{"id":1746,"date":"2019-05-16T10:02:53","date_gmt":"2019-05-16T14:02:53","guid":{"rendered":"http:\/\/news.colgate.edu\/magazine\/?p=1746"},"modified":"2019-05-15T23:30:50","modified_gmt":"2019-05-16T03:30:50","slug":"patient-zero-meningitis","status":"publish","type":"post","link":"https:\/\/news.colgate.edu\/magazine\/2019\/05\/16\/patient-zero-meningitis\/","title":{"rendered":"Patient Zero"},"content":{"rendered":"<p><span style=\"font-family: Nocturno; color: #000000; font-size: 35px; font-weight: bold;\">A body under attack. A student fighting for her life. A community making split-second decisions to keep her alive.<\/span><\/p>\n<p>That night, she told her roommate she was going to bed early. The next thing Hannah Tubbergen \u201920 remembers clearly is waking up five days later in St. Luke\u2019s Hospital in Utica.<\/p>\n<p>\u201cI was wondering where I was and why my parents were there,\u201d Tubbergen recalls. \u201cI remember thinking, \u2018Was I in a car accident?\u2019<\/p>\n<p><a href=\"http:\/\/news.colgate.edu\/magazine\/wp-content\/uploads\/sites\/6\/2019\/05\/meningitis_final_01body.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignright size-full wp-image-1798\" src=\"http:\/\/news.colgate.edu\/magazine\/wp-content\/uploads\/sites\/6\/2019\/05\/meningitis_final_01body.jpg\" alt=\"\" width=\"500\" height=\"705\" srcset=\"https:\/\/news.colgate.edu\/magazine\/wp-content\/uploads\/sites\/6\/2019\/05\/meningitis_final_01body.jpg 500w, https:\/\/news.colgate.edu\/magazine\/wp-content\/uploads\/sites\/6\/2019\/05\/meningitis_final_01body-213x300.jpg 213w\" sizes=\"auto, (max-width: 500px) 100vw, 500px\" \/><\/a>\u201cI kept asking them what happened. They kept telling me, and I would ask again a few minutes later. The sedation erases your memory.\u201d Over time, Tubbergen\u2019s parents and others would fill in the gaps.<\/p>\n<p>What happened starting April 1, 2018 \u2014\u00a0which was both April Fool\u2019s Day and Easter Sunday \u2014 transpired like a play, with a full cast of people. Each had to make critical decisions, and each had a life-altering experience.<\/p>\n<hr \/>\n<div class=\"quote\">\u201cThere were like shooting stars of infection throughout her body.\u201d<\/div>\n<div class=\"attribution\">Dr. Merrill Miller<\/div>\n<hr \/>\n<p>\u201cI felt a little under the weather, but just cold symptoms, like\u00a0congestion,\u201d 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 <a href=\"http:\/\/www.colgate.edu\/academics\/departments-and-programs\/computer-science\" target=\"_blank\" rel=\"noopener\">computer science<\/a> major and <a href=\"http:\/\/www.colgate.edu\/academics\/departments-and-programs\/romance-languages-and-literatures\/french\" target=\"_blank\" rel=\"noopener\">French<\/a> 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\u2019t able to fully catch up until Saturday afternoon. \u201cWe knew she didn\u2019t feel well, so we were telling her to gargle with saltwater and that we\u2019d sent her a care package,\u201d Tyler says. \u201cShe gave us no indication that she was that sick.\u201d<\/p>\n<div class=\"miller\"><span style=\"color: #e10028;\">\u2192<\/span> \u201cBacteria are all around. When someone\u2019s immune system and their ability to fight infections are depressed, we can become susceptible to all sorts of health problems.\u201d \u2014 Dr. Merrill Miller, director of student health services, who monitored the situation from campus and controlled the potential threat to the Colgate community<\/div>\n<p>Amina Rehman \u201920, Hannah\u2019s roommate at the time, returned to campus on Sunday around 4 p.m. after visiting her family in Boonton, N.J. \u201cI entered our room, and it was dark, so I thought she wasn\u2019t there,\u201d Rehman says. \u201cBut as soon as I stepped in, she popped up from her bed in the corner and told me she was sick. I didn\u2019t think it was a big deal. Hannah usually has a lot going on, so I thought she\u2019d come down with a cold.\u201d<\/p>\n<p>Hannah complained of a headache, so Rehman gave her some Tylenol.