Previously in our story…Hurricane Maria had just ravaged the island nation of Dominica

While I waited, my school did what many said could not be done. Our staff and administration arranged for us to be able to complete the fall semester, on the only-lightly damaged island of St. Christopher (usually called St. Kitts), which had been grazed by both Irma and Maria.  They arranged for a large passenger ship which normally ferried cars and people from Italy to Spain and back to sail over to the Caribbean and be modified into a floating campus for our thousand-plus student body for the rest of the year.  They arranged for temporary accommodations for faculty and staff on St. Kitts, where our other sister school, Ross University School of Veterinary Medicine (10), is located.  They revised the schedule to have us resume our semester in October and finish in early January.  And then they set these plans in motion.

In mid-October, I finally got the notice I’d been waiting for, my reporting day to arrive on St. Kitts for my temporary assignment there.  I’d lived on St. Kitts before while working at one of my former schools, so I knew that it wasn’t the same as Dominica.  It was wealthier, far wealthier, with so many cruise ships coming to call during high season that we were almost an afterthought to them.  It had the movie theater and the golf courses and the high-end hotels, and the island infrastructure to handle the mass of tourists who came and went by the planeload and shipload every day.  But on the same token, in Dominica we were a part of the community, we were welcomed by the people, and we were careful to try to be good neighbors.  In St. Kitts, we were mostly treated like tourists, who were perhaps staying a little longer than usual, and on a ship that wasn’t going to sail away with us.  Most of the Kittitians were still the very friendly people you can find everywhere in the Caribbean, of course, but it wasn’t Dominica and I knew it before I arrived.  We faculty were to arrive a few days before the students to get situated and find places to live on the island while the student accommodations/our campus continued its journey across the Atlantic to our new home away from home.

When I got to St. Kitts, it was…a pleasant surprise.  It wasn’t half as hard to get through customs as I had feared, and the Marriott is a nice hotel.  We stayed there a day or two before the students started to arrive.  To make room for the students, most of the faculty were moved to an eco-resort on the far side of St. Kitts for about a week, which opened in its off-season just for us.  While I appreciated their going above and beyond on our behalf, I only stayed one night before moving into an apartment in town. I just wanted to unpack my suitcases, settle in somewhere, and get back into a routine.

Because I left the eco-resort so early, I was available to help the students come in on their arrival day.  And come in they did, one charter flight at a time to the airport, and one to three buses (they call them cruisers) at a time to the Marriott.  Tired, bleary-eyed, some clearly still suffering the effects of six or more days on Dominica under indescribable conditions ending in evacuation and weeks of uncertainty, the students came.  You couldn’t help but feel for the ordeal they had survived… or admiration for their grit to return anyway, when a small group of others had taken a leave of absence.  On that day and night when the students came in charter flight after charter flight, wave after wave, a dozen volunteers and I helped each group one by one.  We were the friendly faces from home greeting them after their long ordeal.  We smiled and shook their hands and took their bags inside, helped them through check-in, provided them some simple meals, and tried to make each returning student feel special.  It started for me in the afternoon, and then into the evening, and then into the night, with each group of students arriving more and more exhausted.  By 1 a.m. I was feeling pretty exhausted too, but we kept going until the very last group made it in somewhere close to 2 a.m.

I am told that still more planeloads of students flew in the next morning, but I slept in.  That afternoon, students were being transported from the hotel to the port, where our ship had come in.  The lines were long and the sun was hot and the students just wanted to get inside and get to their new berths.  Many of the faculty who were staying at the eco-resort had come into town that morning to help students move in during the morning/afternoon shift.  I showed up for the afternoon/evening shift.  As we had done the previous day, we volunteers did our very best to keep everyone comfortable at the port, as students went through the tedious process of being identified, cleared to come onto the ship, given berth assignments, and other things past my station at the port.  I made a point to smile and joke and most students appreciated it.  By mid-evening the last students had made it past my sorting station at the dock entrance and headed into the ship, so I stumbled home for another exhausted sleep.

