In this week's episode, we share two stories of exposure, from exposure to Ebola to exposure therapy.
Part 1: Journalist Erika Check Hayden travels to Sierra Leone and sees Ebola up close and personal for the first time.
Erika Check Hayden is an award-winning San Francisco-based science, health, and technology reporter. She writes for the science journal Nature, and on a freelance basis for a variety of publications. She is the incoming director of the University of California, Santa Cruz, Science Communication Program. Find her at erikacheck.com or on Twitter @Erika_Check.
Part 2: As a child, psychologist Ali Mattu suffers from paralyzing social anxiety.
Ali Mattu is a clinical psychologist who specializes in the treatment of anxiety and body-focused repetitive behaviors (trichotillomania/hair-pulling disorder and excoriation/skin-picking disorder). He aspires to bring psychology to everyone, everywhere by hosting THE PSYCH SHOW, writing about the psychology of science fiction at Brain Knows Better, presenting to the public, and advocating for the brain and behavior sciences through the American Psychological Association. Dr. Mattu is an assistant professor at the Columbia University Medical Center.
Part 1: Erika Check Hayden
Seeing the babies was the hardest part. It was December 2014 and I was reporting on Ebola in Sierra Leone. I’d arrived at a clinic in the city of Bo in the middle of the country. There were so many sick babies coming into this clinic that the doctors there had created a dedicated ward just for infants who had Ebola. That’s how bad it was. They had their own special tent.
Just before I’d arrived that day, a mother and a baby with Ebola had checked in together, but there was no sound coming from that tent. The whole time I was there, the baby tent was completely silent.
I knew from my own small kids that a healthy child would never lie still and quiet for hours. The next day, I learned that the baby had died. His mother lived, but the doctors were worried that when she found out about her son, she would give up on her own fragile recovery.
At another clinic in a city called Makeni, I met a little boy. He was scooting around the nurse’s station in a rolling walker. He had checked in with his mom and she’d died of Ebola and her family had refused to take this boy in. They were afraid of Ebola. They somehow thought that because the boy had been with his mom when she was sick, he might somehow infect them too. It couldn’t happen, but they wouldn’t take him in and he was an orphan. He had nowhere else to go and so he was living there at the Ebola clinic. It was hard to see. It might be hard to hear about now. Just think how hard it was for that boy and for his family.
At the same clinic, I met a woman in her twenties. She was very pregnant. She didn’t look sick at all, but she did look terrified. I noticed that she was sitting on a bench in the intense afternoon sun, and I wondered why she didn’t move to a nearby bench in the shade. She said that her name was Mabinti. When I met her, she was about eight months pregnant. Just a little bit before then, she’d felt a pain in her abdomen. She wanted to be sure that everything was okay with her pregnancy and so she went to get it checked out at a local clinic, but the nurses there wouldn’t treat her. They were spooked by Ebola.
So many healthcare workers had died taking care of pregnant women with Ebola, because these women often miscarried their babies, and when they miscarry, they bleed a lot. Their blood contains the infectious Ebola virus so these nurses weren’t going to take a chance. They told Mabinti that they wouldn’t see her, that she could go get an Ebola test and if the result was negative, then she could come back and they would take care of her then so she did what they said. She went to get the test.
The problem was that while she waited for the results of the test, she had to stay in this facility that’s called a holding center; that’s where I met her. That’s where you go if doctors suspect you have Ebola or if they know you have Ebola but you can’t get a hospital bed. She was living there in the holding center waiting for the result of her test, side by side with people who had Ebola. So every day that she stayed in this holding center increased her chance that she would become infected with Ebola if she wasn’t already. It’s no wonder that she didn’t go sit on the shady bench because it was occupied by sick people who had Ebola. They were sitting and lying down on that bench. She was terrified for her life and for her baby. I knew that I would have done the same things she had and yet now she was living with this unfathomable daily risk. I really felt for her because my own kids were two and four at that point, and reporting from Sierra Leone was the first occasion when I spent any real time away from them.
