By Ron Mott, Correspondent, NBC News

MOORE, Okla. – Like many of her classmates here, Saturday’s high school graduation was an emotional ceremony for 18-year-old Alyson Costilla, a moment of pride long anticipated.

But unlike most of her peers, she accepted her diploma one day after a final farewell to her mom, Terri Long, one of 24 people killed in Monday’s devastating tornado.

“She talked about how exciting, like how excited she was to see me walk across the stage,” Costilla said, choking back tears. “How excited she was going to be for me to move to college.”

Costilla’s mother was aware ominous weather was headed toward town and authorized the school to allow her daughter to leave early for home.

While waiting there for her mom to arrive -- who, too, had left early from her job at the Federal Aviation Administration to check on Costilla -- the phone rang.

“She called and told me I needed to get out of the house and drive as far south as I could. So, I did,” Costilla said.

Fleeing for safety as the massive tornado churned and roared ever closer, Costilla repeatedly tried reaching her mother.

“She wasn’t answering,” she said. “Eventually got through to her and she told me she was on I-44 and driving toward the house, which I didn’t understand.”

After a few harried minutes, both mom and daughter behind the wheel, they connected again by cell phone.

“She stopped at the 7-Eleven, and we don't know why because it's not on her way home,” Costilla said. “She said she was in the 7-Eleven in a bathroom with a whole bunch of people, and she said she was going to wait it out.”

Terri Long never made it out of the convenience store alive.

For her worried family, it would take an agonizing delay to learn her fate.

“After it happened, my sis called me and told me that 7-Eleven had been hit,” Costilla said. “We were calling all the hospitals and none of them had her.

“You think it would never happen to you, like, mom's strong. She's going to get through it. It’s not going to happen to her.”

Later, Costilla’s uncle identified her mom’s body at the morgue.

When her name was called at the graduation ceremony Saturday—one of three for Moore’s high schools—Costilla’s biggest supporter was missing. In the audience, though, as friends and family cheered her accomplishment, there were large photographs of Terri Long clutched in their hands.

“It's just really hard because I wanted her there, and you can't physically hug her,” Costilla said.

Ever since the unimaginable happened Monday afternoon, however, Costilla’s heart has been engaged in an unbreakable emotional embrace.

Tucked among the cornfields, windmills and water towers of Littlefield, in west Texas, Dr. Isabel Molina treats one patient after the next at Lamb Healthcare Center.

Littlefield is a small, dusty town of about 6,500 people, but Molina's two-doctor practice draws from a much larger area. She and her partner serve a total population of about 15,000, she estimates. To keep up with her patient load, Molina regularly works 13-hour days without stopping to eat.

"I usually eat breakfast over charts. I usually eat lunch over charts while I call patients back and take care of my dictations," says Molina, 38. "I do love what I do, but it is getting a lot harder to do this."

Molina is just one of thousands of primary care doctors nationwide working in an area designated as having too few health professions to meet the needs of the population.

The Association of American Medical Colleges (AAMC) estimates that there is a shortage of up to 20,000 physicians and that the deficit will grow to 100,000 physicians in the next decade. An aging population - and an aging population of physicians themselves - will make matters worse as health needs become more severe and as doctors retire without enough new ones to replace them. And, millions more Americans will rely on our existing physicians when the Affordable Care Act fully kicks in next year.

"We are very concerned that we're going to hand insurance cards to 30 million people and we won't have the doctors to treat them," says Dr. Atul Grover, the chief public policy officer at the AAMC.

West Texas is one pocket of the country where entire counties lack even a single health care provider. The dire need inspired an innovative program at Texas Tech University Health Sciences Center in Lubbock, Texas.

"We felt at Texas Tech that it was very important to help solve the primary care crisis as best we could and one of the ways of doing that was to try to make sure we get enough students into primary care and into family medicine," says Dr. Steven Berk, the dean of the School of Medicine at Texas Tech University Health Sciences Center.

From that concern, the Family Medicine Accelerated Track (FMAT) was born at Texas Tech. The program teaches the competencies of four years of medical school in only three years and offers a scholarship to all students in their first year.

Keeley Ewing-Bramblett is a third-year medical student at Texas Tech who grew up in the rural, one-physician town of Post, Texas, and saw firsthand how overloaded the town's only doctor was.

"I really just want to go back to a place where I know I'm going to be making an impact and where I'm going to get to see kind of the fruits of that impact," says Ewing-Bramblett, 24. She signed up for the FMAT program the day she heard about it, and hasn't looked back.

"When they offered an accelerated track where I could get out and be doing what I love essentially a year sooner and also for half the amount of debt that would have otherwise been incurred, for me it was kind of a no-brainer,” recalls Ewing-Bramblett.

