Lindsey Hallen is in the bug spray aisle at REI, the outdoor equipment emporium in SoHo, looking for exactly the right mosquito repellent to take to West Africa’s Ebola zone, when her phone rings. Three ascending tones, the personal anthem of an emergency room nurse, captured in a ringtone called “Summit.”
“Hello?” she says, pulling the phone out of her jacket pocket. Then in an aside, “I think this is them.”
Ms. Hallen listens, pacing back and forth along the aisle, as her gaunt face takes on the same wide-eyed look of concentration it assumes as when she works in the emergency room at Lenox Hill Hospital in Manhattan. Total Focus. Matter of Life and Death.
Since the latest Ebola outbreak entered public consciousness, most accounts of United States health workers have focused on the ones returning; the missionaries who were airlifted out and brought back from the brink of death, or Craig Spencer, the young doctor cured of the virus at New York City’s premier public hospital, Bellevue Hospital Center in Manhattan, while much of the city held its breath.
Lindsey Hallen has two years of experience working with critically ill patients in this country. Credit Chang W. Lee/The New York Times
Now Ms. Hallen, a 31-year-old nurse with two years’ experience working with critically ill patients in this country, is going the other way, heading to West Africa to fight an epidemic that has sickened 21,000 people and killed more than 8,000.
“Why?” her friends and colleagues invariably ask when they find out what she is doing. Why would a relatively young, untested nurse want to risk putting her life in jeopardy to help save people living thousands of miles away, people sick and dying of a brutal, bleeding, contagious fever?
The question annoys her. Her reasons are instinctive, from the gut. You feel driven to do this or you don’t. The thinking only comes later.
“Why not?” she replies. “Why not me?” So the phone call shakes her. The woman on the other end of the line is a recruiter for Partners in Health, the Boston organization that is sending her to West Africa. Instead of Sierra Leone, as had been planned, the group now wants her to go to Liberia, the woman says. Ebola cases there have fallen, but they need people who can rebuild the shattered medical system, teach about controlling infection. She won’t have direct contact with patients. Yes, she can still go to Sierra Leone if she wants to, and take care of patients there. The final decision is up to her.
So the choice is this: Be an instructor, safe, teaching other people how to wear a protective suit, or be the one wearing the suit. She is given a day to decide.
Ebola officially reached American shores on Sept. 30, when Thomas Eric Duncan, a Liberian visiting family in Dallas, tested positive for the virus. Preparing for a possible onslaught, Lenox Hill Hospital set up a room within the emergency department where Ebola patients would be isolated. The staff had to be trained in wearing protective gear, the stifling, fluid-proof layers that include bootees, gloves, gowns, goggles and face shields. The more Ms. Hallen learned, the more she wanted to know. She volunteered for advanced training. She started lingering on the website of the Centers for Disease Control and Prevention. “I was looking at the case numbers and I started to become a little obsessed with everything that was going on over there, and how it was impacting us here,” she said.
She spoke of her newfound interest to her older sister, Kimberly, a real estate photographer, who sensed that this was more than a casual attraction. “She texted me saying she had volunteered to train how to handle Ebola if it came to New York City,” Kimberly recalled. “In the back of my head, I was like, ‘Oh, God, I feel like this is going to expand into her wanting to do a little bit more.’ But I kind of put it away. Maybe not.”
“She’s always been like this ever since she was little,” Kimberly Hallen said. “She was always the one who was trying to find the next fun thing to do. She was bored so easily.”
Lindsey Hallen, a slight blonde with eyes that shift from green to blue depending on the weather and her mood, grew up in suburban Cheshire, Conn., and was a communications major in college, but not a very serious one. “I was very social and that was what I cared about,” she said. After graduation, she moved to Hawaii, without knowing anyone or even having visited. “I was amazed how well everything fell into place,” she said.
She worked at an animal clinic and went to South Africa on an unpaid internship in wildlife conservation. After two years, she moved to Boston, where her sister lives, and began working at Global Vision International, the organization that had sponsored her internship. Her job sent her to South Africa, Guatemala and Costa Rica, to make sure projects were running smoothly. As a memento, she wears three bracelets on her right arm made of twisted copper and brass that she bought at street markets in South Africa. She never took them off, but she had to leave them with her sister before departing for Africa.
After three years, she wanted to grow. She thought about veterinary school, but she also wanted to travel. “Nursing came to mind as a perfect middle ground,” she said. Now, after two years in the E.R., the dread that she has done something wrong no longer wakes her at night. She can rattle off the medical script for an alcoholic with the shakes, a child with the flu or an elderly woman with a broken hip like someone reciting a Social Security number.
There has to be more to life than the three-block dash from her Upper East Side brownstone studio to the 8-a.m.-to-8-p.m. shift at Lenox Hill, and back.
