Forces of Nature

From space, Hurricane Maria looks almost tranquil, like a flower. But it is a very different scene on the Earth’s surface for Tara Lyons ’16 and Michael Kelley ’06, who have taken refuge with their Vermont Army National Guard unit on St. Croix, USVI. At the time of this infrared photo, Maria has torn part of the roof off their shelter, and the hurricane’s eye is on the approach just east of them.

Alumni Deploy for Hurricane Relief Effort

By Carla Beecher

 

UH-60 Blackhawk helicopter transporting the Vermont National Guard medical team from St. Thomas to St. Croix. The team evacuated to safety before Hurricane Maria hit the region.

Harvey began as a tropical wave off east Africa in early August 2017. By mid-month, it had gained enough traction over the Caribbean’s Lesser Antilles to become a tropical storm. It died down on its way over Mexico’s Yucatán Peninsula, but as it traveled over the Gulf of Mexico, it quickly became a full-fledged Category 4 hurricane reaching speeds of 134 miles per hour. It slammed the Texas coast on August 25, then circled, stalled, and meandered between Texas and Louisiana before finally settling over eastern Texas and dumping a record-setting amount of rain—the tiny town of Nederland peaked at 60.58 inches. The storm’s flooding caused billions of dollars of damage, especially to the hard-hit Houston area. It was the end of August, but just the beginning of an unprecedented hurricane season. There was much more to come.

 

With Harvey on the wane, the National Weather Service turned its attention to Irma, which was proving an exceptionally powerful, massive but slow-moving, catastrophic Cape Verde–type storm whose winds eventually reached 185 miles per hour as it gathered strength on its way through the Caribbean. Before hitting the Florida coast September 10 and wreaking havoc on Georgia and other parts of the South, Irma carved a 400-mile-wide swath of destruction in the Caribbean.

As soon as the weather service sounded its alarms, the Department of Homeland Security and the Federal Emergency Management Agency (FEMA) began coordinating with federal, state, and island partners to prepare local responses to Irma. FEMA requested medical support from the Vermont Army National Guard (VTARNG) to aid military personnel and civilian volunteers on the U.S. Virgin Islands of St. Thomas, St. Croix, and St. John.

Meanwhile, Hurricane Maria was just getting started.

Vermont National Guard Adjutant General, Major General Steven A. Cray greets Lyons at Schneider Regional Medical Center.
Kelley is to her left.

“Once the call came from FEMA for us to assist with the aftermath of Irma, everything happened very quickly,” said physician assistant and VTARNG mission commander Major Michael Korczykowski. Within three days the Vermont National Guard put together a medical-relief team of 22 soldiers and airmen that included Captain Michael Kelley ’06 and Second Lieutenant Tara Lyons ’16.

“We left two days after being notified,” said Lyons, a registered nurse at Dartmouth-Hitchcock Medical Center who had been training with the Guard since her sophomore year at Norwich, when she joined ROTC. Lyons, Kelley, and the rest of the unit arrived on St. Thomas Saturday, September 16. That night, they slept in the airport.

Maria, Waiting in the Wings

Immediately on Irma’s heels—and an unwelcome surprise to those on the already storm-torn islands—came the powerful Hurricane Maria. Yet another Category 5, Maria became a tropical storm on September 16, only two days after the Vermont medical contingent arrived. Maria would deliver the final one-two punch that would leave not only Puerto Rico ravaged, but also the U.S. and British Virgin Islands, the Bahamas, Turks and Caicos, Montserrat, Guadeloupe, St. Kitts and Nevis, the Dominican Republic, and tiny Dominica, the island that was hit first and suffered almost total devastation. The flooding and destruction wrought by these deadly and costly storms struck a crippling blow to the tropical islands. The economic costs are in the hundreds of billions of dollars. The deaths are still being counted.

