On the frontlines of health care

On the Front Lines of Health Care

By Kim Grizzard Greenville: Life in the East

Dr. Donna

Lake

For a high-ranking former military officer, Donna Lake has an office that is rather low-profile. Small and nondescript, it is tucked away on the third floor of ECU’s health sciences building, so easy to miss that Lake sometimes greets visitors in the lobby and brings them up the elevator with her.

She does not mind the accommodations. The environment is far superior to many of her previous work spaces, which have included Haitian refugee camps and war-torn regions of Kosovo.

Inside this room, there is little to suggest that this wife and mother of two is a retired Air Force colonel and the recipient of two Department of Defense Bronze Star Medals. Among the few clues are pictures dotting the bookcase — photos with presidents Carter and Clinton and with

former U.S. Secretary of State Madeleine Albright.

After a 25 years and 46 countries, Lake has put her military career on the shelf. But at East Carolina University’s College of Nursing, she is still on the front lines of health care.

In the military, working in the forefront of nursing sometimes required her to wear a flak jacket and a weapon, in case her Humvee was attacked. In academia, it means being part of the fight to change the way health care providers are trained so that they work as a team.

“I learned that through aviation and I learned that through the Air Force,” said Lake, a clinical associate professor in the ECU College of Nursing and Brody School of Medicine. “Being in the back of an airplane taking care of critical-care patients,

it’s not just the nurse. It’s the medical technician. It’s the physician. It’s the pilot. It’s everybody. It’s a team.

“I’m convinced we have to teach our students and our faculty how to do that,” she said. “You need to know how to lead teams whether it’s in war, peace or health care.”

Growing up in New York as the oldest of four siblings, Lake did not necessarily consider herself to be a leader. While she “came from tough stock” (her father served as supervisor to 1,000 men during the initial construction of the World Trade Center), Lake imagined that after high school she might become a secretary. Though she had worked as a candy striper at 14 and taken a paid position as a nurse’s aid at 16, nursing school would require college, and no one in her family

Donna Lake,Clinical Associate Professor at ECU, holds a photo of her shaking President Bill Clinton’s hand. (Molly Mathis/Greenville Magazine)

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“

Being in the back of an airplane

taking care of critical-care patients,it’s not just the nurse.

It’s the medical technician.It’s the physician.It’s the pilot. It’s everybody.

“

It’s a team.

Donna Lake, third from left worked to facilitate aeromedical casualties in Kuwait. “I was forever putting U.S. servicemen in a coffin, moving them on an airplane back home,” she said. “I can remember standing on the tarmac and saying i’m a mother and somebody’s son is coming home.”

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had ever been to college.

Lake became the first, receiving a nursing diploma from Long Island College Hospital and later her degree in nursing from Stony Brook University. No one in the family had served in the military either, but that didn’t stop Lake from enlisting in the Air Force at age 25.

“My father didn’t want me to go,” she recalled. “My mother was in shock, and my father said, ‘Why would you do this?’ He said, ‘Only go in if you’re going to be a captain.’”

She had already obtained a bachelor’s degree but wanted money to pursue a master’s, and she wanted to travel. Lake was so intrigued by other cultures and curious about global affairs that, while working as a nurse in Manhattan, she sometimes spent her days off at the United Nations headquarters, sitting in the visitors’ gallery listening to meetings about UNICEF.

Although she longed to see the world, her first assignment in the Air Force was stateside. For a native New Yorker, the move to Mississippi provided its own form of culture shock.

“They didn’t trust this damn Yankee and they reminded me,” she said, laughing. “But I loved Mississippi.”

Lake had planned to spend only three years in the Air Force, but after two years, she met her husband at a leadership school in Alabama.

Lake’s next military move would test those new skills. In her late 20s, she began the evolution from critical-care nurse to policy maker, becoming assistant director of the Air Force Health Promotion Program. Working with the Air Force surgeon general in the late 1980s and early 1990s, Lake was responsible for dozens of medical hospitals and clinics.

“This was during the days we were telling people to stop smoking and to exercise. We were telling them about prevention,” she said. “I kept saying, ‘How did I get here?’”

By the early 1990s, Lake had welcomed her second child and her first assignment

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Donna Lake, who spent 25 years as an Air Force nurse, is now a fellow in the American Academy of Nursing. Lake became a registered nurse at age 19. “I worked as a nurse’s aide at 16,” she said. “I’ve never had any other kind of job.”

Donna Lake was part of a humanitarian mission that provided primary care to 19,000 people in half a dozen African villages over 10 days, included 11, 874 meningococcal vaccines.

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abroad in Cuba. She was still breastfeeding her 6-week-old son when she was sent to care for Cuban and Haitian refugees at Guantanamo Naval Base.

Escorted by Marines, Lake remembers being spit at and cursed at as she made her way through refugee camps, where tuberculosis was rampant and mothers were giving birth in filthy conditions.

“I was trying to establish a policy and a process that we would take these refugees legally back to the United States. They needed health care,” she said. “The Haitians, 99 percent of them were HIV positive, and they were very sick.

