“In our survey, interruption of medical care was the primary cause of sustained high mortality rates in the months after the hurricane, a finding consistent with the widely reported disruption of health systems.”
—Nishant Kishore, MPH; Domingo Marqués, PhD; Ayesha Mahmud, PhD; Mathew V. Kiang, MPH; Irmary Rodriguez, BA; Arlan Fuller, JD, MA; Peggy Ebner, BA; Cecilia Sorensen, MD; Fabio Racy, MD; Jay Lemery, MD; Leslie Maas, MHS; Jennifer Leaning, MD, SMH; “Mortality in Puerto Rico after Hurricane Maria,” The New England Journal of Medicine, May 29, 2018
I was excited to help. The response here, officially, was bad. A lot of us knew we needed to react to that somehow. We wanted the victims to know that not everybody here felt like he did. But also, yeah, that’s the word for it, excited.
I applied to go through my union. I’m a nurse in San Bernardino Memorial’s critical care unit. My union had asked for names of people who were willing to go there and do first aid, public health, whatever was needed. Our representative didn’t say anything outright political, but a lot of us didn’t like the president’s tone. He’d said, “They want everything done for them.” We knew that you can’t talk like that about patients, victims. I signed up right away.
My husband looked bashful with pride when he saw me packing my bags. He told everybody at his work that I had been chosen to do triage in a crisis zone. He said he’d get his mom to help with our daughter and that everybody at home would be OK without me for a little while.
“You’re an amazing woman,” he said. That made me feel good.
Two days later I left.
We landed in Luis Muñoz Marín Airport in San Juan. A bunch of girls and guys from all over California, not just San Bernardino, were on the flight. We were very geared up on the trip over. Nobody drank anything and we discussed how serious the situation was. But there was also a lightness about it, people glowing and speaking loudly and quickly, like they were on a date.
At the airport you could see the beginnings of the real damage. The lights were out. Hundreds of people lived in the hangars. Families sleeping there, eating there. We did first aid on many children. It was not clean. It was wet, there was a smell. We hiked up our bags onto our shoulders and ran out into the crowds. One mother cried as I cleaned her daughter’s foot, which had been cut by falling branches. Another old woman came up tome and asked in English for penicillin. I had a few small bottles on me and I gave her two, which I later knew had been a stupid mistake. At the airport, it was a populated area and those people had some care; there were doctors and nurses. The older woman was really grateful, though, you know. I told people at home about it later. I said her reaction was the real story of the people there, and gave a picture that folks in the States—I mean, in our parts of the US—weren’t getting over the news. Anyway, she was thankful. She kissed my hand.
The government sent us cars to take us to the city, the capital. It’s a little over seven miles to get there on the 26 Expressway from the airport. The sky by that time had turned blue again but power lines and tree branches were still scattered on the freeways. We weaved back and forth on the road. Our driver had seen some bad things already. He was tall and nervous, sort of zany. He acted serious when the advisers assigned him to our group and told him where to take us. But once he got on the road he zipped back and forth through the power lines, smiling at us through the rearview so that we could see his spaced-apart teeth.
“The fast and furious!” he yelled, I guess like the movie. He kept laughing.
We’d been in good moods on the plane but we smiled at him with closed lips like we were being empathetic but didn’t think it was funny.
San Juan. At first I thought, Oh my God, this is terrible. Some of the buildings were crushed and people milled around, asking for food and supplies. That’s when I first saw the huge lines. FEMA had set up shop in the middle of the city and victims were lined up to get an application for hurricane relief, if that’s what you call it.
The nurses gathered into groups of ten or so. The FEMA officer in charge of our quadrant assigned my group an attaché, Brian, from Kansas City. I pegged him at forty years old, with a Bluetooth that he talked on constantly. He wore glasses and he had to clean them with his shirt every five minutes because of the humidity. He wore the blue FEMA slicker. He gave us rubber pants and boots and our own FEMA ponchos for the rain, even though we weren’t government employees. He was getting pulled in every direction but would click his Bluetooth off to listen to our questions.
“Where’s the deepest impact?” one of our group asked.
“Have you segmented by pathology?” another inquired.
“Is there a geriatric unit around here?” is what I wanted to know, as I’d had some experience with the elderly.
“Well, we’ll see what kinds of trouble we can get into,” Brian joshed. He brought us to the Coliseum. There we did a little triage again like before at the airport. The hundreds of victims made the space dirty, hot, and steamy, but guards and nurses and doctors had been stationed there. From what I could tell, the Coliseum wasn’t like the Superdome in Katrina where people did die.
After a couple of days, Brian took us to the historical district, with the romantic pink and blue colonial buildings. We saw more flooding. Trees and a couple of cats floated in one of the streets. The police kept people clear of them. We passed by the state capitol, a white building with marble or concrete steps that had been covered in sludge. Three men washed the steps clean with huge hoses. Brian then brought us to a clinic at the San Jorge Children and Women’s Hospital, where we showed a mother how to breastfeed and treated four children for dehydration. The power had all switched over to auxiliary. We walked around the plaza and saw other groups from our union walking around too, and waved at them. We saw Mayor Yulín Cruz running across Avenida Juan Ponce de León. She had this blue sweater on her shoulders that dropped on the street and she just left it there, racing to wherever. She had this totally fierce look on her face, just furious.
The people had no power, no reliable power. The grid had gone out the first day the storm hit, on September 20. In the capital, people used generators. You had to come to the main city mostly to get help. FEMA didn’t really go to you. A lot of people had traveled. I don’t know how the folks from the mountain towns got to San Juan without any juice up there. Maybe the army? And they’d traveled all that way just to stand in line. They stood in long rows, and I saw a lot of people falling asleep, just like that, on their feet.
The most FEMA investigators I saw were in the capital. I didn’t see them anywhere else. In San Juan, they sat at tables and gave out the applications in one section and the water and beef jerky and cookies in another. Everybody spoke English. FEMA made their announcements on Twitter, though bilingually. At first I didn’t question it, because I use social media constantly. But then, later, I wondered.
