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Happy Birthday, Talk Loudoun! This week, Talk celebrates one year of offering heartfelt, in-depth stories to our loyal readers every week. We've struck a chord beyond expectations, and we thank all of you for your e-mails of kudos and support. Just a reminder: this is our last e-zine of the summer. As we prepare to take time off to focus on our families, we also look forward to bringing you more unique "good news" journalism after Labor Day. Enjoy the rest of your summer.
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A doctor in the house
By Nancy Croft Baker
 On a recent rainy Saturday morning, an inactive taxiway at Dulles Airport was the scene of a bloody melee. A departing flight, encountering severe wind shear and downdraft during takeoff, plummeted onto the Smithsonian taxiway. As black smoke billowed violently from the aircraft, dozens of passengers lay twisted and bleeding. Within minutes, a tanker doused the inferno while teams of emergency responders burst onto the scene. Paramedics, EMTs and firefighters jumped from their vehicles and surveyed the disaster, then took quick and precise action. Some tagged victims for triage, while others calmly interviewed the coherent and treated surface wounds. The more serious cases -- the ones with red tags -- were loaded onto ambulances and transported to Reston Hospital Center, where a team of emergency doctors hurriedly rallied their troops to continue the treatment initiated on the taxiway.
The scenario seemed surreal -- and it was. The activity on the taxiway was part of a triennial emergency exercise for the airport's first responders and Reston Hospital Center's emergency doctors, who treat patients from Airport, which is uniquely located half in Fairfax and half in Loudoun counties. The casualties were volunteers from Stone Bridge High School, local scout troops and area fire and rescue stations.
Orchestrating the action at the airport and the hospital was Dr. Darren Lisse, who for nearly 20 years has served as both the chairman of Reston Hospital Center's emergency department and the operational medical director for the Metropolitan Washington Airports Authority (MWAA) at Dulles Airport, just a stone's throw from his home. The successes and failures of this drill would reflect directly on how well Lisse had prepared his emergency responders. For Lisse, however, it was another vital opportunity to teach great medicine.
"There's a lot at stake when you respond to emergencies at a facility this large," Lisse says. "There's very little room for error."
To put his statement into perspective, more than 40 million travelers passed through Washington Dulles International Airport last year. In addition, there are thousands of airline employees, MWAA personnel, concession workers and contractors. The airport's fire and rescue crews also serve dozens of neighborhoods surrounding Dulles. |
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| A tireless professional, Lisse regularly works 60 hours a week at the hospital emergency department, devoting weekends and evenings throughout the year to training, teaching, counseling and introducing new drug treatments and devices to the airport's three fire and rescue stations. Not a single emergency medical technician -- and all personnel must be EMT-certified -- is credentialed at Dulles unless he or she passes muster with Dr. Lisse. |
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He has a lot riding on keeping his medical professionals primed for action. Given the airport's international traffic, their training, readiness and response could mean the difference between heading off an infectious disease and unleashing a pandemic.
That very scenario unfolded during the recent SARS epidemic. An individual traveling with the U.S. State Department through China arrived at Dulles Airport with a high fever, cough and all the symptoms of SARS. "The pilot contacted us from the plane. It was a frightening possibility when you consider an entire nation could be infected, depending on our response," Lisse recalls. MWAA's EMTs immediately placed the passenger in isolation and transported her to Reston Hospital Center where she was quarantined. Fortunately, it turned out to be an ordinary flu, but Lisse gets excited about cases that challenge the knowledge, skill and physical stamina of his medical teams.
"Flight medicine is fascinating," he says. "With all these flights comes a lot of movement of disease, things most EMTs and doctors don't see in emergency medicine in this country." For MWAA Battalion Fire Chief David Testa, that means keeping his emergency responders abreast of the latest infectious diseases (and all their various mutations) posing a threat to the airport. "In our world, the threat is always imminent," he says. "Thank God for Dr. Lisse. He teaches the latest in infection control and pandemic prevention, as well as the best strategic and tactical approaches for treating the patient while protecting the public." |
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Towering both literally and figuratively over his contemporaries, "Dr. Lisse has been larger than life to me," Testa says. "He's such cool cat under fire, exuding the confidence and well-being of having your feet planted solidly on the ground. He stays on the cutting edge of emergency medicine and speaks in a commanding tone but in such a personable way that he fosters the trust and confidence of the people who serve under him."
He's also the first to jump into the trenches when needed. While Lisse was teaching a training course at the airport, an emergency dispatcher reported a passenger in cardiac arrest. Lisse and his students jumped into an ambulance and raced to the plane where the passenger had coded. They deftly made their way through tight corridors and a crowd of passengers to administer automatic external defibrillation and other medical support to the patient.
