We drove through the National Guard checkpoint and turned left on Highway 90, towards my office and the hospital. On the corner we caught a glimpse of the K-mart parking lot, now known as "Camp Katrina." Survivors and volunteers alike had congregated here and proceeded to take over the lot, which was now populated with RVs, campers, and tents.
The tire store in front of the K-mart looked like it had collapsed in on itself; the glass was smashed and the metal garage doors were caved in. Along the road, store signs were either down or the plastic blown out, leaving gaping rectangles. Some stores had their roofs torn off or fallen inwards.
We continued down Highway 90 and arrived at my office. The building looked largely intact from the outside, even though its neighbor had lost its metal roof. I peered in the waiting room and saw chairs and tables intact, on the ground, if not in the exact position where they had been 1 1/2 weeks ago.
I unlocked the front door and was hit by an overwhelming smell of mold. Wallpaper in the hallway was warped and buckling, and part of the hallway wall had actually given out, exposing the flooring store next door.
Picture my office as basically one long hallway. From the waiting room, the hallway went down the left side of the office. First room on the right was the reception and business office, followed by three exam rooms, and then my office, which was also the break room, which had a back door to the outside. The lab was across the hall from my office.
The reception/business office was trashed. Ceiling tiles had collapsed to the floor, covering a desk and bookcase with grey foam on the way down. The flood line was three feet off the floor, just above the desktop computers, laser printer, flatbed scanner, telephones, and all other electronic equipment. A horizontal file, which had been completely submerged, wouldn't even open anymore.

The exam rooms originally had white vinyl floors, but now they were just a thick brown-grey, covered with muck. The exam tables had also been submerged, and water still remained in the drawers. I couldn't even enter the third exam room; presumably a chair had floated between the exam table and the door, blocking the way.
In the lab, the refrigerator had tipped over on its side. Vaccine vials were strewn across the floor. But as I entered the back office, I realized the office had saved the worst for last.

The back bookcase, which previously held my medical textbooks, was now half-full, as its contents were strewn around the room and up the hall. My desk was tipped up at an angle, with a book somehow wedged under one corner. Whatever had originally been on, and on top of, my desk, was now also on the damp floor. The break room refrigerator had floated out of its corner into the middle of the room. The office server, placed up on the nurse's desk, was neatly covered with water, muck, and even dried leaves and grass.
I tried to open the back door to let in fresh air, but it wouldn't budge. On further inspection, I saw the back door had been wedged out of its frame. I wondered if a looter had tried to break in to the office. I then took a closer look at the door between the back office and the hallway. The door, including frame, had been torn out of the wall and was lying at the end of the hall. No looter did this. I realized the storm surge must have built up outside the back door, until it was breached; then the flood waters came in with such force, like a burst dam, that it swept books off the shelf and pushed the inner door completely aside, before tossing about the refrigerators and furniture.
I set to gathering a few basics, knowing that we had limited space in the car and had yet to visit the house. Salvaged from this first trip: office spirometer (purchased two weeks before Katrina, never used on a patient), cash box contents, damp office files (receipts, contracts, personnel papers), hard drives from desktop computers, and the office computer server. The latter weighed eighty pounds and drained water when we lifted it, but I hoped against better judgement that something might be salvageable--perhaps, if nothing else, the hard drives? Besides, if the drives were even remotely intact, they might have recoverable patient medical data, and I couldn't risk that information falling into the wrong hands.
We got back in the car to drive next door, to the hospital.
What used to be a hospital now looked like a military base. Army green tents covered the front lawn, and a black metal fence surrounded the entire military-hospital complex. On the road, a wooden sign painted green had a red cross letting people know that this was where they could get medical care. National Guardsmen milled about or walked to and fro. We drove up near the ER entrance, where we faced another guard post and more soldiers with M-16s. After producing my hospital badge, we were waved through and pulled up to the ER itself.
The waiting room had become a warehouse, where both donated and pre-existing supplies were being organized into neat stacks and piles. Here was the sterile gauze, there were boxes of gloves, that's the place for diapers and baby food. Extension cords snaked through the ER and the hallways, running from generators to construction floodlights. I found the hospital administrator in his new "office," a dark nook of the ER that used to be the staff lounge and library. He was talking to the head of maintenance on a two-way radio, hopeful that Mississippi Power might be able to restore electricity to the hospital this afternoon.
As it turns out, the hospital had not closed, but instead remained open during the storm. By the time they tried to evacuate some of the sicker adults, the storm was upon them and ambulance transports were no longer running. The wind ripped open a ventilation duct during Sunday night, but otherwise the building did fairly well until Monday morning, when the storm surge arrived. The first floor hallway became a stream. Then the generators flooded. As the water level continued to rise, the staff started evacuating patients up to the second floor, in the dark, in the heat and humidity.
After the storm, the worst was yet to come. Within a few hours, a steady stream of survivors began making their way to the ER. A nurse described it as a scene straight from "Dawn of the Dead," with an advancing horde of staggering, dazed people. Many had physical injuries: cuts, bruises, scrapes; others were trying to find food and water, though the hospital barely had enough for its own personnel. Some just wanted to be checked out after their ordeal. The makeshift ER ended up seeing
800 people in the first 4 days, before the federal Disaster Medical Assistance Teams finally arrived. Only then did the hospital close its doors and the brave, battered staff go off shift.
Needless to say, the hospital was in no shape to reopen anytime soon; the CEO thought it would take at least a month before even the basics could be provided. I asked about office space, since mine was completely unusable, as was just about every other building in town, and it might be two months or more before electricity and running water was restored. He said that FEMA might be providing the hospital some portable trailers in the next few weeks, perhaps by the start of October, and that the hospital would allow interested doctors to use the temporary space. I also learned that FEMA does not provide trailers directly to doctors; apparently, we are considered the same as any other small business, and our services are not essential to the community, no more than the local burger shop or clothing boutique.
Now we had some timeframe and direction: a hospital-provided trailer, in early October. This would be my new office.
Before I left the hospital, passing stacks of donated medicines arrayed in the ER, I realized I probably had some intact samples back in my office. The administrator said, "yeah, I don't think we went in your building." What did that mean? In the first few days after Katrina, the police and National Guard broke into some offices to commandeer medicines and create a small stockpile at the hospital. It was decided that the meds could better be kept safe, and distributed as needed, under appropriate supervision, at one central facility--which now happened to be also under armed guard. I should note that some offices stored not only antibiotics or cholesterol meds, but also controlled substances: painkillers, Valium, and similar.
We offered to add my meager pediatric samples to the pharmacy, since I wouldn't be distributing them anytime soon. We ended up collecting five boxes worth of medicines, all above the flood line, untouched and usable.
Outside the ER a truck from the Florida Department of Health was unloading bags of ice.
We walked back towards my office, about three blocks away. Just outside of the hospital grounds I saw a multicolored foot-long shard of hard plastic that looked vaguely familiar. It was a fragment of my office sign that had originally been by the road, perhaps 1/4 mile away. It was the only piece of the 4 x 6 foot sign I would ever find.