Having kids had reordered my world. I had been a journalist for a decade before I had my first child. I reported on all kinds of things and I’d travelled lots of places and then I had my son and then my daughter. I wanted to be with them so I cut way back on work and I tried to squeeze it into a normal forty-hour week. I pretty much stopped travelling. I knew that I was dialing back on my own expectations for my career, and I didn’t know if I’d ever feel the same way again about work.
Then 2014 came and the Ebola crisis hit. As a science journalist who covers infectious disease, I had to get on top of the story so I was reading and reporting, basically trying to figure out why the epidemic had gotten so far out of control. There had been Ebola epidemics before this one where dozens of people or maybe a hundred people had died, but there had never been anything like this where tens of thousands of people got sick and thousands died.
One day, I was reading an article by a nurse who worked for Doctors Without Borders. It’s the medical aid group that cared for a lot of patients in this epidemic. She describes treating a two-year-old girl who died in an Ebola clinic without any of her family around her.
At that time, my own daughter was two. As I read this, I wondered what it would be like for her to be sick and alone in a hospital without me or her dad there to hold her. Later that night, we were playing together in her room before bedtime and I tried to imagine checking her into a hospital knowing that I might never see her alive again. It made me feel hollow inside to know that mothers in Sierra Leone were doing that every day. I started to see what was really so horrible about Ebola. Not that it might make you bleed from the eyes and not that it would very likely kill you, but that it was ripping apart families and neighborhoods and communities and all the social fabric that holds people together.
A few days before I left Sierra Leone, I called Mabinti’s husband to check up on her. He said that Mabinti’s Ebola test result had come back and it was negative so that seemed like great news. Mabinti could go home now, right? But no, there was a catch because by that point she had been living in that holding center for weeks and she was in close proximity with Ebola patients. Now she had to get a second Ebola test just to make sure that she hadn’t become infected in the holding center while waiting for the results of her first test so she was still in the holding center waiting for the results of that second test. She was still in danger.
I came back home and when I got back to my house on Christmas Day, my own kids were happy and healthy and well cared for, just as I knew they would be, but I couldn’t stop thinking about Mabinti and whether she was okay. She’d done the same thing I would have done, but because Sierra Leone is a poor county and because the rest of the world took way too long to respond to the Ebola epidemic, she was fighting to stay alive and to keep her family together while I was helping my kids try on their new Christmas pajamas.
After Christmas, I called Mabinti’s husband again to check up on her. She said that against all odds, Mabinti had survived. Her second Ebola test was negative and she had been allowed to leave the holding center. Then, in February, she had her baby, a completely healthy little girl named Sale. It felt like a miracle. It shouldn’t have to be. Thanks.
Part 2: Ali Mattu
I was a really cute kid. I know this because my parents told me so. In fact, my dad said he would love to make just cry a little bit. He said, “You were the most cute when you would just start to cry.” That was cool and that was my early childhood, and then one day I went to kindergarten. I wasn’t one of those kids who had gone to pre-K or anything like that. This was my first time really being in a large group of people.
On that first day in kindergarten, we had circle time, where everyone sits in a circle, and everyone had to go around and say their name. It was going, going, that person over there, and I started to feel this feeling so strange and new. It was my heart starting to race. It was pounding, and I felt myself shaking.
Eventually, it got to me and I had to just say my name. I knew what my name was. It was an easy question. I just had to say it, and I couldn’t. I just couldn’t say my name and I started to tear up. The teacher came over, and the teacher whispered something in my ear and said, “It’s okay,” and she said “Everyone, this is Ali,” and it went on.
Later that day, when my mom came to pick me up, the teacher said, “Ali had a great first day. He’s a little shy, but he’s so cute. He’s just so cute and I’m sure he’ll be fine." I learned something that day, that if you don’t want to do something, just look cute and start crying and it will be okay. And kindergarten was kind of awesome. Other kids would start to speak up for me. If someone called on me and I didn’t know what to say, I’d freeze and I’d kind of look like this. One of the other kids would come over and I could whisper in their ear, and they would speak up for me.
Then there was this girl, Jessica, and Jessica and I became boyfriend and girlfriend. We would hold hands and just walk up and down the hall, and that’s all we did because it’s kindergarten. It was pretty good. But then I failed an English proficiency test, not because didn’t know how to speak English but because I didn’t speak.
