By Chasidy Kearns, MA, EMT-P
On Friday September 27, 2024, I awoke to news of significant flooding and damage to the western mountain region of North Carolina (NC). This was highly concerning not only because this is an area of the state where I love to visit and hike, but also because my oldest son is a college sophomore in the area.
My son is also and brand new EMT. He was released to practice just two days before and had spent the night on duty with the local rescue squad, they had not run a call all night, but the calls were beginning to pour in as the rain continued to fall. Our ability to talk was provided by Starlink Wi-Fi access as cell phone towers were already down in the area.
The area where I live was not out of the woods yet from the storm either. Anticipating heavy rain bands and possible tornadoes coming our way, I double checked our home before heading off to work as a county EMS Administrator.
I had not been at the office long when our first tornado warning went out. School was canceled for the day, so I had my fourteen-year-old on speaker phone insuring he was safe. All while preparing to take cover myself if need be.
In between the two tornado warnings we had that morning, I was working with our deputy chief to answer the call from the state office of EMS to send a team west to assist in relief efforts.
Like most EMS counties across North Carolina, we were struggling with staffing needs. Luckily, when Helene struck, sixteen new-hire employees had just completed orientation. Asking these folks to deploy allowed our county to keep its released to practice staffing in place at home.
At 11:12 a.m., I sent an email request to all sixteen of the precepting employees to deploy with me to the state EMS staging area in Mocksville. Ten new employees responded in the affirmative and by 11:52, we had a plan in place to pack, shower, eat well, and meet at our headquarters at 3 p.m.
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Packing was hectic, I am a list maker, and there was simply no time to make a list or check it twice that day. The department emergency management and logistics team had come through for me. When I went home to pack, they prepped our vehicles and loaded our meals, water and prepped a radio cache.
Our team arrived at the state staging area by 6 p.m. With night quickly approaching, there was not much we could do to give the necessary aid. A decision was made for us to billet in a local hotel overnight.
While the rooms were comfortable, I slept very little. The news coming through about the remarkable natural disaster that had occurred, the known suffering, and the fact that I had ready helping hands with nothing to do made sleep nearly impossible. We woke early to have breakfast in the hotel. None of us slept well.
I checked in with our staging manager after breakfast. EMS missions were pending but we had yet to be assigned. We were told to be ready to deploy early in the afternoon. With that news we headed back to bed. Most of us were able to take a nap. At noon we arrived at state staging for lunch, this would be our last hot meal for the next 27 hours.
Just after 3 p.m., we received our mission orders. The directive was to provide medical support for a new shelter being set up at Asheville Buncombe Technical College (AB Tech). We received needed PPE, medical supplies, and cardiac monitors from the staging area and hit the road.
Traveling on I-40 west, and as far out as Morganton, you could tell that a major event had occurred. In the beginning of our journey, we noticed just a few trees down. At major exits, you could also tell there was no power in the area. Then we drove over the Catawba River on I-40, which was nearly reaching the top of the bridge.
At the town of Old Fort, the scene on each side of the highway was utter destruction: mud everywhere, cars washed into trees. Entire homes moved off their foundations. Did I mention the mud?
Old Fort was the last stop for civilian traffic. North Carolina State Highway Patrol created a convoy of emergency vehicles and led us safely up I-40 into Black Mountain. The Jersey barrier sections of the highway were removed so we could travel in the eastbound lanes to get around the landslides that occurred because of the heavy rain. From our highway view, Black Mountain and Swannanoa were still underwater.
We arrived in Ashville a little before 6 p.m. The conference center at AB Tech was the pre-selected shelter location. On arrival, we were greeted by Red Cross volunteers who had put out water and food supply boxes. Our small but mighty team got to work in the conference center space, setting up one hundred and fifty cots. In the meantime, we had around 75-100 folks already waiting to get into the shelter.
The Red Cross began to register the displaced folks and get them some water. The displaced were sitting in chairs, watching us work, anxiously waiting for a bed. More help started arriving and it didn’t take long to have the shelter up and running. Port-A-Johns were set up outside. Shower trailers were being moved in and a generator was set up outside for lighting and to run a satellite Wi-Fi station.
When the cots were ready, folks began to settle into rest. The medical team then deployed throughout the conference center to identify any injured people and treat what they could. Simple injuries were addressed by bandaging and splinting. Needs of the elderly were paramount to keep up with. Cots are low to the ground, and for folks who do not ambulate well normally, simply navigating laying down to cot height required assistance.
Adequate restroom facilities were nil, so with smiles, the team obliged to get these folks into wheelchairs and out to the restroom. While outside the normal EMS realm of care this served a twofold purpose that was outside of a medical need, but very necessary. For one, it kept us from having an indoor hazmat situation. Secondly, it kept our new residents comfortable. We did not have adult diapers, much less wipes to clean up, or fresh clothes for the displaced to change into.
Additional medical problems and challenges we encountered were charging portable oxygen equipment and reaching local EMS in a reasonable manner. Cell phones were simply not working to call 911, all ambulance transport needs had to be relayed through the local EOC via handheld radio. “Adapt and make do,” was the true spirit needed to provide adequate care.
I’m not going to lie; those initial hours were tough and hard work. We took turns sleeping in four-hour stints that night. Not nearly enough, but the medical assistance needed was great. The work continued with more and more displaced folks checking into the shelter. All ages and a few dogs.
