January 24, 2020

In 2015, Preston Gorman spent 27 days at NIH fighting the Ebola virus and survived, but his battle didn't end when he went home: Gorman struggled with post-traumatic stress disorder (PTSD) after his recovery, losing his family, job, and his "sense of security" in life, Lenny Bernstein reports for the Washington Post

Primer: Here are 9 innovative behavioral health care delivery models

Gorman's battle with Ebola

When the Ebola outbreak occurred in 2015, Gorman, a former firefighter and paramedic, quit his job and joined an organization where he could volunteer to help.

After a week of training, Gorman arrived in the Maforki community in Sierra Leone in March 2015 and spent a few days shadowing caregivers at an Ebola treatment center. Gorman was then assigned to manage a men's ward that mostly treated tuberculosis, broken bones, and malaria, Bernstein reports.

Gorman wasn't required to wear any protective clothing, as any patient suspected of Ebola was separated at the entrance of the clinic and sent to a treatment center. However, shortly after his arrival, Gorman passed out and awoke the next day with a high fever—a sign of Ebola—Bernstein writes. No one knows how Gorman contracted the disease.

Gorman was quarantined and later sent to a treatment facility for caregivers run by the British Army. No one accompanied him on the two-hour journey. He was given a protective suit and placed in the back of a van. "No one could touch him," Bernstein writes.

Gorman continued to decline, and 19 days after his arrival in Sierra Leone, Gorman made the more than 20-hour journey to NIH in the United States. The first leg of the journey was a four-hour drive to the airstrip.

"I've got two [IVs] and I've got two catheters sticking out of me that I'm going to have to take with me on this damn ambulance and be all by myself the whole time. Nobody was gonna get in the back," Gorman said.

On the plane, Gorman was placed in a coffin-shaped plastic bubble and given pain medications to knock him out for the 16-hour journey.

At NIH, Gorman was sent to an isolation unit where 50 or 60 specially trained doctors, who had volunteered to treat Gorman, monitored him, Bernstein reports. According to Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID) and a doctor on Gorman's case, Gorman was one of the sickest patients to ever stay in the NIH unit.

Gradually, Gorman's organs started failing, so he was sedated and put on a ventilator. That lasted for 10 days, of which Gorman remembers nothing.

However, when Gorman was about to be placed on dialysis, his kidneys started to improve, so the doctors held off. Gradually, his other organs also improved, Bernstein reports. "Sooner or later, if you can maintain someone the way we maintained Preston, chances are the immune system will clear the virus," Fauci said.

On April 7, 25 days after being transported to NIH, Gorman was moved from the isolation unit, and two days later, he was released from the hospital and sent home to his parents' house outside Dallas.

Gorman's struggle following the disease

According to Gorman, the two or three years following his recovery were a "fugue state" full of overwhelming sadness, loneliness, and confusion.

Gorman found himself unable to connect with his family, his friends, or his girlfriend.

"I was happy to be alive. But I was now instantly confused," he said. "It was like my sense of security, stability, everything had just been stripped like overnight. Is anyone going to get this?"

Gorman's father, Gene Gorman, said, "We just allowed him his space. When he wanted to talk, he talked … we knew this was a huge healing process, both physically and emotionally."

Gorman said he felt massive pressure to move on with his life. One friend told him, "Hey, dude. Ebola was last year. You need to get over it."

"What I felt was deep, significant, shame," Gorman said. "Like a catastrophic level of shame." It was this shame that ultimately led Gorman to break up with his girlfriend and move out of his parents' house.

According to Gorman, the only people who understood were his coworkers from Sierra Leone. Larry Geller, a retired pediatric nurse who worked with Gorman, said their phone calls together "would frequently be two or three hours. He was kind of in a feedback loop where his frustration and inability to move on was feeding his frustration and inability to move on. He was really in a dark place."

Near the end of 2016, Gorman began seeing a therapist who specializes in trauma, Bernstein reports.

In January 2017, Gorman quit his job and checked himself into a mental health treatment center. Gorman remained at the center for several weeks and began to understand how his trauma had affected both him and his family.

"The family bonds while it happens, and they all feel close and tight," he said. "The individual comes back and goes, 'Well, why am I not a part of this?' And they feel worse and more alone."

The little-discussed side effect of surviving a life-threatening illness

Medical experts today are learning that patients who survive a life-threatening illness like Ebola can develop PTSD or post-intensive care syndrome, Bernstein reports.

But the U.S. health system has yet to figure out how to support and care for those patients once they are released from the hospital.

Natasha Tobias-White, an intensive care nurse who worked with Gorman in Sierra Leone, said, "We're not very good, even in this country, at figuring that all out and giving people that support."

In 2017, Gorman visited NIH and handed out copies of "The Body Keeps the Score," which Bernstein writes is "a highly regarded book on recovering from trauma."

"I said, 'You need to know for your patients, when they come in here, if they have something as serious as I did, this is what can happen. And you've got to prepare your patients, and you've got to prepare your families for this,'" Gorman said.

Today, Gorman continues to see his therapist and is attending a new faith-based program aimed at helping people change. While he has not yet reconnected with his family, he's found a job he enjoys at the University of Texas with a supportive boss.

While he still has his struggles, Gorman said he's starting to feel joy and hope again. "It forced me to dig deep, find out who I really was, and rely on God's direction in the healing process that is still ongoing to this day," he said. "There were many mistakes and dark moments. But a journey that, I hope, in the end will be worth it" (Bernstein, Washington Post, 12/27/19).

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