To curb the physician shortage, medical schools across the country have boosted their enrollment by 16.6 percent since 2000. Five-thousand more students are expected to graduate per year by 2019, according to the AAMC. 

But just graduating more students won't reverse the physician shortage.

There has been a bottleneck to getting more young doctors into residency programs: the stage in medical training that follows graduation from medical school and takes place under the supervision of licensed physicians. The number of federally funded residencies has been frozen since 1997 when Congress passed the Balanced Budget Act.

"A lot of the benefit of increasing those class sizes and building those new medical schools - a lot of those benefits won't be realized unless there's additional residency positions," admits Berk.

Of almost 22,000 U.S. medical school graduates who wanted to be "matched" to a residency position this year, 1,600 applicants did not find one, according to the National Resident Matching Program that places residents.

That's one more reason why lawmakers are stepping in. Congressman Aaron Schock (R-IL) and Congresswoman Allyson Schwartz (D-PA) introduced the "Training Tomorrow's Doctors Today Act" in March that would create 15,000 new Graduate Medical Education slots over the next five years.

In an interview, Schock stressed that, "We know that a crisis is coming where there are more and more Americans who need doctors that are going to go without if we don't get them trained and in the field."

Even if the bill passes - no easy task in an era of squeezed budgets - there is no guarantee that new doctors will practice in the areas where they are needed most.

"Physicians cluster in urban centers where they can work with each other efficiently and leave the rural areas and some other areas underserved in the process," explained Dr. Richard "Buz" Cooper, director of the New York Institute of Technology's Center for the Future of the Healthcare Workforce.

Back in Littlefield, Molina bounds from one appointment to the next. "When you're this short-staffed, it becomes something that is at the cost of everything else. Missing things with my kid, missing things with my family," she admits.

As she leaves one exam room, files the necessary stack of papers and steps into another room to asses a patient, , she smiles all the while. "Once I actually have help, I think then I'll be able to relax and see what a real life feels like again."

Dr. Michael Johns, a professor in the Schools of Medicine and Public Health at Emory University, says it will take wider reform to get doctors the help they need. "Just having more doctors is not going to fix this." he says. "For one, we need a team-based approach that will get nurses, and other members of the healthcare team more involved with more responsibility."

And, while the Family Medicine Accelerated Track will graduate more family care doctors, it does nothing to increase the number of specialty physicians nationwide.

"What everyone is missing is that a little over half of the shortage is in specialty medicine," argues Johns. "The battle shouldn't be about having a 30-to-70 ratio of specialists to primary care doctors, it should be about how we have a shortage of both."

The slow pace of reform is frustrating for medical students like Ewing-Bramblett who chose  primary care medicine because her mother suffers from chronic illness and a primary care physician made an outstanding difference in her care.

"It hurts me on a few levels," said Ewing-Bramblett. "There's just no way that you can establish the type of relationship with your patients that's going to really foster their care like I experienced with my mom. There's no way you can do that in the 10 minutes that you have to see each patient."

For now, all she can think to do is hold on to her determined spirit. She knows what to expect: the long hours, waiting rooms packed with patients, even personal sacrifices.

"There's really no question about where I want to go," she says. "I'm going to be making a difference in at least one small community."

EPHRATAH, N.Y. -- A small airplane operating as a volunteer Angel Flight crashed into a pond in upstate New York on Friday evening, killing at least two people, authorities said.

Fulton County Sheriff Thomas Lorey said the flight's two passengers were found dead and investigators are searching for the pilot, who is missing. Officials did not immediately identify the passengers or pilot.

The Piper PA 34 airplane originated in Massachusetts and crashed about a half-mile west of Caroga, N.Y., just after 5 p.m. Friday, Federal Aviation Administration spokeswoman Kathleen Bergen said.

Lorey said the twin-engine plane crashed in a wooded area in Ephratah, about an hour west of Albany.

"The bulk of the plane is in the water, in a pond, completely submerged and we have to wait until daylight to put divers in," the sheriff said.

Larry Camerlin, president and founder of Angel Flight Northeast, a nonprofit group that arranges free air transportation for sick patients from volunteer pilots, said the organization was "tremendously saddened" by the tragic news of the crash.

"We all offer our thoughts and prayers to the families of those affected," Camerlin said in a statement. "Our volunteer pilots are the most compassionate and generous individuals who donate their time, aircraft and fuel to transport patients and loved ones for free to essential medical care that would otherwise not be readily available to them. There are no words that can adequately express our sorrow."

An employee at an ice cream shop in nearby Johnstown who refused to give her name said she heard what sounded like engine failure and then a loud explosion, "like a gun shot."

She said she went outside and "there were pieces of airplane coming out of the sky."

