|
Day Five
Ben Springgate (bspringgate{at}mednet.ucla.edu), an internist and pediatrician, is a Robert Wood Johnson Clinical Scholar at the University of California, Los Angeles. A native of New Orleans who attended Tulane University School of Medicine, he returned to Louisiana three days after Hurricane Katrina hit; he is still there, working on health projects in New Orleans. THOUSANDS OF EVACUEES—tired, hungry, dehydrated, and anxious—are crowded inside the New Orleans International Airport when I arrive by ambulance at Concourse D. This generator-cooled portion of the terminal, with roughly four hundred patients, is the medical area created by the disaster medical assistance teams (DMATs). It is divided into four color zones on the basis of the patients’ condition: Green for those whose needs aren’t urgent (mild dehydration, rashes); yellow for those who are more seriously ill (often recent arrivals from hospitals); red for those in critical condition who need intensive care; black for those who died en route to the airport. The sick are being flown in by helicopter from the rooftops and parking lots of hospitals (Charity, University, Methodist, and others). Since Katrina slammed the city, these patients have received twenty-four-hour care from health professionals who stayed through the storm, watching with them, day after day, from the darkened upper floors of the hospital buildings as their homes and communities were ravaged by the hurricane and destroyed by rising waters. Now those patients are being flown here; other patients are arriving in ambulances from nursing homes or walking in on their own. In these initial hours at the airport, I am assigned to the yellow zone. Our patients have undergone major operations, are recovering from heart attacks, or have tuberculosis or AIDS. Their soft-tissue infections are untreated, their mental health symptoms are escalating, and their dehydration and hyperglycemia are still unchecked. In recent days at the hospitals, food and water had begun to be rationed, and there had been limited access to medications and needed treatments. Two nurses, another physician, and I attempt to triage and comfort the yellow zone’s two hundred patients; a few are on gurneys, but most lie directly on the dirty, hard terminal floor. Everywhere we turn, desperate voices and beckoning hands call for attention. I attend to a woman with rapid, shallow breathing and end-stage renal disease who complains of worsening "shortness"; a woman with postoperative uterine hemorrhage; a demented, combative elderly man with no ID. The highly skilled DMAT units are outfitted to attend to mass casualty incidents, but not to address the needs of entire hospitals and communities isolated by a flood of epic proportions. There is only one blood pressure cuff available, and soon no functional glucometers, no diapers, no catheters, and no materials to clean patients who can’t get to a bathroom. We have no blood to transfuse and no access to lab tests. Even if we had supplies, few of our patients know their diagnoses and medications. Fewer still have their charts; only some are accompanied by family members who can identify them and provide medical histories. Our patients need to be evacuated immediately and directly to receiving hospitals. But even now, on day five, they continue to wait on the floor.
| ||||||||||||||||||||
