Josia Mamora

Josia Mamora

Q: Hello, this is Sam Robson, here with Josia Mamora. Today is October 4th, 2016, and we're in the audio recording studio at CDC's [United States Centers for Disease Control and Prevention] Roybal Campus in Atlanta, Georgia. I'm interviewing Josia today as part of our CDC Ebola Response Oral History Project. Josia, thank you so much for being here with me today. Really looking forward to hearing about your experiences. Just off the top, would you mind pronouncing your full name for me?

MAMORA: Josia Mamora.

Q: Great, thank you. Can you give me a brief capsule description, like a few-sentence description, of what role you had in the Ebola response?

MAMORA: I was one of the clinical nurses that actually took care of patients. I've taken care of all four of our Ebola-positive patients, including, I think, a good handful of potential high-risk maybes, and then the Lassa fever patient who came through not too long ago. I'm currently the charge nurse of the unit. 00:01:00Do all the trainings, help with recruitment and education of the unit and personnel.

Q: And is this, is the unit the Serious Communicable Disease Unit?

MAMORA: Yes, the Serious Communicable Disease Unit, yeah.

Q: Over at Emory?

MAMORA: Yeah, over at Emory.

Q: Got you. So cool, okay. We're going to dive back into the past a little bit, though, if that's cool. When and where were you born?

MAMORA: I was born in Indonesia. Bandung, Indonesia, 1985.

Q: Did you grow up there?

MAMORA: I grew up there, yeah. I move to the States when I was four, I believe. Yes, 1989, four, yeah. My first memory of America was when the Berlin Wall came down, with David Hasselhoff--which I endearingly called him Knight Rider, because I didn't really know his name from the show, I just knew Knight Rider--on the wall, dancing and singing as it came down. That was my memory.

Q: Excellent introduction. [laughs] Doesn't get better than that.

MAMORA: It doesn't.

Q: Sorry about the rest of it.

MAMORA: That's great. I don't know why that memory sticks so well, I don't know, just because I thought Knight Rider was cool, and I was like, damn, that's the guy from Knight Rider, dancing on this wall. I didn't know the significance of it, of course, because I was four years old. [laughter]

Q: Where did you move in the US?

MAMORA: I moved initially to LA [Los Angeles], and then, after two years in LA, I moved to San Bernardino. Well, Loma Linda, California, which is part of San Bernardino, it's a city in San Bernardino County. But no one really knows what that is, like what city that is. So I just say San Bernardino because it's more known.

Q: Sure. I know San Bernardino.

MAMORA: Sixteen miles east of LA, there you go, that's the best way I can 00:03:00describe it.

Q: Is that where you spent most of your time, growing up?

MAMORA: Yeah. I was pretty much raised there, in Loma Linda, the community, it's a small community. It's known for being a Seventh Day Adventist town. The hospital that was there was known for--one of the first, if not the first, non-human-to-human heart transplants. Yeah. By Dr.--I think Dr. [Leonard] Bailey. He's the one that did the operation, and that was a big deal. If anything really steered me to the medical profession--of course, my mom was a nurse, but things in medicine have always been in my mind.

Q: Who was in your household, growing up?

MAMORA: Both my parents, and I have two older brothers, they're both nurses as 00:04:00well. My oldest brother initially wanted to do computer science because we grew up during the birth of the internet. Schools during that time were very heavy in, you should get a computer job. He tried that, and then of course the bubble burst, and he was like, let's do medicine because family-wise, that's what we know. He wanted to be a doctor, but he realized how long, and how much debt that would incur, so he did nursing instead. That influenced me, honestly, to do nursing, because I was like, man, my brother's making a good living, he's pretty independent, and school-wise it wasn't--like four years, just like any other undergraduate degree. And you're making--in California, anyway, at the time, like, eighty, ninety [thousand dollars] a year. People were throwing on sign-on 00:05:00bonuses, hospitals, so I was like, that's a sweet deal. [laughs] That really convinced me to do nursing.

Q: Do you have any memories of your mom doing nursing that kind of, when you look back, they're powerful for you, or--

MAMORA: I remember her relationships. She was kind of like a semi-acute-care home health nurse, so she would go work with families who need long-term acute rehab--they would have trachs [tracheostomy tubes], or PEG [percutaneous endoscopic gastrostomy] tubes--a trach is a breathing tube that's permanently in your throat, or PEG tubes, which is like a feeding tube in your belly. There were really young kids. She used to talk about them a lot when I was a kid, and she even had really good relationships with most of them. Of course, most of the 00:06:00kids that she took care of didn't grow up to have normal lives. They usually ended up dying. But she had really good relationships. There was never a negative experience, I should say. Like, when you get a postcard, or something in the mail, a handwritten letter--because people used to write letters, back in the day, [laughs] prior to email--and she would just read them. It's like, man, she actually made a difference in someone's life, and that was pretty interesting. It was like, over and over, people would be really appreciative of what she did. There was never--there was not one memory that stood out, but just an experience that stood out where she was making a difference.

Q: That makes sense. Where did you go after high school?

MAMORA: After high school, went to San Bernardino Valley College. It's a junior college. Again, I didn't really know what I was trying to do. This is when I was trying to figure it out, and my brother was trying to convince me to do nursing school. [laughs] So I was taking the prerequisites. But during that time, I actually worked at the library, at Loma Linda University library, which was attached to the hospital that I talked about previously. I was working at that library, and it was a great paying job for someone who was eighteen, nineteen, and they told me, "Hey, do you want to go to library school? We'll pay for your school, just come back and work with us." I didn't know that there was a library school. [laughs] But again, I think it's just the--so I had a crossroads moment, 00:08:00whether I wanted to do nursing, which seems to be like the family business, or do something different. Be a real librarian, whatever that entails. I chose nursing, obviously. [laughs] So I went into nursing, got my degree, and started work. I think I was twenty-three when I finished, yeah.

Q: Twenty-three when you finished? And then where do you go?

MAMORA: I worked at Arrowhead Regional Medical Center, which was the--I guess the regional hospital, county hospital, for San Bernardino County, which--fun fact--I think I still have this right. San Bernardino County is the largest county in the contiguous United States. If you discount Hawaii, Alaska, and the regional territories, San Bernardino's the largest county. We served a very 00:09:00underprivileged community, and it was a tough hospital to work at. I guess one way I could consider it, it would be like the Grady [Memorial Hospital] of San Bernardino. Of that area. I worked in the emergency department. A couple of my goals, my life goals when I was at the emergency department, of course, was just to get some experience. I was going to be there for one or two years, get my experience, go back to school, and maybe become a CRNA, which is a certified nurse anesthetist. But of course, that didn't pan out because I ended up loving 00:10:00working in the ED [emergency department]. I met a group of guys that were fresh out of school like I was, and we bonded together, we developed a good crew, and we worked it. We worked five, six days a week, all year 'round. We made good money. [laughter] We made good money, but it was a lot of work.

After a while, I felt a need--I needed a life change. So I made three nursing goals. One was to do a precordial thump on someone. What that is, is--it's not part of the advanced life support protocol anymore because they say it doesn't work, and it--so what it is, like how you see in the movies, you pound someone's chest real hard when they go into what's called a ventricular tachycardia. You 00:11:00can only do it when you witness it. You pound the chest, and they convert back into a regular rhythm. I've done that twice. It works, it just doesn't fix the problem, they just jump back to the arrhythmia. But it does work. So that was my goal number one. Goal number two was to deliver a baby. I delivered four, got two named after me. This was my emergency department days.

Q: Got two named after you?

MAMORA: I got two named after me, yeah. They were like, one didn't know what they wanted to name the baby, and they just saw my name badge, and were like, "Josia, that's a pretty name." And I was like, "It is. It's the best name I know." [laughter] And then the other one was, she just convinced herself that 00:12:00Josia was a better name than--I think it was Steven or something. [laughter]

Q: I would agree with that, yeah.

MAMORA: So she changed the kid's name. Then my last goal--which of course, the first two I thought I would probably never do. Then the last goal was treat an Ebola patient. Which at the time, this was like, what? 2009, 2010? Ebola's a far-away disease, and it's not actually around. It seemed so foreign, it seemed such a--I was like, "When I complete these three goals," I told my buddies, "When I complete these three goals, I'm going to quit nursing." [laughs] Because I'll fulfill every--you know, my top three things I wanted to do in healthcare.

