Wednesday, September 07, 2005

Tulane Hospital : A Katrina Story

From the LSU Alumni - Richmond - Online Newsletter
Date: Tue, 06 Sep 2005 07:36:55 -0400
Subject: Tulane Hospital Story - Compelling

This is my dad's story from his experience last week. Thought you might like to read it. Thanks for your concern & prayers. M.

I thought it might be easier to compose an email to all of you at once that tells some of the story of the past few days. First and foremost
I felt your prayers and heard your concerns that were registered with
Donna and others and they comforted me and kept me calm which was essential in this time.

In this crisis the images were moving so fast that I think it'll take awhile to put it together but here's an attempt to do so.

This storm as of noon Friday the 25th didn't seem like it would be much of an event, but by 5pm things began to look different. We met as a group on Saturday to begin our routine preparations for a hurricane, I went home to put things together there. I started to think what do I absolutely not want to lose in case the house would be swept away and the answer only revealed the photos of the family thru the years so that and few clothes was all I took.

The Storm: God's Natural World has an awesome power. From the small observation windows [in the Hospital] from our tallest floors, we observed awnings
being blown off, a blinding rain and a general sense if God's ever angry we're going to lose big. Our first inspections revealed little damage. A few broken windows and some roof damage but the building held up well. In fact, if you were in the inner core of the facility you only vaguely heard it.
We even walked around late in the afternoon since there was only limited flooding no worse than a heavy thunderstorm. Overconfident, we even stated we had
absorbed the best punch that nature could throw and we seemed intact.

At 1:30 am on Tuesday morning began the biggest crisis and challenge of my life and in the life of Tulane and no doubt New Orleans. I was awakened by my COO who told me the water in the boiler room was rising a foot an hour since midnight and if it continued at that rate at best we had only another two to three hours before we would lose all power since we already were on emergency power since early Monday morning. We had only 7 ventilator patients whose lives would be in jeopardy, and we had to move fast
to get them out. We had no boat and no helicopter pad. Houston we have a problem.
I called Acadian Ambulance (who I know well) but had no business connection to our hospital and asked their immediate help. We have a parking deck connected to the hospital that we had evaluated as sturdy enough to support helicopter flight, but it had four light poles in the
middle. I want to tell you what happened in the next four hours was nothing short of a miracle. Our maintenance group got the light poles down; Acadian agreed to pick our patients up, we made arrangements with our other HCA
hospitals to take them. Our staff and physicians got their
patients ready,and most importantly, the water rise began to slow to an inch/hr and a little after the sun came up copters were on the roof and patients began to be transported.

Early on Tuesday morning we met with our key managers who were at the hospital. We prayed for support and comfort and guidance for what we knew was going to be a difficult period. We talked about what we knew,
and what
we didn't know which was considerable because we had no contact from FEMA or the Mayor's office. We had no idea why the water was rising and from what limited facts we had, no one did. We had to assume that it would keep rising and we would lose power and then we would have no power at all. Thus, no light, no ac, suction, oxygen, elevators, phones ie. everything that is precious to good care. We had to get out so we hatched a plan and I tried to stay out of the way and let our physicians and nurses triage patients; others determined what vital supplies we needed replenishing; HCA was working frantically to coordinate a transportation effort to pick up patients and eventually, our staff. How many people? Good question. At least 1200 which included a total of 160 patients, employees and physicians and their families and 76 dogs and cats that I didn't know about at the time.

Tuesday: The looting began. We witnessed people, dozens of them, wading in front of the hospital with bag after bag of stuff from different stores in the vicinity. Bandits took over two hotels adjacent to us and forced out many of our employees families who had been housed there forcing them back to the hospital creating further complications. That night our people on the roof evacuating patients heard gunshots in the air but they continued their work. The lawlessness and insurrection certainly was a distraction but our Tulane Police were great, and they are very capable.

Late in the day we ran out of fuel so our generators shut down and the building began to get hot. The last of the ventilator patients had to go up six stories by way of pickup trucks since the elevators shut down and our ambulance was too tall to squeeze to the top. During the day, I had a conversation with a patient's father who told me that the parking deck pad would hold big helicopters. How did he know? Because he was a Blackhawk pilot. Ok. Then there appeared out of nowhere this guy, John Holland, who was sent in by HCA to be our Flight Coordinator - whatever that is. "The man" had arrived who would communicate with the birds in the air and boy is that important because our patients had begun to fly away.

Wednesday: If you would like to know if we slept. Here's a little experiment. Try heating the bedroom up to about 90-95 degrees. First, you're hot and then you sweat and get cold and then the cycle repeats. Daybreak and I tell you patients are being moved into a queue to move. I saw our staff, residents, and faculty move sick patients with a grace and dignity that was most impressive. This was our third day and the stress on our people began to show. Everyone was asking when, where, & how were we going to get out. The city sewer system was obviously backing up and spilling out and creating an acrid smell that over the next few days made it almost impossible to breath. With no water pressure you can't bathe. But here's a general observation: if everyone smells the same you really don't notice it, you just feel unclean. On this day, the La. Wildlife and Fisheries Department showed up to help us move some patients that we had inherited from the Superdome on Sunday night. Yes, over 60 extra medically
needy people with chronic conditions. So by boat we sent them and their loved ones away. I met a woman whose most valuable possession was her pillow and her radio that I personally promised her to protect. It's in my office now.