“What the hell are we doing?” Craig asked after a week of this. He was one of the nurses in our group, a big, tall guy with a red beard from Chicago. He’d just put a Band-Aid on a man with no mobility issues.
“Yeah,” I said. “Let’s get out of here.”
“I’m in,” Latisha said. She was a girl we had met from Oklahoma, an emergency RN.
Another girl, Ranee, wanted to tag along too. She came from New York.
“I didn’t come here to be a tourist,” Ranee said.
So we looked around and scrounged food, medicine, water, batteries, and a sat phone that we thought we’d need. Finally we also got ahold of a Rambler. We split.
We went to the mountain areas. We had the rubber gear—rubber boots and pants and gloves, and our FEMA slickers. We ate power bars. We cursed and swore when we looked out of the Rambler’s windows and saw the smushed cars and ripped trees. Meanwhile, we also talked some about the political scene, but then Ranee wound up saying she liked the president fine and so I kind of kept all that to myself.
The thing is, these people are Americans. They are United States citizens. That’s what a lot of people didn’t understand back home at the time.
I felt better once we left. I had that feeling again on the road, that this was new and I was doing something important and big. Like it was war. I mean, it looked like warfare out there, past the city. The roads were just destroyed, often impassable on account of live electrical cables, cracked surfaces, and huge palms that had been pulled from their roots. Boulders toppled from cliffs or mudslides and landed in the highways. Utility poles had tipped over. The mud ran thick and filled with rocks and our car skidded out of control over the slick parts. Trash spread out everywhere in huge piles—plastic, torn furniture, hazardous materials like asbestos and electronics, chemicals, batteries, televisions. Aluminum hung on the standing utility poles and dragged down the cables, which shot sparks. About ten miles out we had to physically pick up the cables to let the car squeeze in beside the piles of trash, a big mound made up of what looked like a broken sofa and plastic bags and gas cans that spilled everywhere.
The worse part was the flooding. We saw dead animals, dogs and cows. The water stood sometimes two feet up on the road, three feet, as we splashed through.
About twenty or thirty miles out of town we saw a man walking through a passable part of the current with his little girl on his back. We stopped and yelled at him to get out of the water. When we got them into the car we freaked because he had a cut on his arm and the girl had one on her stomach. We stuffed them with Cipro and cleaned the wounds as best we could and then drove them to shelter on higher ground.
“Don’t walk in the water,” I told him in English. I swear to Christ none of us spoke Spanish; it was stupid. A lot of nurses have some medical Spanish but none of us did. We’d tried to get ahold of a translator in San Juan but they were all doing administrative tasks and didn’t want to go to the mountains. I told the man, “There’s sewage, chemicals, viruses, mold. Don’t touch the water. Don’t let your daughter touch the water. If you need some water, clean what you get from a tap with bleach or chlorine tablets. Don’t get near it otherwise.”
“Thank you,” he said. He had streaked dirt all over his face from where he’d rubbed it with a cloth.
“Do you understand what I’m telling you?”
“Thank you, thank you,” he said.
“Thank you,” his daughter said. She was like six, with light brown hair and wrapped up in my sweatshirt. My daughter at home is four years old so it was like, you know.
“Yeah, you’re welcome,” I said.
But at least we saved them.
After we dropped them off we zoomed through the flooding and the water splashed into the Rambler from a crack I’d idiotically left open in a back window.
What was he doing at this point? This was, like, October 3. I think he was throwing paper towels to rich people in Guaynabo. But the people in the mountains didn’t know about that. They didn’t know where anybody was or what was happening.
I don’t know why the people in the mountains stayed so long. I’m talking about the ones that the army for some reason didn’t get out. Mostly, it might have been because they just couldn’t walk or drive out under their own steam. But I think other people got confused by how smooth things went down in Houston earlier—when, oh, Hurricane Harvey happened those last weeks of August 2017.
I think the people in the mountains thought that if they stayed put they’d get the same kind of help that folks in Texas got.
We saw a woman standing on top of her house in Camarillo. She was a large, heavy lady, really broad, wearing a mud-covered dress and waving her hands. She was crying. The flooding had come up halfway to her house and when she saw us she started screaming about her dogs. Latisha in our group knew the word for dogs, perro, and when I thought about it, I knew the word too.
“Here we go,” Craig said.
“She’s in trouble,” I said.
We ran out to save her. We pulled on our rubber pants and wandered through the water, trying to figure out how to get her down. Latisha found a ladder sticking through a smashed window and we pulled that up and propped it against the roof of her house. I climbed up first.
The woman’s eyes looked strange, but I’m a nurse and so I’d seen that before. A real spaced-out look, like an animal’s. Maybe I shouldn’t say that. It’s just a human thing, though. You get animal when you get that scared, we all do.
She fucking gripped onto my legs, yelling about her dogs, and I thought she was going to pull me down.
“Wait, wait!” I yelled at her. Craig came climbing up and he’s got a way with the ladies, I guess. He knew how to use his voice to calm her. She clambered up on his back and kept slipping down, so I held her up by her bottom, like to support her. We lugged her down the ladder somehow. Then we carried her over the water, the whole team did. She kept crying. She yelled at us about her dogs. We finally hauled her to higher ground and she sat down in the mud, exhausted and talking excitedly in Spanish.
I ran back to the house. Climbed up through the smashed window where Latisha found the ladder. The house smelled awful. Black mold. Gets in the lungs. The woman had been stranded for a week, maybe, but I think more. The ceiling curdled or buckled or something. The walls had cracked with water damage. I tried not to breathe. I went wading through the kitchen, the water up to my stomach, pushing past floating plastic forks and spoons and cups, until I got to the bedroom.
Two of those little itty-bitty types of dogs looked straight at me. Soaked and trembling. They stood up on a bureau, just above high water. Those pop-eyed dogs. Chihuahuas. They started howling with their poor little mouths. I chugged through the water and grabbed them and hauled ass out of there before the ceiling came crashing down.
