CAONILLAS, Utuado, P.R. — Dr. Lissette Gutierrez is normally not one to curse. But when the S.U.V. she was traveling in hit a rut and bounced wildly on a mud road carved into a mountainside — a steep decline inches to her right, the pounding rain all around — an expletive escaped her lips like some rare ugly moth.

It was Saturday afternoon, and Dr. Gutierrez was part of a small medical convoy trying to get to an isolated community called Don Alonso, in the mountainous center of Puerto Rico. There was word that no doctor had been to the place since Hurricane Maria had roared over the island Sept. 20, triggering mudslides throughout the largely rural municipality of Utuado, at least one of them deadly.

Dr. Gutierrez, 45, a gynecologist, is a Puerto Rican living on Long Island, and her decision to come here on her own is part of the narrative of resilience and selflessness defining life on Puerto Rico as the island struggles to navigate the devastation that Maria left. But on this day — through no fault of her own — Dr. Gutierrez would become part of a parallel narrative of failure that also defines Puerto Rico.

Failure here is not a possibility, but a fact. Failed roofs, failed water systems, a failed electrical grid. Failed hillsides, running chocolate brown with mud in the rain.