So they put me in ESL, and I was going to ESL for like six months. You’re probably wondering, “Well, wait a minute, Ali, why didn’t one of your parents say, 'Ali knows how to speak English'?” I never told my parents that they put me in ESL because I would freeze. The only way I got out of ESL is I figured out one of the teachers was talking about the kids in ESL behind our backs. You could do that in ESL because the kids can’t speak English, but I figured out that one of them was saying, “That kid over there, he still can’t figure out his right from his left hand.” I looked at her, looked at the kid, and looked at my hands, and the teacher went, “Oh, crap. Ali knows what we’re saying.”
They took me out of ESL and eventually I’d make it to first grade. First grade was rough; it’s a big step up. Jessica and I broke up. She started holding hands with this kid named Nick, and I hated Nick. He looked just like Macaulay Culkin when Home Alone came out, and I was like, “Oh, sure, that’s your type.” I was really pissed, and I had this teacher who wouldn’t really tolerate my cuteness.
One day, we were in circle time again. It was shortly after winter break so the teacher had this bright idea: “Let’s have everyone go around in a circle and share what they got for Christmas.” I remember her saying that and then... I was this little Muslim kid, and me and all the Jewish kids look at each other like, “This is going to be bad.”
It’s going around and everyone is sharing what they got for Christmas, and I was like, “I don’t celebrate Christmas. What the heck am I going to say?” It finally gets to me and I freeze, but this time she won’t let anyone speak up for me. One of the other kids tries, [but she's] like, “No, let Ali speak.” [My] heart was racing, [I was] trembling, sweating. I don’t know what to say -- my mind is going blank. Then I get this image of Bugs Bunny in my head and I say, “Rabbits. I got rabbits for Christmas.” And the teacher goes, “Rabbits?” and I go, “Yes, rabbits.”
I walk home and I felt pretty crappy about because even as a first-grader, I knew that’s a pretty bad lie, like, who gets rabbits for Christmas? You get video games, you get Nintendo or like, I don’t know, crappy sweaters, but you don’t get rabbits.
I remember going home that day and locking myself in the bathroom because that is the only safe place you have when you are a little kid. I remember looking in the mirror and going, “Why did it have to be me? Why did I have to be the only brown kid in that class?” This is when I started to feel like there was something wrong and something strange about me.
I suppose I should mention at this point that I was also a really big Trekkie. It was the one place where I felt safe, at home watching Star Trek: The Next Generation. It was all of us -- no matter who you were, what you believed, or what you looked like, it was all of us -- in this future where we worked together and things were good.
There was even someone in Star Trek like me. His name was Lieutenant Barclay, and he was this nervous wreck. And yes, Captain Picard once called him Lieutenant Broccoli. But I was like, “Hey, look, there’s someone who also struggles with this stuff too, and he is contributing to the USS Enterprise.”
I wanted to live on the Enterprise and I knew you couldn’t, but I found out later on in fourth grade that there’s this thing called Star Trek conventions. I was like, “Oh, I can’t live in the future. I can’t live in the twenty-first century, but I can go to a Star Trek convention.” So I asked my parents, “Can I please, please go to this convention?” and they were like, “Okay, sure.”
They take me to the San Jose, California, convention center. They drop me off and they say, “Have a good time. Call us when you are done. Here’s thirty bucks,” and they drive off. I’m standing there in front of the doors of this convention center and I freeze. I’m excited and I’m also terrified. Inside these doors or past these doors, in this convention center, are the coolest people in the world and I so want to impress them. I so want to impress them. So I look around and make sure no one’s watching me, and I take off my glasses. And I put them in my pocket. Because I don’t want anyone inside at this Star Trek convention to think I’m not cool because I’m wearing glasses.
I walk in without my glasses and I’m pretty blind. I can’t see much so I kind of see this Klingon. I can tell that person is like a red shirt because they’re wearing red. That’s easy to see, and this person is in command yellow from the original series. I’m walking around and at the dealer room, I can now pull stuff really close to my head, which doesn’t look that unusual because Trekkies are a little obsessive and they look at stuff.