<\/p>\n<div class=\"miller\"><span style=\"color: #e10028;\">\u2192<\/span> \u201cThe 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\u2019s a limited amount of space within the skull and spine for there to be swelling and infected fluid. Because it\u2019s totally surrounding the brain, often, you will have a very bad headache.\u201d \u2014 Dr. Miller<\/div>\n<p>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, \u201cI really need a steam to open up.\u201d<\/p>\n<p>Rehman\u2019s concern heightened upon hearing Hannah throwing up in the suite\u2019s bathroom. When her roommate came out, Rehman suggested they go to the emergency room. \u201cNo, no, I\u2019m totally fine,\u201d Hannah reassured her. \u201cIt\u2019s probably just norovirus.\u201d<\/p>\n<p>They skipped their ritual before-bed talk because Hannah fell fast asleep. Rehman woke up Monday morning for her 9:20 biology class. \u201cHannah, are you going to class?\u201d she asked. \u201cNo, I\u2019m just gonna nap,\u201d Hannah responded. \u201cThat makes sense; she\u2019s sick,\u201d Rehman thought. After her 10:20 logic course, Rehman would normally go to the Coop for lunch, but Hannah hadn\u2019t 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.<\/p>\n<p>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, \u201cWe need to go to the health clinic.\u201d Hannah weakly answered, \u201cOK, OK.\u201d 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.<\/p>\n<p>She needed help.<\/p>\n<p>\u201cHannah went from zero to eighty overnight,\u201d Rehman says. \u201cShe was a normal sick person the night before. She was responding. She didn\u2019t have a temperature. And then, the next morning, she was burning up. She was delirious. She could barely speak.\u201d<\/p>\n<div class=\"miller\"><span style=\"color: #e10028;\">\u2192<\/span> \u201cThis type of bacteria often spreads, and rapidly. When I say rapidly, I mean hours. This is full steam ahead.\u201d \u2014 Dr. Miller<\/div>\n<p>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\u2019s legs. Maybe they were bruises from rugby practice, Rehman thought.<\/p>\n<p>\u201cThey call it petechiae,\u201d explains Heather Williams, a SOMAC paramedic who was one of the first responders on the scene. Hannah\u2019s blood vessels were rupturing and her blood was reverting to her core where it needed to be to keep her alive.<\/p>\n<figure id=\"attachment_1786\" aria-describedby=\"caption-attachment-1786\" style=\"width: 1000px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-1786\" src=\"http:\/\/news.colgate.edu\/magazine\/wp-content\/uploads\/sites\/6\/2019\/02\/meningitis_final_inset_01-resize2.jpg\" alt=\"artistic representation of blood clots in a human heart\" width=\"1000\" height=\"813\" srcset=\"https:\/\/news.colgate.edu\/magazine\/wp-content\/uploads\/sites\/6\/2019\/02\/meningitis_final_inset_01-resize2.jpg 1000w, https:\/\/news.colgate.edu\/magazine\/wp-content\/uploads\/sites\/6\/2019\/02\/meningitis_final_inset_01-resize2-300x244.jpg 300w, https:\/\/news.colgate.edu\/magazine\/wp-content\/uploads\/sites\/6\/2019\/02\/meningitis_final_inset_01-resize2-768x624.jpg 768w\" sizes=\"auto, (max-width: 1000px) 100vw, 1000px\" \/><figcaption id=\"caption-attachment-1786\" class=\"wp-caption-text\">The attack on Hannah\u2019s organs \u2014 including her heart \u2014 caused blood clots.<\/figcaption><\/figure>\n<p>Williams and two other SOMAC EMTs arrived around noon. \u201cI was not expecting what I saw,\u201d Williams says. Blue feet \u2014 that\u2019s the first thing she noticed. Then she observed the mottling on Hannah\u2019s skin and knew the blood wasn\u2019t circulating to the extremities. \u201cSomething\u2019s not right,\u201d Williams thought. She quickly grabbed a mask and instructed her colleagues to do the same.<\/p>\n<p>An experienced EMT, Williams started cycling through the possibilities. Spring break was two weeks ago \u2014\u00a0had Hannah contracted something abroad? But when the patient reported a headache and neck pain, this was a tip-off. \u201cI went right to meningitis,\u201d Williams says.