In a moment that felt straight out of a “Mission Impossible” movie, students in the University of Lynchburg’s Doctor of Medical Science Emergency Management and Global Health concentration were met with a striking mission brief upon their arrival at Claytor Nature Center on May 8:
“A powerful tropical cyclone has made landfall in the region, causing widespread devastation. Roads are blocked, healthcare infrastructure is overwhelmed, and clean water is scarce. Communications are disrupted in multiple sectors, and thousands have been displaced from their homes.
“You have received notification of deployment. Your team is expected to launch operations within 24 hours.”
This brief defined the next seven days, as the students completed their required in-person practicum at Claytor, a Bedford County, Virginia, nature center owned and operated by the University.
“You are deploying as part of a multidisciplinary medical response team conducting operations in both urban and rural environments,” the briefing continued. “This mission will require adaptability, teamwork, and effective coordination across all units.
“Your mission begins immediately.”
After a day of orientation and team building on Lynchburg’s rope course, located on the University’s main campus, the cohort, which had previously only interacted virtually, began a series of hourslong simulations meant to push them to their limits.
The students faced a variety of challenging scenarios, all aligned with what one might expect to find in the aftermath of a tropical cyclone in a region lacking adequate resources and infrastructure to effectively respond to the crisis.
During the simulation, the students — all members of the DMSc Emergency Management and Global Health Class of 2025 — took on assigned roles within the incident command system, such as incident commander, safety officer, field medical officer, and communications officer.
Patients were played by Lynchburg Master of PA Medicine students, and other roles were filled by DMSc faculty.
Students were divided into two teams — wilderness and aid station — and each simulation was performed twice, allowing students the opportunity to experience the scenario as members of both teams.
The scenarios were designed by Dr. Travis Kaufman ’20 DMSc, lead faculty for the EMGH concentration and a retired U.S. Army officer.
Claytor’s pavilion served as the main aid station for the exercise. Beside the pavilion were two large white tents, a smaller blue tent, and a red University of Lynchburg canopy.
One white tent was designated for “immediate” patients, those with life-threatening injuries or illnesses. The other was for those marked “delayed,” as their condition, while serious, didn’t necessarily require immediate attention. Both tents were outfitted with cots and a variety of medical supplies.
The red canopy was initially designated for those labeled “minor,” but was eventually reassigned and the patients were seen under the pavilion. The canopy was then designated for the “expectant,” those who had died or were wounded beyond the point of help.
Communications with the wilderness team and simulated helicopter and ambulance crews, as well as tracking patients at the aid station, were managed from the blue tent.
The A. Boyd Claytor III Education and Research Facility was used as a staging site for Lynchburg faculty and the volunteer PA student “casualties.” Once assigned descriptions of their injuries and symptoms, they were directed to the appropriate location to enter the simulation.
Earlier, after receiving their assignments, the PA students and faculty worked together to apply moulage, fake injuries made with makeup, paint, and latex. Some students were even given silicone sleeves connected to a squeeze pump, allowing them to simulate blood gushing from a large laceration.
While painting each other in strokes of red, black, brown, and blue, it was clear the PA students were having a grand time. The room was filled with choruses of “That’s so cool,” as Kaufman squeezed one of the pumps and demonstrated how far the fake blood would spurt from a simulated wound.
Back at the pavilion, the EMGH students gathered for breakfast and their morning briefings.
“I got a report from Chief Machichi that the villagers are feeling much better,” Kaufman said as the recurring simulation character known as “Base Camp Doug.”
He emphasized the value of clean water the team had brought to the village the day before, but said there was still a lot of illness and unrest in the area.
“There’s a lot of panic spreading right now,” he said. “Resources are low, and this is causing people to have a lot of angst about foreigners that are here. The U.S. military is all on the ground now, and in typical U.S. military fashion, they’re causing a lot of panic amongst the people here.
They’re not doing anything wrong. It’s just their presence. So we really have to be careful of that to let people know that we’re not working with the U.S. military.”
Kaufmann/Base Camp Doug instructed one team to remain in camp to manage the aid station and care for incoming patients, while the wilderness team was sent to San Isidro, a fictional village in the Pacific region, to address problems with propane tanks another nongovernmental organization, or NGO, had provided the villagers.
With rising local tensions and global attention, teams were warned to keep their IDs readily available to avoid confusion with local authorities who may arrest them on sight. They were also reminded that media coverage of the situation was becoming more negative and to keep in mind what they had been taught in their media relations course.
The wilderness team set off for San Isidro at around 9 a.m. They didn’t get very far before black smoke, held down by morning fog, could be seen creeping through the trees. They soon happened upon a wrecked truck, its radio blaring Bonnie Tyler’s “Total Eclipse of the Heart.” Inside were multiple PA student “casualties.”
Battling real-life intermittent downpours, the wilderness team quickly began to extract the victims from the truck. There were four casualties to evaluate: three from inside the truck and one who had been ejected through the windshield and was lying on the hood of the “burning” vehicle.
Once the patients were moved a safe distance away from the vehicle, the wilderness team stabilized the living patients and radioed the aid station for the single ambulance. It would take 45 minutes, round trip, for the ambulance to get to and from the aid station. Due to weather conditions, calling for a helicopter evacuation was not an option.
Two of the victims were classified as “expectant” and marked with black tags. The other two faced life-threatening injuries and were tagged with red for “immediate.”
After the patients were transferred to the ambulance for transport, the wilderness team was able to continue on their mission toward San Isidro.
The path to the village took them off the paved road and onto a wet, sandy trail along a rushing creek. The dense canopy of trees provided some cover from the rain.
As the team came around a bend in the trail, a body was spotted lying face down in the shallows of the creek. The team jumped into action, racing down the embankment to pull the woman from the cold water.
