for this disease is 21 days.  He started feeling tired on a Tuesday but continued his outings for two days before calling for help.  There is absolutely no excuse for this behavior.

The second healthcare worker, Kaci Hickox, was initially required to be quarantined at a New Jersey Hospital after arriving back in the US from Sierra Leone where she was involved in fighting the outbreak of Ebola.  She fought her hospital quarantine and was allowed to go home to Maine to wait for the duration of the incubation period.  She has refused to isolate herself and has caused havoc in the community around her.

Dr. Nancy Snyderman, a physician who returned to the US from Ebola ravaged West Africa agreed to a 21 day quarantine only to violate that promise, a violation that including driving to a restaurant to pick-up takeout food.

All of these health care professionals are shameful to the medical profession.  There is so much we don’t know about Ebola.  Sixteen physicians from Doctors without Borders have fallen ill from the disease, of whom 9 have died – just over 50% mortality among probably the most experienced personnel handling this virus.  The two physicians who were transported to the US for treatment and survived, do not understand or know how they contracted the disease.   We learned just recently that Ebola can live in sneezed particles and inhaled by those near the infected individual.  There are so many questions regarding the ravages of Ebola that the phrase “abundance of caution” is bandied about whenever discussing measures taken to limit this disease that has a fatality rate of about 70%.

Remembering that part of the job of physicians and nurses also is to manage the expectations and psychology of the illness, why would the three aforementioned healthcare workers selfishly not obey quarantine?  Even if they did not believe it necessary, what harm would come from staying at home for 21 days?  Obviously, they were able to take off months at a time, indicating that financial pressures were not in play, as if that would have been an actual excuse.  Ignorance of the disease could not possibly have played a factor as these individuals had experienced the disease first hand.  “Making a statement” is a possibility, but isn’t there a better way to accomplish this after the 21 day waiting period?  There is no reason to cause public consternation and anger when simply following state (and I hope one day federal) mandated orders.

I will not even hypothesize about the logic of their actions.  There is none.  But the public should know, these individuals do not represent me or my ideals.  I suspect they do not represent the vast majority of physicians and nurses in the country.  It is truly a shame that their noble selflessness helping the victims of Ebola in West Africa are more than cancelled by their selfishness to their friends and neighbors at home.