I don’t know how I got through the window with a dog under each arm. One of them started biting me. I was like, laughing, I guess from fear. I gave the dogs to Ranee, and she ran over to the woman and gave them to her.
The woman stuck her face into the dogs and just cried and cried. We all started crying.
We looked at her feet and asked her, “Are you diabetic?” The word for diabetes is almost the same in Spanish. She said yes. She didn’t have her medicine. Later I learned that a lot of people didn’t know that it could go unrefrigerated, and they threw it away.
We cleaned her wounds and bandaged them. We gave her insulin and Cipro and water and some food. We treated the dogs too, even the bitey one. They had sores.
After a while some girls from higher ground showed up and all of them starting talking really fast in Spanish. Then the girls spoke English and said that the woman was very thankful. The girls said that they knew the lady, and she could come stay with them because their house was undamaged.
We dropped everybody at the girls’ house. The parents came out and wrapped up the woman in a blanket.
I felt like a hero.
Toa Baja sits on the northern coast, about twenty-five kilometers from San Juan. It’s a smallish city, maybe eighty thousand people. It looked deserted. It got really ripped up. A lot of the little houses there didn’t have roofs. It’s a tourist place because it’s by the water, which wasn’t perfect when the storm came. Later I learned that the army had come and evacuated a lot of people. But they didn’t get everybody.
We found a man on the outskirts of town. He waved at us from the top of a small apartment complex, trying to yell, but his voice didn’t work anymore. He looked to be about eighty years old. I couldn’t see that then, exactly how old he was, but I’ve learned the general look of geriatrics. We stopped on the side of the road and yelled back up at him that it was OK and we were going to get him.
His apartment complex had been crushed on the side and was not stable. It was only two stories. The ceilings had come crashing down on the interior and blocked the staircase. I don’t know how it was still standing. We couldn’t get up through the inside of the building.
I could hear him trying to yell at us for help. Heeeeehhh Heeeeehhhh. His voice had just been completely thrashed.
“Call San Juan,” Ranee said.
Craig called on the satphone. He got through to Brian, but Brian said there was nothing he could do right then. I said to Craig, Call Brian’s boss at FEMA. I said, Call the army. We didn’t know who the hell to call. We just dialed Brian again and nobody answered.
“What are we going to do?” Latisha said. She looked really tired and wiped her eyes with her hands, until she remembered about infection.
I looked over at the much taller, four-story stucco building next to the one where the guy was. It was crushed too. But it had some black metal balconies sticking out from the side. These balconies were so close to the old guy’s apartment complex that they were in almost jumpable distance. I thought that maybe I could climb up those balconies and then somehow scramble to the other building’s roof. It would only be two or three stories to be level with it. It’d be like Spiderman. Like parkour. You had to be creative out there.
“No,” Craig said, when I told him my plan. You know, a man. But the victim was still trying to scream at us and I said, Fuck it.
I ran over to the side of the building with the balconies and started to climb up, from floor to floor, from the outside. I’m in good shape, thankfully. I lift weights and I do trail running. I do yoga. Not that it helped me much.
I climbed up to one of the first-floor balconies. It was wrought metal, black, and very slick from the water. I clambered up and jumped down into it. It was fine. And then it turned out that there was a little fire exit extending from the second floor’s balcony to the first, and so I climbed up that, even though it had been broken in the storm. I grabbed onto the little steps, but the fire exit swayed almost all the way out and I thought I’d come crashing down.
The nurses below were all yelling at me and I thought, Yeah, maybe not a great idea.
But I hooked my foot onto the second-balcony railing and swung the fire exit back. I hopped into the little balcony. It didn’t feel very stable. It creaked. But from there I had a good view of the roof of the two-story building where the old man was stranded. I could see that he needed immediate crisis care. He had this old shriveled face. His hair came down over his eyes. He was hurt.
His whole left side was just red. I couldn’t tell exactly what was going on. But from the position of the leg I could see it had broken. And he had some serious hematomas and lacerations. Exterior wounds of that size mean a good chance of internal bleeding too. He must have fallen or had something topple on top of him. I don’t know how he made it to the roof. He had crawled over it to scream at us from the edge.
I could see him pretty close. I could see his eyes. He didn’t have animal eyes like the lady. He had the kind of eyes that terminal patients get when it sinks in and they know they have to get ready. The light goes out of them.
I yelled when I saw that. I said, “Hey! Hey! Hey! Hey!”
He nodded and laid his head down on the ground.
“Hey! Hey! Hey! Hey!” I’m yelling. “I’m coming to get you!”
I couldn’t hop to the roof from the second balcony. From that height, there was a good chance I’d just hit the wall and have to grab the edges with my fingers. The third balcony up rose higher than the top of his building. I could do a long jump down from there, maybe. But when I grabbed up at the third balcony’s ironwork, it shook loose from the stucco. Then it just collapsed. It popped out from the top, swung all the way down, and then hung toward the ground from one rivet. I had to duck because it almost knocked my head off. I started trembling then. I knew I was a complete tool with no idea what I was doing.
“Sindy!” they’re all yelling down there.
“It’s fine!” I yelled back. It wasn’t fine. I couldn’t jump from building to building. I’m not Spiderman and I don’t do parkour. Also the balcony
I stood on was creaking and shaking.
I looked across at the other building, at the man, who still lay down on the roof by the edge, trying to raise his hand at me. I looked at his eyes, at the red on his skin and clothes all down the left side. On the part of his rooftop I could see, there was a red stain around his body. I didn’t know how long he had been there but the bone can get set wrong and there is a serious problem with bacterial infection, septicemia, in those conditions.
He looked at me again and shook his head. I could see him really well, that’s how close I was. But not close enough to get to him. We looked at each other for a long time.
Then he started shuffling. He tried to scream, I guess from the pain, but couldn’t. He was rummaging through his pocket with his good hand. He took something out of his pocket and dropped it from the roof into the shallow water below. I heard it plop.
“He dropped something!” I yelled.
“I got it,” I heard Ranee say.
