Tuesday, January 23, 2007

Katrina Story, Chapter 4: A Failure to Communicate

The very first news out of Bay St. Louis came Tuesday night, when the ticker at the bottom of the screen on CNN announced that Hancock Medical Center was asking all available personnel to report in.

Wednesday morning I tried calling the hospital, but phone lines were out of service, as they would be for the few weeks or more. The Mississippi Emergency Management Agency had no information, nor did the Mississippi Department of Health. I managed to eventually reach a regional commander for FEMA, who said he had heard the announcement. He gave me the main number to the hospital.

I told him that number was of no help. Perhaps he had a satellite phone number, or he could coordinate a special patch-through. No, he said, and his own satellite phone was given to someone else earlier today; he also had no communication to the coast.

In retrospect, this was probably the first sign of things to come. And so, for the time being, Hancock Medical Center would have to survive without me.

Other than the CNN news ticker, there was no news whatsoever from town, which was more than a little disconcerting. Where were the news crews? Was the devastation so profound that no one could make it through? But what about helicopter footage? Or was it that no one cared about lil' ol' Hancock County, when Gulfport/Biloxi was a more recognizable name, not to mention the emerging crisis in New Orleans around the levees and the Superdome? A most grisly thought occurred: perhaps there were bodies strewn everywhere and the footage would be too shocking.

Finally, on Wednesday night, Anderson Cooper was on the beach in Bay St. Louis. For the first time, we had a glimpse into the destruction. Survivors talked about a monstrous storm surge and hanging on to tree limbs to survive as their homes and storefronts washed away. Every modern convenience was gone--electricity, phones, water, sewer. The camera crew showed stragglers gathering at the remains of the Bay St. Louis bridge, where some had found a strange little zone of cell phone coverage. We wanted to both cry and cheer when Cooper, in his now famous broadcasts, asked Michael Brown and the country where FEMA was. Why were our citizens going without basic food and water? If Cooper could get a CNN satellite truck down onto the beach in Hancock County, why couldn't any government agency do the same? For that matter, if Cooper had a satellite hookup to the outside world, why were FEMA, MEMA, and the MS DoH seemingly unable to duplicate the feat?

We called the Red Cross to see if they had any word about the family that had stayed in our house. Again, no news, but they would try to alert the search and rescue teams. We searched online bulletin boards, but the postings were too numerous and unorganized. We tried not to dwell on nightmarish visions of the entire family of six drowning in our home.

My office nurse, who was in Bay St. Louis for the storm, has commented that in some ways, it was easier to be a survivor in town than an evacuee on the outside. She knew that she was alright, whereas her family had no idea what had happened; all they could do was wait, and worry.

Eventually, later in the week, we received the first precious gems of communication from friends. Our office billing manager was safe in Louisiana with her two kids, having evacuated beforehand. Her boyfriend was my friend the Waveland cop. Despite rumors that the entire police force had perished, she found out he (and the others) had indeed survived, and she was going to drive to Oklahoma to meet him at his father's place at the end of the week. Apparently the Waveland police department building flooded to the second floor, and the officers climbed out a window and survived only by holding on to a scraggly tree. (*) She also mentioned that her sister had stopped by my office and reported, miraculously, that the waiting room looked largely untouched. Meanwhile, our office nurse--who had also left for Louisiana--had returned to Gulfport but now couldn't get out, since there was no gasoline. Her apartment off the beach was entirely, completely gone.

As anxious as we had been to flee the coast to the safety of family, we were now agitating to return to assess the situation first-hand. As a doctor, I also wanted to go back to help my patients and lend my skills. I called the Red Cross to see if a local team might be going down soon, but the training session was still a week away. I thought about just finding my way down to the coast, but I started to worry about being stopped by the National Guard because I didn't have the right clearance. When I contacted the Mississippi Department of Health, they informed me they would soon be collecting names and credentials of doctors wanting to help, but this was more for out-of-state volunteers; as a local, they didn't know what to make of my situation, and could offer no advice. Clearly this was not a situation they had ever prepared for, they were making it up as they went, and it showed.

The more I though about how to get down to the coast, the more my wife became concerned. In a pivotal conversation, she said: you are not just a doctor. You are a father and husband. Right now, we need you more than the hospital does. We may have lost our home and belongings, but we are not going to risk losing each other.

And so, by the end of the week, a plan had emerged: we would find a "staging ground" closer to the coast, from which we could drive in and out (possibly even commute, if close enough) yet still be safe and surrounded by basic amenities.

(*) This incident is detailed in Douglas Brinkley's masterful book, The Great Deluge. I wouldn't be surprised if it makes it onto film or TV someday. Or you can read more here.


brockton said...

I'm just shaking my head here. Forget having an advance plan for a natural disaster on this scale (obvious as it should have been given the locality) - it seems like there was a lack of even one intelligent person on the other end of the phone lines.

They wanted you to wait a week to get TRAINING to come back? What, were they going to train you to recognize hypothermia?

Dr. Mary Johnson said...

The "Great Deluge" is an incredible book.

Like many doctors I suppose, when the hurricane hit, I had an immediate desire to go down there - to do something to help. I was coming off a vacation break and still had some time to work with. But I was no longer licensed in LA, and realistically where would I go or practice or stay? I'd be just another mouth to feed. If I wrote prescriptions how would they get filled? How would seriously ill or injured patients be handled? As a physician, you've got to to be credentialled or privileged in some fashion. Apart from the very basics, what could I really do?

I knew it was fairly hopeless, but I called around, sent some e-mails. But (as you say) the "official" federal programs required disaster training and long/indefinite arrangements. No one seemed very willing to work around a volunteer's schedule. Everybody thinks all doctors are "rich" and can just afford to drop everything. Not so in my case. It could not be done.

I personally think Katrina provides us the best example EVER that the licensing of physicians should come under federal control - each state could still have its own little fiefdom, but there would be universal standards of conduct and discipline . . . and it would be much easier for doctors to cross state lines. The government then could moblize FAST out-of-state medical help during national disasters.

Of course, one can argue that the Feds scewed everything about this response up. What makes anyone thing they wouldn't mess up a national physician licensing program as well?

Your wife was right.

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