<\/p>\n<div class=\"miller\"><span style=\"color: #e10028;\">\u2192<\/span> \u201cShe had meningococcal meningitis and meningococcemia, which means it spread throughout the blood stream.\u201d \u2014\u00a0Dr. Miller<\/div>\n<p>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\u2019t walk or sit up, they folded her into a MegaMover, which looks like a canvas sheet with handles.<\/p>\n<p>As Rehman watched frightened, a team of people carried the 125-pound student and the attached equipment down two flights of stairs. \u201cIt\u2019s going to be OK, Hannah,\u201d she called after her. \u201cIt was the most traumatizing image ever,\u201d Rehman says.<\/p>\n<hr \/>\n<div class=\"quote\">\u201cIn 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.\u201d<\/div>\n<div class=\"attribution\">Dr. Miller<\/div>\n<hr \/>\n<p>After loading Hannah into the ambulance, Williams urged SOMAC volunteer Katie Steklac \u201918 to \u201cdrive safely, but drive fast.\u201d 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.<\/p>\n<p>\u201cWe\u2019re going to make our best time to get up there because I don\u2019t know if she\u2019s going to make it,\u201d Williams told the dispatcher.<\/p>\n<div class=\"miller\"><span style=\"color: #e10028;\">\u2192<\/span> \u201cAny 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\u2019s very critical.\u201d \u2014\u00a0Dr. Miller<\/div>\n<p>As the ambulance sped northeast, Williams \u201cstarted to get scared,\u201d she recalls. But, as a medical professional \u2014\u00a0and a mother \u2014 she curbed her emotions and talked to Hannah during the 40-minute drive, reassuring her that they were going to get her help.<\/p>\n<p>Earlier, while waiting for the paramedics to arrive, Rehman had used Hannah\u2019s thumb to open her phone and access the Tubbergens\u2019 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\u2019s.<\/p>\n<p>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.<\/p>\n<div class=\"miller\"><span style=\"color: #e10028;\">\u2192<\/span> \u201cThey needed to treat the infection. She needed very high-dose antibiotics given intravenously to get throughout her entire body.\u201d \u2014 Dr. Miller<\/div>\n<p>It was now 3:30 p.m. The doctor called Tyler to say, \u201cShe\u2019s the sickest we\u2019ve ever seen. You need to get here.\u201d As Debbie was driving home, she remembers, she let her tears escape. \u201cI told myself, get it all out now because you need to be strong for Hannah,\u201d she says. \u201cI knew they were trying to keep her alive long enough for us to say goodbye.\u201d<\/p>\n<figure id=\"attachment_1784\" aria-describedby=\"caption-attachment-1784\" style=\"width: 800px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/news.colgate.edu\/magazine\/wp-content\/uploads\/sites\/6\/2019\/02\/2nd-Night-w_-Hannah-resize-1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-1784\" src=\"http:\/\/news.colgate.edu\/magazine\/wp-content\/uploads\/sites\/6\/2019\/02\/2nd-Night-w_-Hannah-resize-1.jpg\" alt=\"Hannah in the hospital with her dad, Tyler\" width=\"800\" height=\"450\" srcset=\"https:\/\/news.colgate.edu\/magazine\/wp-content\/uploads\/sites\/6\/2019\/02\/2nd-Night-w_-Hannah-resize-1.jpg 800w, https:\/\/news.colgate.edu\/magazine\/wp-content\/uploads\/sites\/6\/2019\/02\/2nd-Night-w_-Hannah-resize-1-300x169.jpg 300w, https:\/\/news.colgate.edu\/magazine\/wp-content\/uploads\/sites\/6\/2019\/02\/2nd-Night-w_-Hannah-resize-1-768x432.jpg 768w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\" \/><\/a><figcaption id=\"caption-attachment-1784\" class=\"wp-caption-text\">Hannah in the hospital with her dad, Tyler<\/figcaption><\/figure>\n<p>The frantic parents threw a few days\u2019 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\u2019d 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\u2019t want her to expend any extra energy.<\/p>\n<p>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\u2019s 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.<\/p>\n<div class=\"miller\"><span style=\"color: #e10028;\">\u2192<\/span> \u201cWhen 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\u2019re dealing with.