A body under attack. A student fighting for her life. A community making split-second decisions to keep her alive.

That night, she told her roommate she was going to bed early. The next thing Hannah Tubbergen ’20 remembers clearly is waking up five days later in St. Luke’s Hospital in Utica.

“I was wondering where I was and why my parents were there,” Tubbergen recalls. “I remember thinking, ‘Was I in a car accident?’

“I kept asking them what happened. They kept telling me, and I would ask again a few minutes later. The sedation erases your memory.” Over time, Tubbergen’s parents and others would fill in the gaps.

What happened starting April 1, 2018 — which was both April Fool’s Day and Easter Sunday — transpired like a play, with a full cast of people. Each had to make critical decisions, and each had a life-altering experience.

“There were like shooting stars of infection throughout her body.”
Dr. Merrill Miller

“I felt a little under the weather, but just cold symptoms, like congestion,” Tubbergen says. It was a typical weekend. She went to a party with friends Friday night. Saturday, she ran errands and then had a two-hour phone call with her parents, Debbie and Tyler. It had been a busy school week since Hannah returned from a spring break trip to Martinique with the French Club eight days earlier. On her way back from the airport, the computer science major and French minor had an interview in Syracuse for a summer internship with the FBI, where she hoped to one day start her career. During that week, Hannah had brief chats with her parents, but they weren’t able to fully catch up until Saturday afternoon. “We knew she didn’t feel well, so we were telling her to gargle with saltwater and that we’d sent her a care package,” Tyler says. “She gave us no indication that she was that sick.”

“Bacteria are all around. When someone’s immune system and their ability to fight infections are depressed, we can become susceptible to all sorts of health problems.” — Dr. Merrill Miller, director of student health services, who monitored the situation from campus and controlled the potential threat to the Colgate community

Amina Rehman ’20, Hannah’s roommate at the time, returned to campus on Sunday around 4 p.m. after visiting her family in Boonton, N.J. “I entered our room, and it was dark, so I thought she wasn’t there,” Rehman says. “But as soon as I stepped in, she popped up from her bed in the corner and told me she was sick. I didn’t think it was a big deal. Hannah usually has a lot going on, so I thought she’d come down with a cold.”

Hannah complained of a headache, so Rehman gave her some Tylenol.

“The brain sits inside the skull and is connected to the spinal cord; they are surrounded by a thin covering called meninges and by spinal fluid. If spinal fluid gets infected, it infects the meninges and the surface of the brain. That causes pressure on the brain because there’s a limited amount of space within the skull and spine for there to be swelling and infected fluid. Because it’s totally surrounding the brain, often, you will have a very bad headache.” — Dr. Miller

Around midnight, as Rehman and their other two suitemates were getting ready for bed, Hannah told them she was going to take a shower. Rehman remembers her saying, “I really need a steam to open up.”

Rehman’s concern heightened upon hearing Hannah throwing up in the suite’s bathroom. When her roommate came out, Rehman suggested they go to the emergency room. “No, no, I’m totally fine,” Hannah reassured her. “It’s probably just norovirus.”

They skipped their ritual before-bed talk because Hannah fell fast asleep. Rehman woke up Monday morning for her 9:20 biology class. “Hannah, are you going to class?” she asked. “No, I’m just gonna nap,” Hannah responded. “That makes sense; she’s sick,” Rehman thought. After her 10:20 logic course, Rehman would normally go to the Coop for lunch, but Hannah hadn’t responded to her text, so the roommate was concerned. She had a couple of free hours before Challenges of Modernity at 1:20, so Rehman decided to return to the room and insist that she was taking Hannah to the health center.

As soon as Rehman approached the floor of their building, she was struck by a pungent odor emanating from their room. She entered the room and said, “We need to go to the health clinic.” Hannah weakly answered, “OK, OK.” Opening the curtains and seeing that Hannah was only wearing undergarments, Rehman picked her clothes up off the floor and attempted to dress her, but Hannah was unresponsive.

She needed help.

“Hannah went from zero to eighty overnight,” Rehman says. “She was a normal sick person the night before. She was responding. She didn’t have a temperature. And then, the next morning, she was burning up. She was delirious. She could barely speak.”