“I have to get down,” I said to the man.
He didn’t say anything to me. He laid completely flat on the roof and then I couldn’t see him as well.
“Just wait here,” I said. “We’ll send someone for you.”
He still didn’t say anything.
“We’ll send somebody,” I said.
I climbed down.
We got back in the Rambler and drove away. Craig drove and Latisha sat in the front. Ranee put a blanket over me.
“What did he throw down?” I said.
Ranee had put it inside her rubber pants and now fished it out. It was a small soaked square object. She handed it to me.
It was his wallet. I opened it up and saw his identification cards. He was smart. It had his address, his location.
His name was Antonio Hernandez.
As soon as we got to San Juan I tracked down Brian and I was like, this guy needs our help. He lives here. I showed Brian the address. We need to call the army, I said. We need FEMA. We have to get the police.
Brian took the wallet that I handed him. He said he’d write the guy’s name down. “I’ll let our team know,” he said.
“No, you don’t understand. We need to get him now,” I said. I explained about the hematomas and the balconies.
Brian took off his glasses and cleaned them with his shirt, from under his FEMA slicker. He tilted his head at a line of people who were waiting for I don’t know what. The line was so long I couldn’t see where it ended.
“We’ll do what we can do,” he said. “But we have our hands full.”
“You need to listen to me! This is an emergency!”
Brian walked away.
Later, that night, in our hotel, I got so mad. I realized that if I could just somehow get ahold of rescue equipment or some people myself, I could go save Mr. Hernandez before he died. I could get a ladder, like the one I’d used to help the woman and the dogs.
I just lay there all night thinking of his whole left side that had been turned red from the hematoma and the cuts. I thought of his eyes. Thought how stupid I’d been to just give his information to Brian and then expect a miracle. I had to do it myself.
Thing was, I couldn’t remember exactly how to get back to the apartment in Toa Baja. I tried to track it in my mind, but couldn’t. I called Craig about it, in the middle of the night. He said that he didn’t know how exactly to track back either, because we’d been going all over the place without a plan. So I called Latisha and Ranee but they didn’t know either.
“Didn’t Brian say they’d get him?” Ranee said into the phone, sleepy. What I needed was that wallet. With the wallet and an ID card, I’d plug in the address using GPS.
I got up the next morning and it was raining. I prepared by putting on my rubber pants and my slicker, so when I got Mr. Hernandez’s information I could just get a car and go. After that, I started running everywhere looking for Brian. The mother and child clinic, the Coliseum, the historical district. When I found him, around three o’clock in the afternoon in the cantina, I started hollering at him that I needed the wallet. He was like, What are you talking about? Then he remembered. He said, “I gave that to so-and-so.” A supervisor. He said, “They’ll take care of it when they can.”
I said, “Just give it back to me and I’ll get a car and a ladder. I’ll get supplies. I’ll go up there myself.”
Brian looked at me sort of sympathetically. “I can see this is getting to you,” he said.
“Just give me the wallet back,” I said.
He put his arm around me and gave a little tug on the FEMA slicker I wore. “You’ve done really great work here, you’ve been such an incredible part of the team.”
We stood by a pile of sandwiches wrapped up in plastic, but in my mind I saw the long lines with the people sleeping standing up, and the FEMA guys handing out applications. I said, “No, I’m doing something different. We went up to the mountains.”
“Every little bit helps,” Brian said.
“I’m not part of this,” I said. “We went up to Toa Baja, and I have to get back.”
Brian looked at me and said, “Sorry, I’m coming. I’ll be right there.”
“What?” I said.
“I have a meeting,” he said, getting suddenly busy. He’d been talking to his Bluetooth.
“His name’s Antonio Hernandez,” I said.
“I know, thank you, good,” Brian said. He took off again.
He never got back to me about the wallet. I must have called him six or seven more times, but he didn’t answer.
Two days later it was time for us to leave.
I heard that the president said that the death toll was sixteen. He was like, This is a really impressive number.
Later there were some studies by Harvard and George Washington Universities.
Those estimates said that eight hundred to eight thousand people died in Puerto Rico, mostly from “interruptions in medical care.” That just means that they didn’t get seen by surgeons or doctors or nurses. Less people died from drowning, or direct impacts.
So I went home. I went home to my husband and my daughter.
They looked so crazily happy to see me that at first it was OK. At the airport, my daughter crawled all over me and got too excited, so I had to sing to her so she’d stop screaming. My husband wrapped me up in his arms and then drove us all back to the house. I slept in the car and when I woke up we were there.
Our place looked like a palace, I swear.
I slept in our bed. It was good to be back. Like the other wasn’t real almost. My husband cooked me eggs and pizza. I was just so grateful to have my family. My daughter showed me some pictures she’d taken while I was away. They were of flowers and grass.
I told my family about the woman with the little dogs, and how I’d held her by the butt and saved her Chihuahuas by basically swimming through the house. My daughter liked that. I told my husband, later, at night, about the man and his daughter in the floodwater and how we’d treated their wounds and given them Cipro. I talked about how FEMA stayed in San Juan while we went to the mountains in that Rambler, and how we’d had to pick up the fallen cables with the electric sparks. I drank a lot of wine and went on and on about it. How the old woman at the airport had kissed my hand and blah blah. I told my husband all of the stories except for the one about the man on the roof. And he, my husband, was really, really proud of me.
The problem was that after a few days I started to feel like just lying down on the floor and not getting back up. I got this idea that Brian had been right when he’d said that I was part of the team. He’d hinted to me that I didn’t count as some special superhero. I hadn’t wanted to hear that at the time, when I was yelling at him about Toa Baja. But after a few days of telling my stories and eating my husband’s cooking, I saw that he had a point. Because I didn’t speak Spanish. I let myself feel all puffed up when that old lady kissed my hand just because I gave her a couple little bottles of penicillin. Me thinking that I’m righting some wrong, sort of resisting the political crap. But the truth is I never even thought about Puerto Rico until the union emailed us about the opportunity. I’ll just say too that I didn’t realize they were citizens until the rep explained it all to us. And then, even though I knew he was still out there, might be dead already, I’d just gone home when the time for our trip was over.