\u201d \u2014\u00a0Dr. Miller<\/div>\n<p>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 <a href=\"https:\/\/www.colgate.edu\/about\/people-of-colgate\/president-brian-w-casey\" target=\"_blank\" rel=\"noopener\">Brian Casey<\/a> waited. \u201cTo see the president there at two in the morning really floored us,\u201d Tyler says. \u201cVery humbling.\u201d<\/p>\n<p>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. \u201cI couldn\u2019t touch her without gloves,\u201d Debbie remembers.<\/p>\n<p>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.<\/p>\n<p>A cooling blanket was on top of Hannah to lower her fever, while heating pads covered her extremities because of her poor circulation. \u201cHer hands and feet were almost black,\u201d Debbie remembers.<\/p>\n<p>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\u2019t want to leave the hospital. Chapman had given them Hannah\u2019s rugby jersey, which Debbie says she used as a security blanket. \u201cIt was with me everywhere I went.\u201d<\/p>\n<p>The next morning, Tuesday, at 7:43, laboratory results confirmed meningococcal meningitis and meningococcemia.<\/p>\n<div class=\"miller\"><span style=\"color: #e10028;\">\u2192<\/span> \u201cIn 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.\u201d \u2014\u00a0Dr. Miller<\/div>\n<p>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.<\/p>\n<p>\u201cThere\u2019s 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,\u201d Gough says.<\/p>\n<p>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\u2019t be an outbreak.<\/p>\n<figure id=\"attachment_1789\" aria-describedby=\"caption-attachment-1789\" style=\"width: 800px\" class=\"wp-caption alignright\"><a href=\"http:\/\/news.colgate.edu\/magazine\/wp-content\/uploads\/sites\/6\/2019\/02\/Visit-from-Pres-Casey-resize-1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-1789\" src=\"http:\/\/news.colgate.edu\/magazine\/wp-content\/uploads\/sites\/6\/2019\/02\/Visit-from-Pres-Casey-resize-1.jpg\" alt=\"President Brian W. Casey and his dog, Emrys, beside Hannah's hospital bed.\" width=\"800\" height=\"450\" srcset=\"https:\/\/news.colgate.edu\/magazine\/wp-content\/uploads\/sites\/6\/2019\/02\/Visit-from-Pres-Casey-resize-1.jpg 800w, https:\/\/news.colgate.edu\/magazine\/wp-content\/uploads\/sites\/6\/2019\/02\/Visit-from-Pres-Casey-resize-1-300x169.jpg 300w, https:\/\/news.colgate.edu\/magazine\/wp-content\/uploads\/sites\/6\/2019\/02\/Visit-from-Pres-Casey-resize-1-768x432.jpg 768w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\" \/><\/a><figcaption id=\"caption-attachment-1789\" class=\"wp-caption-text\">President Brian W. Casey and his dog, Emrys, visited Hannah as she was recovering.<\/figcaption><\/figure>\n<p>Coincidentally, less than two weeks prior, the EOC had practiced a public health emergency tabletop exercise, \u201cso it was fresh in everyone\u2019s minds,\u201d 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. \u201cThat\u2019s what emergency management is \u2014\u00a0making sure you\u2019ve done all the training and planning,\u201d Gough says.<\/p>\n<p>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 \u2014 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 \u2014 for both strains \u2014 but it is not 100 percent effective. It is unknown how and from where Hannah contracted the infection.<\/p>\n<p>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\u2019s expenses. Many others whom the family did not know sent supplies, homemade cookies, and cards. \u201cWe felt we were part of the Colgate family, and that was just amazing,\u201d Debbie says.<\/p>\n<p>Throughout that week, Hannah\u2019s condition was in a state of constant fluctuation. The medical team needed to address minute-to-minute changes as they were happening.<\/p>\n<div class=\"miller\"><span style=\"color: #e10028;\">\u2192<\/span> \u201cThere were like shooting stars of infection throughout her body \u2014 through the blood vessels, causing various organs to not function. Things were churning in her body. Various chemicals get affected \u2014 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.\u201d \u2014\u00a0Dr. Miller<\/div>\n<p>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.)