Courage is not absence of fear but acceptance. Fifth of a seven-part series.
I met Trish and Cheesy on an aeromedical evacuation flight from Diego Garcia to Singapore. It was in November 2001, and the war against terrorism was in full swing. The island of Diego Garcia was a staging location for U.S. aircraft bombing Afghanistan. I was assigned to the island as an Air Force flight medic. On this day, I was asked to assist a Navy flight nurse, Lt. Trish Hansen, on a simple medevac of a British Royal Marine commando who broke his ankle playing football (soccer to us Yanks).
It did not take long to figure out that there was a special relationship between the flight nurse and the commando, named Cheesy. I learned that, in addition to her flight nurse duties, Trish was assigned to perform rescues at sea, and the Royal Marine commandos provided security for those missions. Frequently, rescues were made aboard civilian ships near Diego Garcia. Trish and Cheesy worked together on these missions and had developed a friendship. But there was something more. I could feel it and had to ask, so I did. As the P-3 Orion droned east toward Singapore and Trish responded to my question, she still seemed profoundly moved by what she told me. Like a puppy
Rescues the flight nurse performed while protected by commandos were phenomenally dangerous. The team would head out to sea on a tugboat or other vessel and meet up with a large freighter in the open ocean, often in foul weather with heavy seas and strong wind. Military security was always a primary concern as rescues occurred on ships with foreign registrations and occasionally on ships from nations hostile to the United States, but the most dangerous part of the mission was always moving the team from one ship to the other.
As large boats meet up at sea, they frequently collide with each other. Tons of steel coming together with just an occasional buffer of thick rubber make for a dangerous environment, as deadly as any combat assignment in Afghanistan. Trish told me about getting aboard the ship and how, despite being at sea, the rescue crew did not wear life jackets. The reason for this was, if a person fell into the water, he or she was to attempt to continue sinking and then swim out from under the ships—avoiding the spinning props—and pop up on the other side. If someone remained in the water between the ships, they would most certainly be crushed to death in an instant.
On a recent rescue mission, Trish had worked hard to get a patient from one ship to the other, and, with the help of the commandos, the patient made it aboard the tugboat. When it was her turn to move from the freighter to the tug, the ships collided, and she fell off the freighter’s staircase toward the water. She described seeing her boots and legs enter the water and realized her chance of survival was limited. But in that same instant, in the middle of the fall, a large hand grabbed the collar of her flight suit and pulled her from the water just before the ships closed in and crashed together. The hand was Cheesy’s. She described it as being picked up like a puppy, by the scruff of the neck. Cheesy delicately placed Trish on the tugboat, and the mission continued. He saved her life. It was all in a day’s work.
After that incident, the two of them became much closer. Trish learned that Cheesy was not his real name, but that he was from the town of Cheddar in England, which is why the commandos called him Cheesy. She took him to dinner and presented him with a package of Life Savers candy. They had a bond. Now, she was accompanying him, with a broken ankle, on the first leg of his trip home. It was an amazing story to hear, and it was wonderful to meet these amazing people. I was proud to be part of their team. My turn
A few weeks later, another rescue was needed at sea. A sailor on a Chinese freighter, the Ever Guest, had his foot injured, nearly amputated, and the crew was unable to control the bleeding. The captain called “Mayday,” and Lt. Trish Hansen and the commandos headed back out to sea. On this day, I was again asked to join her team as a medic. It was exciting and scary. I remembered the story Trish had told me of how she was nearly killed by the collision of the ships. As the ships moved toward each other and we prepared to board—without wearing life jackets—I found myself suddenly realizing the danger of the mission. But I have always thrived on danger and was excited to make the move between the ships.
The tug and freighter moved toward each other, and a staircase was lowered. The ships collided frequently, and the waves moved the vessels up and down as much as 10 feet. What was initially exciting had now become a technical operation. To help me make it aboard, the commandos coached me on the timing of the ship movement. The first commandos made it aboard quickly and started climbing the stairs to take security positions. Before making my maneuver, I looked at the medical team behind me. Lt. Trish Hansen stood stoic and ready for action. But there was something in her eyes. I could see it clearly. It was fear.
As the ships moved up and down, the staircase came into perfect position, and I stepped onto it. For a moment, it seemed too simple. Then the ships collided—hard. The force knocked me off my feet, and I found myself lying on my abdomen on the bottom of the staircase with the rest of my body hanging overboard. My feet were about to touch the water, and the ships were closing in again for another collision. I rapidly pulled myself out of harm’s way just before they collided. Above the noise, I heard Trish say, “My God, I don’t want to do this!” She did not yell it. I am certain it was mostly a thought that she never intended to verbalize. But I heard it—an expression of terror rising above the machinery. I ignored the words and rapidly started moving up the stairs to complete the mission.
Near the top, I paused and turned back to see how the rest of the team was proceeding with boarding. Lt. Hansen was right behind me, her “game face” on. She moved briskly. She was on a mission, and lives depended upon her actions. The patient was recovered, and a technical rescue managed to move the patient between the ships with a crane and ropes. My adrenaline was surging the entire mission, but when it was over and I had time to reflect, I found myself amazed at this nurse who led the medical team.
What courage is not
Courage is not absence of fear but acceptance. A courageous person accepts fear and continues with the mission. The difference between Trish and me was, I had a vague concept of the dangers associated with the mission, and I never once considered I could die. Trish saw death looking straight at her. She had an all-encompassing understanding of the danger. Despite her fear and her desire to turn around, when the staircase met with the tugboat, she stepped forward and ensured the patient was moved safely between the vessels. Afterward, she again made the perilous movement from the freighter to the tugboat.
Trish was not the only member of the team who felt apprehension with this mission. But through her courage, others on the team found courage. It was a most amazing display of transformational leadership. She was a leader who walked the walk.
How many nurse leaders can lead under such stressful conditions? On this mission, the medical team watched its leader act fearlessly in the face of danger. It was not hard for the rest of the team members to believe that, if Trish could walk the staircase, so could they. Rescue at sea
(photos courtesy of U.S. Air Force) Rene Steinhauer, RN, EMT-P, has served as a nurse on all seven continents—as flight nurse in Antarctica; as combat medic in Iraq; as disaster manager following the Indian Ocean tsunami (2004), Hurricane Katrina (2005), Haiti earthquake (2010), and Typhoon Haiyan, known as Yolanda in the Philippines (2013); and as chief nurse in an Ebola Treatment Unit in Liberia (2014). The author of
Saving Jimani: Life and Death in the Haiti Earthquake, Steinhauer is presently working toward his MSN degree at Hawai’i Pacific University.
Part l: Nursing leadership? Reminds me of a movie
Part 2: Transformational leaders: Change agents for good
Part 3: When ‘bad’ is good: A time and place for autocratic leadership
Part 4: Laissez-faire leadership: You’d have to be crazy to be this kind of leader
Part 6: The most transformational leader I've ever known
Part 7: In crucible of crisis, "Trust me" not enough