I tried to call Brian again but I just got dumped into voice mail.
The way he’d dropped the wallet into the water, hoping. Just hoping to live.
About a month later I was crying into the sink in our kitchen and my husband found me.
“Honey, baby.” He hugged me and kissed me and rocked me back and forth. “What’s wrong?”
I applied to go through my union. I’m a nurse in San Bernardino Memorial’s critical care unit. My union had asked for names of people who were willing to go there and do first aid, public health, whatever was needed. Our representative didn’t say anything outright political, but a lot of us didn’t like the president’s tone. He’d said, “They want everything done for them.” We knew that you can’t talk like that about patients, victims. I signed up right away.
My husband looked bashful with pride when he saw me packing my bags. He told everybody at his work that I had been chosen to do triage in a crisis zone. He said he’d get his mom to help with our daughter and that everybody at home would be OK without me for a little while.
“You’re an amazing woman,” he said. That made me feel good.
Two days later I left.
We landed in Luis Muñoz Marín Airport in San Juan. A bunch of girls and guys from all over California, not just San Bernardino, were on the flight. We were very geared up on the trip over. Nobody drank anything and we discussed how serious the situation was. But there was also a lightness about it, people glowing and speaking loudly and quickly, like they were on a date.
At the airport you could see the beginnings of the real damage. The lights were out. Hundreds of people lived in the hangars. Families sleeping there, eating there. We did first aid on many children. It was not clean. It was wet, there was a smell. We hiked up our bags onto our shoulders and ran out into the crowds. One mother cried as I cleaned her daughter’s foot, which had been cut by falling branches. Another old woman came up tome and asked in English for penicillin. I had a few small bottles on me and I gave her two, which I later knew had been a stupid mistake. At the airport, it was a populated area and those people had some care; there were doctors and nurses. The older woman was really grateful, though, you know. I told people at home about it later. I said her reaction was the real story of the people there, and gave a picture that folks in the States—I mean, in our parts of the US—weren’t getting over the news. Anyway, she was thankful. She kissed my hand.
The government sent us cars to take us to the city, the capital. It’s a little over seven miles to get there on the 26 Expressway from the airport. The sky by that time had turned blue again but power lines and tree branches were still scattered on the freeways. We weaved back and forth on the road. Our driver had seen some bad things already. He was tall and nervous, sort of zany. He acted serious when the advisers assigned him to our group and told him where to take us. But once he got on the road he zipped back and forth through the power lines, smiling at us through the rearview so that we could see his spaced-apart teeth.
“The fast and furious!” he yelled, I guess like the movie. He kept laughing.
We’d been in good moods on the plane but we smiled at him with closed lips like we were being empathetic but didn’t think it was funny.
San Juan. At first I thought, Oh my God, this is terrible. Some of the buildings were crushed and people milled around, asking for food and supplies. That’s when I first saw the huge lines. FEMA had set up shop in the middle of the city and victims were lined up to get an application for hurricane relief, if that’s what you call it.
The nurses gathered into groups of ten or so. The FEMA officer in charge of our quadrant assigned my group an attaché, Brian, from Kansas City. I pegged him at forty years old, with a Bluetooth that he talked on constantly. He wore glasses and he had to clean them with his shirt every five minutes because of the humidity. He wore the blue FEMA slicker. He gave us rubber pants and boots and our own FEMA ponchos for the rain, even though we weren’t government employees. He was getting pulled in every direction but would click his Bluetooth off to listen to our questions.
“Where’s the deepest impact?” one of our group asked.
“Have you segmented by pathology?” another inquired.
“Is there a geriatric unit around here?” is what I wanted to know, as I’d had some experience with the elderly.
“Well, we’ll see what kinds of trouble we can get into,” Brian joshed. He brought us to the Coliseum. There we did a little triage again like before at the airport. The hundreds of victims made the space dirty, hot, and steamy, but guards and nurses and doctors had been stationed there. From what I could tell, the Coliseum wasn’t like the Superdome in Katrina where people did die.
After a couple of days, Brian took us to the historical district, with the romantic pink and blue colonial buildings. We saw more flooding. Trees and a couple of cats floated in one of the streets. The police kept people clear of them. We passed by the state capitol, a white building with marble or concrete steps that had been covered in sludge. Three men washed the steps clean with huge hoses. Brian then brought us to a clinic at the San Jorge Children and Women’s Hospital, where we showed a mother how to breastfeed and treated four children for dehydration. The power had all switched over to auxiliary. We walked around the plaza and saw other groups from our union walking around too, and waved at them. We saw Mayor Yulín Cruz running across Avenida Juan Ponce de León. She had this blue sweater on her shoulders that dropped on the street and she just left it there, racing to wherever. She had this totally fierce look on her face, just furious.
The people had no power, no reliable power. The grid had gone out the first day the storm hit, on September 20. In the capital, people used generators. You had to come to the main city mostly to get help. FEMA didn’t really go to you. A lot of people had traveled. I don’t know how the folks from the mountain towns got to San Juan without any juice up there. Maybe the army? And they’d traveled all that way just to stand in line. They stood in long rows, and I saw a lot of people falling asleep, just like that, on their feet.
The most FEMA investigators I saw were in the capital. I didn’t see them anywhere else. In San Juan, they sat at tables and gave out the applications in one section and the water and beef jerky and cookies in another. Everybody spoke English. FEMA made their announcements on Twitter, though bilingually. At first I didn’t question it, because I use social media constantly. But then, later, I wondered.
“What the hell are we doing?” Craig asked after a week of this. He was one of the nurses in our group, a big, tall guy with a red beard from Chicago. He’d just put a Band-Aid on a man with no mobility issues.
“Yeah,” I said. “Let’s get out of here.”
“I’m in,” Latisha said. She was a girl we had met from Oklahoma, an emergency RN.
Another girl, Ranee, wanted to tag along too. She came from New York.
