Following call after dropped call, an evacuation plan emerged: Rubinson would travel that afternoon with a WHO driver to Freetown, Sierre Leone’s capital, where Rubinson would stay until colleagues at the Centers for Disease Control and Prevention in Atlanta could arrange for an experimental drug to be flown out to him. He would fly back to Washington on the same plane.

The drug had never been used on a human being during an Ebola outbreak. It belonged to a small group of new therapies aimed at preventing someone who has been exposed to the virus from falling sick. None is known to work. None had passed the rigorous process of randomized clinical trials required for Food and Drug Administration approval.

Collecting data about a drug’s efficacy is notoriously difficult when a new disease emerges or an old one suddenly starts to spread. The real world is not “CSI”; scientific investigation moves at a far slower pace than infection. So new therapies are often pressed into use without anybody learning whether they actually work. Rubinson had seen that happen during the SARS epidemic in the early 2000s. And he had helped lead the U.S. government’s effort to gather useful information during the swine flu outbreak of 2009 when the FDA authorized emergency use of the experimental antiviral Peramivir for some hospitalized patients; 1,200 people were given the drug, but not in a way that provided conclusive data about its efficacy and safety.

So the decision to take an experimental drug was an easy one for Rubinson. What happened to him would be data for the clinical trial. This was his life’s work – he had a PhD in clinical investigation. The difference this time was that he’d be experiencing it from the other end of the stethoscope, from inside the test tube.

He settled up at the Kenema guesthouse, then took 30 minutes to go through the dispiriting process of air-hug goodbyes – staying three feet from colleagues who had been through so much with him for three weeks.

That evening, the WHO driver delivered him, bearded and now in jeans, to Freetown to await the plane. The hotel where he spent the night – this time, he chose the best in town – turned out to be where many senior members of the international Ebola response were staying. It had showers, air-conditioning, WiFi. He found fresh fruit. A disco. People were dancing.

Touching.

Rubinson was less than 200 miles from Kenema but already a world away. In Kenema, “no touch” was the mantra. Your pen was your pen. Your phone was your phone. You shared nothing.

He was symptom-free for almost the entire 12-hour flight to Frederick, in the privately owned jet under contract with the State Department and operated by three pilots and two nurses. It was equipped with an isolation unit he had no need for. But about 10 minutes before the Gulfstream GIII eased in to land in suburban Maryland, Rubinson started to feel flu-like and unsettled. That was just when doctors suspected the drug would kick in. He climbed into protective gear – with the slightly queasy awareness that it was now a means for others to safeguard themselves against him, just in case. And as soon as the plane stopped rolling, he was swept off to NIH at breakneck speeds in an ambulance.

From inside the hermetically sealed bag of an isolation stretcher, he still felt well enough to be entertained by the surreal spectacle unfolding through the back window: Two police cars and a fire chase vehicle were tailing them, lights flashing, sirens screaming. He had no idea what was up front, leading the procession.

Or what this whole effort might cost. No telling how many tens of thousands of dollars.

He had just seen people, babies, die in Africa without having even a handful of cash spent on them.

On Sunday, Sept. 28, Rubinson was admitted to NIH at 4 p.m.

In Texas, Duncan returned to the ER by ambulance, was admitted and placed in isolation. Two days later, the CDC announced he had tested positive for Ebola.

NIH’s seven-bed Special Clinical Studies Unit opened four years ago to replace the “Slammer” (so named because of the sound made by the door closing behind patients), which the U.S. Army Medical Research Institute of Infectious Diseases used to operate. Only a couple of the beds in the new unit – which was designed for research as well as for isolating patients – can accommodate the specific clinical needs of people with Ebola.

That’s where Rubinson was hit with gut-churning nausea and spiking temperatures unmitigated by medication; as part of the clinical trial he had agreed to give researchers as pure a record as possible of his body’s reaction to the experimental drug.

A plastic tube called a picc line ran from a vein in his arm to a bigger vein just above his heart, providing a daily source of blood for researchers to monitor his body function, his immune system’s response to the drug, and whether he had Ebola. Four times a day, nurses appeared in their otherworldly outfits to take his vitals, rotating through to gain experience treating the first patient on the unit with possible Ebola.

His body quaking and head hammering, Rubinson lay freezing under a pile of blankets in the isolation unit, which was kept at a steady 66 degrees.

After two days the fever fell; two more days and it was gone.

On Oct. 1, Rubinson was five days into the 21-day incubation period.

In Sierra Leone, WHO reported 2,304 cases and 622 deaths.

In Texas, authorities began tracing Duncan’s contacts, and four people living in the apartment where he had stayed were put into home quarantine.

The drop in Rubinson’s temperature brought a drop in anxiety: The fever was clearly caused by the drug, not the disease.

But the country’s anxiety was mounting.

On TV in his room, Rubinson watched talking heads who hadn’t been to West Africa holding forth about Ebola. During his three weeks in Kenema he had seen more patients than all responders had seen in any single previous outbreak.

One so-called authority praised the possibilities for novel therapeutics – expensive new drugs that might one day change the face of an Ebola epidemic. And all Rubinson could think of was how little financial interest there was in providing the most basic of care for Africans in the current outbreak. In Kenema, health-care workers were using antiquated IV equipment.

The TV experts reiterated that U.S. hospitals were prepared to care for patients with Ebola. How could they be? Rubinson thought. All 6,000 or so hospitals? Yes, every hospital should be able to identify a patient and keep staff safe. But he knew that the specialized knowledge and equipment, as well as the costs of extensive care, exceeded the capabilities of most U.S. hospitals. The how-to-stay-safe practices he had learned in Africa from doctors who had years of experience with Ebola would surpass anything even large, high-quality U.S. hospitals could rapidly implement. For patient care, it would make more sense to focus on regional planning than to expect every hospital to be able to do everything.

He didn’t think that people were reassured by oversimplified messages.

We need better strategies, he believed, informed by sound science and boots-on-the-ground experience. That’s the role of public health.