“This type of bacteria often spreads, and rapidly. When I say rapidly, I mean hours. This is full steam ahead.” — Dr. Miller

After calling campus safety and Southern Madison County Volunteer Ambulance Corps (SOMAC), Rehman continued the task of dressing Hannah. Moving the blanket aside, she noticed plum-colored, quarter-sized spots on Hannah’s legs. Maybe they were bruises from rugby practice, Rehman thought.

“They call it petechiae,” explains Heather Williams, a SOMAC paramedic who was one of the first responders on the scene. Hannah’s blood vessels were rupturing and her blood was reverting to her core where it needed to be to keep her alive.

artistic representation of blood clots in a human heart

The attack on Hannah’s organs — including her heart — caused blood clots.

Williams and two other SOMAC EMTs arrived around noon. “I was not expecting what I saw,” Williams says. Blue feet — that’s the first thing she noticed. Then she observed the mottling on Hannah’s skin and knew the blood wasn’t circulating to the extremities. “Something’s not right,” Williams thought. She quickly grabbed a mask and instructed her colleagues to do the same.

An experienced EMT, Williams started cycling through the possibilities. Spring break was two weeks ago — had Hannah contracted something abroad? But when the patient reported a headache and neck pain, this was a tip-off. “I went right to meningitis,” Williams says.

“She had meningococcal meningitis and meningococcemia, which means it spread throughout the blood stream.” — Dr. Miller

Williams hooked Hannah up to a monitor to check her vitals and heart rhythm, as well as an IV with saline for rehydration. Because Hannah couldn’t walk or sit up, they folded her into a MegaMover, which looks like a canvas sheet with handles.

As Rehman watched frightened, a team of people carried the 125-pound student and the attached equipment down two flights of stairs. “It’s going to be OK, Hannah,” she called after her. “It was the most traumatizing image ever,” Rehman says.

“In the United States each year, there may be between three hundred to five hundred cases of this type of meningitis. It has a very high mortality and a very high morbidity rate.”
Dr. Miller

After loading Hannah into the ambulance, Williams urged SOMAC volunteer Katie Steklac ’18 to “drive safely, but drive fast.” With near certainty that Hannah had meningitis, Williams knew they had to take her to a larger hospital outside of Hamilton, so they raced to Utica.

“We’re going to make our best time to get up there because I don’t know if she’s going to make it,” Williams told the dispatcher.

“Any infection of the brain is serious, but when it spreads to the rest of the body, then you have body-wide multi-organ disease, and it’s very critical.” — Dr. Miller

As the ambulance sped northeast, Williams “started to get scared,” she recalls. But, as a medical professional — and a mother — she curbed her emotions and talked to Hannah during the 40-minute drive, reassuring her that they were going to get her help.

Earlier, while waiting for the paramedics to arrive, Rehman had used Hannah’s thumb to open her phone and access the Tubbergens’ phone number. When Hannah was on the way to the hospital, Rehman called them back on her own phone to tell them their daughter might have meningitis. Debbie, a middle school teacher, left work. At home in Clackamas, Ore., Tyler was trying to find out which hospital their daughter was being taken to. He logged into her iPhone account and tracked the device to St. Luke’s.

By the time the ambulance arrived, the doctors were prepared based on the information Williams had provided. Within 37 minutes, the doctors did a spinal tap, saw cloudy fluid indicating meningitis, and started administering antibiotics.

“They needed to treat the infection. She needed very high-dose antibiotics given intravenously to get throughout her entire body.” — Dr. Miller

It was now 3:30 p.m. The doctor called Tyler to say, “She’s the sickest we’ve ever seen. You need to get here.” As Debbie was driving home, she remembers, she let her tears escape. “I told myself, get it all out now because you need to be strong for Hannah,” she says. “I knew they were trying to keep her alive long enough for us to say goodbye.”

Hannah in the hospital with her dad, Tyler

Hannah in the hospital with her dad, Tyler

The frantic parents threw a few days’ worth of clothes into a bag, dropped off their La-Chon at the kennel, and headed to the airport, buying tickets on the way. Trying to make the next flight out of Portland, Ore., they had 90 minutes to park the car and go through security. When the Tubbergens stopped in Minneapolis for a layover, they talked to the doctors, who provided an update. They’d put Hannah on a ventilator because, although her lungs were functioning, her body was working so hard to fight the infection that the medical team didn’t want her to expend any extra energy.