Q: Were you hoping to leave nursing?

MAMORA: I don't know. It was just kind of like shot--we're just talking. Just be like, oh yeah, I'll quit nursing. But of course, I never did. And I've completed all three. It was kind of a weird moment when I actually did take care of an Ebola patient, and then I remembered telling my friends about it. Actually, one of my good friends from the emergency department texted me the day that the press got out that an Ebola patient was coming to Atlanta, and he knew I was in Atlanta, he was like, "Hey, man, now's your opportunity." And I was like, "It kind of is." Actually, I am kind of taking care of--because I actually forgot about those three goals. He texted me and was like, "Hey, man, are you going to quit nursing now?" And I was like, "I don't know." But of course I haven't because I'm like, well, on to the next chapter. It's been an interesting kind of 00:14:00ride. You make three goals that you don't think are--it's going to happen, and it just kind of happens. Yeah.

Q: You were looking to challenge yourself, it sounds like.

MAMORA: I don't know if I was looking to challenge myself. I was looking to just kind of like, justify a long career, a long, fruitful career. If someone asks me, "Hey, did you ever think of doing something else?" I would be like, "No man, I haven't done my top three yet." But then I actually did all three. Yeah. So I've been kind of at a loss, but not really, because now I'm really involved in the whole administration of the unit. That's been really fulfilling my time, and fulfilling in general.

Q: Wait, so what drew you to the emergency medicine at first?

MAMORA: Well, it was always a fun time. Nursing school, I rotated, I did a 00:15:00clinical rotation in the emergency department, and everyone was fairly young, roughly around my age. They were happy, it was fast-paced, it was just like--what's that show? With George Clooney?

Q: Oh, ER?

MAMORA: ER, yeah. [laughter] We watched that on TV, and I was like, oh, man, ER, yeah. Totally. And then it wasn't just like how it was on TV, but it was pretty close. It was pretty close. Pretty exciting. We were a trauma hospital, we saw a lot of trauma. One of the cases there, it stayed in my head, was one of our trauma docs [doctors], and the trauma surgeon, one of our trauma nurses--I wanted so bad to go, but they didn't let me because I was still too green at the 00:16:00time. They went off to--I guess someone had gotten run over by a train, and his arm was pinned by the train, like one of the train wheels, and they did a field amputation. They came back, I remember, through the trauma bay, with an arm in a cooler, and a patient who was pale white. It was crazy. It was insane. I was like, this will make for some good stories. [laughs] Yeah. That's why I love the ED. I still do, and it's definitely a place to go if you want to challenge yourself and sharpen and hone your skills. I can pop in IVs [intravenous therapy lines] like nobody's business. Work fast and work efficiently because if you don't, especially in the emergency department that we were in, if you don't, if 00:17:00you're not working efficiently or quick enough, you're just going to get drowned. You're going to get drowned with patients. Yeah. It was tough, it was a tough work environment. Honestly, the only reason why I worked there for the five years that I did is because, like I said earlier, we really had a good crew and we bonded really well with the group of guys that I worked with and everyone else. We really had--not so much a dream unit, but a dream unit personnel-wise. People-wise. Even now, I feel like anyone can do the work, but what makes work pleasurable is the people around you. Because you could be doing what you love, but if your coworkers are jerks, it's tough. [laughs] It's tough, man, yeah. 00:18:00That's what I've learned. That's what I love about the Serious Communicable Disease Unit, or the SCDU, what we call it, is because everyone--it's a great work environment, you love all your coworkers. You could ask any one of us, and it's like, yeah, man, we're like a real family.

Q: What brought you down to Atlanta, and to the Serious Communicable Disease Unit?

MAMORA: What brought me down to Atlanta in general was my wife. She's a physician, she got accepted for a pediatric anesthesia fellowship position at Children's [Healthcare] of Atlanta, CHOA, at Egleston, which is across the street from Emory main campus--or Clifton campus, I should say. Which is where I ended up applying and working. I transitioned from the emergency department to 00:19:00the ICU [intensive care unit] when I moved down here. The emergency department was--it's tough if you don't have a good crew. You're going to get drowned. The ICU, it's always a good place to end up being if you're a nurse because if you want to further your career in the future, do nursing admin [administration] or CRNA, like I said earlier, a good ICU is a really cool place to be. Where I ended up working, the surgical ICU at Emory, it's endearingly referred to by people in the area as a tough ICU to work with. To work at. And that's what I wanted to do.

Q: Why?

MAMORA: Just--

Q: Sorry, why is it called the tough ICU?

MAMORA: Well, we have a physician by the name of Dr. [John R.] Galloway in our 00:20:00ICU. He's a surgeon, and he takes on really tough abdominal surgeries. These patients will come back with four, five drains, an open abdomen, on death's door, and we'd fix them. [laughs] It's crazy. It's like, things that you would see in the trauma bay, but once they go through the operation, the ORs [operating rooms], you don't ever see, ever. And now I get to see what happens after, the aftermath. But we also do a lot of liver transplants in the surgical ICU, in our ICU. Very sick and complicated patients, usually a lot of multi-organ dysfunction. Patient-wise, they're very interesting patients. 00:21:00There's so much pathophysiology to learn about these patients. Honestly, anyone who goes into a multi-organ dysfunction will end up in our ICU if they're sick enough. It's such a unique, I feel like, a unique ICU in general, because I don't think most hospitals even have this level of care. I applied and had the opportunity to work there, and I accepted. Actually, it was more me interviewing the interviewer about what they can tell me about their ICU, because honestly, after working in the emergency department, I felt like there's really nothing that could really surprise me, work-wise. And there still isn't. I mean, 00:22:00obviously, there's Ebola. [laughs] There's Ebola, but this surgical ICU would at least appease my kind of wanting-ness to have a challenge.

Q: When was it that you went into the surgical ICU?

MAMORA: That would be--three years ago now?

Q: Like 2013?

MAMORA: Yeah. It's the year before the Ebola outbreak, 2013, yeah.

Q: And you're still there, is that right?

MAMORA: I'm still there, yeah. I'm still there. I work in the Serious Communicable Disease Unit and in the ICU. I split my time between the two. I have a very unique role that most people don't have the privilege to have, and 00:23:00I'm very grateful. Like I said earlier, I've fulfilled my three goals and I was going to quit nursing, but [laughs]--this is such a unique experience, what I'm having, and in life in general. I can't pass that up. Yeah. It's interesting every day, every month. If it's ho-hum in the SCDU because we don't have any patients or training gets mundane and routine, there's always the surgical ICU. Every time the ICU gets mundane, routine, something happens in the Serious Communicable Disease Unit, and we get activated and we train. It's nice to see people from different departments because our unit is staffed by people from different ICUs, from different hospitals. Throughout all of Emory Healthcare. 00:24:00We've got people from Midtown, we've got people from Saint Joe's [Joseph's Hospital], we've got people from Clifton campus. There are the neuro-ICU, medical ICU, surgical ICU, cardiac ICU. Different people, and seeing people from different departments, building relationships and just getting to know these people. We really want to build our unit and make it into a family. So we have a lot of trainings, a lot of meetings. I just like the people interaction.

Q: Sorry, to clarify, you're talking about the surgical ICU, still?

MAMORA: No, this is the Serious Communicable Disease Unit. We staff the SCDU for multiple ICUs.

Q: Okay, I understand. Did you enter the SCDU at the same time that you entered the surgical--

MAMORA: No. I worked at Emory in the surgical ICU for the year, and then I remember seeing, on the news, about the Ebola outbreak. I was like, man, that's a big outbreak. You could see it on CNN, or whatever news channel you watch, MSNBC or Fox News, this outbreak just growing, people predicting. I was like, man, that's crazy. Ebola's out there still. After a while, I was just like, there's going to be a certain point in time that someone from the [United] States is going to get sick. Because I know there's people from the States out there, CDC people and all that other stuff. I didn't even know about the existence of our unit. Our unit, the Serious Communicable Disease Unit, was established I think ten, twelve years prior to the outbreak. I don't really know 00:26:00the history, but yeah, it was established years prior. I don't even know that it was in our hospital, for that matter. Most people didn't because there hasn't been anything really before Ebola, or this outbreak. I remember seeing it on the news, and then my unit director comes to me and says, "I wanted to see if you want to volunteer for something. To work, like a special project." I was like, "Special project? What are you talking about?" I was like, "Sure."