“I didn’t come here to be a tourist,” Ranee said.
So we looked around and scrounged food, medicine, water, batteries, and a sat phone that we thought we’d need. Finally we also got ahold of a Rambler. We split.
We went to the mountain areas. We had the rubber gear—rubber boots and pants and gloves, and our FEMA slickers. We ate power bars. We cursed and swore when we looked out of the Rambler’s windows and saw the smushed cars and ripped trees. Meanwhile, we also talked some about the political scene, but then Ranee wound up saying she liked the president fine and so I kind of kept all that to myself.
The thing is, these people are Americans. They are United States citizens. That’s what a lot of people didn’t understand back home at the time.
I felt better once we left. I had that feeling again on the road, that this was new and I was doing something important and big. Like it was war. I mean, it looked like warfare out there, past the city. The roads were just destroyed, often impassable on account of live electrical cables, cracked surfaces, and huge palms that had been pulled from their roots. Boulders toppled from cliffs or mudslides and landed in the highways. Utility poles had tipped over. The mud ran thick and filled with rocks and our car skidded out of control over the slick parts. Trash spread out everywhere in huge piles—plastic, torn furniture, hazardous materials like asbestos and electronics, chemicals, batteries, televisions. Aluminum hung on the standing utility poles and dragged down the cables, which shot sparks. About ten miles out we had to physically pick up the cables to let the car squeeze in beside the piles of trash, a big mound made up of what looked like a broken sofa and plastic bags and gas cans that spilled everywhere.
The worse part was the flooding. We saw dead animals, dogs and cows. The water stood sometimes two feet up on the road, three feet, as we splashed through.
About twenty or thirty miles out of town we saw a man walking through a passable part of the current with his little girl on his back. We stopped and yelled at him to get out of the water. When we got them into the car we freaked because he had a cut on his arm and the girl had one on her stomach. We stuffed them with Cipro and cleaned the wounds as best we could and then drove them to shelter on higher ground.
“Don’t walk in the water,” I told him in English. I swear to Christ none of us spoke Spanish; it was stupid. A lot of nurses have some medical Spanish but none of us did. We’d tried to get ahold of a translator in San Juan but they were all doing administrative tasks and didn’t want to go to the mountains. I told the man, “There’s sewage, chemicals, viruses, mold. Don’t touch the water. Don’t let your daughter touch the water. If you need some water, clean what you get from a tap with bleach or chlorine tablets. Don’t get near it otherwise.”
“Thank you,” he said. He had streaked dirt all over his face from where he’d rubbed it with a cloth.
“Do you understand what I’m telling you?”
“Thank you, thank you,” he said.
“Thank you,” his daughter said. She was like six, with light brown hair and wrapped up in my sweatshirt. My daughter at home is four years old so it was like, you know.
“Yeah, you’re welcome,” I said.
But at least we saved them.
After we dropped them off we zoomed through the flooding and the water splashed into the Rambler from a crack I’d idiotically left open in a back window.
What was he doing at this point? This was, like, October 3. I think he was throwing paper towels to rich people in Guaynabo. But the people in the mountains didn’t know about that. They didn’t know where anybody was or what was happening.
I don’t know why the people in the mountains stayed so long. I’m talking about the ones that the army for some reason didn’t get out. Mostly, it might have been because they just couldn’t walk or drive out under their own steam. But I think other people got confused by how smooth things went down in Houston earlier—when, oh, Hurricane Harvey happened those last weeks of August 2017.
I think the people in the mountains thought that if they stayed put they’d get the same kind of help that folks in Texas got.
We saw a woman standing on top of her house in Camarillo. She was a large, heavy lady, really broad, wearing a mud-covered dress and waving her hands. She was crying. The flooding had come up halfway to her house and when she saw us she started screaming about her dogs. Latisha in our group knew the word for dogs, perro, and when I thought about it, I knew the word too.
“Here we go,” Craig said.
“She’s in trouble,” I said.
We ran out to save her. We pulled on our rubber pants and wandered through the water, trying to figure out how to get her down. Latisha found a ladder sticking through a smashed window and we pulled that up and propped it against the roof of her house. I climbed up first.
The woman’s eyes looked strange, but I’m a nurse and so I’d seen that before. A real spaced-out look, like an animal’s. Maybe I shouldn’t say that. It’s just a human thing, though. You get animal when you get that scared, we all do.
She fucking gripped onto my legs, yelling about her dogs, and I thought she was going to pull me down.
“Wait, wait!” I yelled at her. Craig came climbing up and he’s got a way with the ladies, I guess. He knew how to use his voice to calm her. She clambered up on his back and kept slipping down, so I held her up by her bottom, like to support her. We lugged her down the ladder somehow. Then we carried her over the water, the whole team did. She kept crying. She yelled at us about her dogs. We finally hauled her to higher ground and she sat down in the mud, exhausted and talking excitedly in Spanish.
I ran back to the house. Climbed up through the smashed window where Latisha found the ladder. The house smelled awful. Black mold. Gets in the lungs. The woman had been stranded for a week, maybe, but I think more. The ceiling curdled or buckled or something. The walls had cracked with water damage. I tried not to breathe. I went wading through the kitchen, the water up to my stomach, pushing past floating plastic forks and spoons and cups, until I got to the bedroom.
Two of those little itty-bitty types of dogs looked straight at me. Soaked and trembling. They stood up on a bureau, just above high water. Those pop-eyed dogs. Chihuahuas. They started howling with their poor little mouths. I chugged through the water and grabbed them and hauled ass out of there before the ceiling came crashing down.
I don’t know how I got through the window with a dog under each arm. One of them started biting me. I was like, laughing, I guess from fear. I gave the dogs to Ranee, and she ran over to the woman and gave them to her.
The woman stuck her face into the dogs and just cried and cried. We all started crying.
We looked at her feet and asked her, “Are you diabetic?” The word for diabetes is almost the same in Spanish. She said yes. She didn’t have her medicine. Later I learned that a lot of people didn’t know that it could go unrefrigerated, and they threw it away.