As Maria was building speed and heading toward St. Thomas, the team—consisting of three physician assistants, five nurses, twelve army medics, a medical logistics specialist, and VTARNG state surgeon Colonel Gino Trevisani—boarded Blackhawk helicopters to evacuate to St. Croix, where they rode out the storm in a brick, new-but-untested, hurricane-proof building. “It’s the first time I’ve been in a storm of that power,” Kelley said. “I did feel safe even though there was water leaking through the window seams and part of the roof had blown off. But the building was structurally sound.” He likened the facility’s size to a two-story elementary school.

For Lyons, Maria was anything but routine. “I tried to sleep, but woke up to a wind so powerful and so loud. It helped that the leadership didn’t seemed fazed: they were easygoing and in good spirits, even when the rain started to seep in through doors and pool into puddles. My thoughts also went to the islanders.” Maria, by then upgraded to a Category 5, landed around 10 p.m. Tuesday, September 19. As hard as it hit, by morning it had dwindled to a light rain.

While awaiting safe passage back to St. Thomas to begin medical operations, the team assisted the Virgin Islands National Guard with medical support to route-clearance missions on St. Croix, and provided sick-call operations for the uniformed soldiers on St. Croix.

On Friday, the unit returned to St. Thomas. The following day they helped move $2.2 million worth of medical equipment from the airport to the SS Wright, the logistics support ship that was docked near shore and equipped to house and provide aid to the soldiers and crew for the following three weeks. The ship became their home base. “I was eager to get busy,” said Lyons, who is completing a yearlong residency in the medical specialties unit at Dartmouth-Hitchcock, where in-patient adults with chronic or acute-on-chronic diseases, such as diabetes, are treated. “I’m pretty well-versed in the group of disorders that includes diabetes, so my year at Dartmouth-Hitchcock prepared me for what I saw in the Virgin Islands,” she said.

Korczykowski’s unit pushed out from the ship each day to do missions around the island. They performed sick-call operations for the Red Cross and for the Wright crew, which numbered about 400. They also did door-to-door health checks in coordination with the Department of Human Services and the Department of Health, and provided medical and logistical support at the St. John Shelter, the East End Clinic, the Lockhart Elementary School Shelter, and the Knud Hansen Shelter. “Our primary mission was to provide medical support to Schneider Regional Medical Center’s Emergency Department by taking care of soldiers and military personnel,” Korczykowski said. “But we quickly found ourselves serving the civilian population as well.”

The storm’s aftermath left some of the floors at the medical center flooded, though the operating room and emergency department were intact. The 602 Medical Company out of Fort Bragg, North Carolina, helped the team by fast-tracking patients outside the hospital so they could focus on emergencies, Lyons added. “We took patient assignments from the moment we got there,” said Kelley, a critical-care nurse and firefighter-paramedic in Bedford, N.H., who is emergency room and ICU trained. As acting executive officer of the unit, he was responsible not only for working as a nurse, but also coordinating logistics and moving equipment and personnel to St. Thomas.

Not surprising, the older Norwich graduate took Lyons under his wing. “Tara started off following me around to see how an ER worked, which is very different from a normal patient unit in a hospital,” he said. “After a few days she took more responsibility, and by the end of the three weeks, I acted more as a resource for her. She only came to me as needed to ask questions.”

According to Kelley, the mission was a good training opportunity for Lyons and gave her exposure to cases she wouldn’t see in her current job. “We saw a diverse group of injuries and medical conditions, from diabetic ketoacidosis to cardiac arrests to seizures,” he recalls. “At one point the hospital only had one vial of insulin.” They also saw dementia patients who would normally have caregivers, but didn’t because they had fled to be with their own families. “These patients were left to fend for themselves,” he said. “They had no medications, some weren’t fed, and many were becoming dehydrated.”

Lyons admits that emergency medicine wasn’t a specialization she had considered prior to this deployment, but now she sees things in a different light. “Because the storm hit homes and stores so hard, we saw patients who had the more chronic diseases,” she reflected. “The storm destroyed buildings, including doctors’ offices, so diabetes patients no longer had insulin and could only watch their sugar levels climb every single day.”