The FAA and the National Transportation Safety Board will investigate the crash, including what the weather conditions were like at the time of the accident.

At the time of the crash, in Rome, N.Y., visibility was 10 miles, there was slight rain and winds of about 13 to 14 mph, according to National Weather Service meteorologist Brian Montgomery.

The flight departed from Hanscom Field in Bedford, Mass., and was headed to Rome, N.Y., before crashing about 57 miles to the east, near Caroga, according to Bergen.

Camerlin's statement said that since Angel Flight NE was founded in 1996, the group has set up free air transportation and medical care for more than 65,000 children and adults on about 60,000 flights covering a total of more than 12 million miles. 

-- The Associated Press

By Becky Bratu, Kate Snow, Tim Uehlinger and Jay Kernis, NBC News

As she tours the husk of Plaza Towers Elementary School in Moore, Okla. -- the little that was left behind after a powerful tornado shredded everything in its 17-mile path -- Principal Amy Simpson thinks back to Monday morning, when her biggest task was helping the sixth-graders get ready for their graduation ceremony.

Pre-K teacher Linda Patterson and aide Kaye Johnson were working on report cards, while kindergarten teacher Erin Baxter was having her 6-year-old students write about the weather.

Four miles to the east, Susie Price began the last week of her 41-year career in public education preparing her retirement speech, getting ready for graduation -- and watching the sky for any possible threats.

“That’s what we do in Oklahoma on those days,” Pierce, the Moore Public Schools superintendent, told Rock Center’s Kate Snow.

Hours later, a Category EF5 tornado would touch down killing 24 people, injuring more than 370 and destroying as many as 13,000 houses.

Sixteen minutes. That was how long Pierce had to prepare between the time she heard that a tornado had hit the ground and the time Moore was in the middle of it.

“It's not a lot of time,” she said. “But because I know these people and I know everybody that works in our district. … we've been through this before.  I know that they know what to do.”

“This is part of our reality,” Pierce added.

Simpson was on alert after receiving an email from the district office about an incoming storm. Not long after, she heard the thunder.

The storm began getting heavier with hail that pummeled the school’s skylights. Then sirens started going off.

It’s not uncommon to hear sirens in Oklahoma, but she knew she couldn’t take any chances.

“Get into your places,” Simpson said over the school’s loudspeaker system.  

“They know exactly what that means,” she said. “It means hallways, bathrooms, the safest places in the building."

The kids got on their knees.  They put their heads right up against the hallway brick wall and covered the backs of their necks with their hands and their heads with their backpacks. To keep calm, teachers led them through the ABC song and “Twinkle, Twinkle, Little Star.”

Baxter, the kindergarten teacher, could hear the storm coming.

“It’d get louder. And you'd think it would be about to hit. And then it'd just get louder and just louder,” she recalled.

By that point, teachers were using their bodies to protect the children. Right before impact, Simpson got on the loudspeaker one last time.

“It’s here,” she remembers saying, before quickly ducking into a bathroom as the tornado smashed into the building.

“At first, it's just a rattling, like someone walking on the roof.  And then you feel things fall into your hair.  Just little things, you know?  Nothing more than if somebody was up there fixing the air conditioning unit,” she said. “And it's -- but then all of a sudden-- bigger things.  Could hear the air duct crash down and a pipe. … And that's when I started to yell.”

"In God's name, go away. Go away,” Simpson remembers yelling.

As she climbed out of the debris, Simpson noticed most of the walls around her were gone.

In a different part of the building, Patterson, the pre-K teacher, was pinned under a wall, some 2-by-4s and a car the tornado had spun up and dropped on top of the collapsed wall.

“I'm hearing the child under me saying, ‘I'm not breathing. I can't breathe,’ because I had weight on her, you know?” Patterson recalled. 

“That's where I needed to be. I needed to be between that debris and those children,” she added.

Rescuers poured into the school, pulling kids and teachers from the debris, but Simpson noticed none of the third-graders had come out.

Third-grade teacher Jennifer Doan, who was just finishing her second year in the classroom, had just found out she was pregnant. Now Doan was shielding two boys with her body, trying to hold up a collapsed wall, Superintendent Pierce said.

“The little boy said, ‘Can't breathe. I don't want to die.’ And as [Simpson] said, they pulled Miss Doan out and that little boy,” Pierce said. The second little boy was buried by debris and didn’t make it.

Simpson said Doan could hear other children crying. “And she was hearing crying, and crying, and crying.  And then after the tornado, the crying stopped.  And it's -- what she said was, ‘The crying was horrible, but when it stopped, it was worse.’”

Of the seven children who died at Plaza Towers Elementary, six were in Doan’s class. The teacher suffered multiple injuries, but her unborn child is fine. Her friends say she’s been told about the children’s deaths and is overcome with grief.