She wasn’t moving, her lips blue with cyanosis. A large gash, where she had struck the rocky creekbed, split across her forehead. A team member began administering CPR, while another prepped a litter so the woman could be carried back to the road to meet an ambulance.
“Boom!” Dr. Jon Christensen ’22 DMSc, an adjunct professor, shouted to simulate a nearby explosion.
After some additional descriptive prompting from Christensen, the wilderness team split up. Part of the group went to investigate the explosion, while the rest completed the evacuation of the patient they pulled from the creek.
A couple hundred yards down the trail, on the creekbank, lay two more casualties, victims of a propane tank explosion. They had been attempting to cook with propane, which had been provided, without adequate instructions, by another NGO.
The two patients were severely burned and struggling to breathe.
Back at the aid station, there was a flurry of activity, as the medical personnel there received an influx of patients with head injuries, broken legs, amputations, hypothermia, diarrhea, and vomiting.
Since the initial tropical cyclone, a series of landslides had further complicated response efforts, leading to more injuries and civil unrest. As people evacuated their homes and searched for loved ones, they fell from cliffs, were pinned under trees, drank contaminated water, and were even shot.
The aid station worked diligently to track and monitor all incoming patients and their needs, as well as coordinate ambulance use and the needs of the wilderness team. If an ambulance was in the field en route to the wilderness team, it was unavailable to transport patients to the hospital and vice versa.
At the aid station, one could see the toll these kinds of catastrophic events take on those working to deliver care. During the exercise, the students checked on each other, within the confines of the simulation but also in the “real world,” making sure everyone was staying hydrated and in good physical and mental condition.
The potential impact of not taking the time to care for themselves and each other could be seen when Dr. Jamla Rizek, an adjunct faculty member playing an ambulance driver, became emotionally overwhelmed by what she witnessed and was temporarily unable to fulfill her duties.
Her character’s momentary breakdown meant that the ambulance was delayed until she could either be replaced or soothed.
Aid station workers also were occasionally plagued by media and reporters, portrayed by faculty wearing yellow vests, who tried to push their way into the medical tents to question the NGO’s work.
One reporter, Humphrey Wiggens of the BBC, played by Dr. Eric Holden, was especially aggressive. While being escorted from the immediate tent, he could be heard shouting, “How dare you treat a British citizen like this! I’m going to tell the king!”
During a press conference, Wiggens/Holden also dug into a conspiracy that the evacuations were all a “charade” and that the NGO was trying to remove people from the area so they could access lithium deposits.
This line of questioning was also picked up by Rizek, who was then playing a Reuters reporter. She expanded the accusations, insisting that the NGO was removing children as well.
The communications teams worked hard to shut down this characterization, trying to redirect the reporters to the real issues and what the NGO was doing in conjunction with the local government.
All of this occurred before noon.
During a debrief session, Kaufman asked the group about their experiences during the simulation thus far.
“We had a patient who came in with trauma to the head,” Dr. Monica Rocha ’25 DMSc said, going on to explain how they worked to stabilize the patient but ultimately had to mark him as beyond their help.
“I think, in the real world, it was hard for me because I’m like, ‘Wait, he still has a pulse. Why are we? … Why are we moving him? But you know, frankly, we’re not gonna be able to save him.’ … I’m glad my teammate … called it, because I probably would not have been able to call it.”
Kaufman acknowledged how difficult it can be to make those calls. It’s a balancing act between recognizing what may feel right and what reality demands.
“I want you to be forced to make some decisions on expectants,” he said, referring to those patients who were expected to die. “One thing, in medicine, we’re all pretty sucky at triage.
“We think we’re good at triage; we really do. The rest of you military people think, ‘Oh I know triage.’ But honest to goodness, if you have a mass casualty, we’re all kind of sucky at triage.”
As Dr. DeAngela Minter ’25 DMSc described it, in a well-executed simulation, the lines between fiction and reality blur.
“I was charged with telling the [village] chief that her daughter and grandchild were dead, and it was scary,” she said, “It’s a simulation, but I was scared. I didn’t know how she was going to take it.
“Trying to go in there, you know, calm and cool — this is the good news and the bad news once again. ‘One daughter is stable at the hospital … but, I’m very sorry to tell you, your other daughter and grandchild passed away.’ ‘What does that mean? Are they dead?’ ‘Yes, they’re dead. I’m very sorry for your loss. I don’t know what else to say.’”
Dr. Rob Gray ’22 DMSc talked about the emotional roller coaster providers experience in these situations and the toll it can take. Even in a simulation, he said, unplanned things can occur in such a way as to deepen the experience and allow you to see the full circle of life.
“There was a moment where they just looked at each other, because the immediate tent realized they had an expectant patient,” Gray said. “They paused to have a moment of silence. Once that moment of silence wrapped up, you could hear [a] baby crying as it was being delivered in the other tent.
“We didn’t set that up. That wasn’t scripted. That wasn’t part of the deal. That stuff happens.”
As the debrief ended, faculty expressed how impressed they were with the students’ performance in the simulation.
“I just really enjoyed observing everyone’s teamwork and communication,” said Dr. Jenna Rolfs, dean of Lynchburg’s School of Medicine and Health Sciences. “I saw you on Friday and I can already tell you’ve really grown together as a team.”
Following the simulation, in a post on LinkedIn, Kaufman reflected on the experience.
“In the hardest moments, it’s not speed that carries us — it’s each other,” he wrote. “What endures is unity, trust, and shared purpose. This week, I watched a group of individuals transform into a team.
“They led with courage, served with humility, and proved that the most powerful medicine we bring into any crisis … is each other. The mission doesn’t end here. It carries forward — in every student, every future deployment, every life saved.”