There was a lot more involved in starting work at the temporary campus than just showing up, but I and the other faculty made do.  The ship had just one large cafeteria so we sometimes had to wait in meal lines during its designated breakfast-lunch-dinner times.  Many of the prior amenities on the ship (e.g., a movie theater and a pool deck) had been converted into classroom and study areas before we boarded, and other spaces were modified for student use later.  This included the conversion of an entire deck of the ship which is usually a car garage into an air-conditioned suite of temporary study spaces, clinical exam rooms, and simulation labs. Since the ship spent most days at sea, it was rather crowded at first.  We faculty didn’t have offices per se but like the students we each found our place to be during the day.  My place was at the back of the third semester classroom, in a corner with AC, electric hookups, and a view of the harbor.  I usually teach in second semester as do most physiologists, so I absorbed a lot of clinical applications even as I worked on lectures and active learning sessions, module directing, pre-mini-workshop design, and all the other routines of a typical teaching-oriented school.  And in so doing I, like so many other faculty who don’t get to know a lot of students normally, did connect with many of them.  When we had to get up at 3:30 a.m. to catch the 4:15 a.m. bus to get us to the boat before it sailed at 5:00 a.m. to make room for a set of larger cruise ships throughout the day, we shared in the students’ experience of having to make sure they too were up at the same time, early enough to download their most important materials of the day before we sailed, just in case the harbormaster put us far out at sea.  When the days came that other ships left late and we didn’t dock until 7:30 at night, the students shared that with us too.

Along the way, we made time for some activities.  Twice I went scuba diving with fellow members of our RUSM (Med School) Scuba Club (11); others went diving even more regularly.  People organized groups for exercise on the outside deck every morning and night.  There were religious services, club meetings, and other miscellaneous activities on the boat.  Off the boat there was at least one school-planned movie outing, an island tour, and a few students even made it to a “beach bash” hosted by the RUSVM (Vet School) Scuba Club.  More informally, the port facilities were nice as one would expect at a regular Caribbean cruise ship stop, with everything that entails. It became a shared experience of life in close quarters, dedicated to a common purpose and with a common spirit that we would make it through, together and with no drop in our commitment to teaching and learning despite it all.

Would I have traded it for a nice quiet semester in Dominica with no Hurricane Maria in the first place?  Well, sure!  But you have to deal with what life gives you and we made the best of it.  And the quality of the teaching did not go down.  We might have been in close quarters but we delivered virtually the same curriculum in the fall as we had in the previous spring and summer.

By mid-November, air service to Dominica was spotty but running, so I booked a trip there for a few days including Thanksgiving Day.  We’d just found out that we were going to be in Knoxville, Tennessee for the January semester but no one knew much more than that.  While some people started actively looking for places to live, I planned my return to Dominica and hoped the school would handle the Knoxville move for me and many others (it did).  I booked a room at the only hotel open in Portsmouth, Dominica, just in case my cottage was uninhabitable, and then I hoped for the best.

When I flew in, it was afternoon and, well, the island I loved looked different.  This was now two months after Hurricane Maria did its damage and still the island was brown, not green.  The volcanic ridges were sharp and distinct, and the remains of trees were all over them, standing tall and naked.  But if I looked closely, I could see that at the tops of the trees, leaves had started growing again.  Not enough to cover the scars on the land, not yet, but enough for some hope.  I had the taxi driver take me to my cottage before going to the hotel, and amazingly almost everything had survived.  The food and other perishables were gone with a few other items (e.g., my Swiss army knife), but overall I had a lot of things to ship home.  When someone had built the place he or she had cemented the window frames into the concrete wall for extra strength, which isn’t standard practice anywhere but it worked there.  Whoever it was had also put odd-looking vents under the roof which somehow prevented the roofs from flying.  As a result, though my furniture was flooded at floor level, almost everything else was salvageable.  It was a miracle compared to the sheer devastation we’d driven through from the airport to town.  That night I saw my first sunset on Dominica in many months, and it was beautiful.

I spent the next two days getting almost everything from my cottage packed up and sent to the local shipping agent for transport back to the USA.  Since my office had survived intact (another unexpected blessing) I took a couple of textbooks and other important items from there. But I didn’t take everything. I left most things in my office against the day I would return.  I also took a few photographs. I chose to avoid taking pictures of the damaged areas. Instead I shot photos of things I’d never seen before, like the caved-in side of a cliff face on the mountain north of town that to me looked just like a monkey’s hand.  Along the way I saw the determination of the people to recover even as they all hoped we would be back in May, and I hoped the same thing.  But it was not to be.  As I flew out with my bicycle sold, my cottage empty, and my most essential items from home and office in two suitcases, I was pretty sure that Dominica wouldn’t be ready for us by then.  There were still too many without power, too many living under tarps and in barely-repaired dwellings, too many roofs still off and the insurance companies being slow to pay claims.

