Countrymouse
Country exile in the city
Doctor gets emotional recounting Ebola patient Thomas Eric Duncan's final days, efforts to save him
http://news.yahoo.com/dallas-doctor...final-days-efforts-to-save-him-195701003.html
Dr. Gary Weinstein in his interview with WFAA-TV. The doctor has treated three Ebola patients at Texas Health Presbyterian. …
DALLAS — It’s been popular in the court of public opinion to condemn West African Thomas Eric Duncan for delivering Ebola to America’s doorstep.
But a Texas doctor who tried to save the Ebola patient’s life doesn't see it that way.
“I don’t think about it in terms of blame,” said Dr. Gary Weinstein, a Dallas critical care physician who was with Duncan when he died earlier this month.
Duncan was living in Ebola-ravaged Liberia before arriving in Texas, but relatives have repeatedly said the 42-year-old had no idea he was infected before leaving his homeland — even after aiding a sick neighbor four days before his Sept. 19 flight. His neighbors and employer in Liberia have reported that Duncan received his visa to travel to the U.S. in early September. http://www.nytimes.com/interactive/...ng-the-steps-of-the-dallas-ebola-patient.html
Either way, Weinstein — in a lengthy interview with Dallas’ WFAA-TV (http://www.wfaa.com/story/news/heal...doctor-talks-about-ebola-response/17483917/)— said it would be difficult to second-guess Duncan for leaving West Africa, where the World Health Organization says the outbreak has killed 4,546 out of 9,191 known cases in Guinea, Liberia and Sierra Leone since March.
“It’s hard for me to imagine being in a country, being sharp enough to know that if I get this disease in the location where I am that I’m going to die, and then do nothing about it,” said Weinstein, 55. “So I think that many, many people might act in a similar way to do whatever they needed to do to get somewhere safe.”
Family and friends said love, not Ebola, (http://news.yahoo.com/ebola-patient-thomas-eric-duncans-love-story-162328179.html) drove Duncan to Dallas, where he had plans to marry Louise Troh, a long-lost love and the mother of his 19-year-old son, both of whom are now American citizens. On his fifth day here, Troh took Duncan to Texas Health Presbyterian Hospital where he told emergency room workers that he had just come from West Africa. But according to the hospital, he answered no when asked if had recently came in contact with any sick people.
“I can image that if I was in a situation like that from another country that I might be pretty frightened to say something like that for fear of what would happen,” said Weinstein, who did not see Duncan in the ER. “What if they send me back from the place I just escaped from? I don’t know.”
Weinstein, Texas Health Presbyterian’s chief of critical care medicine, was making his rounds three Sundays ago when Duncan returned to the hospital a second time and in worse condition. A nurse told him that the ER had a patient with a suspected case of Ebola, which had never been diagnosed in the United States.
“That can’t be right,” Weinstein recalls thinking. “Doesn’t seem right, that’s not likely, find out what the real story is.”
[Related: Dr. Weinstein's moment with nurse Nina Pham, who contracted Ebola]
http://news.yahoo.com/nina-pham-ebola-nurse-video-112056625.html
The hospital cleared an entire 24-bed intensive-care unit to isolate Duncan. Weinstein wasn’t on duty during Duncan’s first days in ICU, but drew the assignment by the time the patient took a turn for the worse.
“He had already deteriorated significantly, was critically ill, and was on a ventilator, asleep, pharmacologically — medically — in a coma,” Weinstein told WFAA. http://www.wfaa.com/story/news/heal...n-doctor-talks-about-ebola-response/17483917/
In addition to the ventilator, Duncan also underwent dialysis during the last four days of his life due to kidney failure.
These were two surprising life-saving measures for an Ebola patient, Dr. Tom Frieden, director of the Centers for Disease Control, said during a news conference on Oct. 12.
.
The CDC's Dr. Tom Frieden said he didn't know of an Ebola patient who had undergone intubation or dialysis, but Weinstein says both had been done at Emory. (John Amis/AP)
The CDC's Dr. Tom Frieden said he didn't know of an Ebola patient who had undergone intubation or dialysis, but …
“I don't know the details of the other patients cared for in other parts of the world, but I’m not familiar with any prior patient with Ebola who has undergone either intubation or dialysis,” Frieden told reporters. “Certainly it would be very unusual if it has happened before.” (http://www.cdc.gov/media/releases/2014/t1012-ebola-reponse-update.html)
Apparently he's never read The Hot Zone---the very earliest pages describe the attempt of an ER doctor to intubate an ER patient with ebola whose airway was blocked or collapsed)
However, Weinstein said Texas Health Presbyterian’s doctors compared notes daily with experts from the CDC, Emory University Hospital and Nebraska Medical Center, which is also among the four hospitals designated to handle Ebola cases by the U.S.
