The Day After the Goats Died

When I arrived to Bai-Suba Resort in Lunsar three weeks ago, a dozen or so goats, mostly kids, spared outside the bungalow where we usually gather at night to eat and decompress from the day.  As I started working in the treatment center and became alarmingly familiar with how aggressively this virus drains the lifeforce out of young bodies, I watched the goats play.  I would sit outside on a wooden bench, listening to Jay Mascis on spotify, and watch them raise up, horns first,  in a display of power and youth.  Goat TV with a guitar odyssey soundtrack.  Elemental and raw. Healing.

As the weeks wore on, the goats became less and less playful until finally they were laying down in the tall brush that would later be set on fire, with heads askew.  Their pointed muzzles had that familiar froth, a web of dry saliva and their bellies bloated like ancient tribal drum skins.  They were all dying, the darkness lashing and raking them in and taking them across.  We called and they were taken away- we don't know where or what was done with them.  I hope they didn't end up being consumed, conflated with non-diseased meat in the catacombs of the outdoor market I visit in the center of town.  Shakira, the lamb who sits guard outside my door, was washed in laundry detergent and is now blue.  But still alive.  Blue isn't her color, but today is mine.  I will miss those darn kids.

Hawa, the 18 year old who was about 28 weeks pregnant, died yesterday around 4 pm.  I saw her on rounds around 1 pm as she lay on the concrete floor, trying to stay cool, or more likely, no longer aware of her surroundings.  We gave her some IV fluids through her left arm which we actively had to unfold to expose her IV.  It thumped the mattress like a fat snake.  She was becoming too weak to even hold herself up.  I wanted to, but couldn't, believe her when she told me that she still felt her baby kicking.  I wanted her to believe her baby was still alive, that somehow it  would survive, even if she didn't, and make it out of her alive.  She dreamed her last dream for her unborn.  As I left the confirmed ward, I looked at her in a diaper on the plastic coated mattress the way I have come to look at patients when I am fairly certain I will never see them alive again.  It starts in the toes and rises like a morning mist in the muscles, swings softly from the ligaments, rafts in the wild vena cava, and spelunks in the ventricles of your heart.  Until it finally meets up with condensation from the clouds of your mind in the small recesses behind your eyes and emerges, to take flight one more time in the hallowed, blue sky that separates the living from the non-living.

Fifteen minutes later I was calling out information I collected inside the tents across the orange plastic fence to a nurse when I heard Hawa calling out, "Doctor.......doctor.......doctorrrrrrrrr."  I went back inside to find her twisted uncomfortably on the floor with her head underneath the metal frame of the bed.  I put her legs back on the mattress and then moved her torso by putting my arms underneath her arms.  Then I sat her up and sat next to her on a stool to give her some oral rehydration solution.  We sat there together, me filling up her plastic mug with the salty and sweet fluid, talking little, until she could drink no more.  I helped her lay back down and put my hand on her forehead.  Then I left to take off all of my protective equipment and be washed in chlorinated water until it stung my eyes.

The number of new infections in neighboring Liberia has slowed to a trickle, with only 10 reported cases in the whole country over the past 4 weeks.  Here, in Sierra Leone, we are starting to see fewer confirmed cases as well in the past two weeks.  I hope this indicates a true decrease in the number of new infections and not just that we are no longer finding the cases to bring in for treatment.  We currently have about 15 patients in our unit, but are seeing an influx and efflux of patients daily.  Ibrahim, the 13 year old, who has been in our unit for 21 days, finally cleared the virus from his blood and was sent back to his village today.  He holds the record since I have been here for the longest stay in confirmed ward.  He has been the first one to discover dead bodies, frozen yet warm, in the middle of the night.  He has seen other kids like him make it out quickly and has watched as they danced in celebration on the other side of the fences.  But the deeper the anchor of despair the higher the kite of hope flies.  I could hear the drums starting to thump and clap hollow outside of our meeting and I knew.  I went outside to witness him in the middle of a circle, dancing and smiling as the nurses, washers, kitchen staff, social workers, and now medical staff snapped, clapped or yelled along with the beat of the drums and the blessed cadence of the  locally crafted "Ebola Song."  Out in the gravel, under the early afternoon white sun, the taste of sweat, chlorinated water, and tears are indistinguishable.

Ibrahim is free at last!