Dr. Lance Plyler was desperate. It was late July, and two of his American relief workers in Liberia were showing worsening symptoms of Ebola.
Believing he couldn't handle such "dire circumstances" alone, the medical director for Samaritan's Purse turned for help to Lisa Hensley, a federal virologist from Maryland who was working in a lab near the international airport of Monrovia, the Liberian capital.
Plyler said it was Hensley — a world-renowned Ebola researcher based at Fort Detrick in Frederick — who first made him aware of the experimental drug ZMapp. She showed Plyler promising data on the drug's use in primates, introduced him to other scientists involved in its development, and helped transport a rare course of the drug from Sierra Leone to Liberia to be used by the afflicted workers.
Without Hensley's work, Plyler said, Dr. Kent Brantly and Nancy Writebol — the first Americans to become infected in the current outbreak — might never have received the treatment that "potentially saved their lives."
"She was so significant in enabling me to make the decisions I did," he said.
As the U.S. government has stepped up its efforts against the deadly spread of Ebola in the West African countries of Liberia, Sierra Leone and Guinea in recent months, federal and military personnel in and around Maryland have joined the fight.
Many, Hensley included, have repeatedly answered calls for assistance, lending their expertise in research and lab work. Some have provided direct medical treatment or counseling to Ebola patients.
They have waded into uncharted waters — the outbreak is the worst in history, with more than 13,000 cases and 5,000 deaths reported — as an extension of their duties to the United States and what they see as their responsibility to the international community.
They are "superstars" in their fields and "deserve all the credit in the world," one National Institutes of Health spokeswoman said, but also are "extremely humble and team-oriented" and "happiest staying below the radar."
Hensley, an All-American lacrosse goalkeeper at the Johns Hopkins University in the 1990s who now serves as deputy director of the National Institute of Allergy and Infectious Disease's Integrated Research Facility in Frederick, was already in Liberia conducting testing when Plyler first sought her assistance.
Soldiers from the 1st Area Medical Laboratory at Aberdeen Proving Ground have deployed to set up laboratories for Ebola testing in Liberia as well.
When the deployment was announced, the group had less than a month to prepare, pack and ship off, with the goal of cutting down the time it takes to test people for the virus, said Col. Patrick M. Garman, who is leading the mission.
"This allows for epidemic processes like isolation, quarantine, case tracing, and contact identification to happen faster," he said. "The results will be a quicker reaction time to stop the spread of Ebola."
Part of that pre-deployment preparation, he said, was assuring family members that the soldiers on the team would be safe. And so far, they have been.
"So far we work long days that seem to run together, but after a while, if I have time to stop and reflect on how far the 1st AML has come and admire what U.S. service members can accomplish, my energy returns and I'm ready to go again," Garman said.
The fight came home in October, when officials monitoring two Texas nurses — both infected with Ebola while treating a Liberian man in Dallas — decided the women needed to be transferred to state-of-the-art isolation units for the remainder of their care.
One of those nurses, Nina Pham, was sent to the National Institutes of Health Clinical Center in Bethesda. Awaiting her was a team of highly trained physicians, nurses and social workers who staff the facility's Special Containment Studies Unit.
Officials at the NIH opened the containment unit in 2010, according to deputy clinical director Dr. Richard Davey, Pham's physician and a member of the team that planned and designed the unit.
The unit consists of four patient rooms — three with two beds and one with a single bed — a kitchen, a common area and a nurse's station. Pham stayed in the single room. Her caretakers suited up in personal protection equipment, or PPE, every time they entered.
Davey said the facility was developed to meet the need for a containment unit in case of a mishap at Hensley's research center at Fort Detrick — one of the most advanced infectious-disease research labs in the world, and a place where Hensley and her colleagues have handled Ebola and other infectious diseases over the years.
Davey and others said it was a privilege to treat Pham, regardless of the fear the virus has stirred in some corners of society. He said he went into medicine because it "put a much-desired 'human' spin on a career in the sciences, and meant the ability to see one's efforts translated directly into helping people in need."
He saw treating Pham as an extension of that initial motivation, and as one of many cherished opportunities that federal service brings for researchers keen on changing the world.
"NIH's mission is to both support and to be at the forefront of medical research in this country," he said.
Katy Cone, a clinical social worker who worked with Pham at the center, said she is similarly proud of being part of the NIH team.
"When I began practicing medical social work in 2001, I made a commitment to treat each patient with dignity and respect, while at the same time following all current infection control and safety guidelines that are in place," she said.
While extra precautions may be necessary with Ebola patients, Cone said, she viewed caring for Pham the same way she has viewed caring for all her patients, including others with infectious diseases.
"I am trained to start where the patient is," she said. "It is important not to have an agenda set when you enter the room, but rather be emotionally present for the patient and empathize with their experience and hear it from their perspective."
Both Davey and Cone appeared outside the center with Pham on Oct. 24, the day Pham was declared Ebola-free and discharged. Her treatment included a blood transfusion from Brantly, another indirect benefit of Hensley's intervention in Liberia.
Despite Cone's appearance in the media — she stood just behind Pham as her release was streamed online and covered by local and national media outlets including The Baltimore Sun — Cone said she hasn't been recognized publicly. She said she is lucky to have supportive friends and family, many of whom are in the medical field and understand her work does not pose a threat to them. (Her father is a doctor, and her mother is also a medical social worker, she said.)
Davey's family has been equally unfazed, he said. They have been more concerned that he complete his household chores than with what goes on at the office.
He told one family member he was working on Pham's case.
"That's cool," the family member said. "But don't forget to empty the cat box next week when I'm away."
Davey said some members of his staff have endured discrimination since it became public that the NIH was treating an Ebola patient.
He called the phenomenon "disturbing" and "generally born of unfounded fear and ignorance," and said it should be "challenged at every opportunity" — especially considering the important role medical providers are playing in the global fight against Ebola.
"Principally, I just wish that the general public could be reminded that this illness, like other infectious diseases, can be cared for safely and effectively when the well-established and time-tested principles of infection control are brought to bear, as they now have been," he said.
"I would also just echo the sentiments of many others that the health care workers involved in providing care for Ebola patients are deserving of respect."