Lately, I have heard over and over again that African cultural practices are responsible for the spread of Ebola. I agree. However, having experienced quarantine in the U.S., I can also say that American cultural practices could lead to the spread of Ebola. There are three American cultural practices in particular that I wanted to address in this blog post. First, that American medical professionals tend to scoff at self-diagnosis. Second, that health departments generally quarantine individuals only after diagnosis. Third, that Americans tend to perceive quarantining as the equivalent of ostracizing. My personal story illustrates all three of these weaknesses.
If You Self-Diagnose, You Must Be a Hypochondriac
Back in 2003, Hepatitis was the last thing on my mind. All I knew was that I had an incurable desire to lie on the couch watching Oprah. This wasn't something I normally did, and I couldn't figure out what was wrong. I rationalized that I was really tired of the contractors working on my bathroom. But no matter how much I rested, the fatigue grew worse. Finally one day, I noticed that my hands were yellow. I looked in the mirror. My face was yellow. So were the whites of my eyes. Because I'd served a mission in Africa, I knew I had Hepatitis. I immediately called my doctor. At my appointment, I told him I thought I had Hepatitis A. Like most doctors, he wasn't impressed with my self-diagnosis. He ordered a blood test to appease me, but also scheduled an ultrasound because he was sure I was having trouble with a gall stone.
I've thought about this a lot in the context of Duncan Eric Thomas. What if the doctor had simply asked him, "What do you think might be wrong with you?" Then, what if they had listened and considered that he could be right?
Quarantining After Diagnosis, Instead of Before
By the time my doctor got the results of my blood test, I was already starting to feel better. He immediately called the health department and told me not to go out in public. I remember thinking, "Wait, now that I'm feeling a little better, they're going to quarantine me? Wouldn't it have made more sense to start the quarantine a few days ago when I felt like I was going to die?"
This is a problem that also showed up with the nurses who worked at the hospital in Dallas. They weren't quarantined until after they showed symptoms. It looks like the government might try to reverse this practice by quarantining those who've had contact with the disease. Yesterday, for example, we heard about a nurse from the Dallas hospital who's been quarantined on a cruise ship. The news is making a big deal about her quarantine, but the truth of the matter is that she has no symptoms. It's a precautionary quarantine.
The Stigma of Quarantine
The health department called me the same day of my diagnosis. I provided them with a list of everyone who'd had close contact with me, including the contractors who worked on my bathroom. Every one of those people had to get gamma globulin shots at the health department. (That was pretty embarrassing for me, and in hindsight, it was hard to say everyone's name, knowing they'd all have to get a shot.) After that, it was a long, lonely three weeks at home. I was blessed to have people from my church who helped me shop and prepared meals for my family. I'll admit, though, I felt a little ostracized. I'd never known anyone else who'd been quarantined, and I wondered if people would judge me as someone who had poor hygeine.
We need to turn the stigma of quarantine on its head. People who submit to quarantine are brave and generous. They are protecting their communities. They deserve thank-you notes, phone calls, and applause from the media. No, we don't want to be around them, but we can give them the respect they deserve.
My prayers go out to the West African people and those elsewhere who've been affected by Ebola. I hope as a world, we can find a way to end the suffering.