Q: Who was this, who was asking you?

MAMORA: It was my unit director, Stephanie Pieroni. Yeah. She's the unit director for the ICU, for the surgical ICU. I know, there's a lot of U's and 00:27:00I's. [laughter]

Q: I think I'm doing okay so far.

MAMORA: Yeah, so you know, we were in the surgical ICU, and she asks me if I wanted to volunteer for a special project. I was like, "Yeah, sure." I was kind of waiting about it, and then of course we had our ICU director, who is the person that kind of makes sure that all of our ICUs are working appropriately. She comes and asks me, "Are you sure you want to volunteer?" And I was like--this is the first time meeting this person. I was like, "Whoa, you're actually high up and could fire me on the spot." [laughter] She's that person, right, she's that high up.

Q: And what's her name?

MAMORA: Her name's Pam Cosper. She comes up and was like, "Are you sure you still want to volunteer for this?" And I was like, "Oh." Special projects, I thought, was just a unit thing. But now it becomes--in my mind, I was like, oh, 00:28:00this is actually something bigger. Right? Then I kind of put the two and two together. In my head I was like, CDC's around the corner. Ebola outbreak. "Special project," in air quotes. I was like, okay, I think we're about to take care of an Ebola patient. Of course, I wasn't the only one to get this kind of asked-to-volunteer call thing. And I believe they asked me to volunteer just because I had the ER experience. Skill-wise, I know not to toot my own horn or anything, but I was one of the more experienced nurses in the ICUs in general. But yeah, I think they asked me to volunteer for it just because I had the 00:29:00really strong ER experience, and I was always a yes person, and I was like, "Yeah, sure, whatever"--you know, whatever you asked of me, I always try to kind of give what I can, if I'm able to. After I kind of realized that it potentially could be an Ebola patient, I was talking to the other people that were getting asked to volunteer, and they were like, "I wonder what this is?" They didn't know, but then of course, enough people were asked that were, like, "Oh, it's like--especially in our own hospital, because this is where, the Clifton Campus is where the unit is, so they asked a lot of the ICUs in our kind of hospital. And then, after talking to a couple of the people that I knew from the other ICUs, we were like, "Hey. I think they're trying to staff a unit." And then, of course, one of the more veteran nurses were like, "Yeah, you know, we have a 00:30:00Serious Communicable Disease Unit that they built years ago, I don't even know who staffs it, but I mean, it's down there somewhere." So I was like, this could be good or bad because it's this secret unit that's probably covered in dust and under tarps or whatever." [laughter] Being covered with nurses that have never really worked together before, and they're trying to just--it felt like they were building a unit, right? Just from all the recruiting. Finally, we were like, "I think we're getting," we all kind of came to the consensus that we're getting an Ebola patient. And then, and that started the freak-out, of course. Rhis is before the word got out to the press. Internally, it started a freak-out 00:31:00where people from my ICU were like, oh man, we can't take care of Ebola patients. Medical workers get sick with Ebola. And of course that data was out by then, and it was--the rates were climbing. You know. "Medical workers get sick with Ebola, people are dying left and right, it's very contagious, we're going to bring it to America." Just like how the views were with everyone else around the country once the news got out. You know, like, it's going to start here, it's ground zero. Of course, I think the show The Walking Dead was already out at that time. [laughs] And we were like, "Oh, man," you know, "the zombie apocalypse, CDC. Just like the show." Or "Ebola apocalypse," I guess I should say. But to me, it was very exciting. You know? It was like, man, this is awesome, this is an opportunity that people won't have. I just know from my own 00:32:00kind of experience, I mean, both my wife and I have done medical missions out of the States. We know that equipment-wise, infrastructure, nowhere near the same. So I was like, "That's probably why people are really getting sick out there, because the infrastructure wasn't laid out, or it's not as laid-out as it is here in the States." I've always had confidence in my own ability, but also in what level of care we're actually able to give on a regular basis. I was like, I think we'll actually be alright. I was more excited than worried about anything, about getting a patient. Once we kind of established the staff members--of 00:33:00course, I didn't get to meet everyone at the time, it was just the staff members that were from my ICU, and the cardiac ICU, which I knew some people from there--once that was established, the press release was two days or three days later. That Atlanta, Emory Medical Center, was receiving a patient from West Africa positive for Ebola. Jill Morgan, one of my coworkers, she has an awesome picture of Emory Circle, which is where the buses stop in front of Emory Clifton Campus, on Clifton Road. She has a before and after picture. Before, when we were just internally mulling about, are we getting an Ebola patient? It was 00:34:00quiet. Business as usual, a few people out there, couple of buses. The day of the press release, roads were packed. [laughter] Roads were packed, tents were up, media everywhere. It was crazy. I've never seen such a big media response. You watch the news and you're like, man, this is actually going to happen, and I'm actually going to be a part of it. And then I think to myself, I should really talk to my wife about this, that I just volunteered to do something. [laughs]

We had that conversation, my wife and I. Of course, she's in the medical field as well, being that she's a physician. She was like, "This is an awesome 00:35:00opportunity for you." And I was like, "Wow, that's not the response that I was preparing for, but it is." You know, it really is. To take care of a really infectious disease. How we imagine Ebola is, like, bleeding out the eyes, just bleeding everywhere, vomiting, like how you would see in the movie Outbreak, with--I think it's Dustin [L.] Hoffman, yeah. Everyone's bleeding, dying, the military were coming out with guns, and we were like, man, it's crazy. That's how it was in my head, it was going to be. It was very exciting. [laughs] But I think my wife's version is a little bit more realistic. She was like, "No. Well, you're probably going to be wearing the suits." We didn't know what suit at the time, yet. "You're going to be wearing the suits, and some gear, and you're probably just going to be doing ho-hum kind of--what you do in the surg"--it's 00:36:00not really ho-hum, but you know, like, "what you would do in an ICU."

Q: The usual.

MAMORA: The usual. "It wouldn't be that foreign to you." And I was like, "Yeah, you're probably right." She was very assured that nothing really bad was ever going to happen. So I got the greenlight from my wife, and I think that weekend, Saturday, we did a full eight-to-ten-hour training day. Because there was a lot of volunteers, and I'd come to find out there were a lot of original staff members.

Q: What does that mean?

MAMORA: The Serious Communicable Disease Unit, even though it was inactive for so long, there were still staff members that were on call. It was "prepared," in 00:37:00air quotes. I got to meet the original staff members, and I was like, "Hey, nice to meet you guys." Some of them bowed out because they were like, oh man, this is serious. [laughs] This is actually serious. And of course, the media and hysteria and everything else is coming up, that's not something they want to deal with or even potentially deal with, or have to deal with, with their families. Because when you volunteer for something like this, it's never just about you, it's about everyone else around you. Because in a perfect world you can just do your work, but it affects everyone else around you, too.

I got to meet the older members, and then the new members, and some people I knew, some people I didn't. We all got to have a meet-and-greet, that day of 00:38:00training. We spent six hours in PPE [personal protective equipment], taking it off, putting it on. Our donning-doffing, that's what we called it. Over and over and over and over, and drill drill drill drill. We were like, okay. The people that were comfortable were like, oh yeah, we're comfortable, this is good, just follow the protocol. Great. Some people weren't able to physically do it, or they panicked underneath the hoods. So they bowed out. But there was a good number of us, I think there was around twenty-four, twenty-six members at the time, after that training.

Q: All of you nurses?

MAMORA: All of us nurses. We got to meet the infectious disease physicians, we call them the G5 now. [laughs] Because there's five. We got to meet them that 00:39:00day. Just a meet-and-greet, sort of like, hey, we might get this patient, we might not, we're just preparing. It was still that kind of preparing thing, but of course in the media, you're like, oh, yeah. You'd also hear, they're preparing to fly someone out, they might not. They might. It's still up in the air during that time. We weren't really expecting to work within the week, or even two weeks. We were just being ready, right? They were just being ready. And then the next day, they were like, yeah, our patient's going to come. [laughs] Patient's coming. It's probably going to be in the evening or late in the 00:40:00morning. We were like, oh, man. This is real now. This is real-real. Of course, that patient didn't end up coming, I think, until the following day, I believe. I think it was, we got trained Saturday, we got word they were going to come Sunday, but I don't think they came until Monday morning, I believe. I might have that wrong, but the time sequence was just--

Q: A few days?

