Entering Suffering

THIS PAST June, Dr. Kent Brantly lay in the same bed, in the same house, where Ebola almost took his life just 11 months before.

The Indiana University School of Medicine alumnus had returned to Liberia for the first time since he was evacuated to America under the glare of the international media in August 2014. During the visit, Brantly and his wife, Amber, stayed with their two young children in a house on the Atlantic Ocean that they had called home after moving to the West African country as aid workers. It was also the same house that later became his isolation unit as he fought Ebola.

As he lay there, emotion overcame him.

“I rolled over to Amber and said, ‘The last time I was here I didn’t know if I would ever see you again,’” Brantly recalled recently. “I just wept for, I don’t know, a long time. “

Given his near-death experience and the anguish his family endured, it would be easy to understand if Brantly chose a safer and more predictable path forward. But that is not his way. While he and Amber, a nurse, don’t know exactly where their future will take them, they remain committed to a life of service and are pledging not to shy away from countries in need because of the threat of Ebola and other potential dangers.

“To be a person of faith does not mean to be safe,” said Brantly, who speaks frequently about how he is called by his faith to serve the poor and underprivileged. “To be a person of faith means to take action.”

For now, action means using his newfound fame to advocate for the people of Liberia and West Africa. Since recovering, he has sat down with President Barack Obama, testified before Congress, and was a fixture in the 24/7 news cycle.

Most recently, he and Amber released a book, “Called for Life—How Loving Our Neighbor Led Us into the Heart of the Ebola Epidemic,” and they embarked on a book tour this summer that included a stop in Indianapolis hosted by the IU School of Medicine.

“This is not something we sought out,” he said of all the attention. “It’s not really something we enjoy.” But, he added, “We feel the responsibility to be good stewards of all we have been given. Right now that means being a voice for the people who don’t have a voice in West Africa.”

That should come as no surprise to those who know Kent Brantly or who have followed his story.

Service Through Medicine

Brantly grew up in Indianapolis and attended Heritage Christian School. Though his father is a physician, he didn’t always see himself following in those footsteps. When he enrolled at Abilene Christian University in Texas, he had not decided on a major. He toyed with the idea of being a high school math teacher and coach, but that didn’t stick.

Eventually, he settled on studying Biblical texts, though he wasn’t quite sure what career that would lead to. Medicine didn’t enter his mind until the summer between his junior and senior years, when he traveled to East Africa as part of an internship. He began seriously considering a life of service through medicine.

He stayed on at Abilene Christian University for a fifth year to take the science classes needed to get into medical school. The effort paid off: He was offered admission to the Indiana University School of Medicine.

When a 24-year-old Kent Brantly set foot on campus in Indianapolis in August 2005, he had a clear focus. He wasn’t just training to be a doctor, but for a career serving in long-term medical missions. And he took that responsibility seriously.

“He had already done some volunteer work in more countries than I had visited,” said Javier F. Sevilla-Mártir, MD, now the assistant dean for diversity affairs and an associate professor of clinical family medicine. “Nevertheless, his humbleness and desire to learn were obvious, as he often sought advice about caring for the underserved locally and globally and in the selection of the medical field he should pursue to better serve communities.”

He had already done some volunteer work in more countries than I had visited. Nevertheless, his humbleness and desire to learn were obvious, as he often sought advice about caring for the underserved locally and globally and in the selection of the medical field he should pursue to better serve communities.

Richard Gunderman, MD, PhD, a Chancellor’s Professor, recalls that the aspiring physician enrolled in a Spanish-language version of an introduction to medicine course and served on a number of medical mission trips during his time as a medical student.

He also served as president of the Christian Medical and Dental Association and was elected to the Gold Humanism Honor Society, which recognizes those who are exemplary in humanistic patient care.

“He was not as concerned about grades and test scores as other students, and treated his entire education as preparation for his calling,” Gunderman said.

For Brantly, IU was a place to learn, to soak up the knowledge and skills he would need to serve those most in need. He credits Sevilla-Mártir and Gunderman, as well as other faculty physicians, as being important influences in his life. He’s also quick to note that many important lessons came from basic science faculty members who taught him during the earliest stages of his medical school career.

“These people taught me how to be a doctor, but so many of them also taught me how to be a good doctor,” he said of his IU Mentors and professors. “They taught me that there is more to medicine than simply diagnosing and treating pathology. And they never discouraged me from the calling that took me to medical school of the first place.”

After graduating in 2009, Brantly pursued a residency in family medicine and other advanced training at John Peter Smith Hospital in Fort Worth, Texas, a large, publicly funded hospital that serves a substantial poor population.

In October 2013, just months out of residency, he and Amber moved to Liberia with their then 4-year-old daughter, Ruby, and son Stephen, who was not yet 3. They had signed up for a two-year stint with the international aid organization Samaritan’s Purse. 

Life in Liberia

Brantly was assigned to work at ELWA Hospital, a facility with about 50 beds on the south side of the capital city of Monrovia. Liberia is a poor country that was devastated by civil wars and relies heavily on foreign assistance. Medical resources common in America are scant there. ELWA Hospital didn’t have even some of the most basic equipment, and there were only four working sinks.