Back in Hamilton, a small team of Emergency Operations Center (EOC) employees was called together by Dan Gough, associate vice president for campus safety, emergency management, and environmental health and safety. Gough identified the group’s main objectives, including: protecting the University community, conducting a public health meningitis education campaign, supporting the Tubbergens as well as the students, and ensuring limited disruption to normal University operations.

“When you have an infection that can be contagious, you like to know where it started, and that would be patient zero. And then you say, firstly, how is this type of infection spread? Is it spread by direct contact? Or through the air? Some types of bacteria can spread far and wide. So, you need to know what you’re dealing with.” — Dr. Miller

It was 2 a.m. when the Tubbergens arrived at the Syracuse airport, where Val Brogen, a member of campus safety, was ready to drive them to the hospital. In Utica, Catholic Campus Minister Mark Shiner, administrative dean Sarah Jones, rugby coach David Chapman, and President Brian Casey waited. “To see the president there at two in the morning really floored us,” Tyler says. “Very humbling.”

A nurse ushered the parents into the ICU and prepared them for what they were about to see: Their daughter was in a medically induced coma, and she was connected to approximately a dozen IV tubes. Because Hannah was still contagious, they were given gowns, masks, and gloves. “I couldn’t touch her without gloves,” Debbie remembers.

Tyler composed himself, while Debbie walked into the room, sat next to Hannah, held her hand, and talked to her. Later, the parents would learn from one of the nurses that as soon as Hannah heard their voices, her breathing and heart rate calmed.

A cooling blanket was on top of Hannah to lower her fever, while heating pads covered her extremities because of her poor circulation. “Her hands and feet were almost black,” Debbie remembers.

That first night was a blur, Tyler says, as a constant stream of specialists flowed in and out. Although Colgate made arrangements for the parents at a nearby hotel, they understandably didn’t want to leave the hospital. Chapman had given them Hannah’s rugby jersey, which Debbie says she used as a security blanket. “It was with me everywhere I went.”

The next morning, Tuesday, at 7:43, laboratory results confirmed meningococcal meningitis and meningococcemia.

“In the United States each year, there may be between three hundred to five hundred cases of this type of meningitis. It has a very high mortality and a very high morbidity rate.” — Dr. Miller

The EOC had anticipated that they would need to prepare for a case of bacterial meningitis, so staff members had already started gathering medication and the names of people whom Hannah had been near. Between her rugby team, Delta Delta Delta sisters, and other friends, Hannah has a wide social circle.

“There’s a ten-day incubation period for meningococcal meningitis, so we had to find everyone who had been in close contact with her and who may have had an opportunity for transmission through respiratory secretions,” Gough says.

The EOC also set up informational sessions for students who were anxious but not in immediate danger and started disease prevention in the community to ensure that there wouldn’t be an outbreak.

President Brian W. Casey and his dog, Emrys, beside Hannah's hospital bed.

President Brian W. Casey and his dog, Emrys, visited Hannah as she was recovering.

Coincidentally, less than two weeks prior, the EOC had practiced a public health emergency tabletop exercise, “so it was fresh in everyone’s minds,” Gough says. As part of that exercise, they used a Medical Emergency Distribution System Plan, which includes setting up a Point of Dispensing (POD) in order to deliver prophylaxis and vaccinations to numerous people within a short period of time. “That’s what emergency management is — making sure you’ve done all the training and planning,” Gough says.

Hundreds of students showed up to the POD. Through an information session as well as interviews conducted by medical professionals, the health center narrowed down the pool of at-risk students. With the Madison County Department of Health, the Colgate health center administered ciprofloxacin to 170 people — such a large supply that they drained the resources of local pharmacies. In addition, the health care center offered (and continues to offer) the vaccine to students. Surprisingly, Hannah herself had received the vaccine — for both strains — but it is not 100 percent effective. It is unknown how and from where Hannah contracted the infection.

