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 18th. 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 18th, 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…