Controlling fear, not just infection

Prior to my 10 a.m. patient, I went into the staff room for my mid-morning hard boiled egg. I thought about how studies have shown that the “germiest” part of an office isn’t the bathroom, but the staff room door knob.

We eat, we touch our face. I joke about my mid-morning snacks coming with a Purell chaser now. What percentage alcohol is it? At my age it is perhaps the closest thing I’ll ever get to a Jell-O shot. I pulled my phone out of my purse and there it was. An NBC newsflash. A Yale graduate student, back from setting up computer software in West Africa, had been admitted to the hospital for Ebola testing. I brought the screen out to our receptionist with the warning “don’t say anything.” My fear being that a patient might hear her gasp.

While Mr. Duncan still lay suffering in Dallas, I was reading ”The Hot Zone.” A best seller from more than 20 years ago, it documents the discovery of the Ebola virus. I thought it was scarier than a Stephen King novel, mostly because it wasn’t fiction. It was all fact.

I speculated that my patients would be glued to their television screens and not come in for their dental appointments. What I experienced instead was what I now dub the “9/11 effect.” Not only did they come in for their appointments, but they couldn’t wait to talk about the “big event.” Every single patient in my schedule, with the exception of a 6-year-old, sat in the chair and started to say, “Did you hear about that Yale student?” I could see the fear in their eyes. One patient told me she had just gotten off the phone with her daughter, who was a panic-stricken preschool teacher. Patients looked to me for infection-control information. They looked to me for reassurance in our community. Suddenly, I became the tribal medicine woman, the earth mother. My nursing abilities kicked in. The soothing voice usually reserved for toddlers became the tone of the day.

What really surprised me was my patients’ ready confidence in me. They felt as if anyone in health care would somehow be knowledgeable about every aspect of an international infectious disease. The Ebola experts will readily admit there is a great deal they don’t even know. It’s a double-edged sword and a huge responsibility. On the one hand, we are expected to display calmness and compassion above all else. On the other hand, when we show our humanness via frailty, misjudgment or misinformation — the public is not so forgiving. They blame the nurse.

By 5 p.m. I was back in the staff room looking at my phone. Twitter was reporting that the Yale student had tested negative. Germ carrier or not, I loved my phone again. This tidbit of information was very reassuring to my final patient of the day. An older man with a heavy Vietnamese accent, he was no different than every other concerned patient of the day. Did I hear about Ebola at Yale? I sighed a sigh of relief because I had factual information to put his mind at ease. Twitter beat out the news networks by hours. The patient talked to me about the abject poverty in many African nations and the terrible problems with disease. We talked about superstitions in some developing countries being problematic. He had never heard of this Ebola before. Had it been around long — and how did it get its name? As luck would have it, I remembered the historical facts in “The Hot Zone” and ended my day on a less frightening note. I could tell him the disease had been studied for about 30 years and that there was an Ebola River in Zaire.

The unofficial state song of Connecticut is “Boola Boola,” the Yale football fight song. By the end of the week, we were all breathing a bit easier and joking Boola Boola yes, Ebola, no. And there was more good news. The Associated Press had decided that announcing every single hospital admission with “Ebola-like symptoms” was perhaps not such a good idea after all.

This article was published in Hygiene Tribune U.S. Edition, Vol. 7, No. 7, December 2014 issue.