There were several great outcomes of this incident, Lisse says. "I got to see my students in action, and they were extraordinary. I got to give them valuable feedback on what to consider for future incidents. And later I saw the patient in ICU, reading a book."
Dulles Airport, like Reagan National Airport, is equipped with dozens of automatic external defibrillation (AED) units throughout the terminals and concourses that any individual can operate, something Lisse was instrumental in implementing. "There are endless stories of people not medically trained saving people's lives because of these units," he says. Lisse also manages the AED training of some 1,200 airport personnel, concessionaires, contractors and flight attendants annually.
"Our abilities as first responders are greatly enhanced because of Dr. Lisse's foresight," says Scott Chamberlin, assistant chief of emergency services for MWAA . "He gives really constructive feedback on our performance, teaching the whole physiology of emergency treatment. He teaches that it's not just what we're responsible for until we get the patient to the hospital, but what happens after we leave. Our decisions in the field have a direct impact on treatment in the hospital."
 Sometimes, the whole physiology of emergency treatment doesn't even involve medicine. "Dr. Lisse has been a huge role model for patient advocacy," Testa says. "He is quick to remind us that often our work is not as much about the drugs or advanced life-saving procedures we administer as providing good old-fashioned TLC." Testa, for example, has responded to numerous calls of passengers extremely agitated over unforeseen flight changes and language barriers. "Dr. Lisse has instructed us to just step back and take time to understand the patient's needs," Testa explains. "In one case, all I needed to do was help a distraught passenger get a ride to BWI airport and give her a contact number to reconnect with her luggage. If I hadn't taken time to listen, we would have transported the passenger to the hospital, which would have exacerbated her dilemma. Dr. Lisse always reminds us that we are there to help fix the problem, act in a role of crisis intervention and serve the customer."
Lisse also is a big advocate for his first responders. "When you've run the twelfth call of the day and you need a shower and a meal, he takes time to know how you're feeling," Testa says. "He cares as much for the caretakers as he does the people who need us. He absolutely cares." |
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| Once more, with feeling! Occasionally, Talk likes to rerun a past article that we hope will appeal to our ever-expanding roster of new readers (as well as to any longtime readers who might have missed it the first time around). The original version of this Total Health article ran last October. |
Unstoppable: The Journey of Maimah Karmo
By Betsy Allen
 Aldie resident Maimah Karmo remembers the precise moment she learned she had breast cancer: February 28, 2006 at 4:45 p.m. She was at her desk on a conference call, a common part of her job as a proposal manager with a government contractor. With her line busy, her other phone rang insistently.
She had been to the doctor, and she had her suspicions -- she felt she already knew what the person on the other end would say. "I stayed on the conference call," she said. "I took my time. I knew it was the last normal thing I would do in my life."
That call did indeed change Maimah's life forever, but it was a life fraught with challenges from the start. Maimah Karmo was born in Monrovia, Liberia, in West Africa in 1973. She had strong guidance in her younger years and worked to meet the high standards set by her parents. "My parents were awesome. My dad talked to me about having goals -- being the crème de la crème. He told me, 'Whatever you think you can do, you can do more than that.'" She added, laughing, "I thought, why was I born to be tortured by this man? But they put their time and energy into making sure I had what I needed."
In the 1980s, several coups d'etat in her country forced Maimah and her family to the United States to take refuge with relatives. Each time, they would come to this country during the worst of the fighting and return when conditions improved. But the final conflict lasted 16 years, and they lost everything. During that last coup and the turbulent times that followed, they decided to stay in the U.S. permanently. Maimah had an aunt who lived in Reston, and by this point, they had a good network of other people they knew.
Maimah, finished with her secondary schooling at 16, had no money for college tuition. She did, however, have a strong desire to work. Many times she was turned down for being too young, so she took another tack. "I transformed myself. I bought nice clothes, put on makeup and heels. I looked much older," she said. When she went for the next job interview, "the guy didn't even ask how old I was. He just hired me."
It was that kind of determination that propelled Maimah forward to a series of administrative jobs, which paid for tuition at George Mason University, where she graduated with a degree in communications in 1999. "I couldn't go every semester," Maimah said, explaining that she would take time off to earn the money she needed to complete her studies. "I didn't feel sorry for myself. It was just what I had to do. I had a goal: finish school."
During this time, she lived in a two-bedroom apartment with her parents and her four brothers. She slept on the couch. She took the bus to her jobs. One day she missed the bus, but instead of being late or missing work that day, she chased down a mail truck and talked the guy inside into a ride. "My parents wanted me to be responsible," Maimah said with a smile. "They created a monster. I was unstoppable."