The semester ended relatively uneventfully.  The students adjusted to where they were going to be in the spring, and so did I.  Knoxville, Tennessee is a nice southern city with both friendly people and all the movie theaters one could ever want. I even went once!  Most of our students are here with us, though some are still in St. Kitts with some of our faculty.  We’ve learned we’re to be here through the September 2018 semester so we have some sense of permanence.  Though I would love to return to Dominica as soon as possible, having a safe, happy Dominica with functional buildings, power, water, cell service, and the other non-movie theater basics restored is really important too, so I can’t complain.  Here I am, a professor at a medical school in the United States, just like I wanted to be so many years ago.  And whether here or Dominica or anywhere else my fate takes me, I’ll get by.

As I told one of my advisees who was having a bad day last December, in the end a school isn’t buildings at all.  A medical school is its people, medical faculty training students through increasingly difficult tasks until at the end the students have risen up to a higher level, doctors ready to begin their postgraduate medical education journey.  The medical arenas and the classrooms and the simulation labs and the journal collections and the fraternity/sorority homes and even the occasional Italian ship sailing thousands of miles to become a “floating campus” are all just the scaffolding around what is really important.  That one student, his or her classmates, his or her basic science and clinical faculty, and everyone else from the Dean to I.T. to the people washing dishes in the back of the cafeteria who make sure everything else runs…these people are the real school.  They make it possible for that one student to excel.

And that’s something that no hurricane– however powerful– can stop.  Ask LSU if it stopped for either Camille or Katrina.  Ask Hofstra if it stopped for Sandy, Baylor if it stopped for either Rita or Harvey, or Nova Southeastern if it stopped for either Andrew or Irma.  Like those other disasters, Hurricane Maria is part of history now. And just like those other schools went on after their respective storms, we’ll keep going too, training the next generation of physicians, semester after semester.  As we do, I’ll be right there doing my part for my students, my school, and the greater medical education community.  Because in the end, that’s not only what I was trained to do, it’s still my passion today.

Bruce E. Wright graduated with a PhD in Physiology from LSU Health Sciences Center in 1993.  He had postdoctoral fellowships/research faculty positions at the University of Florida and East Carolina University.  He served several years as faculty at a liberal arts college in Georgia.  He worked at three Caribbean medical schools from 2005-2008 before joining the faculty at Ross University School of Medicine in 2008.  He worked for two years at a US-based osteopathic medical school in 2013 and 2014 before returning to Ross University in late 2014.  Dr. Wright is currently Treasurer/Award & Event Coordinator for the American Physiological Society’s Teaching Section.  He has served as a reviewer for Advances in Physiology Education.  He is National Faculty for the National Board of Osteopathic Medical Educators (NBOME), for whom he has written and reviewed items for different exams.  He regularly attends Experimental Biology and was an attendee and presenter for the first Institute for Teaching and Learning meeting in Bar Harbor, Maine in 2014.  He is currently interested in educational research involving teaching methodologies.

Photograph: The author with three RUSM students (from left to right, Armin Hojjat, Harenda Ipalawatte, Bruce Wright, and Eddy Mora) just after a double-tank scuba dive, off St. Kitts, November 2017. Used with permission by Harenda Ipalawatte.

References/links/other:

1. http://www.dominica.gov.dm/about-dominica/country-profile
2. https://medical.rossu.edu/about.html
3. http://www.dominica.gov.dm/tropical-storm-erika
4. https://weather.com/storms/hurricane/news/tropical-storm-harvey-forecast-texas-louisiana-arkansas
5. https://weather.com/storms/hurricane/news/hurricane-tropical-storm-irma-recap-2017
6. https://en.wikipedia.org/wiki/Hurricane_Maria
7. https://www.youtube.com/watch?v=l-5fHwER-Zc
8. https://www.caricom.org/media-center/communications/press-releases/dominica-prime-minister-roosevelt-skerrit-addresses-the-un-general-assembly
9. https://www.wunderground.com/cat6/category-5-hurricane-maria-hits-dominica
10. https://veterinary.rossu.edu/about.html

It’s funny, as I begin to write this blog, that I realize that it’s nearly 25 years now since I received my Ph.D. in Physiology in New Orleans.  Back then, I was sure that my career track would lead me to becoming a full professor at a medical school in the United States one day, though I didn’t know exactly how I would get there.  Not being a world traveler, I certainly never expected to spend a day in the Caribbean, but life is funny sometimes.