As the Colgate community was working to protect itself, it also extended its support to the Tubbergens. The athletics department and bookstore sent clothing to the family, who only had a few changes of clothes. Chartwells sent food to provide an alternative to hospital fare. The Tri-Delta sisters raised money for the family’s expenses. Many others whom the family did not know sent supplies, homemade cookies, and cards. “We felt we were part of the Colgate family, and that was just amazing,” Debbie says.

Throughout that week, Hannah’s condition was in a state of constant fluctuation. The medical team needed to address minute-to-minute changes as they were happening.

“There were like shooting stars of infection throughout her body — through the blood vessels, causing various organs to not function. Things were churning in her body. Various chemicals get affected — sodium, potassium, all those things. Hers were bouncing around from this turmoil, and all of the blood cells were being affected. It was like a tsunami inside the body.” — Dr. Miller

Debbie posted on Facebook to keep family, friends, and concerned community members updated on the constant ups and downs. (At one point, 14,000 people were seeing her posts.)

The night of Wednesday, April 4, Hannah was trying to bite through the breathing tubes, so she needed to be sedated. Consequently, the sedation was dangerously lowering her heart rate. “Vicious cycle,” Debbie posted.

The attack on Hannah’s organs was causing blood clots, including one in the right ventricle of her heart. The doctors weren’t able to administer anticoagulants because her platelet count was so low (30,000; a normal range starts at 150,000) that they would cause bleeding.

“For those first few days, we could have lost her at any point,” Debbie says.

Hannah tackling an opponent during a rugby game.

Hannah (center) tapped into her rugby training
to help manage her pain in the hospital.

On Thursday, Hannah opened her eyes for the first time since Monday morning. “The nurses started crying, we started crying, and Dr. Brehaut was almost in tears,” Debbie remembers. The doctor had been cracking jokes to prompt Hannah to respond, and suddenly, they could see her grinning through her intubation. He also asked the patient to raise her hand, but she was only able to lift it slightly because her muscles had atrophied due to decreased blood flow and being bedridden. “She had been in top shape for rugby and then she was skin and bones,” Debbie remembers.

Still, “Ain’t no mountain high enough,” Debbie posted the following day, embracing the rugby team’s mantra. The medical staff removed Hannah’s intubation, her heart and kidney functioning improved, and the antibiotics had decreased the level of bacteria in her body.

Hannah’s brother, Scott (who is earning a master’s/PhD in microbiology/infectious diseases), posted on Facebook: “The first couple of patients during a meningitis outbreak are typically guaranteed fatalities, but this patient zero decided to be the immovable object to meet the not-so-unstoppable force of the disease.” Hannah had always been stubborn, he went on to write. “This situation, however, takes it to a whole new level.”

When Hannah was in 8th grade, she broke her elbow sliding into third base during a softball game. She kept playing through two innings until she had to stop from the swelling and immobility of her arm. A fresh cast didn’t stop Hannah from playing her trombone in the upcoming middle school band competition. She simply taught herself how to play left-handed. As far as softball was concerned, she taught herself to pitch to rehabilitate her arm and ended up being a pitcher for her high school. “Every coach, every teacher has said that she has a positive attitude. She is the hardest working person,” Debbie says.

By the end of the first week in April of 2018, Hannah again proved her determination. At 3:12 p.m. on Friday, April 6, she was sitting up and eating a Popsicle. “Miracles happen!” Debbie posted.

Hannah’s status started looking up when she was moved out of the ICU to the secondary care unit on April 9. Optimism was on the rise, and Tyler returned to Oregon for a few days to handle household business. But, a few days later, Hannah started having painful headaches and was sent back to the ICU. A CT scan confirmed she had a brain aneurysm that bled.

“Anything that could happen to anybody happened to her.” — Dr. Miller

Tyler was quickly back on a plane. “After everything we were feeling good about over the weekend, that was a shock,” he says.

Progress and regress. Moving from one hospital unit to the next and back to ICU. In these challenging weeks, Hannah would often tap into her rugby training. During a particularly agonizing few days, the red blood cells that leaked around her brain and spinal cord were dissolving, causing pressure. Like a woman in labor, Hannah held her mom’s hand and asked her to count her down until she made it to the next pain level. “Coach always talks about the 78th minute,” she told her mom. “When you’re exhausted and you’ve got two more minutes, give it your all.” So Debbie would count down the minutes until Hannah could have her next dose of morphine. “Watching her with that grit, knowing she had to gut it out,” Debbie says, “she’s my hero. I don’t think I could do what she did.”