<\/p>\n<p>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. \u201cVicious cycle,\u201d Debbie posted.<\/p>\n<p>The attack on Hannah\u2019s organs was causing blood clots, including one in the right ventricle of her heart. The doctors weren\u2019t 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.<\/p>\n<p>\u201cFor those first few days, we could have lost her at any point,\u201d Debbie says.<\/p>\n<figure id=\"attachment_1785\" aria-describedby=\"caption-attachment-1785\" style=\"width: 800px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/news.colgate.edu\/magazine\/wp-content\/uploads\/sites\/6\/2019\/02\/IMG_9285-resize-1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-1785\" src=\"http:\/\/news.colgate.edu\/magazine\/wp-content\/uploads\/sites\/6\/2019\/02\/IMG_9285-resize-1.jpg\" alt=\"Hannah tackling an opponent during a rugby game.\" width=\"800\" height=\"534\" srcset=\"https:\/\/news.colgate.edu\/magazine\/wp-content\/uploads\/sites\/6\/2019\/02\/IMG_9285-resize-1.jpg 800w, https:\/\/news.colgate.edu\/magazine\/wp-content\/uploads\/sites\/6\/2019\/02\/IMG_9285-resize-1-300x200.jpg 300w, https:\/\/news.colgate.edu\/magazine\/wp-content\/uploads\/sites\/6\/2019\/02\/IMG_9285-resize-1-768x513.jpg 768w, https:\/\/news.colgate.edu\/magazine\/wp-content\/uploads\/sites\/6\/2019\/02\/IMG_9285-resize-1-360x240.jpg 360w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\" \/><\/a><figcaption id=\"caption-attachment-1785\" class=\"wp-caption-text\">Hannah (center) tapped into her rugby training<br \/>to help manage her pain in the hospital.<\/figcaption><\/figure>\n<p>On Thursday, Hannah opened her eyes for the first time since Monday morning. \u201cThe nurses started crying, we started crying, and Dr. Brehaut was almost in tears,\u201d 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. \u201cShe had been in top shape for rugby and then she was skin and bones,\u201d Debbie remembers.<\/p>\n<p>Still, \u201cAin\u2019t no mountain high enough,\u201d Debbie posted the following day, embracing the rugby team\u2019s mantra. The medical staff removed Hannah\u2019s intubation, her heart and kidney functioning improved, and the antibiotics had decreased the level of bacteria in her body.<\/p>\n<p>Hannah\u2019s brother, Scott (who is earning a master\u2019s\/PhD in microbiology\/infectious diseases), posted on Facebook: \u201cThe 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.\u201d Hannah had always been stubborn, he went on to write. \u201cThis situation, however, takes it to a whole new level.\u201d<\/p>\n<p>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\u2019t 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. \u201cEvery coach, every teacher has said that she has a positive attitude. She is the hardest working person,\u201d Debbie says.<\/p>\n<p>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. \u201cMiracles happen!\u201d Debbie posted.<\/p>\n<p>Hannah\u2019s 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.<\/p>\n<div class=\"miller\"><span style=\"color: #e10028;\">\u2192<\/span> \u201cAnything that could happen to anybody happened to her.\u201d \u2014\u00a0Dr. Miller<\/div>\n<p>Tyler was quickly back on a plane. \u201cAfter everything we were feeling good about over the weekend, that was a shock,\u201d he says.<\/p>\n<p>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\u2019s hand and asked her to count her down until she made it to the next pain level. \u201cCoach always talks about the 78th minute,\u201d she told her mom. \u201cWhen you\u2019re exhausted and you\u2019ve got two more minutes, give it your all.\u201d So Debbie would count down the minutes until Hannah could have her next dose of morphine. \u201cWatching her with that grit, knowing she had to gut it out,\u201d Debbie says, \u201cshe\u2019s my hero. I don\u2019t think I could do what she did.\u201d<\/p>\n<p>Moving day arrived on April 17. Hannah was released to the inpatient rehabilitation center. By that point, she\u2019d lost 20 pounds, so she needed physical and occupational therapy to rebuild her body. Offering reassurance, a nurse told her, \u201cWithin a year, you\u2019ll be back to normal.