Among the many things her mother taught her was the importance of a monthly breast examination. When a 13-year-old Maimah was first approached by her mother with this request, she balked a bit. "I said, 'It's not important! I don't have breasts!'" "It's OK," her mother told her. "You will. And you'll know if something changes."
 Fast forward 18 years, and Maimah now had a daughter of her own and was working toward a master's degree. One day while showering, she found a lump. "At 31, I went to my OB/GYN and was sent for a mammogram. A consulting surgeon found two lumps, but reassured her that they were in all likelihood benign cysts. "She said I was too young. People don't get breast cancer at my age," Maimah said. "But I heard my mother's voice: You'll know."
The doctor did an aspiration (fluid drainage procedure), which was not effective. Maimah was advised to come back in six months for a re-check. Within that time period, one of the lumps doubled in size. Maimah had an uncharacteristic, chronic sense of fatigue, and she started to experience night sweats. A friend who had had the disease told her, "I think you have cancer."
Upon returning to the doctor, Maimah said, "I really want you to do a biopsy." When she still encountered resistance to this idea, Maimah insisted. Soon after, the fateful phone call was placed to her office. When the conference call had ended, the ringing on the other phone persisted. Maimah removed my headset and took the call. "They said, 'We got your path(ology) reports back,'" she recalled. She had Stage 2 breast cancer. When she was told the bad news, the phone dropped from her hand. "I thought, 'I'm not ready to die. I can't leave my daughter.'"
Her suspicions finally confirmed, Maimah was understandably terrified. "I had been a woman of action, but I just froze. I didn't know where my purse was, I didn't know where my keys were."
Eventually her mother, so long a source of strength, told her, "You've got to snap out of this." One of her best friends, out in California, called her with a simple request: "Breathe." That friend also helped Maimah figure out the insurance procedures and find a good oncologist and a radiologist. It was also around this time that surgeon Dr. Virginia Chiantella of Leesburg came into Maimah's life. "I'm in a chair, curled up, shaking," Maimah said, "and Dr. Chiantella told me, 'I'm your new buddy.'"
Once a treatment team was in place, they got to work fighting the cancer. What followed was an all-out battle, with doctors and specialists wielding the weapons of surgery, chemotherapy and radiation. The struggle took its toll, not just on Maimah's body, but on her mind and spirit as well. "I was sick, and I was depressed -- that just made it worse," she said. "I thought, I've spent my life being a strong woman, and now even my hair is gone. I had bought a Lexus and had a six-figure salary. This sickness took everything away. Everything that defined me as a woman -- as a person -- was gone." Maimah reached her lowest point and despaired, "I don't care if I die. I don't care. Why did God do this to me?"
One night, after her second round of chemo, Maimah lay in her bed, initiating a last, desperate conversation with God. "I said, I can't do it anymore," she remembered. "If you exist, give me some kind of sign. If I do live, I will do whatever you want with the rest of my life."
The next morning, Maimah said, "I felt different. I thought, He does exist! I felt closer to God than ever before. I never asked him to help me (before). I never asked, 'Can you help a sister out?' And he showed up."
Maimah did start to feel better, and her cancer went into remission. She felt she knew what God wanted her to do. "Then the Tigerlily was unleashed. Before, I was passionate, but now it's like a whole other propulsion, bigger than me."
Maimah began the Tigerlily Foundation, an organization devoted to helping young women with breast cancer. The name, according to the foundation's website, comes from the association of lily flowers with "all things eternally feminine." Maimah started with a simple online presence in June 2006, but Tigerlily has grown into a multi-faceted effort that helps women ages 15 to 40 become educated and empowered before, during and after a breast cancer diagnosis.
The foundation provides a Chemotherapy Buddy Program and an ongoing support structure so that young breast cancer patients feel less alone. It also offers assistance with finances and insurance issues, as well as with cleaning and groceries, among many other services.
Maimah is making terrific progress, but then again, she has a pretty good guide. "I didn't do anything without asking God," she said. "Every step of the way, God's been telling me what to do."
Maimah's daughter, Noelle, started first grade last September, early on a day that was bittersweet for the young mother and the child who was there for her entire illness. "The first day of school was so emotional for me," she said, her eyes shining with tears. "I didn't know if I was going to be there to see it."
But Maimah was there to face the morning - beautiful, strong, unstoppable.
For more information on the Tigerlily Foundation, facts about breast cancer in young women, and support for young breast cancer patients, visit the website at www.tigerlilyfoundation.org |
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