Of the many dangers the Brantlys might have worried about, Ebola was not one of them. There had never been a documented case of Ebola in West Africa. “When we moved there it was not on the radar,” Brantly said. “It was not even on the list of scary things you might worry about. Shark attacks were on the list.”

Right from the beginning, he worked long days at the hospital, seeing children and adults with a variety of medical needs, caring for pregnant women, and serving as the physician liaison for the hospital’s HIV treatment program. While that time was trying, it turned out to be the calm before the storm.

Ebola first started appearing in West Africa in March of that year, but it had not yet crossed into Liberia. Nonetheless, Brantly and his colleagues began preparing. They converted the hospital’s chapel into an isolation unit to treat those infected. They developed protocols and learned all they could.

They received their first Ebola patient by ambulance on June 11, 2014. She would not survive.

Over the next several weeks, dozens of infected patients arrived at the hospital. They would writhe in pain, suffer through horrendous diarrhea and vomiting, spike dangerous fevers, and struggle to breathe. Brantly has called it a humiliating disease that leaves its victims utterly helpless.

Dressed in layers of protective gear, he held patients’ hands, sang songs to them, and tried to help them maintain a sense of dignity. In the end, all but one patient he cared for died. The lone Ebola survivor was a 14-year-old boy named Gebah.

‘It’s positive for Ebola’

The story of Brantly’s personal battle with Ebola is now well known.

He awoke on the morning of July 23, 2014, and he just didn’t feel right. Amber and the kids had flown out a few days earlier in advance of a brother’s wedding in Texas, so he was alone. He decided to stay home from the hospital until he could shake whatever was ailing him. He didn’t think it was Ebola, but hospital staff came to his house anyway, dressed themselves in protective gear, and drew blood. As he awaited the results, his home became his personal isolation unit.

Convinced he had malaria, he performed three rapid tests on himself that first day. All came back negative. Meanwhile, his health continued to decline.

The official diagnosis came July 26. Brantly’s friend and colleague, Dr. Lance Plyler, stood outside the small house, unable to enter without full protection. His other friend and caregiver, Dr. John Fankhauser, stood at his bedside in protective gear. Speaking through an open bedroom window, Plyler delivered the news to the feverish and dazed patient: “Kent, bud, we got your test result. I’m really sorry to tell you it’s positive for Ebola.”

When we moved there it (Ebola) was not on the radar. It was not even on the list of scary things you might worry about. Shark attacks were on the list.

Within days, Brantly was clinging to life. Thousands of miles away, Amber hunkered down out of the public view, prayed and waited for updates. When he was well enough to FaceTime, she’d take a screenshot, not knowing if that would be the last time she’d see her husband alive, she recalled in their book. “He can’t die,” she wrote in her journal one night. “I can’t raise these kids on my own. They need their daddy. I need their daddy.”

At one point, as his fever hovered around 105, his heart raced, and he labored with every breath, colleagues decided to administer a dose of the experimental drug ZMapp. Though it had been tested in animals, no human had ever been treated with it.

Shortly after, Brantly was evacuated on a private air ambulance to the United States for treatment at Emory University Hospital, becoming the first person with Ebola to set foot on American soil. In a moment that was captured by hovering news helicopters and watched live around the world, Brantly mustered the strength to climb out of an ambulance and walk into the hospital in his white hazardous materials suit. At that point, it was uncertain whether he would ever walk out.

Improbably, he did.

On what he called a “miraculous day,” Brantly was discharged from Emory on August 21, just shy of a month after his ordeal began. 

The Suffering of Another

In May, Brantly returned to his medical alma mater to deliver the commencement address to the 404 physicians, scientists and researchers who graduated from the IU School of Medicine.

In his speech, he asked graduates to take the time to dig through their computer files and find their medical school application essay. The vast majority of the newly minted physicians, he guessed, had written about how they were driven to medicine by a sense of compassion, by a desire to help others. He implored them not to lose sight of that.

“Compassion is a visceral image,” he said. “It doesn’t mean to feel sorry for somebody, or to have pity, or to give charity to. Compassion means to be moved in your inward parts, to relinquish your own right to comfort and safety, and to step into the suffering of another. And isn’t that exactly what physicians do? We give up the comfort of a 9-5, Monday-to-Friday job in order to enter into the suffering of others. We give up our nights and weekends to be on call for other people’s emergencies. We take care of people with deadly disease despite the risk to our own health. When everyone else is running away in fear, we stay to help, to offer healing and hope.”

It is through that lens, he said, that he considers his time spent treating Ebola patients a success, even though so many lives were lost.

“Losing so many patients certainly was difficult, but it didn’t make me feel like a failure as a physician, because I had learned that there’s a lot more to being a physician than curing illness,” he said. “In fact, that isn’t even the most important thing we do. The most important thing we do is to enter into the suffering of others, and in the midst of what was becoming the worst Ebola epidemic in history, we were showing compassion to people during the most desperate and trying times in their lives.”