Doctor on the ground in New Orleans: Part I
On Thursday, September 15, 2005, I received this email by way of a friend. It is written by Benjamin Littenberg, MD who, as you will see, was on the ground in New Orleans last week. It painted a remarkably vivid picture of what was going on there, and what continues to go on there during the rescue effort that I have asked permission to republish parts I and II of his report to his wife. The "K-Mart" hospital has made into other news reports. In Part II, you'll see why my reservations about donating to Red Cross were confirmed. (Thank you Liza!)
I arrived in Baton Rouge on Sunday, found the Dept of Health and Hospitals, was vaccinated for tetanus and Hep A and driven to an abandoned K-Mart where we set up a 250-bed field hospital. Although we had capcity for acute dialysis, ventilators, IVs, minor surgery and OB, most of the patients were not very acute. A few had acute Katrina-induced issues such as cellulitis, pneumonia, enteritis or rash. More commonly, they had chronic conditions that were badly exacerbated by the evacuation before the storm or the trauma of 3 to 6 days in New Orleans. Many had been hours or days in the water to their chests or exposed to very high temperatures in attics or roof tops. ? The more acutely ill were generally seen at local permanent hospitals.? We treated lots of blood pressure (220/125 was my personal high), diabetes, COPD, etc. We saw patients with renal and liver transplants,paraplegia, sleep apnea, stroke, HIV and plenty of acute stress reactions. Many had no meds, no idea of what they were usually taking, and no place to go.
Amazingly we discahrged literally hundreds of patients in 72 hours. As of tonight they had all been placed with shelters, nursing homes (several sent buses for 10 to 15 patients without inquiring about insurance), and relatives.
Today, as this wave of patients tapered off, we decomissioned the K-Mart Hospital and aseembled a team of me, an Internist from Telluride CO, a Tulane med student, 4 nurses from Mountain Home, AK, a nurse from South Haven IL, and a pharmacist from Baton Rouge. We were asked to go into Algiers (across the river from the French Quarter) by helicopter to relieve a crew that was exhausted. Later, we learned that there were no living patients left in Algiers. So, we have now been asked to prepare the team to go to Hauma, a town on the Bayou. We added a bus driver from Columbus OH and prepared enough food, water, medications and supplies to keep us going for 3 days. If this assignment sticks, we will leave tomorrow. If not, I suspect we will turn the bus into a travelling clinic to deliver care at the many improvised shelters in southern LA.
The volunteers have been brilliant, cooperative, energetic, caring and effective. The locals have opened their homes to us and fed us with gracious hospitality. The Red Cross is invisible. The state is confused and disorganized, but struggling mightily. The feds are arrogant, misleading and mostly obstructionist. The patients are needy, sad, grateful, inspiring and getting some of the best care I have ever seen in twenty years of doctoring.? It is a great pleasure to be here.
I arrived in Baton Rouge on Sunday, found the Dept of Health and Hospitals, was vaccinated for tetanus and Hep A and driven to an abandoned K-Mart where we set up a 250-bed field hospital. Although we had capcity for acute dialysis, ventilators, IVs, minor surgery and OB, most of the patients were not very acute. A few had acute Katrina-induced issues such as cellulitis, pneumonia, enteritis or rash. More commonly, they had chronic conditions that were badly exacerbated by the evacuation before the storm or the trauma of 3 to 6 days in New Orleans. Many had been hours or days in the water to their chests or exposed to very high temperatures in attics or roof tops. ? The more acutely ill were generally seen at local permanent hospitals.? We treated lots of blood pressure (220/125 was my personal high), diabetes, COPD, etc. We saw patients with renal and liver transplants,paraplegia, sleep apnea, stroke, HIV and plenty of acute stress reactions. Many had no meds, no idea of what they were usually taking, and no place to go.
Amazingly we discahrged literally hundreds of patients in 72 hours. As of tonight they had all been placed with shelters, nursing homes (several sent buses for 10 to 15 patients without inquiring about insurance), and relatives.
Today, as this wave of patients tapered off, we decomissioned the K-Mart Hospital and aseembled a team of me, an Internist from Telluride CO, a Tulane med student, 4 nurses from Mountain Home, AK, a nurse from South Haven IL, and a pharmacist from Baton Rouge. We were asked to go into Algiers (across the river from the French Quarter) by helicopter to relieve a crew that was exhausted. Later, we learned that there were no living patients left in Algiers. So, we have now been asked to prepare the team to go to Hauma, a town on the Bayou. We added a bus driver from Columbus OH and prepared enough food, water, medications and supplies to keep us going for 3 days. If this assignment sticks, we will leave tomorrow. If not, I suspect we will turn the bus into a travelling clinic to deliver care at the many improvised shelters in southern LA.
The volunteers have been brilliant, cooperative, energetic, caring and effective. The locals have opened their homes to us and fed us with gracious hospitality. The Red Cross is invisible. The state is confused and disorganized, but struggling mightily. The feds are arrogant, misleading and mostly obstructionist. The patients are needy, sad, grateful, inspiring and getting some of the best care I have ever seen in twenty years of doctoring.? It is a great pleasure to be here.
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