Like so many other graduates of my day, the “optimal” career track didn’t pan out for me.  My postdoctoral experience didn’t involve receiving any federal grants, so instead of moving straight into medical school, I became involved in undergraduate education. Several years later while advising students, I learned about Caribbean medical schools. When I studied them in more depth, I discovered one program in particular in which I could teach college seniors advanced A&P part-time while I took medical school courses part-time too.  I took a leap of faith and applied for it. Shortly after they accepted me, I took my first flight over the turquoise-blue of the Caribbean Sea.

 

That was the day my life changed

There was and is something different about the Caribbean, its varied islands and its colorful people, so friendly in some places and so unfriendly in others, but always full of life and adorned in bright colors.  Along the way I picked up medical-level Gross Anatomy and with that extra qualification, moved into full-time faculty positions at a couple of small medical schools in the British and Dutch Caribbean.  On those tiny islands I relearned my discipline as a generalist as few others of my generation have done.  There I was THE physiologist with no backup and neither a travel allowance for attending conferences or taking trips home to see my family, nor support for any research.  Instead I had to not only teach the entire medical physiology course by myself three times per year, I also had to assist the anatomy faculty in cadaver dissection twice per week and occasionally teach in an undergraduate course.  My typical medical school course load was 14-16 hours per week of just contact time in lecture and lab, not counting writing exams every three weeks and having many, many meetings with students.  It was hard but it changed me, and made me a better teacher. With this Caribbean-acquired training as a medical physiology generalist, in 2008 I moved up to a first-tier Caribbean medical school in the Commonwealth of Dominica (not the Dominican Republic!), initially to teach digestive physiology.

 

Dominica will always have a special place in my heart.  It is a small volcanic island in the British Caribbean that is shaped like a chrysalis (1).  At its widest it’s only about 18 miles and at its longest 29 miles, but it is almost a mile high. It has no five star resorts, no golf courses, and no movie theaters.  It’s hard to get to by air, and even cruise ships mostly go past it in favor of better-developed ports on the islands north and south of it. When I first arrived the entire population on-island was only about 73,000, mostly hugging the west (Caribbean) coast. But for several years I lived in a house on a hillside 500 feet above the Caribbean Sea watching the sun set over the ocean every night from my front porch. On Saturday I would sometimes go down to the village of Mero below me where there would be a half mile of pure gray sand beach and only a dozen people on it.  On Sunday, I might go down again to where five hundred locals had come to party on the beach, or I might have just sat on my porch and listened to the music from far below, as the stars came out and the Southern Cross hung in the April sky. One time, and only one time, I climbed the 4800 foot mountain in the center of the island where there is no trail up to the cloud-cloaked peak.  One time, I swam, dove, and rappelled down a river through a canyon greener than the Emerald City.  And along the way, I taught at a very special school, with smart, tough, high quality faculty and students alike, Ross University School of Medicine (2).

 

Through most of my years there, Dominica was spared the worst that Mother Nature could bring to bear.  We liked to say that it was in the perfect place in the Lesser Antilles, too far north for the big Cape Verde hurricanes that would not be turned north as they tracked west through the Central Atlantic to hit, and too far south for those Atlantic storms that did get pulled north as they approached the islands.  Sometimes a tropical storm would come and dump a lot of rain but that just turned the tap water brown or white for a day, no big deal.  The island stayed its radiant green from the tropical rain forests, only browning out for 1-2 months per year in the dry season from January to April.

 

 

In 2015, Tropical Storm Erika formed almost on top of us, and hit the island with the worst rainfall it had experienced in decades.  Dozens of people died and whole towns were cut off for months.  We thought we’d been hit by the Big One, as the estimated damage from Erika’s island-wide flash flooding was about 500 million dollars, or well over half of Dominica’s gross domestic product (3). For two years the island slowly recovered, rebuilding its water treatment facilities, repairing washed-out bridges, and helping rebuild flooded coastal communities.