MAMORA: From training to being on the unit, we're doing it, was literally less than forty-eight hours. It was pretty intense. It goes to show how comfortable and how well-trained we were in that short amount of time. Because it's a volunteer group, and if we ever felt uncomfortable, or didn't feel safe, we were 00:41:00more than okay to bow out. Most of the nurses during this time were ER nurses and ICU.

When we got our patient in, Kent Brantly--nice guy, wonderful guy--we got him in, we were all pretty nervous. Most of us just showed up just to see him come in. Because we were all like, we didn't really want to be home. Well, most of us didn't want to be home. We were just kind of being ready, or else just kind of just waiting, watching the TV like everyone else. It was a very surreal moment. 00:42:00It's one of the few times I felt the world kind of slow down. Like, really stop spinning. I remember how everything was really quiet because everyone was nervous, like it got real. It got real, real quick. And Jill Morgan, which--I just talked about her earlier, she was the first, she was one of the veteran members of the team, very well-seasoned, she admitted the patient. It was game on from then. We all got pulled out of our regular units, our home units. We 00:43:00made a schedule, and when it was our turn, it was our turn to go in. It was an--interes--I don't know. I don't know how to word it. It was surreal. But I'll say this: it wasn't like how you imagine. It's not like it is on TV because it's almost less, ah, dignifying. [laughs] Once we saw, had our patient, and knew more about the disease and the realities of the disease, and less of the glamor, the Hollywood. Not that bleeding out of your eyes is glamorous. [laughs] But you just imagine, wow, it's like blood everywhere. But it wasn't like that at all. 00:44:00It was less dignifying. And I mean that, because a lot of these patients lose fluid, they get into an electrolyte imbalance in the most undignifying--and they pass away in the most undignifying way because you kind of stool yourself to death. Or you vomit yourself to death. It's crazy. It was a very sobering kind of experience, like, wow, the reality versus what you have in your mind. Again, not that your imagination wasn't undignifying, it's just, it's a lot more sobering to see someone just--if they pass away from stooling and vomiting. It's less, it's really not glamorous.

Q: Were you told at all, in your training, that there was more vomiting and 00:45:00diarrhea than people were used to with Ebola, or is it something that you'd learn just through caring for these patients?

MAMORA: I mean, they prepped us and told us the symptoms, but I don't think anyone really knew how much you stooled or vomited. Because the previous outbreaks weren't as massive as this one. They were probably fifty, sixty, maybe a couple hundred people. But it was never thousands. It was never really a well--I don't want to say "published," because I'm pretty sure it was well-published--or just well-documented to the public, that it was this severe. Once we saw it firsthand, it was like, wow, this is a lot. [laughs] You feel bad 00:46:00because in the ICU, you can feel safe in that you're cleaning your patients, taking care of them, you can kind of tuck them into a nice bow or whatever, [laughs] and keep them really presentable for the patients' families or whatever. But in this unit, one, it's so difficult to keep them--to have this kind of presentable mindset. It's very difficult. Not only that, but your heartstrings are getting pulled for your patient because you are just seeing them suffer.

The mode of transportation for the disease is bodily fluids. Having that amount 00:47:00of body fluids kind of just everywhere, and you're just not knowing, like--because it's just, it just takes one virus to get you. Even though you're in your PPE, they tell you, they drill you during the training, donning-doffing is very important. Especially doffing because that's the most dangerous part, because you could self-inoculate yourself with the virus. Once you're in the situation, and you remember everything that you heard in training like, be really careful, be vigilant, know what you touch, and now you're in that situation, you're just like, wow, I really do have to be careful and vigilant. And I really do have to depend on my buddy, who's watching me do my work and making sure I'm not cutting corners or getting lax. Just knowing that, "Hey, 00:48:00watch out, there's stool there, make sure you sanitize that area and sanitize your PPE, your personal protective equipment."

Q: Was the situation like--I mean, was there just bodily fluids all over?

MAMORA: I mean, it wasn't like, on the floors, and you're just like waddling through it.

Q: Slip'N Slide.

MAMORA: Yeah, no, not like that. But it was definitely in the bed. The amount of fl--I mean, the risk for a spill--we had bedside commodes, those are big buckets. And filled with a lot of fluid, a lot of stool. Let's just say that if you weren't careful in picking that up and disposing that how you were supposed to, then you would be walking through all that, and that would be a nightmare to 00:49:00clean. We've never had that situation happen because once you're in it, you become more vigilant than you've ever been in your life. But it was definitely all over the patients. We were cleaning the patients pretty often, helping them come, go to the bathroom, just back and forth, back and forth. It's tough, man. You just feel really bad for people suffering with Ebola. Mind you, our first two patients, they were really sick. In our eyes, they were really, really sick. But when you step back, and you think about the people in West Africa, and you're hearing these stories that come back--when our physicians are on phone calls, and we're hearing all the information coming back, they're like, "People 00:50:00get sicker than this." It's like, wow. They get sicker than this?

And then we had our third patient, who was that level of sick. We went above and beyond what literature at that time had evidence for, for taking care of Ebola patients. We did dialysis, we intubated a patient, and we had a really bad situa--like, I wouldn't say bad. Intense. We had a really intense situation, where we were like, wow, this is a really sick patient, how you would see in West Africa. Now it's here. Can we successfully treat without losing [the patient]?" And we did. It was amazing. That level of fear, nervousness, 00:51:00intensity, kind of brings everyone together. This is why this is such a very close-knit team as well. It's been a really interesting experience in general. It's been intense.

Q: Can you talk about just getting to know the first two patients?

MAMORA: The first two patients, they were like the nicest people ever. [laughs] Like, really. They were really, really nice. You just feel really bad for them. I can't say much about Nancy [Writebol], who was our second patient, but I can 00:52:00say a lot about Kent. We spent a lot of time in PPE, once he got kind of--turned the corner and was starting to get better. Kind of building up a--just kind of seeing that, the patient. Sometimes, as healthcare workers, you lose sight that your patient is still a person, and they still have their fears, their needs, their wants. It's really hard for some people. Some people just--they get through the day, especially a tough day, because in your mind, you have to set that this is a job. You can't get attached to everybody because it will just mess with you. But in this case it was like, man. You're a really nice guy. You really got to know him, and it was kind of weird, like--

Q: What did he do that was nice?

MAMORA: Just, like, he would always say please, thank you. Even when it's like, 00:53:00don't worry about it, you know? It seems small, minute, but his mannerisms were very--he was just a nice guy. I can't imagine him being angry. That's how nice he was. It was weird because he'd be watching things on the news about him. You'd be in the room, and he's watching, and I'm like, man, how weird is that? I always like to put myself in their shoes, just to see how I would deal with the situation if I was a patient. And I'm like, man, that's tough. Because there's one side of the world, or one side of the country, that's saying, we don't want you here. And then there's that other side, where it's like, we appreciate that you sacrificed, made a life sacrifice. Not just a life sacrifice, but a family 00:54:00sacrifice, to take care of these patients in West Africa. And then there's another side, where it's like, the whole world's watching and getting to know me, without me actually putting myself out there. He didn't want this.

Q: Right. It's not publicity he sought out.

MAMORA: Exactly. It just kind of fell on him, and you could tell that it was very burdensome for the both of them, especially because they're still sick. The press is like, we want a statement, blah blah blah, what do you say? The worst was when people speculated as to how they got sick, or people were like, "How did they get sick? How did they get sick?" I mean, Ebola is super-contagious, but it's--and I was kind of glad that--because the both of them knew each other 00:55:00in West Africa, and they worked in the same area, I was glad that they both were at Emory, they were both at Emory. Because it kind of made a survivors' group. Or like therapy, group therapy, right? You know that you're not going through all of this alone. If you're getting all this anxiety about the media or whatever, anything else, you can at least bounce it off someone that's going through it the same way you are. I'm not saying I'm glad they both got sick, but just that they were there together, and they were able to confide in each other.

Q: Because they're in these two rooms, separated by just a little space--

MAMORA: Yeah.

