VUSM alum Crozier relates battle to overcome EbolaApr. 23, 2015, 9:06 AM
Ian Crozier, M.D., a 1997 graduate of Vanderbilt University School of Medicine, and a former Vanderbilt resident, chief resident and fellow, spent three weeks treating 60 to 80 Ebola patients a day in Kenema, the epicenter of the Ebola epidemic in Sierra Leone. When he arrived, although he had significant infectious disease experience, he had little exposure to the deadly virus that has killed more than 10,000 of the 25,000 infected since the outbreak began in 2014. “I quickly gained some savvy,” he said.
And then suddenly he found himself the patient.
For 42 days last fall, Crozier, deployed by the World Health Organization (WHO), was known to the outside world simply as Patient No. 3. He was the third patient flown from West Africa to Emory University’s special isolation unit in Atlanta, set up in collaboration with the Centers for Disease Control and Prevention for patients with Ebola and other serious infections. The first patient, Kent Brantley, M.D., recovered in 19 days. American missionary Nancy Writebol, the second, was there for 14.
“It’s a real pleasure to be home,” the mostly recovered Crozier told the standing-room-only crowd in 208 Light Hall at the Ed Holloran AOA Memorial Lecture (which was streamed into an also packed adjoining room). “But it’s a real pleasure to be anywhere,” he laughed.
When Crozier arrived in West Africa, he joined a group of national health care workers who were “fatigued, anxious and unsettled.” Within the first week, he became the lead physician for a new team.
“Nothing prepares you for taking care of these patients. The pace and the aggression rob them of their dignity. Nothing prepares you for the devastation to the patient, the families, their communities.”
Crozier shared a photo of three young brothers, shot from behind, their arms around each other. All three had been infected with the virus, and had clung together in the Ebola Treatment Unit (ETU). “They emerged from that unit in large part because they had each other,” he said.
He also recalled opening the back door of an ambulance filled with patients to find three or four dead after a four-hour trip to the ETU.
When Crozier became ill, he isolated himself and drew his own blood to be tested for the virus. And then he waited — 24 hours — to find out that he was indeed infected. “It was the loneliest 24 hours I’ve ever known,” he said. He said that he is often asked if he was afraid. “Of course I was afraid. I had seen hundreds of patients die from Ebola.”
He remembers being flown to Emory, and walking in, but nothing else until about three and a half weeks later when he awoke days after his 44th birthday. His condition had been grave. A lengthy review of his own medical chart shows he deteriorated rapidly. He had up to 2 gallons of diarrhea a day, became delirious and when his organs and respiration started to fail, he spent 12 days on a ventilator.
He also received blood from British Ebola survivor Will Pooley, and the antibodies were lifesaving, he believes.
“Those would say, and I would have agreed, that life support (for a patient in his condition) was risky and futile. But the Emory team fought tooth and nail for me. My recovery changed the game (for care of the Ebola patient). They were walking on the moon to see a patient that ill recover for the first time in this particular setting.”
While he was hospitalized, his mother and other members of his family talked to him, read, sang and piped his favorite music into his room from an adjoining viewing room. The presence of his own family achingly reminded him of the loneliness of his patients recovering without family in West Africa.
He awoke at Emory to media reports that Ebola patient Eric Duncan had died in Dallas.
“That was extremely disheartening for me, and I made the decision to stay off the radar for some time.”
Crozier thanked his Vanderbilt friends who helped keep his name out of media reports early in his illness and recovery. His identity became known when he agreed to be interviewed for a December story in The New York Times. Vanderbilt University’s School of Medicine’s Vanderbilt Medicine ran a story in January about Crozier’s recovery.
Crozier, who has been hospitalized twice since his initial hospitalization last year, continues to have several ongoing health problems. His Post Ebola Syndrome includes chronic disabling fatigue, joint pain, neurocognitive deficits and vision issues in his left eye. But the eye is improving after treatment and Crozier told the audience to stay tuned for further updates. “You won’t believe it,” he said.
Crozier flew to Liberia the day after his lecture with a group from the World Health Organization. He was eager to see the progress being made in the fight against Ebola.
“I’m haunted not only by what (these patients) were saved from, but what they have been saved into,” he said. “If we don’t pay attention to the long-term lessons, we’ll be here again. The spread of the disease is slowing, but you can’t put out 99 percent of a fire. It’s not over.”