Then I go to the main stage and Leonard Nimoy is speaking. He’s there on stage and I hear him and it’s amazing, but I can’t see him. I just see this blob moving around and I’m just too anxious to put on my glasses. I won’t do it because I don’t want to seem weird. I don’t want to seem strange. I don’t want to seem different. I want everyone there to like me.
When I got to middle school, there were these kids who, about once a month, would dress up as Star Trek characters and I thought they were so cool. Every time I saw them, I wanted to go up to them and introduce myself, go, “Hi, I’m Ali. I’m really interested in Star Trek as well. I like Star Trek: The Next Generation, but I also like the original movies and it’s great. What did you guys all think about Star Trek: Generations?”
That’s how it'd play out in my mind because I didn’t have anyone else besides my family to talk to about this stuff because I wouldn’t... I just wouldn’t reach out and wouldn’t talk to many people. But I never did. I never approached them and I really regretted it. I started to feel like, “What’s wrong with me? Why can’t I just talk to people?”
Then, one day, I’m going to my locker in middle school and I see these kids and I have that urge again to approach them, but this time, there’s this other group there. There’s this group of kids that rip off their backpacks, grab them, and throw them at them, and they say, “You stupid queers.”
I see this happening and I freeze. I don’t do anything. I don’t go and tell a teacher. I don’t say, “Hey stop, what are you doing?” I just let it all play out in front of me. I felt so crappy about that. I started to feel more crappy, gained weight. I got depressed and I thought, “I’m never going to be able to shake this. What the hell is wrong with me?”
When I get to high school, I enroll in Public Speaking. Now, I thought public speaking was going to be a class where you sit and you hear famous public speeches and you study them and analyze them and you write papers about them and then you walk out. The first day of class, my teacher, Miss Georgiana Hayes, says, “Welcome to Public Speaking, where all of you are going to overcome your fear of public speaking,” and I froze. My heart was racing, I started to sweat, and I was like, “What have I gotten myself into?”
I do some research. I read the student handbook about how to drop a class and it said, “It’s very easy. All you have to do is get this form, go to your teacher, explain that you want to drop the class, get their signature, and you’re out.” I read that and I froze because that would involve talking to the teacher and saying I want to drop the class.
I weighed it out in my head, and the anxiety of asking the teacher to drop the class was just too high. I was like, “I can’t do that. I’m just going to somehow avoid it and not do the public speeches and just get through this experience."
What happened was I was expecting something like this, like being in front of a microphone and speaking in front of a crowd, and that’s not what happened. We started off by sitting one to one with another person and giving a three-minute talk to this one other person and I somehow didn’t freeze. It was tough, I was anxious, my heart started racing, but I didn’t freeze.
We did that and we did that over and over again, and then we did it with a small group of people. It got easier and then we did it with a larger group of people. Suddenly, I started to feel like I was a member of the Borg Collective. Now, the Borg are a species in Star Trek. They are a collective, they are a hive mind, but what the Borg are really good at is adapting.
When a phaser fires at them, one of them will fall down, and then the phaser fires again and the other one might fall down, but they learn. Each time they face that same situation, they adapt, they get better. As I was doing these small presentations with these small groups, I felt like I was adapting and I was just like the Borg. It was addictive and it felt really good.
Then we started to share what was going on in our heads when we were doing those small speeches, and I learned that this fear I have of being weird and strange and awkward and like an imposter and someone’s going to find out how fake I am -- everyone else had those fears. And so I did more. I joined the speech and debate team. I joined rally board and I started doing these weird, silly rallies in front of the whole school. I joined the wrestling team, which was probably the biggest exposure I did because you are wearing that singlet and you’ve got nothing to hide.
Years later, when I was college, I realized that what Miss Hayes was doing was exposure therapy, helping people in small amounts to face the situation that they are afraid of, and doing it over and over again until you overcome it. I realized that’s what I want to do. That’s what I want to do with my life. I want to help people so that other kids aren’t in that same situation. So that other kids can go to a Star Trek convention and yes, wear their glasses. So I decided to become a clinical psychologist who helps other people overcome their anxiety. Thank you.