We cleaned her wounds and bandaged them. We gave her insulin and Cipro and water and some food. We treated the dogs too, even the bitey one. They had sores.
After a while some girls from higher ground showed up and all of them starting talking really fast in Spanish. Then the girls spoke English and said that the woman was very thankful. The girls said that they knew the lady, and she could come stay with them because their house was undamaged.
We dropped everybody at the girls’ house. The parents came out and wrapped up the woman in a blanket.
I felt like a hero.
Toa Baja sits on the northern coast, about twenty-five kilometers from San Juan. It’s a smallish city, maybe eighty thousand people. It looked deserted. It got really ripped up. A lot of the little houses there didn’t have roofs. It’s a tourist place because it’s by the water, which wasn’t perfect when the storm came. Later I learned that the army had come and evacuated a lot of people. But they didn’t get everybody.
We found a man on the outskirts of town. He waved at us from the top of a small apartment complex, trying to yell, but his voice didn’t work anymore. He looked to be about eighty years old. I couldn’t see that then, exactly how old he was, but I’ve learned the general look of geriatrics. We stopped on the side of the road and yelled back up at him that it was OK and we were going to get him.
His apartment complex had been crushed on the side and was not stable. It was only two stories. The ceilings had come crashing down on the interior and blocked the staircase. I don’t know how it was still standing. We couldn’t get up through the inside of the building.
I could hear him trying to yell at us for help. Heeeeehhh Heeeeehhhh. His voice had just been completely thrashed.
“Call San Juan,” Ranee said.
Craig called on the satphone. He got through to Brian, but Brian said there was nothing he could do right then. I said to Craig, Call Brian’s boss at FEMA. I said, Call the army. We didn’t know who the hell to call. We just dialed Brian again and nobody answered.
“What are we going to do?” Latisha said. She looked really tired and wiped her eyes with her hands, until she remembered about infection.
I looked over at the much taller, four-story stucco building next to the one where the guy was. It was crushed too. But it had some black metal balconies sticking out from the side. These balconies were so close to the old guy’s apartment complex that they were in almost jumpable distance. I thought that maybe I could climb up those balconies and then somehow scramble to the other building’s roof. It would only be two or three stories to be level with it. It’d be like Spiderman. Like parkour. You had to be creative out there.
“No,” Craig said, when I told him my plan. You know, a man. But the victim was still trying to scream at us and I said, Fuck it.
I ran over to the side of the building with the balconies and started to climb up, from floor to floor, from the outside. I’m in good shape, thankfully. I lift weights and I do trail running. I do yoga. Not that it helped me much.
I climbed up to one of the first-floor balconies. It was wrought metal, black, and very slick from the water. I clambered up and jumped down into it. It was fine. And then it turned out that there was a little fire exit extending from the second floor’s balcony to the first, and so I climbed up that, even though it had been broken in the storm. I grabbed onto the little steps, but the fire exit swayed almost all the way out and I thought I’d come crashing down.
The nurses below were all yelling at me and I thought, Yeah, maybe not a great idea.
But I hooked my foot onto the second-balcony railing and swung the fire exit back. I hopped into the little balcony. It didn’t feel very stable. It creaked. But from there I had a good view of the roof of the two-story building where the old man was stranded. I could see that he needed immediate crisis care. He had this old shriveled face. His hair came down over his eyes. He was hurt.
His whole left side was just red. I couldn’t tell exactly what was going on. But from the position of the leg I could see it had broken. And he had some serious hematomas and lacerations. Exterior wounds of that size mean a good chance of internal bleeding too. He must have fallen or had something topple on top of him. I don’t know how he made it to the roof. He had crawled over it to scream at us from the edge.
I could see him pretty close. I could see his eyes. He didn’t have animal eyes like the lady. He had the kind of eyes that terminal patients get when it sinks in and they know they have to get ready. The light goes out of them.
I yelled when I saw that. I said, “Hey! Hey! Hey! Hey!”
He nodded and laid his head down on the ground.
“Hey! Hey! Hey! Hey!” I’m yelling. “I’m coming to get you!”
I couldn’t hop to the roof from the second balcony. From that height, there was a good chance I’d just hit the wall and have to grab the edges with my fingers. The third balcony up rose higher than the top of his building. I could do a long jump down from there, maybe. But when I grabbed up at the third balcony’s ironwork, it shook loose from the stucco. Then it just collapsed. It popped out from the top, swung all the way down, and then hung toward the ground from one rivet. I had to duck because it almost knocked my head off. I started trembling then. I knew I was a complete tool with no idea what I was doing.
“Sindy!” they’re all yelling down there.
“It’s fine!” I yelled back. It wasn’t fine. I couldn’t jump from building to building. I’m not Spiderman and I don’t do parkour. Also the balcony
I stood on was creaking and shaking.
I looked across at the other building, at the man, who still lay down on the roof by the edge, trying to raise his hand at me. I looked at his eyes, at the red on his skin and clothes all down the left side. On the part of his rooftop I could see, there was a red stain around his body. I didn’t know how long he had been there but the bone can get set wrong and there is a serious problem with bacterial infection, septicemia, in those conditions.
He looked at me again and shook his head. I could see him really well, that’s how close I was. But not close enough to get to him. We looked at each other for a long time.
Then he started shuffling. He tried to scream, I guess from the pain, but couldn’t. He was rummaging through his pocket with his good hand. He took something out of his pocket and dropped it from the roof into the shallow water below. I heard it plop.
“He dropped something!” I yelled.
“I got it,” I heard Ranee say.
“I have to get down,” I said to the man.
He didn’t say anything to me. He laid completely flat on the roof and then I couldn’t see him as well.
“Just wait here,” I said. “We’ll send someone for you.”
He still didn’t say anything.
“We’ll send somebody,” I said.
I climbed down.
We got back in the Rambler and drove away. Craig drove and Latisha sat in the front. Ranee put a blanket over me.
“What did he throw down?” I said.
