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Mass. doctor details his battle with Ebola

WORCESTER — As soon as he started running a fever that Friday night in August, Dr. Richard Sacra suspected the worst: Ebola.

“Of course, I was concerned I might die,” he told a room full of reporters Friday at the University of Massachusetts Medical School, where he is a faculty member. “There’s the human side of me that’s afraid, but I had also thought this through before going.”

Sacra said he had gone back to Liberia, where he had worked as a medical missionary for many years, because his colleague, Dr. Kent Brantly, had become infected with Ebola, and other health care workers had died at the hospital run by the missionary group SIM. Sacra was needed to provide relief to an overstressed system.

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The 51-year-old doctor likened his return to disease-stricken Liberia to the work of firefighters, police officers, and soldiers everywhere “who head the wrong way into, instead of away from, dangerous situations. . . . There’s a sense of obligation, a sense of desire to serve a group of people that they feel connected to. I think we all do have that human instinct that says: ‘I can’t leave somebody who’s in need. I have to help.’ ”

On Friday, a day after he was discharged from Nebraska Medical Center with no trace of Ebola in his body, Sacra appeared lively and happy, clad in a yellow shirt and a flowered tie, his wife, Debbie, at his side. He had just spent his first night at home in Holden after nearly two months away.

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But when asked how he was feeling, Sacra said: “I gotta tell you, I’m tired. . . . My legs are wobbly and I’m very tired.”

Sacra is one of four health-care workers evacuated from Liberia after becoming infected with Ebola while helping fight history’s worst epidemic of the virus, which has killed at least 3,000 people. Brantly and Nancy Writebol, another aid worker, recovered after treatment at Emory University Hospital in Atlanta. Another doctor, who has not been identified, is being treated at Emory.

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Sacra’s connection to Liberia runs deep. He worked there as a medical missionary for the group SIM from 1995 to 2010 and since then has returned for extended periods. When he arrived in Monrovia in August, he found a health care system in severe distress, he said Friday.

“No hospital was open for the capital city of over a million people,” he said. “Women who needed a caesarean section had nowhere to go to get one. Children with malaria or pneumonia were dying at home.”

After decontamination, SIM’s hospital reopened Aug. 6. Sacra did not work in the Ebola unit, instead delivering babies.

“Many of the patients who presented for care had been in labor between four to 10 days. Many had attempted deliveries at other facilities,” he said. “Naturally, many of these women were ill with fever, bleeding, and abdominal pain. Some had vomiting or other symptoms. Many of their babies had already died within the uterus. It was difficult to determine which of them might have had Ebola virus disease, in addition to these other problems.”

Amid this chaos, Sacra and others performed more than 35 caesarean sections and helped with difficult deliveries. He said he believes he was exposed to Ebola from an unrecognized case in the maternity ward.

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“I think the odds of my ending up back there are pretty good. ... That’s where my heart is,” Dr. Rick Sacra said.Joanne Rathe/Globe Staff

Within seven days of falling ill, Sacra was ensconced in a biocontainment unit at Nebraska Medical Center, the largest of four such facilities in the country. There, a staff of about three dozen people cared for him for 20 days. He got to know them all by name, although he could see only their eyes amid protective garb.

Sacra received an experimental drug and a transfusion of plasma from Brantly, in the hope that Brantly’s immunity could be transferred.

Ebola afflicted him with fever, vomiting, diarrhea, coughing, and rashes, but mostly, Sacra said, he just felt “very, very weak.” He was never so weak that he could not get out of bed and stand up, though.

No one knows whether to credit the experimental treatments or the careful medical support, such as intravenous fluids, for Sacra’s recovery. But a federal disease laboratory that tested multiple samples of Sacra’s blood taken since Sept. 19 found no trace of Ebola.

Asked how he felt about getting specialized care when so many are dying in Liberia, Sacra said it is heartbreaking to see the suffering in Liberia, but even in the United States there are limited beds in the kind of unit where he received care.

“I’ve done the best I can to alleviate the suffering in Liberia,” he said. “I’ve poured my life out and done everything I can. The fact that as a US citizen those resources were available to me — I can’t change that. I obviously am advocating for more resources to go into West Africa.”

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Full recovery is likely to take three or four months, Sacra said. But when he is well, he said, “the odds of going back are pretty high.”

“I’ve lived in Liberia for over 15 years. It’s really my adopted home, my adopted second home.”

“Our adopted home,” Debbie Sacra interjected.

Dr. Richard Sacra (second from left) walked away from a news conference held Friday at UMass Medical Center in Worcester.Joanne Rathe/Globe Staff

Felice J. Freyer can be reached at felice.freyer@globe.com. Follow her on Twitter @felicejfreyer.