Moving day arrived on April 17. Hannah was released to the inpatient rehabilitation center. By that point, she’d lost 20 pounds, so she needed physical and occupational therapy to rebuild her body. Offering reassurance, a nurse told her, “Within a year, you’ll be back to normal.” Hannah responded: “I’ll be playing rugby by fall.”

With the aid of a walker, Hannah could only take 10 steps at first. A week and a half later, she was taking 300 steps with the walker.

Characteristic of Hannah, she’d set a goal. Colgate’s women’s rugby qualified for the national championships, which would take place April 28 outside of Pittsburgh, Pa. “Tubes,” as Hannah’s teammates call her, wouldn’t be playing on the pitch, but she’d be there.

Debbie and Tyler consented to Hannah’s request that, if she were discharged in time, she could surprise her teammates. “She’d do anything for her team,” Chapman says. “Having seen Hannah throughout, I thought [her being released in time] was going to be tough, but the last two weeks, she made miraculous strides.”

Driving through Pennsylvania, after all, was on the way home to Oregon. The family had been preparing for the upcoming road trip. Between Hannah’s poor circulation and doctors’ concerns about her blood clotting again, an airplane ride was out of the question. So, when Hannah was released from inpatient rehabilitation on April 27, they packed all of her campus belongings into her Subaru Outback.

Before hitting the road, the family had to say some important goodbyes. They invited Williams (the paramedic) to visit because they credit her as being one of the people who helped save Hannah’s life. “I just did my job, treated her to the best of my ability, and treated her like I would any of my family,” Williams told them.

Hannah in a wheelchair surrounded by the Colgate Women's Rugby team

“Tubes,” as she is called by teammates, surprised them at the National Championships.

Hannah then stopped on campus to say goodbye to her sorority sisters and suitemates. Seeing her for the first time since April 2, Rehman recounted that day for her roommate, filling in more of the details. She also told Hannah to not rush recovery: “This is not your slow — it’s supposed to be actual slow.” Rehman says, “She’s a very tough person.”

The next day, the Tubbergens pulled into Founders Field in Cheswick, Pa. “It was quite the scene,” Chapman recalls. Her teammates clustered around the car, waiting for Tubes to come out. “Everyone was smiling, some were crying, and they all wanted to hug me,” Hannah remembers. The reunion was even more poignant because the players had expressed uncertainty about competing after such an emotional month. “It’s a close-knit community, so when a member of the family goes down, they rally around each other,” Chapman says.

As the Raiders proceeded with the match, Chapman wheeled Hannah around the field. “Wherever we went, she was there with us.”

The fly-half — Hannah’s position — in rugby is like the quarterback in football. Her job is to coordinate the team’s attack and make calls to get the ball where it needs to be. “It’s a fast-paced game, and she’s basically the general,” Chapman explains.

Colgate has a reputation as giant killers, and women’s rugby is no exception. Compared to other teams, Colgate’s women’s rugby players are usually the smallest in terms of their physical stature. “So it takes a special person, with a specific mind-set, to play this game against someone who’s bigger, considering it’s a collision sport,” Chapman explains.

All through Hannah’s ups and downs in the hospital, Chapman often proclaimed, “She’s a fighter” — so frequently that the Tubbergens had the saying engraved on a golf towel for him. “It’s just what I’ve seen in her,” he says.

Even the burly coach gets choked up when reflecting on last spring. “When thinking of Tubes, it’s tough to not think about what happened,” he says. “And when you think about how she took it on, there’s not much difference between that and the field. The way she approaches things — it’s all heart.”

With 2,968 miles to go, the Tubbergens piled back into the Subaru after the tournament and headed west. The trek was not without its own challenges. In Fargo, N.D., the car engine blew, so they had to get a rental for the remaining 1,500 miles. But, finally, on May 6, Hannah was home.