Q: --where you put on your equipment and everything, is that right?

MAMORA: Yeah.

Q: Can they see into each other's rooms, or--

MAMORA: They can. Because we have windows big enough so that they can actually see and wave to each other. We had phones where they can actually talk to each other. And they did, they spent a lot of time talking together. But yeah. It's such a weird position to be in. Just to be in their shoes. You're kind of stuck in a cell, you feel miserable, and everyone's watching and waiting for what you're going to say, what you're going to do, and everything else. It's one of the things that you don't really get briefed on, right? As a healthcare worker, oh, whatever. But you just have to remember that they're people too, they're not 00:57:00just patients. They're people. They've been thrust into this weird world of being a potential survivor--and of course they did survive. But like, this Ebola survivor.

Q: Can you tell me why it was bad when you'd hear people on the news speculating about how they got it?

MAMORA: It's not that it's bad, because that's a valid question, right? For anyone, really, other than someone who gets Ebola. Even for someone that gets Ebola. How'd I get it? Like, I wear the PPE, all that other stuff. How'd I get it, or who gave it to me, or did I give it to myself? And all that. Those are all valid questions. But it's bad in that I know for sure it's in their mind all 00:58:00the time. Not only that, but it's in their mind that they might not see their loved ones, or that they might have gotten them sick. There's so many other things that are probably running through their heads, and that I know that were running through their heads, that you don't really need that noise from the outside world. Because it's like, obviously, I'm worried about it too. Right? And then it puts you in an awkward space because then you're wondering if they're wondering that you're wondering. [laughs] Right? I mean, I was. It's kind of like, do I ask him that? It's like, "Hey man, how'd you get sick?" It's such a com--I guess not a common question, but it's an easy question. I never 00:59:00personally asked. There's really no privacy in the unit, so you knew their business and you knew what they were thinking, but I never wanted to be that guy that's like, "Hey, man, how do you feel about all this?" [laughs] I usually just, I'm an ear. It's not my position as a healthcare worker, I feel like, to pry into your life. If you want to divulge it to me, that's fine, that's totally fine, I'm here for you just like with everything else. I'm your number one cheerleader at this point in time. But yeah. It's just, if I was in their shoes, I would hate it for someone outside, like a layperson who doesn't--or even an expert, you know? Because there were a lot of experts where it's like, oh, man. 01:00:00They did something wrong, it's their own fault. When it's like, in reality, man, I don't know. I think it's just that outside pressure, outside noise was really tough on our patients.

Q: And what about the outside criticism that, why are we bringing them into the United States and endangering everyone? Did you guys talk about that with the patients, and with other nurses?

MAMORA: Yeah. That was definitely on our minds all the time, really. Especially with the first two patients, and this was before we successfully treated them, while they were still in the unit. Even though they were getting better, it was still the conversation du jour. I think we did the right thing, and I think all of our team members will say that we did the right thing. Some people say it's 01:01:00an unnecessary risk, but I look at it this way: we live in the United States of America, we're very fortunate and blessed to be in this country, and these are United States citizens who have sacrificed, made the personal sacrifice, to help serve people in other countries who don't have the same opportunities, or have the same level of healthcare in this situation. I think it's our duty to back them up. Because you can't just isolate yourself in a little world--it'll eventually come to you. And unfortunately, with what happened in Texas, it did. But these people really made a sacrifice, and I think it's at least what they 01:02:00deserve, a chance at getting taken care of. A good chance, a great chance. But yeah. We had a lot of pushback, even from our colleagues in the other ICUs in the hospital. It's like, "Why are you taking care of these patients?"

Q: You would have colleagues ask you about that?

MAMORA: Yeah. All the time. And we did. We--it was a big internal issue, when to--you know. Because we were pulled out, away from our regular home units. When we'd try to pick up an extra shift in the ICU, they were like, it's happened a couple times--previously, not anymore, because I think everyone's comfortable that we got it down pat. [laughs] But during this initial outbreak, people were 01:03:00like, no, we don't want you working here, we don't know if you have Ebola or not. Which is--you can argue it both ways, right? But if you're that person that's getting "No, we don't want to work with you anymore," and these are your coworkers, it's like, dang. [laughs] Ouch, you know?

Q: Throughout the treatment of these patients, you're also working in the surgical ICU a little bit, is that right? You're not wholly dedicated to it?

MAMORA: Yes and no. Some of us were wholly dedicated to the Serious Communicable Disease Unit, and others were doing a split. They were working like two shifts in the SCDU, and then one shift in the ICU or whatever. The people that were split were getting a lot of pushback. I never did. I think just because I'm a 01:04:00very likable guy. [laughter]

Q: Own it.

MAMORA: But yeah. I just remember one of my coworkers getting pushback, and she was like, "Yeah. And the ICU was short. They needed people, and it's like, I'm willing to work here," and she got the pushback. I was like, man. That's real, man. And a lot of people got pushback. Especially the physician group. Because they were a little bit more public, because they had to do media interviews and stuff. Once their neighbors found out, or their school found out, "Hey, that lady takes her kids to our school." [laughs] That was something else. That's 01:05:00like, hey. What do you do with that? It's a reality that fortunately I didn't have--I didn't really go through a lot, but knowing your fellow SCDU coworkers are getting a lot of pushback, trying to help someone out, it puts you in a weird situation. Because you're trying to do a good thing but you're getting pushback for trying to do a good thing. It's like, what? [laughter] Yeah. It was a really weird--I wouldn't say unique, because I'm pretty sure a lot of people go through that, but it was definitely a weird ethical space to be put in. Again, there's valid arguments for both. You could argue both to death. But I 01:06:00think, being that I was part of the group that treated everything, it was unnecessary to me. Because I knew that the training that we had, and the comfort level that we needed to have to treat these patients, and the security, just the internal security of your team members and everything else, I was like, this is not going to happen to us, it won't. Hands down, it won't, unless someone really intentionally goofed up, and it was like, that's definitely my fault. I mean, there were so many variables in West Africa where you can say how our patients got sick. So many variables. The level, the infrastructure of healthcare over there isn't the same as here. Level of equipment, even the level of security of 01:07:00your coworkers.

Q: But then, what did you think after you saw that the Dallas patient had transmitted the disease to the two nurses?

MAMORA: When that happened, that was definitely a wake-up call for the whole team. Because after our first two patients, we were like, we got this, this is down pat. We got this. Bring 'em. [laughter] Bring 'em, roll 'em in. Let's get a conveyer belt going. And then we got our third patient, who was our sickest patient, and we were kind of like, whoa. We were kind of taken aback. We were like, whoa, we've got to be even more vigilant. We had a really good experience with the first two, they were really nice people. With the third patient, we didn't really know because he came to us really sick out of the gate, and we didn't know who he was. Again, it's very undignifying. It was a bad situation 01:08:00with our third patient. But we went above and beyond.

But then during the time of that care, of course, Texas happened. It was kind of a wake-up call for all of us, because we were like, man, the level of care they gave to their patient is on par with the level of care that we give to our patient currently. And they got sick. When Texas did happen, it kind of brought a resurgence in that oh, did we do the right thing? Internally, and of course, externally. But again, we were that confident in our process, that we were like, yeah, we're still confident. I think what happened in Texas was just they were caught off-guard. And I think it's a wake-up call for the country. Because it was stated that any hospital in America is able to take care of an Ebola 01:09:00patient. I can argue for that. I think any hospital in America can take care of an Ebola patient. But you need a process. A process and protocols and training, and then equipment, and awareness of the situation. Unfortunately, they didn't have the luxury of getting press releases, and having their patient shipped to them, knowing that their patient had Ebola. It was kind of like, surprise! Yeah. I think that's the difference. But it was also kind of assurance to us, because their patient went through a lot of gates--from the emergency department, 01:10:00ambulance, the apartment that he stayed in, the family members--and from all those kind of contact points, the two people that got sick were taking care of him during the time, at the last couple days of his life. It was assuring to us because all these people that he had contact with, prior to--without PPE, without any of that other stuff, it's like, none of those guys got sick. So we were like, "Maybe Ebola wasn't so bad." But of course it's terrible. [laughter]

Q: Can you describe for me a little bit of, like, what your activities entail in the SDCU? SCDU?

