FORT MEADE, Md. -- Justin Lee was just 6 years old when doctors first diagnosed his mother with multiple sclerosis -- an unpredictable disease that impacts the central nervous system and disrupts the flow of information between body and brain.
At that young of an age, Lee couldn’t understand the significance of her condition, but he and his two older brothers did their best to support their beloved matriarch as her health declined, he said.
It took most of his childhood and teenage years for her overall condition to improve, but his family received crucial support from other relatives and friends, specifically members of their church, he added.
Encouraged by the resilience of his family, Lee took a chance in his final year of high school and applied to the U.S. Military Academy at West Point, New York -- as part of an unexpected path that would later lead him to the frontlines of the COVID-19 fight.
"Growing up, I was always intrigued by the military, and I valued this idea of serving your country and being a part of something bigger than yourself," he said. "Unfortunately, I got to the final stage and wasn't selected. I had to fall back to a different school.”
With his initial plan uprooted, Lee sought advice from his friends and family. Having experience with supporting his mother throughout his childhood, his friends suggested nursing as a viable career option.
"My mother is a very caring person (and) I think that's where I got my desire to help and support others," Lee said in a bout of self-reflection. "Nursing seemed like a good opportunity to fulfill that desire."
Determined, Lee got accepted into the University of Pittsburgh's School of Nursing. He also joined his university's Reserve Officers' Training Corps program -- the Three Rivers Battalion -- to support himself through college and to fulfill his goal to serve.
In 2018, Lee graduated as a registered nurse and commissioned as a second lieutenant with the Maryland National Guard. Never once did Lee fathom a global pandemic, he said. And with just a few years of experience under his belt, he was called to service, putting all his nursing and leadership skills to the test as part of a unified military response.
The Maryland National Guard activated in early March, a precursor to the state's ongoing effort to fight back against the virus. Close to 2,000 members moved to active duty in Maryland alone. In total, more than 45,000 National Guard troops are part of the national response.
There were a lot of unknowns going into the first week, said Lee, a platoon leader with the 104th Medical Company Area Support. With less than 200 cases reported in the state at that time, officials feared that the spread of the virus would get exponentially worse.
Anticipating the need for more coronavirus screening or testing sites, 104th MCAS personnel "wanted to be ready to respond to anything that came down the pipeline," Lee explained.
The unit quickly worked to assemble and prepare their medical equipment, supplies, and vehicles.
"We were looking into our personal protective equipment. Things like gloves, masks, sanitizer," Lee said. "We also looked at all our (vital signs equipment) … down to the number of probe covers. Under normal operations, those smaller details aren't things you typically think about."
Weeks passed and the Maryland Guard remained flexible as the COVID-19 environment continued to evolve, Lee said. Early on, the 104th MCAS provided medical and logistical support to a newly-established medical screening facility, just outside FedEx Field in Prince George's County.
Confirmed virus cases in the county and surrounding areas are amongst the highest in the state.
"We are here to provide a service to our friends and families -- in communities that we both live and work in," said Maj. Candice Thompson, 104th MCAS commander. "As citizen Soldiers, we are a unique entity. We are trained Soldiers that are proficient in (our) tasks. We are also active citizens in our communities."
In addition to setting up screening capabilities, the 104th MCAS assisted the state’s health department's effort to safeguard residents at long-term care and nursing home facilities around Maryland, Thompson said.
Shortly after commissioning, Lee moved into his new job as a platoon leader -- a unique position for a registered nurse to hold, he said. In his civilian job, he provided rehabilitative care to patients in a skilled nursing facility before transitioning to his current position at Children's National Hospital in Washington, D.C.
"In a medical company, a platoon leader is often a medical services officer," he explained. "Normally, a medical provider would be attached to a treatment platoon.
"I have a chance to lead and learn by stepping up and taking this opportunity," he added. "You do what is necessary to meet the needs of the Army."
Lee's responsibilities shifted to a command-support function once the Maryland Guard moved into an active-duty status, he said. Working closely with a small team of noncommissioned officers, Lee helps manage the company's personnel, reporting, and administrative tasks.
"With all those missions, there are a lot of small details that we need to keep track of and complete before, during, and after our soldiers are on the ground”, Lee said. "We are staying on top of all the requirements vertically from higher command and horizontally amongst our own company."
As a platoon leader, Lee was quick to recognize the contrast between his nursing career and his current position, he said. In comparison, the structure and culture of the nursing profession require people to be much more "hands on" during patient care. In contrast, effective leadership requires leaders to delegate, empower, and then step back and allow others to execute.
Overall, Lee has relished the opportunity to grow, he said. He was quick to recognize the value of the NCO force, which provides a range of subject-matter experts and leaders in their own right.
Lee has proven himself to be a diplomatic leader, his commander said, adding he often takes into account all factors and impacts before offering input or courses of action.
"Lee has stepped up to the plate to embrace the challenges of the mission. He is eager to lead and enthusiastic in his approach to learning and adjusting to the request for time and attention as the scenario continues to unfold," she said.
Nursing home support
When a tasking came down asking the 104th MCAS to help support long term care facilities across the state, Lee was selected to be the team leader as the only medical provider in the company at the time. His previous training and experience in a skilled nursing facility have been critical to the Guard's response, Thompson said.
"Lee has been an invaluable resource in operations supporting the fight against COVID-19. He has assisted in everything from equipment inventories and checks to being the lead (officer in charge) of the nursing home support mission," she added.
The Associated Press reported more than 11,000 nursing home deaths from COVID-19-related complications as of April 26. Maryland state officials have also expressed concern over the rising number of confirmed cases in nursing homes and assisted living facilities. As of April 30, the state had more than 3,000 confirmed cases and just over 500 virus-related deaths.
During each mission, a small multi-disciplined medical team completes a telephonic screening before their arrival to a facility, Lee said. While on-site, the group partners with a disaster medical assistance team and Maryland emergency medical services representative and meet with the facility’s administrative team.
“The overall goal of these visits is to support these facilities in their unique battles with COVID 19,” Lee said. “We review crucial topics like infection control, personal protective gear, cohorting methods, and supply shortages in order to identify any concerns the facility might have, and provide the appropriate recommendations and resources to meet those needs.”
After their visit, information about the facility's condition, capabilities, and needs is collected and sent to state health department officials for review, Lee said. Follow-up responses like test kit delivery, N95 mask fit testing, or even medical support are provided if deemed necessary.
"They are grateful for our support, and we are grateful for their tireless efforts," he said. "Having once worked in a skilled nursing facility, I’m familiar with way things run which helps me connect and communicate with these facilities. We do our best to guide them or help them tackle a specific problem. It has been great to get out there and support these healthcare heroes."
Lee is determined to complete the mission, he said. And when it is all over, he hopes to visit his family in Philadelphia, without fear of exposing his father and mother, who are older in age and more vulnerable in health, to the virus.
"I look forward to the day when this all dies down. I want to go back and spend time with my parents, hang out with my brother and my sister-in-law, and play with my 10-month-old nephew," he said. "I want to see my friends back down in Virginia, D.C., and Maryland, grab some good food, and enjoy the outdoors."
The desire to see friends and family is a shared feeling, Lee said. He often commiserates with his friends in the medical community who are also fighting against COVID 19 in various hospitals. Lee also expresses his concern for his larger military family.
"There are a lot of Soldiers and leaders out there, hard at work … supporting this higher cause of serving and protecting our country. I want to say thank you, and I appreciate everything you are doing," he emphasized.
Knowing that this is a team effort matters, “everyone has their role to play no matter no big or small it might seem,” he said. "I will continue to have hope and push on. I am hopeful that we will all see a brighter day."