The Ones that Emory Didn’t Save

It was with much fan-fare that 2 American aid workers were airlifted from across the world and brought to Emory University Medical Center where they began experimental treatment for Ebola. We hope for a full and speedy recovery for them and others like them who do God’s work.

But it appears to me that lost in this conversation are myriad others who need help but never get it. Right now, humanitarian work is being done all over the world, and in very dangerous places. These people  knowingly put their life on the line for others. Yet  tragically, some of them are injured or sickened in the service of others. But for them, the call from the CDC offering to med-evac them out never came. There was a girl, who died of malaria while in Kenya. Or the young man who was serving in Egypt. Or a myriad other aid workers who die while serving their fellow human beings.

Also at issue, and it needs to be asked, at what cost are we saving lives? Who decides who gets what may have been, all told, a hundred thousand dollar medical evacuation? Susan Grant, the Chief Nurse for Emory Healthcare, in an article for The Washington Post rightly downplayed the infection risk posed by bringing these patients here. She went on to say:

“The purpose of any hospital is to care for the ill and advance knowledge about human health. . . As human beings, we all hope that if we were in need of superior health care, our country and its top doctors would help us get better”

This statement brings to mind others that need saving. They don’t work in far away lands, they live here in the U.S, right across town, in fact. They don’t have fancy, exotic diseases.  Their conditions have names like diabetes, heart disease, hypertension, and lung cancer. Right now many of them are getting collection notices for their inability to pay from medical centers like Emory University. Others have been trying to get appointments at tertiary centers  like Emory. Only they’re told that their insurance is not accepted there, or their co-pays and deductibles will be more than they can afford.

How would Ms. Grant justify the incredible expense spent on this endeavor to those people? What would she say about the necessity of this experiment, a clinical trial with an N = 2? Could she really  tell those sweating in the Atlanta heat after their electricity got shut off that this was all really for their benefit?

I don’t know how to solve the ethical dilemma here. While I am hope for a cure on the one hand, I cringe at the highlight this places on those at the bottom end of America’s healthcare disparity gap. Perhaps someday in the distant future they can take solace in knowing that they didn’t suffer for naught. Because if they ever contract ebola, there will be a cure waiting for them.

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  • jack

    The nearly 10 million + spent in arranging to fly these 2 home and allocating them support and resources, could have been spent in Liberia and Nigeria and could have saved 10s to 100s of lives. Plus this guy (Brantly) was a family practice doc-they have have VERY minimal training in the inpatient setting or the ICU setting, which was needed in this disaster scenario.

  • Tim Mosher

    As one who was in Liberia rendering aid to the two missionaries, I will weigh in here. While the cost of the evacuation is a fair enough question, it must be realized the this was paid for with private, donated funds by Samaritan’s Purse -who has a pact with it’s employees to evacuate them out if possible. This has happened multiple times, it’s just never in the news. I imagine McDonald’s would evacuate it’s sick executives out of a third-world country if needed.

    Secondly, nobody is discussing how this whole incident has spurred the possibility of moving forward the development of the antibody that was used. Until this, there was nothing to indicate that the normal analysis-paralysis of drug development was different in spite of the uptick of Ebola. In fact, it is possible that had an African population been chosen to run trials on, it would have been considered racist (or whatever other term you might like to use). It is my hope that this has helped spur the speedy development of the serum so that many thousands have access to it sooner than otherwise would have happened. So in that case, the cost of this affair is more than worth it.

    And lastly, it seems to me that the opportunity for American researchers to examine these two cases in a safe, controlled environment, and do follow-up studies is a bit of a gift to them. It’s a much better option that the hellish, dangerous, and uncontrolled environment of a third-world Ebola clinic -trust me on that one. To think one needs to be highly experienced in internal medicine or the ICU setting belies the realities of third-world medicine. In my view and experience in international disaster response, it is those very providers who are most often handicapped and unable to function in a minimalist setting. When you don’t have all the bells, whistles, and lab work, most American providers are completely lost.

  • “Could she really tell those sweating in the Atlanta heat after their electricity got shut off that this was all really for their benefit?” and “I cringe at the highlight this places on those at the bottom end of America’s healthcare disparity gap.”

    Exactly! This is the crux of the matter! Thank you for naming the elephant in the livingroom. For a doctor to admit this is quite honorable. I hope you will try to impress this upon your colleagues and those in higher positions of authority.

    There’s something very disturbing about the triage mentality that has become so commonplace around there; deciding who’s life is worth saving and who’s isn’t.

    As I arrive at one of these facilities I’m always struck by the irony of all the new buildings being erected while low income patients’ care is rationed to the point of unbearable suffering and worse, treatments deferred or refused, and specialty clinics that the poorest can see just a few paces away yet somehow never access.

    When one gets very sick and starts costing too much money the corporation is more likely to turn its back on you and just walk away. People will die of neglect of other more common conditions before they’ll ever have to worry about contracting Ebola.