Although the FBI had offered her an internship in Portland, Hannah had to decline in order to continue physical therapy. She also was gearing up to return to her studies. Despite doctors’ concerns about lingering effects on her cognitive ability, Hannah passed the tests with ease. She decided to dedicate her summer to finishing the five weeks of coursework and finals that she’d missed. “I really wanted to graduate with my class,” she says. Professors sent Hannah assignments, which she turned to with her usual diligence.

Unlike her cognitive skills, Hannah’s physical state took longer to recover. In addition to rebuilding muscle, she suffered from open wounds, scabbing, bruises, and hair loss. Debbie and Tyler would clean up clumps of Hannah’s hair from her pillows and car.

“That is how extensive this disease was in her body. It was to every last bit of her.” — Dr. Miller

As she was preparing for finals, Hannah had yet another setback when she learned she’d have to have her pinky toe amputated on June 8 because of poor circulation. “If that was the worst that was going to happen out of all of this, I’m fine with it,” Hannah says now.

“She knows her good fortune,” Debbie adds. That summer, Hannah had met an Oregon State University student who lived near her hometown and also had meningitis. That woman suffered partial paralysis and permanent brain damage.

“How each person reacts to meningitis is different, so each case is different.” — Dr. Miller

Two weeks before rugby preseason, Hannah finished her sophomore year with four A minuses and a B plus. For this trip back across the country, the family flew the distance. When they met Chapman for dinner at the Colgate Inn on Aug. 19, it was the first time he’d seen Hannah since nationals. Going into the conversation, the coach was prepared to suggest ways Hannah could stay involved with the team as she continued to recover.

“This patient zero decided to be the immovable object to meet the not-so-unstoppable force of the disease.”
Scott Eisenhower, Hannah’s brother

So when the Tubbergens told Chapman that Hannah had been fully cleared, he responded, “Great. Cleared for what?” The coach was in disbelief that Hannah could return to playing the full-contact sport, but Hannah would once again prove her strength to overcome.

The next day, the Tubbergens moved Hannah into the Tri-Delta house. “That’s when we left her,” Tyler says. “That was hard,” Debbie remembers.

Hannah then headed to preseason practice on Academy Field, which started with a team meeting. Next: the fitness test — the dreaded Bronco, a 20-, 40-, and 60-meter shuttle run done five times.

“True to form, Hannah finished it,” Chapman says. “All I could think about was, the last time I saw her, she was in a wheelchair. Before that, she was on her deathbed, essentially.” But here Hannah was, finishing a hardcore endurance test in the August heat. “That taught me that she can’t be handled with mitts,” Chapman says, “so just take them off.”

Hannah on her bed in the Tri-Delta house

First day back on campus in autumn ’18

Returning to a full academic schedule, however, did force Hannah to take it (a little bit) easier. Stress built up around midterms, which brought on debilitating migraines. Hannah had to miss a handful of classes, which she’d never done before. Although she worried that professors would think she was taking advantage of her situation, she finally acquiesced to requesting extensions at times. “Her work ethic is off the charts,” Tyler says.

This spring semester, Hannah participated in the Wales Study Group, taking classes on data science and human computer interaction.

She also played on the Cardiff University women’s rugby team — still calling the shots as the fly-half. “You catch the first pass and then decide what happens from that point on,” she explains about her position. But through her experience last year, Hannah’s learned that she can’t always determine what happens next.

“I’m hard on myself and like to have things in control,” she says. “But when a situation is so out of control that you have to rely on everyone around you, it lets you know that even if you aren’t in control, it will still be OK. Sometimes you just have to go with it.”

As part of her new attitude, Hannah is reevaluating her career plan of working for the FBI in data science. “Going through this has given me time to take a step back and think maybe I don’t want to be in that field — or maybe I do,” she says. “I’m still figuring it out.” The good thing is, she has time.

During this writing, Hannah was celebrating her 21st birthday. On her Facebook page, she started a birthday fundraiser for meningitis survivors. She intends to continue raising money to bring awareness to the condition. “I think it would be beneficial for both the people dealing with meningitis and the people around them to know more,” Hannah says. “It is really hard when no one really understands what is happening with your body.”

(Illustrations are by Bryan Christie Design and are an artistic representation only.)