By August 2017, Dominica was almost completely back.  We too were back.  Our school had had its own water supply even before Erika hit, and the electricity never went out in Portsmouth afterwards. Like the rest of Dominica, my school did lose cell phone service and internet for several days after that storm, which was a serious concern.  Once we were reconnected with the world, we moved to make sure our school would never be caught like that again.  My school installed its own satellite, set up evacuation plans, and built a new student center rated to withstand a Category 5 hurricane. Along the way it continued to matriculate three sets of students per year, semester in and semester out.  Collectively, we thought we’d survived the worst and recovered very well.

No one expected the hurricane onslaught of 2017.  Three major hurricanes, three major disasters, with consequences felt in several parts of the United States, were always theoretically possible but most people didn’t expect more than one to pan out. In the middle of August, I was on vacation at my wife’s home in Georgia as eventual Major Hurricane Harvey formed in the Atlantic and passed south of Dominica as a tropical storm.  Most storms that go that way fizzle out in the eastern Caribbean, but Harvey survived and went on to ravage Houston and the surrounding region of the northwestern Gulf of Mexico like few hurricanes ever had (4). The United States’ people and its government mobilized to help Texas and Louisiana, as it so often does after a major disaster.  I breathed a sigh of relief that Dominica was spared again even as I too donated to help the Gulf coast.

I returned to work before the beginning of the September semester.  Irma was still far out to sea in the Central Atlantic, but it looked like it was going to be trouble almost as soon as it cleared Africa.  I told many first semester students days before Hurricane Irma reached the Lesser Antilles that they should invest in a full set of hurricane supplies as if it would be the worst storm they would ever experience in their lives. Then, when it didn’t hit, they could eat the food, drink the bottled water, and cook with the extra propane all semester long.  Some took this advice to heart and others didn’t.  As Hurricane Irma came closer and closer, it kept heading straight for Dominica, defying days of forecasts that it would turn northwest, and strengthening all the way to one of the strongest Category Five storms of all time.  Only at the last minute seemingly did it turn at last.

Irma was a terrible storm, even by historical standards (5).  It destroyed St. Maarten and several other islands but all we got from it was severe rain and tropical-storm force winds, with only minor damage to our fragile infrastructure.  We grieved for our comrades including our sister school American University of the Caribbean north of us, and then watched as this storm’s heaviest rain bands hit the Miami area, causing even more flooding damage only weeks after Houston’s deluge.  As our University headquarters were there, this had some effect on our operations, but again from Dominica we breathed a sigh of relief.  We had been spared the worst again.

Chugging along some distance behind Irma, another tropical wave came off of the African coast, looking suspicious right from the start.  Maria, as it was to eventually be named, was absolutely the worst case scenario for the island of Dominica and for our basic science campus there (6).  It wasn’t supposed to be a major hurricane when it hit.  The forecasts all said if it hit at all, it was likely to be a strong tropical storm, maybe a Category One.  Nevertheless, in preparing for a business trip to Chicago for the second week of September, I had a group meeting with my mentees a week early, because sometimes even a simple rainstorm over Puerto Rico could delay my return by a day, and I was to return on Monday, September 18^th.  I took my work computer with me on the trip on a hunch I might need it before I got back to Dominica.  I had no idea how right I was.

As I worked at my business meeting, I kept following the progress of Maria, joking that it might just prevent me from returning on Monday, but hoping that it would turn like so many storms before it.  This was not to be. By late Saturday even though it was only tropical storm strength, it was apparent that on Sunday the regional airlines were going to evacuate their small aircraft to havens like Aruba and Curacao to the south and Central America to the west.  Since there weren’t going to be any flights, my travel agent arranged for me to go back to my family in Georgia on that Monday to wait out the storm.  We expected I probably wouldn’t get back to Dominica until air service was restored to Puerto Rico, probably four to six days after I’d originally been scheduled to return to Dominica.

September 18^th, 2017… Imagine being inside a tornado.