MAMORA: SCDU, yeah.

Q: Excuse me. [laughter] Like, how much of your time you're cleaning stuff, or talking to the patient, or--I don't know, what are you physically like--

MAMORA: So when they're really sick, most of the time is just making sure, one, they don't soil themselves, or if they do soil themselves, it's very well-contained. When they're sick, that's the goal, to prevent bodily fluids from just being uncontrolled. When they are better, which was our favorite time, we would work out. We'll help them rehab, we'll talk, have these deep life conversations. Epiphanies, I guess. [laughs] Life epiphanies, like, oh man, we made it, man. What are you going to do now? You know? None of those were Disney World. But it was definitely, especially for our first two patients because they were the first--like, they were the first, you have these really interesting conversations about, what are you going to do now? You've got to write a book, you've got to make tours, you've got to--you know, it's like, what do you do 01:12:00now? But activities-wise, day-to-day, you'd try to help them fill the day. I think people, a lot of people don't realize how long a day really is when there's nothing to do for a patient. Because I mean, they're still virus-positive, but then they feel better. And they're kind of just stuck in this room. So we had--what is it, the adult coloring books? [laughs] Yeah, they were coming as a fad during that time. We have adult coloring books, just games, card games. We had the Nerf basketball, which was a, it's become a legend now, like, if you have an Ebola patient, get a Nerf basketball. [laughter] Yeah, but 01:13:00we played Nerf basketball. We even--again, like I said, we worked out with the patient, did push-ups, helped them. Because they wasted away, so they needed to do actual physical rehab. But a lot of it was just filling their day. When they were able to, we'd try to get their family to visit as much as they can. For Kent, his wife was with him the whole time. Of course, they couldn't bring their children, but his wife was with him the whole time, and she was definitely a needed support for him. Not just for him, but for Nancy, too. Because unfortunately, Nancy's husband, they were in West Africa at this--he wasn't 01:14:00allowed to be in the room either because the isolation procedures and stuff. But yeah.

Q: Was she still behind glass when she would meet with--

MAMORA: Yeah. In the anteroom, which is the space in between both patient rooms, yeah. They would just talk through the glass. It's funny to me because it's kind of like how you would see it in the movies, when you're in jail, and there's that solid piece of glass, and you have the two phones. Whoever designed the unit probably never thought about that, but as soon as I saw it, I was like oh, man, this is like prison. [laughter] For all intents and purposes, it was kind of their own personal prison. They were there. They had company, of course. Once 01:15:00they got better, enough to where they can actually eat real food, we'd just try to get real food. Fast food is a bad idea, by the way.

Q: Okay, what food is a good idea?

MAMORA: Just real, good--like, a cooked meal would be great. Hospital food is notoriously bad, right? But fast food, it's too greasy for a sensitive stomach to eat.

Q: Did you try it?

MAMORA: Yeah, and it wasn't good. That's why I said fast f--[laughs] I mean, it--I didn't, per the patients. But yeah, you just try to fill out the days. Again, when they want to talk about something deep and personal, you just have 01:16:00to be there and listen and keep their confidence that you're going to protect their secrets or whatever.

Q: Are there memories, any moments that stick out from interacting with let's say the first three patients, that--

MAMORA: Yeah. With Kent, especially. Nancy was actually released prior to Kent, she was released first, she got better quicker. She wasn't--well, I can't say she was physically not as sick, but she cleared out the virus quicker than Kent did. Kent was alone there for a little bit in the unit, just by himself. I tried to make his exit special. We were planning about it, and we were like, "Hey man, your wife's been here the whole time, she hasn't been able to touch you or hold you or anything like that." Because we don't allow visitors to have that close 01:17:00of an interaction, just through the window. I was like, "I want to make your exit special." So I got a sample bottle of Versace body wash, [laughter] so that when he made that exit, that moment would be really special because he would smell really nice. He wouldn't smell like hospital body wash, or soap, or hospital scrubs, he'll smell like a real person. And he did, he used it. He used the whole bottle. It's funny, it's weird because it's always the small moments, right? He used the whole body wash, and when he went out that room, I remember they had their first embrace, everyone was there, because again, this was the moment that we've all been waiting for, kind of thing. And when she held him, I 01:18:00remember her saying, "You smell so good." And I was like, yes! Yes. Yes, he does. [laughs] He does smell good, he smells great. And you know, Kent wrote his book, and that moment was in his book. I was like, oh, man. I made a difference.

Q: What's it like, with him having a book out there, and--I don't know?

MAMORA: I mean, it's cool. I think, again, it's a very unique life experience. Everyone has a unique life experience, but I think his situation more so, because he was--again, it's not to diminish the Ebola survivors in West Africa, or those victims. There's a lot of controversy about, why does he get this level 01:19:00of treatment, and they don't? And you can argue that to death. But I think his experience was unique because he was the first. It was so well-publicized. I think on a personal level, it was hard for him to deal with that responsibility. Because again, all these arguments and questions that you can propose for discussion, they've had this discussion internally, this whole time. And really, by themselves, there's really no one to really bounce it off of. Does he become the figurehead of fighting for Ebola now? Does he have to do that, does he need 01:20:00to do that? Is there a responsibility that he has to do that? For the other survivors, other victims? It's hard. It's one of those things where, if you have the power to save ten lives from any disease, and you can only give to ten people, but then you have a million people to save. Who gets what? It's like a Sophie's Choice thing. It's hard, right? That's why I feel for these, for our patients, and all the survivors and victims. I feel for them because it's, again, it's a very undignifying kind of disease. And especially for him, now that he's made it, it's like, does he have all this, the weight of responsibility?

Q: What was it like treating your fourth patient, who came from Dallas, right?

Mamora; Oh, yeah. Man. That was surreal for a lot of our team members. Because she was one of us. She was a healthcare worker in the States, trying to take care of an Ebola patient. In her mind, she was confident about everything she did, and she still got sick. It really rattled a lot of us because we're like, man. If we're doing the same things, then have I just been naive this whole time, that we're not going to get sick? Of course, you have the argument of, they were right. [laughs] We shouldn't have brought it here. It's like, again, all those questions run in your head. But for me personally, I saw it as another 01:22:00healthcare worker that deserves a chance at the best healthcare possible, too. Because they've made that sacrifice. And especially more on their end, because they didn't have the prep [preparation] time like we did. They just got their patient. I remember her saying, "They came on to the unit and were like, 'Hey, guess what? We have an Ebola patient.'" How do you come to work one day--[laughs] How do you respond to that? If you went to work and someone, your manager said, "Hey. We have an Ebola patient, and we're going to take care of him."

Q: Yeah. It's like, we can think about how wild it is, that you had that training and then forty-eight hours later you're caring for an Ebola patient, but--

MAMORA: But we had that time, we had forty-eight hours.

Q: Forty-eight hours.

MAMORA: Forty-eight hours is forty-eight hours, yeah. And also, even before then. Because we had the time to kind of redevelop--we had the infrastructure, for one. Even though it was dusty and had tarped, just for figure of speech purposes. But we had the infrastructure, we had the equipment, we had the expertise. We had so much, so many more resources and capability. Now, again, maybe they felt like they did too. I know that we have a lot of resources, and I think we have very unique capabilities here at Emory. But man, it's surreal. 01:24:00Like, that could have been you. I think that hit a lot of people hard, our team members. But she did well.

Q: Are there memories that you have, specific ones, about caring for her?

MAMORA: I remember the different level of media. We were prepared for a lot of media, but the first two, definitely, a whole lot. The third, we almost did it under the radar. But with her, we were expecting a lot more media because she 01:25:00was, I guess, Patient One or Two? Not Patient Zero, because obviously. In the American outbreak. The different level of media was--and by saying different, it's--one, because there wasn't as much media attention when she came to us. But then, there was a different kind of media attention, because it's like an "I told you so" kind of thing. I think it was tough on her, too, because she was out the gate villainized. Because she had made travel plans, and was trying 01:26:00to--I mean, she was trying to plan a wedding, for crying out loud. She was villainized for traveling here and there, and everyone was like, aaah! Like, we might all have Ebola now. And I think she became the villain. She's not a villain at all. She was just trying to do her job the best way she could.

Q: Is that something you guys talked about?