I laid down from 3 to 7 a.m., short and sweet, but the workload was too great, and we had no relief coming. Upon waking that morning, we found the need for continued care, but also needed to ask our emergency management partners to order more trash bags, a large dumpster, more Port-A-Johns, and pumping/cleaning of the facilities.
On day two, we had residents in need of medication-assisted therapy (MAT). Already missing a dose of Suboxone the day before these folks were getting desperate. MAT is an indiscriminate coordinated approach to substance abuse where a community paramedic bridges the gap between overdose and treatment clinic by meeting the patient to administer the medication.
Often, this involves responding routinely to a person’s home or workplace to make sure they receive the correct therapy. Understandably in this crisis, the local clinics were closed. The Buncombe County Community Paramedics came through and were able to provide this care.
The team encountered a left ventricular assist device (LVAD) patient in the shelter, whom they needed to send out for further care post head trauma. Often, we received a local ambulance, but occasionally we got to meet crews that had responded to the call to help from as far away as New Hanover County, over 300 miles away.
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Meanwhile, Asheville is just 35 miles from Brevard, the worried parent feeling was growing, and my son was on his fourth day straight of ambulance coverage. The displaced in our shelter were telling stories of utter despair and I was truly worried about how he was coping.
One woman sheltering with us, stated she had lost her three-month-old baby from her arms while fleeing the high water. The baby was swept away and lost to her forever. Two sisters had survived by floating on a mattress until they were rescued. Many others had lost their homes and vehicles to fallen trees. So naturally, when your brand new EMT son is riding on an ambulance, with true boots on the ground duty, you worry. I was worried about him both physically and mentally. In spurts, we were able to text. It let me know that he was in quarters and back on Wi-Fi. A little comfort from the storm for sure.
Slowly, over the course of our second day at the shelter, more help began to arrive. Our request for medical supplies came through, however all the medications in the kit had long expired. Deflated, but not defeated, we carried on.
More volunteers were coming in to assist with the shelter, some as far away as California, but it was clear on their arrival that they simply were not aware of how bad the situation they had flown into was. After giving the rundown of the shelter and operations to a new arrival volunteer, they asked, “Where do I go to pick up my hotel key?” In retrospect I know that my response was not professional, but it also highlighted personal awareness that maybe folks outside of the southeast really did not know what was happening.
Worried about where to sleep, I advised the new volunteers that they were welcome to bunk with us, on a cot, in the gym. I left them with the knowledge that I would take them to the gym later, but I had a crew resting now and they really needed not to be disturbed.
With that I’d had enough time away and needed to check on the team. Our medical operations had taken a hallway corner of the conference center that had a desk and benches and made an ideal medical check-in spot for folks in the shelter and for us to sit. The team was fine, and we had no patient care needs to attend to on my return.
Purposefully, we took some time to check in on ourselves and start planning for the night. The beauty of our medical spot was that we had a clear line of sight to the gym entrance, which gave the team a since of security while resting. Sadly, post team check in, I looked up to see the new volunteers coming out of the gym.
They had woken up the resting crew. Exactly what I had asked them not to do. Mad as hell, I marched up to them and was definitely unprofessional this time, explaining that we were on hour 27 of work with no medical relief in sight.
I had clearly explained the shelter needs. As well as the known destruction throughout Asheville and the region and that they were not running a warming shelter. Firmly reminding them that “this is a disaster shelter,” simply set up to provide shelter, water and small meals for those in need.
Additionally, responders and volunteers needed to be self-sufficient, and that in no way should any of us be taking supplies away for personal use from what the sheltered folks need. I let them know that their arrival was to relieve the exhausted workers, and they needed to do that.
For me, that was the end of the line. I needed a break; we all needed a break. As team leader, I made the decision that we were going to take some time for ourselves. Loaded down with our MREs and water, we commandeered two picnic tables in sight of the shelter, but far enough away to have some privacy. Simply sitting and having a meal together was restorative and regenerating. That hour put the wind back in our sails and we got back to work.
Not long after my son in Brevard got a call through to me. He was fine, exhausted too, but sharing the same survival stories we were hearing in Asheville. It was becoming very clear to me that all western North Carolina was in the same boat and needing the same help and assistance.
Feeling better after our check-in with my son, the team got the best news we could have, a nursing team had arrived to cover the night shift. Thirty-two hours after we received our mission orders, we were allowed to rest.
Our demobilization was scheduled for the next morning. After the first true rest we had received, we packed, and the team said goodbye to the displaced they had bonded with and cared for.
Before leaving, we needed to see the French Broad River for ourselves. We were able to drive down to the Asheville Arts district and see for ourselves what the storm had done to the city. Everything that our patients had told us we could now see was true. This recovery was going to be a marathon, not a sprint.
Traveling home was quiet and somber, all of us hungry, we found a country buffet to eat at in Morganton. Happiest for a working toilet, running water, and washing our hands, with something other than hand-sanitizer, for the first time in days. Four and five plates deep we ate our fill and drank hot coffee by the pot full.
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Serving our western North Carolina neighbors was a pleasure and I’m sure they will gladly return the favor to, when the need arrives our way. Writing this was therapy for me as a responder and, I hope, will highlight the long-term need of support western North Carolina will need in the wake of Hurricane Helene.
Chasidy Kearns is the bureau chief of EMS Training and Development for Orange County Emergency Services in Hillsborough, North Carolina. She holds a Master’s Degree from the University of North Carolina at Greensboro and has been in EMS since 2000.