Imagine looking up to see your roof flying away and then the wind and rain coming in on top of your inadequate shelter as you brace your feet against the closet door, hoping it will hold.  Imagine hanging on for hours and hours of storm, enduring howling winds and painful rain and your stuff blowing away around you, hoping you wouldn’t die. If you have trouble imagining it, so do I, because I wasn’t there.  My colleagues who were there said that I was the luckiest person at the school, to be thousands of miles away that fateful day. From my computer screen at home that night I watched the storm give Dominica a direct hit with 160 mile per hour sustained winds, and turning only as the eye was literally over the island such that the entire west coast of the island was struck by the eyewall of Category Five Hurricane Maria.  As I flew home over the United States that day, eighty to ninety percent of the buildings in the country were about to be damaged or destroyed, the hospital, power generators and water reservoirs damaged or destroyed, and the roads and bridges so shakily repaired after Erika destroyed again (6).  The morning after the storm, people went out and saw that not one tree had escaped unscathed on the entire island, and in many places the trees had lost their bark or been snapped in two (7).  Virtually every telephone pole was either in need of repair or down entirely. The airport was knocked out again from both rain and the river beside it washing through the terminal and over the runway. Unlike with Erika, the seaport and its dock and warehouse capacity on the west coast was heavily damaged as well.  And of course, dozens of people were dead and dozens more are still missing to this day. The island was brought to its knees.

A few days after the storm, the prime minister declared in a speech to the United Nations General Assembly that “Eden is broken” (8).

At our campus, that brand new hurricane-proof building delivered.  All of our people were safe, though many of our older buildings were heavily damaged.  The French islands north and south of us weren’t so badly damaged and they were able to get helicopters up to survey the scene of total devastation that Dominica had become.  Our campus became a site for them and other rescuers to base, as it was more functional than any other location on the north side of the island.  With help from many others including the U.S. military, over a thousand students, faculty, staff, and family members were evacuated off the island through seas crowded with entire forests of dead trees and other debris.  Our CEO was there to greet many Ross refugees in Miami as they returned to the US to an uncertain future.  And as before, I watched it all from a distance, not personally devastated as they were but a refugee just the same.  I found out from a colleague who had been my neighbor that my concrete cottage had held up better than most. Like three of the other cottages in the complex it still had both a roof and windows following the storm, but no one could say if anything inside had survived the flooding, or whether the post-storm looters who sadly went through many other places had broken in after they were evacuated.  As soon as I could, I checked in with my school to let them know where I was and that I was safe. I was told to sit tight and wait for instructions, just like everybody else.  So that’s what I did, for several weeks.

Stay tuned for next week’s exciting conclusion…

 

Bruce E. Wright graduated with a PhD in Physiology from LSU Health Sciences Center in 1993.  He had postdoctoral fellowships/research faculty positions at the University of Florida and East Carolina University.  He served several years as faculty at a liberal arts college in Georgia.  He worked at three Caribbean medical schools from 2005-2008 before joining the faculty at Ross University School of Medicine in 2008.  He worked for two years at a US-based osteopathic medical school in 2013 and 2014 before returning to Ross University in late 2014.  Dr. Wright is currently Treasurer/Award & Event Coordinator for the American Physiological Society’s Teaching Section.  He has served as a reviewer for Advances in Physiology Education.  He is National Faculty for the National Board of Osteopathic Medical Educators (NBOME), for whom he has written and reviewed items for different exams.  He regularly attends Experimental Biology and was an attendee and presenter for the first Institute for Teaching and Learning meeting in Bar Harbor, Maine in 2014.  He is currently interested in educational research involving teaching methodologies.

References/links/other:

1. 1. 1. 1. http://www.dominica.gov.dm/about-dominica/country-profile
         2. https://medical.rossu.edu/about.html
         3. http://www.dominica.gov.dm/tropical-storm-erika
         4. https://weather.com/storms/hurricane/news/tropical-storm-harvey-forecast-texas-louisiana-arkansas
         5. https://weather.com/storms/hurricane/news/hurricane-tropical-storm-irma-recap-2017
         6. https://en.wikipedia.org/wiki/Hurricane_Maria
         7. https://www.youtube.com/watch?v=l-5fHwER-Zc
         8. https://www.caricom.org/media-center/communications/press-releases/dominica-prime-minister-roosevelt-skerrit-addresses-the-un-general-assembly
         9. https://www.wunderground.com/cat6/category-5-hurricane-maria-hits-dominica
         10. https://veterinary.rossu.edu/about.html