The Doryen family, unbowed survivors of Liberia’s civil war, saw seven members die from the virus in a matter of months and lost its sense of unity. Health workers in Liberia and elsewhere in West Africa are finding they have to ration care, operating under constraints they often find frustrating.
As Ebola ravages West Africa, Liberians are losing an integral part of their culture, in which the double-cheek kiss was once the standard greeting. The Ebola patient in Dallas died on Oct. 8, having set off a rapid chain of events. Two nurses who treated him fell ill, shaking confidence in the United States health care system. In mid-October, several New York hospitals volunteered to be Ebola treatment centers, including a sister hospital to Lenox Hill. On Oct. 23, Dr. Spencer, recently returned from Guinea, was rushed to Bellevue and tested positive. The next day, Kaci Hickox, a nurse returning from Sierra Leone through Newark Liberty International Airport, was forced into quarantine because of public officials’ fears.
Rather than being frightened, Ms. Hallen was swept away. Ebola was her 9/11, the disaster that nourished her sense of purpose.
Scrolling through the C.D.C. website, she came across a link to an application form for medical volunteers willing to go to West Africa, kind of like a universal college application online. She recalls sending it in a few days after Ms. Hickox returned. Her first response, from Partners in Health, arrived on Halloween night. She sent back an email as she dressed for a Halloween party. She was not a sexy witch, or even a nurse. She wore a $12 zombie suit with a zipper splitting her face.
Still, she didn’t really think it would happen. And she assumed that even if she were selected, she would not be paid, and she could not afford that. But Partners in Health agreed to pay for her travel, expenses and medical insurance, as well as provide a stipend that would cover most of her lost salary for nine weeks; six weeks in West Africa and three weeks upon her return, during the disease’s incubation period. As a single person, she didn’t have to worry about disrupting anyone else’s life.
The agency also agreed to pay for her evacuation if she contracted Ebola — a further reminder of the dangers.
Her mother, Laura, cried when she heard the news. Her father, Dan, “had a million questions” but was proud of her. “I think that she’s got the right mentality to perform in this type of environment,” Mr. Hallen said. “I guess what I would liken it to is firefighters that rush into a burning building when everyone else is running out. All I can say to that is, thank God for them. Where would we be without them?”
That mentality is not widely shared, the numbers suggest.
Since November, about 1,300 people have applied to travel to West Africa through Partners in Health, and about 360 have been hired, Sheila Davis, chief of the agency’s Ebola response, said. She said she was still looking for people with the right “humility,” but the number of applicants has declined as Ebola has moved off the front pages.
North Shore-LIJ Health System, the hospital network that includes Lenox Hill, has 54,000 employees. Ms. Hallen is only the second one to go to West Africa to treat Ebola, Joseph Moscola, the system’s chief of human resources, said. An informal survey of other New York City hospitals found few if any volunteers at most of them.
At some hospitals an internal debate rages over whether highly trained specialists should be volunteering to do menial work in African field hospitals or can make a better contribution at home, perhaps by doing Ebola research.
“Major academic institutions, you would think, would be those who would be pushing it,” Ms. Davis said. “But it’s the opposite. It’s definitely been Middle America, and California, but not the numbers you would think in Boston and New York.”
In preparation for Ms. Hallen’s trip, Partners in Health sent her a packing list. Mostly it is similar to a list for summer sleep-away camp: shampoo, toothbrush, underwear. But not entirely. She will need a headlamp, in case the electricity goes down, and some fancier clothes to wear for Embassy events. Also, styptic pencils to stanch cuts, and tampons, for nosebleeds, ominous inclusions in an environment where bodily fluids may be deadly. Ms. Hallen has scratched out the word “condoms.” She has enough contagion to worry about, she said. She trades email with other volunteers. Bring washable shoes, they say. Dried fruit, nuts and granola bars, to break the monotony of rice and beans.
She picks up her mosquito net at REI and jokes that she might use it to keep away the cockroaches in her apartment. Last night she slept with a hat on, haunted by a woman who had arrived at the emergency room with ear pain. The diagnosis: a cockroach stuck in her ear canal.
At the checkout counter, the brooding, longhaired salesman examines her basket and asks where she is going. “Sierra Leone or Liberia,” she replies. “You should read this book,” he says, and on a scrap of paper writes the name Peter Piot, author of a memoir about the discovery of Ebola and AIDS.
The next night, she writes an email to the recruiter from Partners in Health. Deletes it. Writes it again. Presses “send” at 11:42 p.m. At 10 a.m. Saturday, she was scheduled to fly to Sierra Leone, to care for people who are sick and dying of Ebola.
By ANEMONA HARTOCOLLISJAN
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