“I can remember bringing Haitians back to Andrews Air Force base and they had never seen a toilet,” Lake said. “They didn’t know how to use a toilet. We had to show them.”

What she learned in her first refugee assignment helped prepare Lake for the crisis in Kosovo, where war had displaced some 30,000 refugees. It was this mission that earned Lake her first Bronze Star Medal for meritorious service in a combat zone.

“There were launch missiles on shoulders of farmers in the fields,” she said. “When you’re flying in a helicopter, you’re only off the ground 500 feet. So you could see the people that were trying to kill you … We were flying over houses that were being lit on fire by the Serbs.”

Lake recalls going to a hospital where she and an Army doctor confronted a physician, an Albanian, who was refusing Serbian patients who needed access to a respirator.

“The Serbs had killed his family,” she said. “That was the first time I witnessed hate among humans. I had never really seen it face to face, and I saw real hate there.”

She witnessed it again on Sept. 11, 2001. Lake was working at Bolling Air Force Base in Washington, D.C., when terrorists flew planes into the World Trade Center. Lake’s husband, who had left the

Air Force and was working for the Federal Aviation Administration, called to warn his wife of the danger.

“(He) said, ‘We’ve lost an airplane. … There’s been a crash into the World Trade Center. It looks like one’s coming your way. Get out of your building!” Lake said.

“All of a sudden, we felt a shake and we looked out our window, black smoke and the plane had crashed into the Pentagon and we all ran out of the building,” she said. “Then we started to hear fighter jets. ... We really thought we were being attacked like Pearl Harbor.”

Security forces, in full gear, surrounded the facility. Members of Congress were brought to the base for safety. A three-star general seated next to Lake said, “Donna, our world is never going to be the same after today.”

From her assignment at Nevada’s Nellis Air Force Base, Lake was part of an effort to rapidly deploy more than 500 Air Force forces to Iraq in the beginning of Operation Iraqi Freedom.

The war took its toll in more ways than one. There were 20 deaths due to suicide at the base where she worked. In 2004, she became medical group commander at Goldsboro’s Seymour Johnson Air Force Base, where she worked on a mental health suicide high risk screening collaborative.

In 2006, she was sent to Kuwait to serve as a medical commander and director of aeromedical evacuation. It would be her last assignment.

“I did not believe in the war. I could not be a cheerleader anymore. I was tired,” Lake said. “I had had enough. I had seen too much death, too many young people hurt. I took care of a lot of critical casualties, kids dying. I saw the poverty. I saw the politics and I said, ‘That’s it; I’m done.’”

She retired five days after she came home to Goldsboro. While Lake was done with military service, retired Lt. Col. Philip Julian, a former assistant professor in ECU’s School of Nursing, saw no need for

her to stop serving as a nurse. He invited her to ECU to make a presentation on global health and then talked with her afterward about a possible second career in academia.

“We’re talking about somebody here who has Pentagon-level experience,” said Julian, former director of the leadership program for the master’s of science in nursing. “She’s been deployed all over the world. She had testified before Congress. That’s the caliber person we’re talking about.

“I don’t think civilians and academics ever fully appreciate what the military instills in people,” he said. “We are by and large very mission-oriented and very focused on teamwork.”

Though she had obtained her master’s degree in education years earlier, Lake felt unprepared for the academic culture. Even during her deployment, she had continued to work toward her Ph.D., though traveling meant coursework had to be completed online.

“I did not have the same degree path that everybody else does,” Lake said. “I wasn’t embraced initially.”

During her first few years at ECU, she seldom spoke of her military service. The memories were too fresh, and there was disagreement across the country on whether or not this was a war Americans should be fighting. Lake decided most people would simply rather not hear about it.

“I don’t think even a lot of the people who worked with her knew how much she had really done and how much of a leader she had been in her career in the military,” said professor emeritus Marti Engelke, former associate dean for research in the College of Nursing. “I don’t think people really understood that.

“She’s very modest,” Engelke said. “She doesn’t go around telling people all the things that she’s done.”

Instead, Lake focused on her new mission at ECU. She took part in a Robert Wood Johnson Grant that studied the

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nursing workforce and health care needs of eastern N.C. She also was awarded a grant to study the resiliency of children of military parents who were deployed. She helped to establish global partnerships with the medical school and nursing teams in Nicaragua.

“I think what she’s really done since she’s been at ECU is she’s worked across disciplines,” Engelke said. “I think that she will help educate nurse leaders who can function in a more interdisciplinary environment, which is where health care is going.

“She takes a lot of leadership positions, but she’s not in it for the glory. She’s in it because it’s something she believes in. She knows all kinds of jobs have to get done in order to be successful at something,” Engelke said. “Just to use a metaphor from the military, she’s the boots on the ground.”

For three years, Lake was the only nurse working on the American Medical Association’s Redesigning Education to Accelerate Change in Healthcare grant. With that mission accomplished, she is working on ways to help military nurses

transition to academic faculty positions and to prepare nurses for hospital leadership.

“I still see myself not finished,” Lake said. “I’m thinking what else can I do to make a difference?”

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