MAMORA: Yeah. We did. It's kind of like a, how do you--it's really hard, because how do you respond to that? Again, for all of our patients, you just have to be a sounding board and just listen. But once you start putting yourself in their shoes, it's like, man, it's tough. It's a tough situation to deal with. And her kind of experience, you know? She's coming to work, finds out there's an Ebola 01:27:00patient, takes care of them. Unfortunately, the patient dies. She's following the protocols. She's planning her wedding at the same time, travels, feels sick, she self-reports, she gets treated, gets to us. And the other, the media narrative, or--not all of the media, but the malicious narrative is that she's trying to hide something, traveling and being selfish. It's like, no. She put her life on the line to help somebody. I think that's very--that's the most unselfish thing you can do. For the first two patients, it was just kind of--it was the situation, it was more of this is a bad situation. They weren't 01:28:00villainized, per se, but they were--the situation was villainized. Her, it was almost like a personal thing. It was like, man, that sucks.

Our third patient, I think, just lucked out. It was crazy because he was the sickest of all of our patients. We did the most with him, and he was with us the longest. I feel like in a kind of post-treatment time period, he's like family. We all know him, we all love him, we got to know all of his family. I think that was how all patients--like, how patients should experience getting treated with 01:29:00Ebola should have been like his. Where it's like, yeah, we have a third patient. Instead of knowing that when you're getting discharged, you have to have a press conference. Which is, as a patient, I'm already dealing with just surviving, now I have to have a press conference about it. It's crazy, man. It's tough. But for me, it's been a very interesting ride. I got to know these four people, I got to fulfill all three of my nursing goals.

Q: Can I ask what it was like interacting with the doctors?

MAMORA: Our physicians are awesome, man. Our ID [infectious disease] physicians are probably some of the best people I know. Like, just people in general. 01:30:00They're all super-nerdy and smart. [laughs] But they, all five of them, they all have very different, interesting personalities. Dr. Colleen [S.] Kraft, she's so sweet, she's the sweetheart of the group. There's Bruce [S.] Ribner, who's the chief, we call him Big Daddy Bruce because whatever he says, goes. But he's very humble about it. He doesn't want to be called Dr. Ribner, he wants to be called Bruce, or then he'll call you Nurse Josia. [laughs] He's like, "I don't need the title." There's Marshall Lyon, super-smart guy, funny, like you'd never--I mean, 01:31:00the other docs call him a genius. Really. You wouldn't know it by the way he kind of talks. He's like a regular guy on the street. Just talks to you, right, whatever, and then he'll drop some big education on you when you ask him. And then there's Dr. Aneesh [K.] Mehta, we call him Fozzie Bear because he's such a nice guy, very lovable. And then there's Dr. Jay [B.] Varkey, who's like, GQ, plain and simple. When he goes up in the media, he's in his best tie, best shirt, pressed suit. They're all--honestly, they're all really good people. The reason why we call ourselves a family, and the physicians are a big part of that, is because most--like, the typical kind of nurse-physician relationship is 01:32:00like, the physician's the boss, nurse is like the employee, and it's one-way, it's not reciprocal. But they really made this work environment--they almost came to it as nurses, physicians were equal. And we are equal, in the eyes of Ebola, because if you get sick, you get sick, it doesn't matter who you are. They were with us in their suits, helping us turn patients, clean. I mean, they've never cleaned anybody in their life. [laughs] Aside from maybe Dr. Kraft, because she works with a lot of stool samples. But you know what I mean? That's not the typical physician's job role, to help clean, pull, turn patients. 01:33:00They helped us cover. They covered us for lunches, for crying out loud. They would come from their clinic hours to run down to the SCDU and help cover the nurses for lunches. All of them have a family sacrifice story. They were on call, there was always a physician with the nurses at all times, or at least within a phone call, within like a five-minute response time. They made a lot of personal life sacrifices. As hard as it was on the nursing staff, I mean, there were twenty-four, twenty-six of us, there were only five of them. They had to be there the whole time. A lot of late-night phone calls to their families, their kids. You hear it in the background, you're like, man, that's tough. You're making that sacrifice, and especially when they were getting that pushback from 01:34:00some of their schools. Because your kid happened to say, "My mom, my dad works with Ebola." [laughs] What do you do, you know? It's tough.

Q: Were some of their kids not allowed into school, or--

MAMORA: I don't know how far--because, again, I'm not one to pry into people's personal situation, or even plan to put it out there, but they got a lot of flak, to say the least. Yeah. They got a lot of flak.

Q: What was it like with your wife? I know she was cool from the get-go with you doing it.

MAMORA: Oh, she was--well, eventually, because our patients came back-to-back-to-back-to-back, our four patients, she kind of got tired of it. Not so much me doing the work, that's cool, she was cool with that. It was more 01:35:00so the schedule, the life schedule. Because you would be at work four, five days a week, and alternating schedules, so I'd work nights in the SCDU, and she'd be working days, and we would see each other for like thirty [minutes], an hour out of the day. Then you can't plan for vacations because you don't know when the next patient's going to come, and even when they were gone, you'd still have to monitor yourself for the next twenty-one days. And let's say you choose to, you made the personal decision to travel, even if you're at your twenty-day window or whatever, or even traveling in general, and then someone asks you, "Have you"--you know, because any time you travel, now, they ask you those questions. 01:36:00During that time, "Have you been in contact with anyone with Ebola?" Or you go to your dentist's office, and they ask you that, or your regular doctor, your PMD [primary medical doctor]. How do you answer that? "Uh, yes?" [laughs] And then you're going to have a whole world freak out on you. It's kind of like, well, you want to be open with information, but then you don't. But my wife was just--she got fatigued about that. I remember, even going to the dentist, and when they had asked me, you know, "Have you been in contact," I was like, "Oh, man. I don't want to lie." Good thing my dentist is actually a real close friend of ours, so she was like, "Oh, don't worry about it." [laughter]

Q: Wow, I didn't even know dentists were asking that question.

MAMORA: During the time. And currently, right now, we're recommending that travel history especially become a standard of care for anyone going into anything. If you're going to a medical office, or anything like that, I think that has to be a standard, part of your standard practice when you're getting your history and physical, or assessing your patient.

Q: Tell me what has happened since the fourth patient discharged, and what you've been working on, and what you see yourself working on in the future.

MAMORA: We've been working a lot with the CDC and the [Georgia] public health department on making sure that the entire state of Georgia--but not only that, the Southern region is well-prepared, and has at least a basic infrastructure, a 01:38:00response infrastructure, to anyone with a serious communicable disease. Working with Nebraska, our partners in Nebraska, and several other hospitals--New York and Bellevue [Hospital], they've taken care of an Ebola patient, and other hospitals who have the capacity. Because one of the bigger things that isn't really talked about in treating an Ebola patient in the States is the cost. And the burden on your healthcare institution. It's not like treating an Ebola patient is a money-making endeavor. [laughs] You're pulling staff, nursing staff, from already-short ICUs; you're having to train on a regular basis because you need familiarity with equipment; you need to set up protocol; you need to set up leadership. Setting the infrastructure, it takes a lot of time and effort, and not only money. So we've developed the National Ebola Training 01:39:00and Education Center, NETEC, to cover pretty much every--and we've divided the United States into ten different regions, and there's a main treatment center in each region. And a rough infrastructure, as to if someone did come into any one of these regions, there would be an appropriate response. Because what we do know is that even though potentially any hospital can take care of whatever disease, we know, realistically, that it's not really reasonable. You need centers, special centers, to be able to respond and take care of a situation like that.

Q: And how about the future?