“God makes our choices for us long before, and he had a plan long before,” Simpson said. “And those little ones, there was no control over it. There wasn't a safer place. There wasn't a better place. There wasn't anything different that Miss Doan could do.”

This weekend, bulldozers will roll in to clear away what remains of Plaza Towers Elementary  –  but Simpson said the only way to move on and process the loss is to rebuild.

“We have a million and one things to do,” she said. “So staying busy is a big part of that.” 

Editor’s Note: If you would like to help the Moore Public Schools, click here ( www.Fundly.com/moorepublicschools ) or write to this address:

Moore Public Schools Tornado Relief Fund
1500 SE 4th
Moore, OK 73160

NBC News' Sylvie Haller, Sabrina Esposito, Jessica Kerry and Michelle Kessel contributed to this report.

Mark Farmer / AP file

Workers lower a ground-based missile interceptor into its silo at Fort Greely near Delta Junction, Alaska, on July 22, 2004.

An Army battalion commander at the Space and Missile Defense Command at Fort Greely, Alaska, is under investigation for allegedly "condoning" adultery and creating an "open season" climate when it comes to sexual activity among the troops, military and defense officials tell NBC News.

As of now, there appear to be no allegations of sexual assault involved in the investigation. The sources report there are allegations that an officer or officers had sexual relations with female soldiers under their command.

Consensual relations with a subordinate would still be a violation of regulations.

The commanding general ordered the investigation upon learning of the allegations. 

Fort Greely is near Delta Junction in the Alaskan interior. It is a launch site for anti-ballistic-missile missiles, and because of the bitter winters there it is home to the Cold Regions Test Center.

The Department of Defense has been ramping up efforts to fight sexual assault within the ranks. Earlier this month, the department said that the number of cases increased sharply in the last year. The military has also been hit with a number of high-profile cases within units that investigate sexual abuse.

In Congress, there have been a number of proposals to address how the military investigates and prosecutes sexual assault cases.

On Friday, President Obama called on graduates of the Naval Academy to “live with integrity” and help restore trust in a military.

“Those who commit sexual assault are not only committing a crime, they threaten the trust and discipline that make our military strong,” he said at the graduation ceremony in Annapolis, Md.

On Saturday, Defense Secretary Chuck Hagel repeated the message to the graduating class at the U.S. Military Academy at West Point, N.Y., calling on cadets to build a “culture of respect and dignity” while calling sexual harassment and assault within the military a “profound betrayal” of “sacred oaths and trusts.” 

Jim Miklaszewski is NBC News' chief Pentagon correspondent. Courtney Kube is NBC News' Pentagon producer.

This story was originally published on Fri May 24, 2013 11:02 PM EDT

Laura Segall / Reuters file

Maricopa County (Ariz.) Sheriff Joe Arpaio announces a new school security plan on Jan. 9.

PHOENIX -- A federal judge ruled Friday that the office of America's self-proclaimed toughest sheriff systematically singled out Latinos in its trademark immigration patrols, marking the first finding by a court that the agency racially profiles people.

The 142-page decision by U.S. District Judge Murray Snow in Phoenix backs up allegations that Maricopa County Sheriff Joe Arpaio's critics have made for years that his officers rely on race in their immigration enforcement.

Snow, whose ruling came more than eight months after a seven-day non-jury trial on the subject, also ruled Arpaio's deputies unreasonably prolonged the detentions of people who were pulled over.

"For too long the sheriff has been victimizing the people he's meant to serve with his discriminatory policy," said Cecillia D. Wang, director of the ACLU Immigrants' Right Project. "Today we're seeing justice for everyone in the county."

Stanley Young, the lead lawyer who argued the case against Arpaio, said Snow set a hearing for June 14, where he will hear from the two sides on how to make sure the orders in the ruling are carried out.

A small group of Latinos alleged in their lawsuit that Arpaio's deputies pulled over some vehicles only to make immigration status checks. The group asked Snow to issue injunctions barring the sheriff's office from discriminatory policing and the judge ruled that more remedies could be ordered in the future.

The sheriff, who has repeatedly denied the allegations, won't face jail time or fines as a result of the ruling.

The sheriff said his deputies only stop people when they think a crime has been committed.

A spokesman for Arpaio deferred requests for all comment to the lead attorney in the case, Tim Casey, who declined comment until reading the judge's full decision.

Arapio, who turns 81 next month, was elected in November to his sixth consecutive term as sheriff in Arizona's most populous county.

Known for jailing inmates in tents and making prisoners wear pink underwear, Arpaio started doing immigration enforcement in 2006 Arizona voters grew frustrated with the state's role as the nation's busiest illegal entryway.