\u201d Hannah responded: \u201cI\u2019ll be playing rugby by fall.\u201d<\/p>\n<p>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.<\/p>\n<p>Characteristic of Hannah, she\u2019d set a goal. Colgate\u2019s women\u2019s rugby qualified for the national championships, which would take place April 28 outside of Pittsburgh, Pa. \u201cTubes,\u201d as Hannah\u2019s teammates call her, wouldn\u2019t be playing on the pitch, but she\u2019d be there.<\/p>\n<p>Debbie and Tyler consented to Hannah\u2019s request that, if she were discharged in time, she could surprise her teammates. \u201cShe\u2019d do anything for her team,\u201d Chapman says. \u201cHaving seen Hannah throughout, I thought [her being released in time] was going to be tough, but the last two weeks, she made miraculous strides.\u201d<\/p>\n<p>Driving through Pennsylvania, after all, was on the way home to Oregon. The family had been preparing for the upcoming road trip. Between Hannah\u2019s poor circulation and doctors\u2019 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.<\/p>\n<p>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\u2019s life. \u201cI just did my job, treated her to the best of my ability, and treated her like I would any of my family,\u201d Williams told them.<\/p>\n<figure id=\"attachment_1788\" aria-describedby=\"caption-attachment-1788\" style=\"width: 1000px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/news.colgate.edu\/magazine\/wp-content\/uploads\/sites\/6\/2019\/02\/P1010048-1000resize-1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-1788\" src=\"http:\/\/news.colgate.edu\/magazine\/wp-content\/uploads\/sites\/6\/2019\/02\/P1010048-1000resize-1.jpg\" alt=\"Hannah in a wheelchair surrounded by the Colgate Women's Rugby team\" width=\"1000\" height=\"750\" srcset=\"https:\/\/news.colgate.edu\/magazine\/wp-content\/uploads\/sites\/6\/2019\/02\/P1010048-1000resize-1.jpg 1000w, https:\/\/news.colgate.edu\/magazine\/wp-content\/uploads\/sites\/6\/2019\/02\/P1010048-1000resize-1-300x225.jpg 300w, https:\/\/news.colgate.edu\/magazine\/wp-content\/uploads\/sites\/6\/2019\/02\/P1010048-1000resize-1-768x576.jpg 768w\" sizes=\"auto, (max-width: 1000px) 100vw, 1000px\" \/><\/a><figcaption id=\"caption-attachment-1788\" class=\"wp-caption-text\">\u201cTubes,\u201d as she is called by teammates, surprised them at the National Championships.<\/figcaption><\/figure>\n<p>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: \u201cThis is not your slow \u2014 it\u2019s supposed to be actual slow.\u201d Rehman says, \u201cShe\u2019s a very tough person.\u201d<\/p>\n<p>The next day, the Tubbergens pulled into Founders Field in Cheswick, Pa. \u201cIt was quite the scene,\u201d Chapman recalls. Her teammates clustered around the car, waiting for Tubes to come out. \u201cEveryone was smiling, some were crying, and they all wanted to hug me,\u201d Hannah remembers. The reunion was even more poignant because the players had expressed uncertainty about competing after such an emotional month. \u201cIt\u2019s a close-knit community, so when a member of the family goes down, they rally around each other,\u201d Chapman says.<\/p>\n<p>As the Raiders proceeded with the match, Chapman wheeled Hannah around the field. \u201cWherever we went, she was there with us.\u201d<\/p>\n<p>The fly-half \u2014\u00a0Hannah\u2019s position \u2014\u00a0in rugby is like the quarterback in football. Her job is to coordinate the team\u2019s attack and make calls to get the ball where it needs to be. \u201cIt\u2019s a fast-paced game, and she\u2019s basically the general,\u201d Chapman explains.<\/p>\n<p>Colgate has a reputation as giant killers, and women\u2019s rugby is no exception. Compared to other teams, Colgate\u2019s women\u2019s rugby players are usually the smallest in terms of their physical stature. \u201cSo it takes a special person, with a specific mind-set, to play this game against someone who\u2019s bigger, considering it\u2019s a collision sport,\u201d Chapman explains.