“There was in fact an [Ebola] patient at Emory who had been intubated and been on the ventilator who did develop renal failure and required dialysis,” said Weinstein, adding that the measures helped stabilize Duncan.
WFAA published the unedited 45-minute interview online.
http://www.youtube.com/watch?v=iiSvb2tU-HE
At one point, Weinstein gets emotional when asked about detractors who said the hospital shorted Duncan’s care because he was black and uninsured.
“I find that remarkably insulting, I don’t know how better to describe that,” he said.
“The team here,” he said, his lip quivering as tears welled up, “worked their tails off trying to save his life.”
Once they got approval, an experimental medication was tried, but Weinstein said he ultimately knew Duncan might be too sick to survive.
That moment came at 7:51 a.m. on Oct. 8. http://news.yahoo.com/ebola-patient-thomas-eric-duncan-dies-at-dallas-hospital-201613535.html
“It was very, very quick,” Weinstein said. “He was critically ill and unstable, and over a period of minutes, he lost his pulse and was dead.”
The doctor said that Duncan, coherent in the early days of isolation, had discussions with Weinstein’s colleagues and instructed them not to resuscitate him or restart his heart in any way.
“He knew he had a bad problem, and he knew from his experience in Africa what happens to people with Ebola,” Weinstein said. “And I presume that all factored into his decision.”
Weinstein never had the opportunity to have a conversation with his patient.
“I’m told that he was a thoughtful, intelligent, kind man,” Weinstein said. “The nurses spent a lot of time speaking with him and trying to comfort him.”
Because he treated Duncan, Nina Pham (http://news.yahoo.com/nina-pham-identified-as-dallas-nurse-with-ebola-165521689.html)and Amber Vinson (http://news.yahoo.com/ebola-diagnosed-in-second-dallas-nurse-105542930.html) — the nurses who contracted Ebola from Duncan — Weinstein is being monitored for symptoms until Nov. 7 and has agreed not to use public transportation or go to public places. That meant missing his son’s final home football game last Friday night.
He said he can’t say for sure, but the doctor figures Duncan felt sorry for creating such a crisis.
“If those are the kinds of thoughts that a thoughtful, kind man would have, then he probably did,” Weinstein said.
Jason Sickles is a reporter for Yahoo. Follow him on Twitter (@jasonsickles).
http://news.yahoo.com/dallas-doctor...final-days-efforts-to-save-him-195701003.html
Dr. Gary Weinstein in his interview with WFAA-TV. The doctor has treated three Ebola patients at Texas Health Presbyterian. …
DALLAS — It’s been popular in the court of public opinion to condemn West African Thomas Eric Duncan for delivering Ebola to America’s doorstep.
But a Texas doctor who tried to save the Ebola patient’s life doesn't see it that way.
“I don’t think about it in terms of blame,” said Dr. Gary Weinstein, a Dallas critical care physician who was with Duncan when he died earlier this month.
Duncan was living in Ebola-ravaged Liberia before arriving in Texas, but relatives have repeatedly said the 42-year-old had no idea he was infected before leaving his homeland — even after aiding a sick neighbor four days before his Sept. 19 flight. His neighbors and employer in Liberia have reported that Duncan received his visa to travel to the U.S. in early September. http://www.nytimes.com/interactive/...ng-the-steps-of-the-dallas-ebola-patient.html
Either way, Weinstein — in a lengthy interview with Dallas’ WFAA-TV (http://www.wfaa.com/story/news/heal...doctor-talks-about-ebola-response/17483917/)— said it would be difficult to second-guess Duncan for leaving West Africa, where the World Health Organization says the outbreak has killed 4,546 out of 9,191 known cases in Guinea, Liberia and Sierra Leone since March.
“It’s hard for me to imagine being in a country, being sharp enough to know that if I get this disease in the location where I am that I’m going to die, and then do nothing about it,” said Weinstein, 55. “So I think that many, many people might act in a similar way to do whatever they needed to do to get somewhere safe.”
Family and friends said love, not Ebola, (http://news.yahoo.com/ebola-patient-thomas-eric-duncans-love-story-162328179.html) drove Duncan to Dallas, where he had plans to marry Louise Troh, a long-lost love and the mother of his 19-year-old son, both of whom are now American citizens. On his fifth day here, Troh took Duncan to Texas Health Presbyterian Hospital where he told emergency room workers that he had just come from West Africa. But according to the hospital, he answered no when asked if had recently came in contact with any sick people.
“I can image that if I was in a situation like that from another country that I might be pretty frightened to say something like that for fear of what would happen,” said Weinstein, who did not see Duncan in the ER. “What if they send me back from the place I just escaped from? I don’t know.”
