Diary Prequel Package — page 431

placebo limb. We arranged a teleconference with him and I led the teleconference. I explained to the general that there was no placebo and that if the patient randomized to the standard of care alone arm we would not delay the flight and he would immediately come to the United States. If the patient randomized to the ZMapp arm we would give the personZMapp right away and then put him on a plane. When he heard that, he apologized blocking this protocol and we agreed that with the next patient who came through, he would be able to help us by participating in the protocol. However, it was too late for this patient since we had already arranged to put the patient on the plane to come back here to the United States. March 13, 2015 - Woke up at 1:45 AM to get to the NIH in time to greet the patient who was being flown in by chartered flight to Dulles Airport to then come to the NIH by He was working fo: Over the past 48 hours in i i has written me several e-mails indicating that he told the patient and the patient's uly that since I was taking care of the patient that he would be getting the best care in the world. The patient arrived rather sick with nausea, vomiting, liver function abnormalities, lactic acidosis, and profound weakness. His condition was deemed to be "serious". He arrived at Dulles Airport at 3:16 AM. He arrived by ground transportation at the NIH at 4:45 AM. We admitted him to the special clinical studies unit (SCSU) and he was randomized into the protocol. As it turned out he was randomized to the supportive therapy and general medical care alone. In other words, he did not get ZMapp. In some respects, this is good since if he was randomized to ZMapp, it is certain that some people would have said that we actually put him on the ZMapp deliberately because he was an American citizen. More later on this patient. March 14, 2015 - Today was a very important day in my personal experience with the Ebola Virus Disease. Nothing like on-hands experience. vie was in the hospital, I had the opportunity to put on personal protective equipment (PPE) and mostly observe and certainly not get involved in her direct care. Although she sick, she was not acutely ill and there was little chance of coming into contact with infected bodily fluid. However, the situation with was entirely different; he is one of the sickest people I have ever had experience with. It was a rainy day today, Saturday in Bethesda. I went over to the SCSU and put on the PPE. I went into the room with Anthony Suffredini and Rick Davey together with nurse Megan. It was an entirely different situation. I I had a rectal tube in and was putting out copious diarrhea that he was also leaking around the rectal tube. His urinary catheter was putting out good urine. He had a temperature of 39° ; his blood pressure was okay when he had diffuse maculopapular rash throughout his entire body. He was extremely weak and could barely talk. His liver enzymes were elevated and his lactate level was 2.9. His electrolytes were reasonably good. However his D-dimer was 20, which is about as high as it can get on the scale of measurement. He was thrombocytopenic and went from 140,000 platelets to 70,000 to 50,000 to 30,000. We will hold off platelet transfusions until he either bleeds and/or goes below 20,000. I assisted in all aspects of his care for an hour and 45 min. in the hot zone. This included moving and turning him in order to do an echocardiogram, examining his extremities and listening to him speak as he was coughing directly at us. I