MAMORA: The future? I don't know. I'm working with--I'm in the Serious Communicable Disease Unit, I'm the charge nurse at this moment in time. I help make sure that we have adequate staff for at least two patients, and that the staff is trained really well. That includes the people in lab [laboratory], nurses, physicians. I update the protocols if we have a change in equipment, because we've changed our equipment, we've changed our protocols. I feel like every time we get a new patient, we have to change a protocol because no protocol's perfect. You have to stay fluid with the disease and kind of change the way you do things. Because you want, you've brought in new equipment, or you've phased out old equipment. But yeah, I've been doing that. I was going 01:41:00around with Georgia public health for a little bit, helping develop the Infectious Disease Transport Network, which is really the first in the United States, as far as I know, extensive-wise, on making sure that public safety departments are really aware--fire, police--they're aware as to how to identify a patient with some rare infectious disease and respond appropriately, and then, who to call. That's the problem. The problem is, who do you call? You can't just get on the phone if you're a sheriff's officer of whatever county, or even a 01:42:00firefighter, and be like, hey, who do we call? So just making sure that people know who to call, the public health number, and educating people on how to keep themselves safe and the community safe, and having more awareness. I think pre-Ebola, people were just not that aware of how big an effect something like that can affect the system. It's almost like a--I don't want to compare it, might be a bad comparison, but it's almost like Ebola was the 9/11 [September 11th, 2011] version of healthcare. Right? Because pre-Ebola, people were kind of 01:43:00comfortable in that, "Healthcare, we got it." But then post-Ebola, you know that we really kind of lucked out. Honestly. We've just been getting lucky. I think we need to be more prepared. And being prepared is not necessarily putting more money into something, it's developing protocols and making sure that you have communication between departments and making sure that people actually know how to work together so that you don't make a small disaster into a raging epidemic. That's what I feel like I'm currently being a part of.

But I think in the future, I might go back to school and complete that CRNA thing that I talked about before. Just because this has been a very interesting experience, and I'm going with it, I have--it's so unique. I mean, honestly. How many people can say that they've taken care of an Ebola patient? Not many, right? And I guess I'm starting to feel the weight of that responsibility, of how far do I take it. Do I stick around and wait for the next outbreak, to make sure that at least my expertise is there for our unit? Because our unit's going 01:45:00to be around for the foreseeable future, unless the CDC ends up moving, which I doubt. Because you've planted your feet here, with a lot of buildings.

Q: It's true. Got a lot of--big campus. Actually, because most of my interviews are about CDC-specific response--first, that makes you a really valuable interview for me, so I appreciate you being here. But I also feel like I have to ask you: how would you describe your interactions with CDC, regarding Ebola?

MAMORA: I think, honestly, on a personal level, CDC's probably one of the coolest places--or if you can work at the CDC. Probably one of the coolest places to work at, I feel like. It's so interesting. It's a whole kind of 01:46:00government shop set up to protect people, and it's like a big science lab, right? In my mind. And from my interactions with CDC of just meeting people that came through and that I've talked to, it's a lot of responsibility. Honestly, I felt for CDC workers in general, especially because you guys are right next door. I felt for you guys because when there's a big outbreak disease, people are going to turn towards the CDC of the United States of America and be like, what should we do? People at the CDC will have to go through all the data, 01:47:00monitor the situation, and just--there's so much--I feel like it's so much responsibility, just to be placing that on one institution. If something goes awry, then you get the blame for it. You have to go to Congressional meetings or whatever. [laughs] Like how I saw on TV. You have to go to a meeting, it's like, oh, man. It's like, man, everyone's just trying to do their best. There's definitely no glitz or glamor, working. Everyone's just trying to do their best for other people. And there's no one, like, no--I don't know when the last famous CDC person, or if there was ever even one--

Q: A famous CDC person?

MAMORA: Yeah. I don't know one. Do you know--

Q: Yeah, but just because I work at the CDC Museum, you know?

MAMORA: Well, yeah. Well. [laughs]

Q: Before that, if you'd asked me, then I'd say, no. I wouldn't be able to name a single person.

MAMORA: It's a lot of unsung heroes, right? A lot of people that make a lot of impact to save a lot of people's lives, and probably millions of lives at this point, and you don't get a byline at the New York Times or something like that.

Q: But working with them, regarding--I don't know if you worked with them regarding PPE, or--and you mentioned, you were working with them now, creating these new networks. Your impressions have continued to be good?

MAMORA: It's, yeah. It's continued to be good. Because honestly, I think everyone, especially with the whole PPE and everything else, everyone's open. Everyone's open to suggestions because I think we realize that there's so much more about Ebola, and diseases in general, that we don't know. For me anyway, if 01:49:00you have a valid suggestion, or input, it's well received. That's just my experience. Again, I'm not Big Daddy Bruce Ribner who has contact with CDC people like on a daily basis. But from my experience it's been great. I've been able to get into the campus one other time before, when President [Barack H.] Obama visited. Everyone was nice.

Q: Great.

MAMORA: Yeah, it was a great time. To me, it was a great experience. Now it might not be like that for everybody. But on a personal, ground level, we didn't get any flak from CDC with our PPE per se. They didn't say, you're doing that 01:50:00wrong. No one was wagging a finger at us. It was kind of like, this is relatively uncharted territory, taking care of a patient here in the States. Because we have so many more standard practices here that--and as institutions, that you're legally liable for. Which is crazy to me, because I've never had a personal experience where if I made a mistake, I would affect so much more than just me. You, as a healthcare worker, you're able to help other people in their 01:51:00personal life, but then that's just like one person. But I feel like, in this situation, it was like--your institution is on the line. Not only that, but healthcare as a practice was on the line. If something went awry on CDC's backyard, which we kind of are, it's like, then they're on the line, and then if they're on the line, then the country's on the line, and I don't know. You can kind of go on and on. It's what's very important for--keep yourself humble, and know that whatever you're doing affects so many more, other people, and that you're never just in a small little bubble.

Q: Is there anything that we haven't gotten to talk about that you want to make sure we have down for the historical record?

MAMORA: No, I think we talked about--

Q: We covered a lot of good ground.

MAMORA: Yeah, we covered a lot. I don't know. I think--mental health. Mental health for someone working in PPE, and especially for the patients, the mental health wellbeing, I think mental health in general. Honestly. But I think mental health for our patients, that mental health aspect of getting treated in an isolation unit, hasn't really been too discussed. Future situations might not be as media-publicized as it was this time around, or last time around, but I think there needs to be a little bit more support. I think what we did at Emory was pretty good, where we had chaplains come by for us any time we needed it, and we had very supportive team members, and all that other stuff. But I think there 01:53:00needs to be more research done as to how you deal, or help someone deal personally, in a situation where you're on death's door and you're isolated by yourself. And also for the workers, the toll it takes on you, on your personal life. You'd like to think that you go to a job because that's your passion, that's what you do, but ultimately it's a job, right? And you're going to treat it like a job. You have your lunch time, you have--whatever, your coworkers. But then you thrust that into an extremely stressful situation, it does take a toll. A mental toll on you. It's like, who do you talk to? Who can actually relate? 01:54:00It's bad that you're thinking about that, who could relate to you, but it honestly is. It's hard to talk to somebody when it's hard to relate to them.

Q: No doubt, absolutely.

MAMORA: But I think mental health in general, just for the patients at least. And the survivors. It's more so a personal decision for everyone, as to what they do afterwards. When we had a group of survivors come to us, it was nice to see. It was our one-year anniversary or something like that. It was nice to see 01:55:00a group of the survivors hanging out.

Q: Survivors from the US?

MAMORA: Yeah. It's like, oh man, there's four of them there. [laughs] Just talking about their experience. Maybe that's the solution, to share, make a little AA [Alcoholics Anonymous] group. [laughs]

Q: Creating community.

MAMORA: Yeah, creating community, exactly. I think that's probably a really good solution. Because it's hard to talk to people about how stressful it is, or even what's on the line, when you don't go through it. It's a lot.

Q: Yeah. Well, I really appreciate you making the attempt today, at least, to talk to me, and to talk to people in the future who are going to be interested in listening to your experiences. It's been great for me, and I just want to 01:56:00thank you for being here.

MAMORA: Thanks, man, you're welcome. It was a privilege.

Q: Cool. Alrighty. [laughs] Alright, let's stop the--

Q: Was that all right?

MAMORA: That was good.

Q: Good, good. I mean, big thank you. I know it--I imagine doing it myself, and I'm not the most comfortable person, actually, when I'm being interviewed. Having that wide space to talk--you do really well with it.

MAMORA: Yeah. I'm trying to say things as candidly as possible without putting people's pers--

Q: Oh, no doubt. Personal information, and--

MAMORA: --out there, yeah. Because it's hard. Because a lot of it's personal. 01:57:00[laughs] You know, without divulging conversations that you had. But, yeah. I tried.

Q: No, I appreciate it. You succeeded.

MAMORA: Hopefully it was good. [laughter]

END