Weinstein, Texas Health Presbyterian’s chief of critical care medicine, was making his rounds three Sundays ago when Duncan returned to the hospital a second time and in worse condition. A nurse told him that the ER had a patient with a suspected case of Ebola, which had never been diagnosed in the United States.
“That can’t be right,” Weinstein recalls thinking. “Doesn’t seem right, that’s not likely, find out what the real story is.”
[Related: Dr. Weinstein's moment with nurse Nina Pham, who contracted Ebola]
http://news.yahoo.com/nina-pham-ebola-nurse-video-112056625.html
The hospital cleared an entire 24-bed intensive-care unit to isolate Duncan. Weinstein wasn’t on duty during Duncan’s first days in ICU, but drew the assignment by the time the patient took a turn for the worse.
“He had already deteriorated significantly, was critically ill, and was on a ventilator, asleep, pharmacologically — medically — in a coma,” Weinstein told WFAA. http://www.wfaa.com/story/news/heal...n-doctor-talks-about-ebola-response/17483917/
In addition to the ventilator, Duncan also underwent dialysis during the last four days of his life due to kidney failure.
These were two surprising life-saving measures for an Ebola patient, Dr. Tom Frieden, director of the Centers for Disease Control, said during a news conference on Oct. 12.
.
The CDC's Dr. Tom Frieden said he didn't know of an Ebola patient who had undergone intubation or dialysis, but Weinstein says both had been done at Emory. (John Amis/AP)
The CDC's Dr. Tom Frieden said he didn't know of an Ebola patient who had undergone intubation or dialysis, but …
“I don't know the details of the other patients cared for in other parts of the world, but I’m not familiar with any prior patient with Ebola who has undergone either intubation or dialysis,” Frieden told reporters. “Certainly it would be very unusual if it has happened before.” (http://www.cdc.gov/media/releases/2014/t1012-ebola-reponse-update.html)
Apparently he's never read The Hot Zone---the very earliest pages describe the attempt of an ER doctor to intubate an ER patient with ebola whose airway was blocked or collapsed)
However, Weinstein said Texas Health Presbyterian’s doctors compared notes daily with experts from the CDC, Emory University Hospital and Nebraska Medical Center, which is also among the four hospitals designated to handle Ebola cases by the U.S.
“There was in fact an [Ebola] patient at Emory who had been intubated and been on the ventilator who did develop renal failure and required dialysis,” said Weinstein, adding that the measures helped stabilize Duncan.
WFAA published the unedited 45-minute interview online.
http://www.youtube.com/watch?v=iiSvb2tU-HE
At one point, Weinstein gets emotional when asked about detractors who said the hospital shorted Duncan’s care because he was black and uninsured.
“I find that remarkably insulting, I don’t know how better to describe that,” he said.
“The team here,” he said, his lip quivering as tears welled up, “worked their tails off trying to save his life.”
Once they got approval, an experimental medication was tried, but Weinstein said he ultimately knew Duncan might be too sick to survive.
That moment came at 7:51 a.m. on Oct. 8. http://news.yahoo.com/ebola-patient-thomas-eric-duncan-dies-at-dallas-hospital-201613535.html
“It was very, very quick,” Weinstein said. “He was critically ill and unstable, and over a period of minutes, he lost his pulse and was dead.”
The doctor said that Duncan, coherent in the early days of isolation, had discussions with Weinstein’s colleagues and instructed them not to resuscitate him or restart his heart in any way.
“He knew he had a bad problem, and he knew from his experience in Africa what happens to people with Ebola,” Weinstein said. “And I presume that all factored into his decision.”
Weinstein never had the opportunity to have a conversation with his patient.
“I’m told that he was a thoughtful, intelligent, kind man,” Weinstein said. “The nurses spent a lot of time speaking with him and trying to comfort him.”
Because he treated Duncan, Nina Pham (http://news.yahoo.com/nina-pham-identified-as-dallas-nurse-with-ebola-165521689.html)and Amber Vinson (http://news.yahoo.com/ebola-diagnosed-in-second-dallas-nurse-105542930.html) — the nurses who contracted Ebola from Duncan — Weinstein is being monitored for symptoms until Nov. 7 and has agreed not to use public transportation or go to public places. That meant missing his son’s final home football game last Friday night.
He said he can’t say for sure, but the doctor figures Duncan felt sorry for creating such a crisis.
“If those are the kinds of thoughts that a thoughtful, kind man would have, then he probably did,” Weinstein said.
Jason Sickles is a reporter for Yahoo. Follow him on Twitter (@jasonsickles).
For the record if I get ebola, I too would want a medically induced coma 