<\/p>\n<p>All through Hannah\u2019s ups and downs in the hospital, Chapman often proclaimed, \u201cShe\u2019s a fighter\u201d \u2014 so frequently that the Tubbergens had the saying engraved on a golf towel for him. \u201cIt\u2019s just what I\u2019ve seen in her,\u201d he says.<\/p>\n<p>Even the burly coach gets choked up when reflecting on last spring. \u201cWhen thinking of Tubes, it\u2019s tough to not think about what happened,\u201d he says. \u201cAnd when you think about how she took it on, there\u2019s not much difference between that and the field. The way she approaches things \u2014\u00a0it\u2019s all heart.\u201d<\/p>\n<p>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.<\/p>\n<p>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\u2019 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\u2019d missed. \u201cI really wanted to graduate with my class,\u201d she says. Professors sent Hannah assignments, which she turned to with her usual diligence.<\/p>\n<p>Unlike her cognitive skills, Hannah\u2019s 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\u2019s hair from her pillows and car.<\/p>\n<div class=\"miller\"><span style=\"color: #e10028;\">\u2192<\/span> \u201cThat is how extensive this disease was in her body. It was to every last bit of her.\u201d \u2014 Dr. Miller<\/div>\n<p>As she was preparing for finals, Hannah had yet another setback when she learned she\u2019d have to have her pinky toe amputated on June 8 because of poor circulation. \u201cIf that was the worst that was going to happen out of all of this, I\u2019m fine with it,\u201d Hannah says now.<\/p>\n<p>\u201cShe knows her good fortune,\u201d 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.<\/p>\n<div class=\"miller\"><span style=\"color: #e10028;\">\u2192<\/span> \u201cHow each person reacts to meningitis is different, so each case is different.\u201d \u2014 Dr. Miller<\/div>\n<p>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\u2019d 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.<\/p>\n<hr \/>\n<div class=\"quote\">\u201cThis patient zero decided to be the immovable object to meet the not-so-unstoppable force of the disease.\u201d<\/div>\n<div class=\"attribution\">Scott Eisenhower, Hannah\u2019s brother<\/div>\n<hr \/>\n<p>So when the Tubbergens told Chapman that Hannah had been fully cleared, he responded, \u201cGreat. Cleared for what?\u201d 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.<\/p>\n<p>The next day, the Tubbergens moved Hannah into the Tri-Delta house. \u201cThat\u2019s when we left her,\u201d Tyler says. \u201cThat was hard,\u201d Debbie remembers.<\/p>\n<p>Hannah then headed to preseason practice on Academy Field, which started with a team meeting. Next: the fitness test \u2014 the dreaded Bronco, a 20-, 40-, and 60-meter shuttle run done five times.<\/p>\n<p>\u201cTrue to form, Hannah finished it,\u201d Chapman says. \u201cAll I could think about was, the last time I saw her, she was in a wheelchair. Before that, she was on her deathbed, essentially.\u201d But here Hannah was, finishing a hardcore endurance test in the August heat. \u201cThat taught me that she can\u2019t be handled with mitts,\u201d Chapman says, \u201cso just take them off.\u201d<\/p>\n<figure id=\"attachment_1787\" aria-describedby=\"caption-attachment-1787\" style=\"width: 800px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/news.colgate.edu\/magazine\/wp-content\/uploads\/sites\/6\/2019\/02\/Moved-to-Delta-House-resize-1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-1787\" src=\"http:\/\/news.colgate.edu\/magazine\/wp-content\/uploads\/sites\/6\/2019\/02\/Moved-to-Delta-House-resize-1.jpg\" alt=\"Hannah on her bed in the Tri-Delta house\" width=\"800\" height=\"450\" srcset=\"https:\/\/news.colgate.edu\/magazine\/wp-content\/uploads\/sites\/6\/2019\/02\/Moved-to-Delta-House-resize-1.jpg 800w, https:\/\/news.colgate.edu\/magazine\/wp-content\/uploads\/sites\/6\/2019\/02\/Moved-to-Delta-House-resize-1-300x169.jpg 300w, https:\/\/news.colgate.edu\/magazine\/wp-content\/uploads\/sites\/6\/2019\/02\/Moved-to-Delta-House-resize-1-768x432.jpg 768w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\" \/><\/a><figcaption id=\"caption-attachment-1787\" class=\"wp-caption-text\">First day back on campus in autumn \u201918<\/figcaption><\/figure>\n<p>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\u2019d 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. \u201cHer work ethic is off the charts,\u201d Tyler says.