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November 5, 2014

The psychological toll of quarantine

Daily Briefing

While quarantine undoubtedly takes a physical toll on a patient's body, the emotional and psychological scars can often last much longer, Michele Lent Hirsch writes in a first-handed account for The Atlantic.

Hirsch was quarantined at Mount Sinai Hospital in New York City because she was taking radioactive pills during her cancer treatment that were supposed to kill off any remaining cancerous thyroid cells in her body.

During her quarantine, she felt like a "walking public hazard" and "a living contaminant." In addition to the fear, pain, and intense pangs of loneliness, Hirsch worried about unwittingly harming her caregivers and family members by contaminating them with radiation.

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Ebola patient Nancy Writebol has described feeling like "an alien" during the course of her treatment at Emory University Hospital. "I could relate," Hirsch writes.

All of Hirsch's caregivers wore radiation monitors around their necks to keep track of how much radioactive material they were exposed to. The device "qualified how much damage my own body had potentially done to theirs," Hirsch writes, adding, and "[b]etween fear of my own sweat getting on a healthy person and the thought that these nurses were risking a lot just to help me, I began to feel myself shrink."

Sarit Golub, a psychology professor at Hunter College and the CUNY Graduate Center, explains that quarantines can make a person feel inhuman. "Illness has a profound impact on identity—even when we have a minor ailment like a cold, we often say, 'I don't feel like myself' [and] when that illness is contagious, the threat to identity is intensified," she says.

Golub adds that the "guilt and shame that comes from knowing you are 'infectious'...can rob individuals of their self-worth and reduce them to their illness."

After the quarantine

Hirsch also remembers the confusion she felt when told that she was "sort of" okay to leave the hospital and finish her quarantine at home. She says instructions from her physicians made it sound like some risky behaviors that could harm others were acceptable, while others that could potentially do just as much destruction were fine.

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For instance, Hirsch notes that she was banned from using public transportation and that everyone had to stay at least 15 feet away from her. However, she was not well enough to drive herself home from the hospital and would have to risk exposing a cab driver to her radioactive materials.

Hirsch notes that these types of contradictory rules are not uncommon. In Dallas last month, Youngor Jallah—whose mother's finance, Thomas Eric Duncan, died after contracting Ebola—was told that she should not take public transportation. However, officials said that occasional trips to a store would be fine (Hirsch, The Atlantic, 11/3).

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