Ranee had put it inside her rubber pants and now fished it out. It was a small soaked square object. She handed it to me.
It was his wallet. I opened it up and saw his identification cards. He was smart. It had his address, his location.
His name was Antonio Hernandez.
As soon as we got to San Juan I tracked down Brian and I was like, this guy needs our help. He lives here. I showed Brian the address. We need to call the army, I said. We need FEMA. We have to get the police.
Brian took the wallet that I handed him. He said he’d write the guy’s name down. “I’ll let our team know,” he said.
“No, you don’t understand. We need to get him now,” I said. I explained about the hematomas and the balconies.
Brian took off his glasses and cleaned them with his shirt, from under his FEMA slicker. He tilted his head at a line of people who were waiting for I don’t know what. The line was so long I couldn’t see where it ended.
“We’ll do what we can do,” he said. “But we have our hands full.”
“You need to listen to me! This is an emergency!”
Brian walked away.
Later, that night, in our hotel, I got so mad. I realized that if I could just somehow get ahold of rescue equipment or some people myself, I could go save Mr. Hernandez before he died. I could get a ladder, like the one I’d used to help the woman and the dogs.
I just lay there all night thinking of his whole left side that had been turned red from the hematoma and the cuts. I thought of his eyes. Thought how stupid I’d been to just give his information to Brian and then expect a miracle. I had to do it myself.
Thing was, I couldn’t remember exactly how to get back to the apartment in Toa Baja. I tried to track it in my mind, but couldn’t. I called Craig about it, in the middle of the night. He said that he didn’t know how exactly to track back either, because we’d been going all over the place without a plan. So I called Latisha and Ranee but they didn’t know either.
“Didn’t Brian say they’d get him?” Ranee said into the phone, sleepy. What I needed was that wallet. With the wallet and an ID card, I’d plug in the address using GPS.
I got up the next morning and it was raining. I prepared by putting on my rubber pants and my slicker, so when I got Mr. Hernandez’s information I could just get a car and go. After that, I started running everywhere looking for Brian. The mother and child clinic, the Coliseum, the historical district. When I found him, around three o’clock in the afternoon in the cantina, I started hollering at him that I needed the wallet. He was like, What are you talking about? Then he remembered. He said, “I gave that to so-and-so.” A supervisor. He said, “They’ll take care of it when they can.”
I said, “Just give it back to me and I’ll get a car and a ladder. I’ll get supplies. I’ll go up there myself.”
Brian looked at me sort of sympathetically. “I can see this is getting to you,” he said.
“Just give me the wallet back,” I said.
He put his arm around me and gave a little tug on the FEMA slicker I wore. “You’ve done really great work here, you’ve been such an incredible part of the team.”
We stood by a pile of sandwiches wrapped up in plastic, but in my mind I saw the long lines with the people sleeping standing up, and the FEMA guys handing out applications. I said, “No, I’m doing something different. We went up to the mountains.”
“Every little bit helps,” Brian said.
“I’m not part of this,” I said. “We went up to Toa Baja, and I have to get back.”
Brian looked at me and said, “Sorry, I’m coming. I’ll be right there.”
“What?” I said.
“I have a meeting,” he said, getting suddenly busy. He’d been talking to his Bluetooth.
“His name’s Antonio Hernandez,” I said.
“I know, thank you, good,” Brian said. He took off again.
He never got back to me about the wallet. I must have called him six or seven more times, but he didn’t answer.
Two days later it was time for us to leave.
I heard that the president said that the death toll was sixteen. He was like, This is a really impressive number.
Later there were some studies by Harvard and George Washington Universities.
Those estimates said that eight hundred to eight thousand people died in Puerto Rico, mostly from “interruptions in medical care.” That just means that they didn’t get seen by surgeons or doctors or nurses. Less people died from drowning, or direct impacts.
So I went home. I went home to my husband and my daughter.
They looked so crazily happy to see me that at first it was OK. At the airport, my daughter crawled all over me and got too excited, so I had to sing to her so she’d stop screaming. My husband wrapped me up in his arms and then drove us all back to the house. I slept in the car and when I woke up we were there.
Our place looked like a palace, I swear.
I slept in our bed. It was good to be back. Like the other wasn’t real almost. My husband cooked me eggs and pizza. I was just so grateful to have my family. My daughter showed me some pictures she’d taken while I was away. They were of flowers and grass.
I told my family about the woman with the little dogs, and how I’d held her by the butt and saved her Chihuahuas by basically swimming through the house. My daughter liked that. I told my husband, later, at night, about the man and his daughter in the floodwater and how we’d treated their wounds and given them Cipro. I talked about how FEMA stayed in San Juan while we went to the mountains in that Rambler, and how we’d had to pick up the fallen cables with the electric sparks. I drank a lot of wine and went on and on about it. How the old woman at the airport had kissed my hand and blah blah. I told my husband all of the stories except for the one about the man on the roof. And he, my husband, was really, really proud of me.
The problem was that after a few days I started to feel like just lying down on the floor and not getting back up. I got this idea that Brian had been right when he’d said that I was part of the team. He’d hinted to me that I didn’t count as some special superhero. I hadn’t wanted to hear that at the time, when I was yelling at him about Toa Baja. But after a few days of telling my stories and eating my husband’s cooking, I saw that he had a point. Because I didn’t speak Spanish. I let myself feel all puffed up when that old lady kissed my hand just because I gave her a couple little bottles of penicillin. Me thinking that I’m righting some wrong, sort of resisting the political crap. But the truth is I never even thought about Puerto Rico until the union emailed us about the opportunity. I’ll just say too that I didn’t realize they were citizens until the rep explained it all to us. And then, even though I knew he was still out there, might be dead already, I’d just gone home when the time for our trip was over.
I tried to call Brian again but I just got dumped into voice mail.
The way he’d dropped the wallet into the water, hoping. Just hoping to live.
About a month later I was crying into the sink in our kitchen and my husband found me.
“Honey, baby.” He hugged me and kissed me and rocked me back and forth. “What’s wrong?”