Ebola survivor Nancy Writebol recalls treatment, recovery

Ebola survivor Nancy Writebol doesn’t remember much about her air-ambulance ride from Liberia to Atlanta.

But she remembers a medic in Monrovia who put his hands on her face and said, “Nancy, we’re going to take you home. And we’re going to take really good care of you.”

After that: She remembers being thirsty during that 15-hour plane ride. She knows the plane stopped in the Azores in Portugal and in Bangor, Maine, to refuel. She remembers thinking, as a nurse at Emory University Hospital cut off her scrubs, These are the only clothes I have.

She knew she’d said goodbye in Liberia to her husband and fellow missionary, David Writebol, without knowing whether she’d see him again.

Writebol arrived in Atlanta for treatment on Aug. 5, shortly after her colleague Dr. Kent Brantly. They were the first people with Ebola in the United States.

Sitting at her son and daughter-in-law’s dining room table on Wednesday in their north Spokane home, Writebol said she is feeling “really good.” Her physical stamina keeps improving.

Emotionally, she said, she struggles sometimes.

“There are days that are really raw,” Writebol said. “Having watched as many patients as we did die, that’s hard.”

Nancy and David, both 59, planned to leave Spokane today after a weeklong visit with their son Brian Writebol, daughter-in-law Esther Writebol, and three grandchildren, ages 2, 4 and 7. They’ll head to Wichita, Kansas, where they’ll visit their other son, Jeremy, and his family.

They are “basically homeless,” David Writebol said, with plans to spend the next months traveling, visiting family members scattered throughout the U.S. and speaking about their experiences.

It’s possible they’ll return to Liberia. Among factors keeping them in the U.S.: Nancy Writebol’s participation in a study that aims to learn how long Ebola immunity lasts.

They want to encourage doctors and nurses to travel to West Africa to help care for Ebola patients, David Writebol said. “The crisis is not over by any means.”

A nurse in Maine who treated Ebola patients in West Africa has been making headlines for rejecting health officials’ efforts to restrict her movements until after the disease’s 21-day incubation period. A judge ruled in favor of Kaci Hickox last week, decrying the “misconceptions, misinformation, bad science and bad information” circulating about the lethal disease in the U.S., the Associated Press reported.

While protecting public health is important, “we should use what we know,” David Writebol said: People without symptoms of Ebola aren’t contagious.

“If we put a huge quarantine on health care workers going, that’s going to decrease the number of volunteers,” Nancy Writebol said. “I don’t think we should stick our heads in the sand.”

Liberia their third stop as missionaries

To hear via Skype that her mother-in-law had Ebola was a surreal experience, said Esther Writebol, whose fourth baby is due in February.

“It felt helpless, really,” Esther Writebol said. “What can you do? We prayed, which was the best thing we could do.”

Liberia was the couple’s third station as missionaries. They sold their house in North Carolina in 1998 and moved to Ecuador, then Zambia. They signed on with an organization called Serving in Mission in 2012 and headed to Liberia in August 2013. The organization has a complex that includes a hospital with about 50 beds, a school and a radio station in the West African nation.

While David worked as the technical services manager for SIM, Nancy was to serve as a personnel director, helping new missionaries get oriented. A nursing assistant, she was to work part time in the hospital, too.

Then Ebola struck, with Liberia’s first cases reported in March. Centered in West Africa, the epidemic is the deadliest on record. In Liberia alone, nearly 6,500 cases had been reported as of Saturday, with about 2,600 deaths.

As patients entered the hospital, Nancy Writebol became a “hygienist” at the isolation unit for Ebola patients. Her job was to spray doctors and nurses with a bleach solution as they removed their personal protective equipment – the gowns, hats, gloves and goggles meant to protect them from the virus.

For her own safety, in a “low risk zone” a certain number of feet from the medical workers, she wore an apron, gloves and surgical masks, the latter to protect from a harsh chemical used in the bleach solution.

Writebol doesn’t know how she contracted Ebola. It might have been from a Liberian colleague whom she trained as a hygienist. It might have been from a patient’s family member who didn’t report their own symptoms. Once, as she sprayed down a doctor’s protective gear, a breeze blew the bleach solution back at her, and she wondered what exactly was in the mist that hit her – just the solution, or also fluid from the doctor’s apron?

‘It was just excruciating’

Her symptoms started with fever. A malaria test came up positive. But even after her malaria treatment ended, her fever persisted. A second malaria test turned up negative.

An Ebola test turned up positive.

Writebol was placed in isolation in her home.

Her symptoms multiplied.

A rash developed. Victims normally experience diarrhea and vomiting; she “thanked the Lord,” she said, that she never vomited. Her body hurt all over. Touch made it worse.

It was difficult for doctors to start IVs, her veins collapsed from dehydration.

David dressed in protective gear to visit her. One night he laid a hand on her leg, “and it was just excruciating,” she said.

There’s no cure for Ebola, which attacks victims’ organs. Those who survive are the ones whose immune systems – supported by clinical care – win in the end.

“Your body basically has to survive to fight it off,” David Writebol said.

But Nancy split a three-course experimental drug called ZMapp with Brantly, each of them receiving initial doses in Liberia.

She stayed in isolation in their home in Monrovia for 11 days, doubtful she’d be evacuated. A plane equipped with an isolation pod, a crew to fly it and a medical team to care for an Ebola patient were difficult to secure.

But U.S. officials quickly rewrote a contract with the owner of such a plane that had been scheduled for decommission.

Brantly, who was in worse condition, was delivered first to Atlanta. Writebol boarded after the plane was decontaminated and the crew had rested.

Plasma being given to other patients

Upon her arrival Aug. 5, Nancy Writebol was too sick to know where she was, she said. But her treatment at Emory was “amazing.” She received the remaining dosage of the experimental treatment, along with blood transfusions and other fluids.

“They were doing lab work continually,” she said.

David arrived six days later by charter plane, remaining in isolation a week before he could see Nancy.

After her release, Nancy “went into hiding,” she said, continuing to recover in private in North Carolina. Now she and David are often recognized in public, she said. Some strangers offer hugs. Others shy away.

Writebol has donated plasma – now containing Ebola antibodies – to be given to other patients being treated in the U.S. It’s been used to treat one patient, Dr. Craig Spencer, in New York City.

That she didn’t spread the disease to her husband or friends and colleagues in Liberia is part of “God’s story,” she said.

“It’s been a real journey, all of this – just seeing God’s grace in it.”