While throngs of people were fleeing Puerto Rico, heading the warnings of officials who foretold of pending storm destruction, Dr. Francisco "Paco" Trilla was boarding a plane headed for San Juan.

It was a day before Hurricane Maria would hit the U.S. territory, destroying much of the island's infrastructure and leaving many desperate for food, water and power.

Trilla, the chief medical officer for Neighborhood Health Plan of Rhode Island and a native of Puerto Rico, hadn't been able to convince his godmother to evacuate Carolina, a middle-class city not far from San Juan. Worried about her safety, he decided to go to her.

"I kind of went down thinking that if it was really bad I'd just get her on a plane and fly her out. But it's impossible for me to get off the island now," Trilla said. "What's worse than I expected is the isolation. I thought the airlines would hold it together much more than they have."

Trilla's relatives were relatively unscathed by the storm that's left him stuck on the island until at least Oct. 8 when his flight is now expected to leave.

He spoke with The Providence Journal this week via cellphone while standing in a field across from a cemetery. He called it "the sweet spot."

After a week without phone access he discovered the area had a signal when a telemarketing call made it through to him while he was in the area. He's kept his phone charged using a diesel-powered backup generator he's had access to while volunteering for FEMA.

When reality set in that he wouldn't be able to get back to the states quickly, Trilla decided to volunteer for relief efforts. Some of his days have been spent doing work he knows well — making house calls to check on residents' health. Of particular concern are patients who are on dialysis and haven't had access to the treatment for several days.

Other times, the help he's offered has differed greatly from his day job. He's also helped to clear roadways with a machete. As bad as the destruction is near San Juan, he said he can't imagine how the storm has ravaged more rural areas, particularly in the mountains.

He said he's heard terrible stories of people who have died of natural causes and been left wrapped in sheets because of the chaos.

On a recent afternoon, Trilla, a Providence resident, said he expected it would take him four hours to get money out of the nearest working ATM roughly 4 miles away. Lines for the cash machine as well as other necessities such as food and gas have been incredibly long, he said.

His hope, he said, is that more relief services are sent to the island. If stocks of gas and diesel are further depleted more chaos will follow, he fears.

"If more help doesn't come, things are going to get really ugly. It's a crisis," he said.

— jbogdan@providencejournal.com

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On Twitter: @JenniferBogdan