<\/p>\n<p>This spring semester, Hannah participated in the Wales Study Group, taking classes on data science and human computer interaction.<\/p>\n<p>She also played on the Cardiff University women\u2019s rugby team \u2014\u00a0still calling the shots as the fly-half. \u201cYou catch the first pass and then decide what happens from that point on,\u201d she explains about her position. But through her experience last year, Hannah\u2019s learned that she can\u2019t always determine what happens next.<\/p>\n<p>\u201cI\u2019m hard on myself and like to have things in control,\u201d she says. \u201cBut 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\u2019t in control, it will still be OK. Sometimes you just have to go with it.\u201d<\/p>\n<p>As part of her new attitude, Hannah is reevaluating her career plan of working for the FBI in data science. \u201cGoing through this has given me time to take a step back and think maybe I don\u2019t want to be in that field \u2014 or maybe I do,\u201d she says. \u201cI\u2019m still figuring it out.\u201d The good thing is, she has time.<\/p>\n<hr \/>\n<div class=\"miller\">Postscript:<br \/>\nDuring 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. \u201cI think it would be beneficial for both the people dealing with meningitis and the people around them to know more,\u201d Hannah says. \u201cIt is really hard when no one really understands what is happening with your body.\u201d<\/div>\n<hr \/>\n<p><em>(Illustrations are by Bryan Christie Design and are an artistic representation only.)<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>When a student contracted a deadly form of meningitis last year, the Colgate community worked to keep her and others safe. <\/p>\n","protected":false},"author":1210,"featured_media":1797,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_hide_featured_image":false,"_jetpack_featured_image_duplicate_dismissed":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[10],"tags":[68,285,387,334,106],"coauthors":[128],"class_list":["post-1746","post","type-post","status-publish","format-standard","has-post-thumbnail","category-features","tag-health","tag-medicine","tag-meningitis","tag-rugby","tag-science"],"jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/palXSH-sa","amp_enabled":true,"jetpack_featured_media_url":"https:\/\/news.colgate.edu\/magazine\/wp-content\/uploads\/sites\/6\/2019\/05\/meningitis_final_01feature2.jpg","_links":{"self":[{"href":"https:\/\/news.colgate.edu\/magazine\/wp-json\/wp\/v2\/posts\/1746","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/news.colgate.edu\/magazine\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/news.colgate.edu\/magazine\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/news.colgate.edu\/magazine\/wp-json\/wp\/v2\/users\/1210"}],"replies":[{"embeddable":true,"href":"https:\/\/news.colgate.edu\/magazine\/wp-json\/wp\/v2\/comments?post=1746"}],"version-history":[{"count":39,"href":"https:\/\/news.colgate.edu\/magazine\/wp-json\/wp\/v2\/posts\/1746\/revisions"}],"predecessor-version":[{"id":2083,"href":"https:\/\/news.colgate.edu\/magazine\/wp-json\/wp\/v2\/posts\/1746\/revisions\/2083"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/news.colgate.edu\/magazine\/wp-json\/wp\/v2\/media\/1797"}],"wp:attachment":[{"href":"https:\/\/news.colgate.edu\/magazine\/wp-json\/wp\/v2\/media?parent=1746"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/news.colgate.edu\/magazine\/wp-json\/wp\/v2\/categories?post=1746"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/news.colgate.edu\/magazine\/wp-json\/wp\/v2\/tags?post=1746"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/news.colgate.edu\/magazine\/wp-json\/wp\/v2\/coauthors?post=1746"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}