In the path of Super Typhoon Yutu

Doctors, nurses and other staff respond to an influx of patients at Commonwealth Health Center Oct. 25, 2018, during Super Typhoon Yutu in Saipan, Northern Mariana Islands. The response effort involved nearly 40 doctors and other staff who provided acute trauma care for more than 150 patients who came to CHC within a two-hour span for injuries as a result of the disaster. (Courtesy photo)

In the path of Super Typhoon Yutu

Dr. John Tudela, center, the chief medical officer at the Commonwealth Health Center, works Super Typhoon Yutu response during an incident command meeting with various key members to include the Department of Defense, World Health Organization, and other community and federal partners Oct. 25, 2018, at CHC in Saipan, Northern Mariana Islands. When serving in uniform as a U.S Air Force reservist, Lt. Col. Tudela is the commander of the Air Force Reserve’s 624th Aerospace Medicine Flight in Guam and is an Air Force flight surgeon. Tudela credited his staff, teamwork and his military training for the successful delivery of timely patient care in response to the disaster. (Courtesy photo)

In the path of Super Typhoon Yutu

Dr. John Tudela, center, the chief medical officer at the Commonwealth Health Center, inspects a patients sutures in the emergency room Oct. 25, 2018, at CHC as part of the medical response during Super Typhoon Yutu in Saipan, Northern Mariana Islands. When serving in uniform as a U.S Air Force reservist, Lt. Col. Tudela is the commander of the Air Force Reserve’s 624th Aerospace Medicine Flight in Guam and is an Air Force flight surgeon. Tudela credited his staff, teamwork and his military training for the successful delivery of timely patient care in response to the disaster. (Courtesy photo)

In the path of Super Typhoon Yutu

Residents of Saipan line up for assistance in the aftermath of Super Typhoon Yutu Oct. 27, 2018, outside the Commonwealth Health Center in Saipan, Northern Mariana Islands. Super Typhoon Yutu reached Tinian and Saipan during the early morning hours Oct. 25, 2018, unleashing sustained winds of nearly 180 m.p.h.

In the path of Super Typhoon Yutu

U.S. Air Force Reserve Airmen from the 624th Aerospace Medicine Flight in Guam build hygiene kits Nov. 5, 2018, for Commonwealth Health Center nursing staff in Saipan to help raise morale in the aftermath of Super Typhoon Yutu. The team put together and delivered hygiene kits for more than 170 nurses in response to the disaster, which made landfall Oct. 25, 2018 in Tinian and Saipan, Northern Mariana Islands. (Courtesy photo)

In the path of Super Typhoon Yutu

U.S. Air Force Lt. Col. John Tudela, 624th Aerospace Medicine Flight commander, and Airmen from the 624th AMDF in Guam donate hygiene kits Nov. 5, 2018, for Commonwealth Health Center nursing staff in Saipan to help raise morale in the aftermath of Super Typhoon Yutu. The team put together hygiene kits for more than 170 nurses in response to the disaster, which made landfall Oct. 25, 2018 in Tinian and Saipan, Northern Mariana Islands. (Courtesy photo)

In the path of Super Typhoon Yutu

Published Nov. 28, 2018
By Lt. Col. John Tudela
624th Aerospace Medicine Flight commander

SAIPAN, Northern Mariana Islands --

I was on-call Oct. 25 in the intensive care wards at the Commonwealth Health Center in Saipan when the typhoon made landfall. Super Typhoon Yutu reached the Commonwealth of the Northern Mariana Islands on a Thursday during the early morning hours, unleashing sustained winds of nearly 180 m.p.h. The National Oceanic and Atmospheric Administration would later report this as one of the largest storms on record to make landfall in the United States and its territories. This event provided just another reminder of what I value as a Reserve Citizen Airman.

It’s about to hit the fan

Saipan is home. When not in uniform as the commander of the Air Force Reserve’s 624th Aerospace Medicine Flight in Guam and an Air Force flight surgeon, I’m a full-time hospital physician and serve as the chief medical officer at CHC. We watched as Super Typhoon Yutu churned its way across the west Pacific headed toward us, toward my home and my community. The hospital has a typhoon disaster plan, which was activated as soon as Gov. Ralph Torres declared “Typhoon Condition II.” Medical, nursing and ancillary staff were placed on high alert and plans were executed to ensure adequate personnel were in place before, during, and after the storm.

And then the storm hit

As the storm moved in, I could hear the roar of the winds and pelting of rain against the glass windows and doors. The whole building seemed to shake. The patients were afraid, but they were safe and secure. As the Category 5 storm raged outside, I made frequent rounds visiting my patients. Inevitably the hospital would have to close down at the height of the storm, and emergency medical service response was halted due to the dangerous weather conditions. The horrifying sounds and sense of dread lasted throughout the night and well into the next day. It seemed like forever before the winds and rain abated ... in reality, it was about 12 hours. Finally the hospital was once again open to the public.

Although my Air Force Reserve unit wasn’t activated for the response, my training and experience paid off. With my military experience, I felt well-prepared and confident for what was to come. I was responsible for the hospital’s capacity to deliver emergent and acute care services across a spectrum of specialties that include emergency medicine, obstetrics, labor and delivery, medical, surgical, intensive care, pediatrics, hemodialysis and primary care. It was crucial that we executed staffing protocols to ensure we were equipped to respond to life-threatening injuries that would come through the emergency room.

And then the patients came

Patients started to arrive with multiple injuries requiring all available physicians to help. The response effort involved 40 doctors providing acute trauma care for more than 150 patients that would arrive over the next two-hours. The ER was in chaos due to the immediate influx of patients, but we were able to quickly triage and treat the patients. It felt like a war zone, and that’s when my Air Force training in trauma management came flooding through my mind. I took charge and directed physicians, nurses, and ancillary staff to make-shift stations in hallways and corridors. At the same time, I was reporting to the incident command on the real-time status of the hospital and its acute care services. I was also the lead for securing medical evacuation resources in conjunction with the Department of Homeland Security and our Department of Defense and federal partners on Guam.

All the past and current training, as well as years of active-duty experience, allowed me to remain calm, effective, and act as a resourceful leader. It also helped that I was very familiar with our medevac system for the DoD region in the Pacific, and facilitated other civilian medical staff personnel to navigate through the process. We were able to successfully execute a medevac request from the U.S. Coast Guard and had a patient transported to Guam for further intervention within an hour.

Although I wasn’t in uniform, I was using the leadership and tools provided by my military experience.

At the end of the day

It would be easy to focus on the devastation caused by Super Typhoon Yutu to the islands of Tinian and Saipan. It wreaked havoc leaving many in our communities in desperate need of housing, food and other assistance. Given the scale of island-wide devastation, it will be months before essential services such as water and power are fully restored. But we are resilient and I’m reflecting on what went right. I celebrate the successes we had with the seamless delivery of timely patient care in response to the disaster. It was achieved through innate will, motivation, training background, and pure adrenaline.

I was fortunate to work with providers and nurses, who never stopped providing phenomenal care to the hundreds of patients. I’m incredibly grateful to them for their willingness to participate, facilitate, and execute our disaster response plan. My training and experience in the military was invaluable in allowing me to provide the kind of leadership that our island communities needed during this difficult time. I’m proud and will continue to reflect with gratitude on my resiliency and experiences gained through service as a Reserve Citizen Airman.