Editors’ note: When a disaster strikes—whether manmade or natural—we are wrenched from our normal existence into another realm entirely. The petty concerns of daily life fade from sight in the wake of destruction and death.
For the practitioner of medicine, this is a time of great challenge to demonstrate the highest ideals of medicine. The people of the Gulf Coast must now face a dawn where the life they knew is gone and must be built anew. In this issue we’re proud to include the memoirs of two New Orleans physicians who worked through this catastrophe.
For more information on how you can help with the recovery effort, visit www.hospitalmedicine.org.
Despite the best preparations and planning, many aspects of managing a physician practice change rapidly, and many new problems arise immediately following a disaster. Below, we present our experiences as a large hospitalist program in a tertiary-care referral center during the days before and the seven days after Hurricane Katrina, a category IV storm, devastated New Orleans.
View from Ochsner Clinic Foundation Hospital, 6 a.m. August 29 during Hurricane Katrina.
PREPARATION
Ochsner Clinic Foundation (OCF) is an integrated medical institution with more than 700 physicians and 24 clinics throughout Southeast Louisiana, including Northshore and Baton Rouge. For nearly 60 years, Ochsner has cared for residents in the greater New Orleans communities at the Ochsner Main Campus, which includes a multispecialty clinic, a 500-bed hospital, and residency training programs. The Main Campus is located by the Mississippi River at the parish line between Orleans Parish and Jefferson Parish—areas protected from flooding under the levee system.
The Hospitalist Program at the Ochsner Main Campus has 18 physicians and four nurse practitioners. Approximately 60% of our patients are managed by Internal Medicine Residency teaching services and the rest by staff physicians. Prior to the landing of Hurricane Katrina, we cared for 60% of the hospitalized patients. Our past hurricane experience led us to develop a two-team system for disasters. Team A has four hospitalists who are required to stay on campus;
Team B is available within a week later to relieve Team A.
We tracked Hurricane Katrina following its exit from the Florida area. The decision analysis for our essential medical team was based on the category of the hurricane, staff location, and projected path. On Saturday, August 27, we were informed that Hurricane Katrina was reaching category V status and expected to hit New Orleans early Monday morning. This unexpected arrival required us to mobilize the hurricane emergency preparedness team rapidly. Hence both teams A and B were requested to remain on premise—preferably without family and pets. On the facility side, we had four generators on site and started to request other generators from around the country on the news of changing course of the hurricane.
View from Ochsner Clinic Foundation, 8 a.m. August 29 during Hurricane Katrina.
SUNDAY, AUGUST 28:
The Day before Katrina Landed
New Orleans Mayor Ray Nagin ordered a mandatory evacuation of the city for the first time in history. At Ochsner, all essential personnel were expected to report to their stations by 7 p.m. The arrival of the hurricane gave little time to our staff to arrange alternative living arrangements for their significant others and pets. Consequently many non-medical dependents and pets arrived at the facility even though we didn’t have adequate supplies to be self-sufficient for more than a few days. Many expected our organization to have ample resources to accommodate all needs—food, shelter, and support. A hurricane disaster phone line was created to update the status of OCF following the hurricane.