Tough Stuff

“Captain Kelley taught me everything while there,” Lyons reflected after the deployment. Under Kelley, she learned time management through multi-tasking and how to change a course of action at a moment’s notice. He explained, “One minute you’re going down one path of treatment, but then you get some new information from an exam or a diagnostic tool and you end up taking another route. After three weeks, Tara began to anticipate those changes and the needs of the patients, and what the physician was going to anticipate from her that needed to be done.”

Second Lieutenant Tara Lyons ’16 and Captain Michael Kelley ’06 during a shift in the emergency department of Schneider Regional Medical Center, St. Thomas.

Without hesitation, Kelley credits his time in the Corps of Cadets and his Norwich education for giving him the skills to communicate clearly and effectively with staff and also within complex organizations like FEMA and other federal agencies. “Norwich instilled in me professionalism and respect for others.”

The unit commander echoes Kelley’s remarks about Lyons, and about Norwich. “Tara was a joy to work with: upbeat, a solid soldier, and she took my gruff Army attitude well and learned quite a bit,” Korczykowski said. “She also got a taste of what it’s like to work in an austere environment. I think Tara is a good example of what to expect from a Norwich alum,” he continued. “Norwich is an outstanding program to have in Vermont and any chance I get, I selfishly grab its students to work for the Vermont National Guard. I know they will have a high military bearing and high standards.”

At her civilian job at Dartmouth-Hitchcock, Lyons reports to Michelle Stavseth M’17, a nurse supervisor for the medical specialties and intermediate step-down care unit. Stavseth hired Tara in May 2016. “Tara is thoughtful in her approach with patients, has great communication skills, is flexible with others in the unit and with our patients, and has persevered with grace in what can be a very demanding career,” Stavseth said. “Her classroom and clinical perspective make her a well-rounded nurse. Her education prepared her well to enter the acute-care environment and help the sickest patients in New Hampshire and Vermont.”

 

On September 26, Tara Lyons ’16 emailed this photo of herself on the SS Wright to her grandfather, Victor Kim ’60.

“I think Norwich puts students in positions that help them grow,” Lyons added. “I remember having a lot of things on my plate that were uncomfortable when I was taking classes, like leadership positions and taking care of patients as a 21-year-old. But my teachers pulled me out of my comfort zone. They made me step up and learn to be a leader.”

 

Tara Lyons comes from tough stuff, cut from a Norwich legacy family with generational roots in the medical profession and the military. Her grandfather, Victor Kim ’60, was born in China to an American mother and a Korean father. His mother, an MD, ran a women’s hospital. Months after his birth, the second Sino-Japanese War broke out, and Victor lived for eight years under Japanese occupation and another three in the midst of a Chinese civil war. He came of age in the U.S. amid great cultural transformations, attended Norwich, and served as an Army officer in the Vietnam War. A true American patriot, he energetically proclaims that “I would rather live in this country than anywhere else I have ever been in the world.” Lyons grew up listening to her grandfather’s prolific and detail-rich stories about Norwich, and to follow in his footsteps seemed natural. But she admits she struggled at first.

“When I started college I was so shy, I barely talked to anyone,” she acknowledged. “But I had to come out of my shell in order to fully participate. Norwich prepared me to look at a situation like this hurricane and say, ‘Yes.’ Part of me questioned whether or not I should go, but the other half said, ‘You need to go. Go do this.’”

Lyons and Kelley (right) pictured with a patient and her uncle as they are discharged from the ER.

Lyons recalled being stricken by the widespread devastation on the legendarily beautiful Virgin Islands. “The locals were saying, It doesn’t look like this. It was very sad to see. Power lines were everywhere. Many of the roads were gone and those that remained had their signs broken in half. The drinking water was dirty and unsafe to drink. I saw how little they had to work with after the hurricanes, and it makes me appreciate all I have now since I’m back home,” she said. “It’s the little things that we normally don’t think about that you notice in a big way when they’re gone. This deployment taught me to be creative in a chaotic environment to get the job done. Now that I’m back home, I appreciate everything.”

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