The Big Birds began to fly. Blackhawk's down. Instead of one or two patients they could move up to four with some additional staff. Beautiful sight but there was more to come. By the end of the day we had moved all but about twenty patients including two who weighed more than 400
lbs and one artificial heart assist-device patient, which was the challenge of the week since the device itself weighted more than 500 lbs. So imagine hauling this weight three to four floors down a dark stairwell at 90 plus degrees. It was a young man's job and it was done. Let me tell you that the coordination from the patient's room to the staging area to the helipad into the helicopter was a work of art composed by many painters. It truly was a thing of beauty and it touched everyone who was there.

By the end of day, HCA had constructed an extraction plan for the remaining staff. Helicopter to the airport, buses to pick up and take to Lafayette.
Sounds good but there were lots of needs and who knows what the government may decide to do.

Thursday: Line up and get ready. Have a little breakfast. We basically were living on Strawberry poptarts, honey oat bars and for dinner a little
protein, tuna fish. Fortunately, I like all of them but I'm sure I lost ten lbs. or so. Anyway, the line was formed and I personally counted. 700 hundred people. Our staff, physicians, their children and spouses, and just to top it off 76 dogs and cats. Holy God. How are we going to deal with that? So we relegated them immediately to second-class citizenship to another line and pray we don't have to put the pets to sleep if no one will haul them.

At first there were just a few small copters and we had some patients to move and it was slow. Moving through the line people were calm with a few exceptions but overall they managed their plight well. Then a situation developed. A frantic Medical Director of Critical Care showed up by boat from Charity. Major problem. Charity was in a meltdown. He had 21 critical care patients many being hand ventilated for two days and he couldn't get any help from the state. You may have heard this story reported by CNN. Their version and ours differs but raise your hand if you think the media gets it right all the time. Can you help me he asked? This was a tough question but it had only one answer. We would give them access to the small aircraft, which wasn't going to help us move our staff anyway.
So that process began much to the chagrin of our non-professional staff and family. They just didn't understand it. Our nurses and doctors did but it increased the crowd's intensity. Midday and it was moving slow.
It didn't look good. Then from 3 to 5 things happened.

A Chinook helicopter is big. Two rotors and it carries about 50-60 people. It moves with a slow deliberate confidence that is hard to describe. But one showed up. We had questioned about could it land so we asked "the man, John" and he said yes but nothing else could be on the pad when it did due to the turbulence. I want to tell you as it approached cheers broke out from below and people thought they had a chance. So for a few hours we made progress and then it stopped. No more big birds, big problem.

What happened? Don't know. I called my daughter Megan where Donna was staying and she seemed elated. "You're back". "What?" I asked. She tells me Gov. Blanco had just announced that Tulane had totally been evacuated.
According to my account she was about 400 people short in her analysis. But we now had a new problem. They think we're not here. Better let someone know. I called the La. Nat'l Guard. Guess who answered, Brad Smith, the patient's father I spoke of earlier. He had gotten a ride back with some of the Wildlife boys and was now flying sorties into New Orleans. He quickly got a hold of the Office Of Emergency Preparedness and let them know we still needed help. So maybe Friday we'd get out. People were remarkably calm when we told them they'd be there another day. The just sat down and began to prepare to go to bed.

We left the hospital and remained in the parking deck. One it was cooler, two, there would be less confusion in the morning and three it was safer since there was less territory for our Tulane Police to patrol. I know the media has played up the anarchy, and no doubt there was some concern, but I always thought we were safe.

So imagine trying to fall asleep on your concrete driveway without a pad or pillow. It's kind of tough. Then throw in an unexpected helicopter landing at 1 am. The wind is a little dicey. The bird dropped off 50% of the Marines in New Orleans. One guy who need to go to Charity so we had to take him over. Next event for the evening: at 4 am we were treated to a massive explosion at a warehouse on the river several miles away. I happened to be looking directly at it at the time. It must have reached a 1000 ft in the air. Then by the end of the evening we began actually to get cold. But it finally ended.

Friday: The end is pretty anti-climatic. At 8 o'clock unexpected Chinooks began showing up taking 60 people at a time. I wonder if our pilot friend in the Guard had anything to do we it but I haven't asked him yet.
So in a matter of 2 1/2 hrs. everyone was gone but our Police and the last remnants of management. So after attempts to arrange a coordination with Charity to use the helipad, we left for home sweet home.

Obviously, this is only phase one of a complicated recovery for New Orleans. Each of you no doubt is praying for this recovery. So many people have lost so much and it reaches far beyond New Orleans.

I talked to the Chairman of the Board of HCA yesterday upon returning and told him it was the worse and most difficult challenge I have ever been personally involved with but at the same time I don't think I've ever felt as great a sense of accomplishment from anything I've been
involved with.
Our staff performed like clockwork and it was a beautiful thing to observe.
Our success in this week is simply measured by the fact that we didn't lose a patient during this trying time.


P.S. This event is just below a nuclear catastrophe in its degree of magnitude, and it's clear we're not ready and if we don't do better the next time a really hard rain's a-gonna fall.

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