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REFLECTIONS

Katrina’s Lessons: Out of the Worst Come Some of the Best

East Jefferson General Hospital, Metairie, Louisiana, USA

Jayne Gurtler, M.D., FACP, East Jefferson General Hospital, 3939 Houma Boulevard Ste. 6, Metairie, LA 70006, USA. Telephone: 504-885-0577; Fax: 504-888-7441; e-mail: jgurtler{at}gs.net

NEW ORLEANS, LOUISIANA, SEVEN DAYS AFTER HURRICANE KATRINA

When raging, 140-mile-per-hour winds, rising water, electrical blackouts and plumbing failures all hit at once, you get back to the basics pretty fast. Without CT scans at the snap of your finger, suddenly you value your stethoscope. No medicines to match every complaint; no electricity for ventilators, much less radiation therapy; no elevators for those nine stories.... We felt the squeeze that makes what’s inside you come out—the best of people, the worst of people.

You have already heard about the worst of Katrina—the Superdome, the convention center, looting, rapes, killings, and suicides. I also saw the best.

HIGH SCHOOL TURNED FIELD HOSPITAL

When it was over, East Jefferson General Hospital was the only hospital open in the area. The doctors pulled together supplies and went to help people at the shelters.

"Ya been out yet?" Scooter, my National Guard driver, asked me. On the way to Bonnabel High School, he explained, "The conditions there are real bad, but morale is real good."

Two policemen, Sgt. Douglas Champagne and Officer Jones, and three National Guardsmen – PFC Williams, Staff Sgt. Roche and Marc Robertson – staffed Bonnabel High School, and they cared for as many as 900 people. Some were healthy; many were elderly – in wheelchairs and walkers – mixed in with several pregnant women ready to give birth, drug addicts in withdrawal, two cancer patients (one also in withdrawal), several paranoid schizophrenics, and the walking ill with bags of empty medicine bottles. Several had come literally without shirts on their backs. The evening before the hurricane, they had packed into a building in the school.

Hours into the storm, the plumbing stopped working, and toilets overflowed. Then as the winds picked up, part of the roof blew off. The building began swaying, making loud groaning sounds. Outside, the water rose gradually, at first blanketing the street, then the parking lot, then the door. The refugees were moved to another side of the building to escape the open roof and foul sewage. Some were carried in their wheelchairs. A schizophrenic man began running around without his pants, Sgt. Champagne giving chase. Finally, when the winds abated, the officers moved desks outside in the sheltered walkway so that people could escape the stench. For four days, radios and cell phones were dead, and there was no communication with the outside world.

Despite a week with no air conditioning and no running water, they all survived. They helped one another, they shared, and they even planned their futures. When it came time to move to a shelter with more amenities, many did not want to go. One pregnant woman called out to Sgt. Champagne, "If it’s a boy, he’ll be Douglas; if a girl, Dougalina!"

His eyes beamed in appreciation.

To me, these five leaders would have made great statesmen—or superb oncologists. They led this desperate, disparate, and dispirited group through the most treacherous event in most of their lives. How did they do it?

LESSONS FROM KATRINA

First, Officer Williams said they never gave false promises or lied to anyone. They did not tell them help was on the way until it was.

Second, they dealt fairly with and listened to the needs of their charges.

Third, because of their ingenuity and tireless efforts, they were respected. For instance, the shirtless were made honorary Bonnabel Band members with high school t-shirts.

Fourth, they established routines—clean-up patrols, meal times, and management of anxious pets.

Fifth, and most important, these guys were sincere about their responsibility. They were not in it for the headlines, the profit margin, or the power play. They were there to serve this community. Their charges sensed this and volunteered to help at every turn.

How else do you manage with walker and wheelchair patients in port-a-potties? How else could all of these people survive without medical science?

Katrina taught us many lessons, and one of them is that out of the worst come some of the best.

These five guys were some of The Best.

FOOTNOTES

In this issue of The Oncologist, we remember the events of 9/11 with a poem, "Modern Minutemen," by our colleague Dr. Joseph J. Fins. Today, we also face the impact of another disaster, this one natural and not man-made, in Dr. Jayne Gurtler’s reflections of what is was like to be an oncologist caring for patients in New Orleans during Hurricane Katrina and its horrible aftermath.

When 9/11 was a more recent memory, I reflected on the association of terrorism and cancer. The analogy remains poignant today. Global terrorism remains a threat, but cancer will be diagnosed in one of two American men and one of three American women. More than 570,000 Americans died of cancer last year. We need to consider this fact in establishing our national priorities and our nation’s investment in cancer biology, diagnosis, prevention, and treatment—especially at a time of major Medicare reform. Americans at risk for or diagnosed with cancer deserve nothing less.

At the time of this writing, the loss of life from Hurricane Katrina remains unknown, but it appears likely to dwarf the deaths caused by the collapse of the Twin Towers. Watching the chaos descend over New Orleans, we asked, "Can this really be America?" As with cancer, it was the underserving and the elderly who were disproportionately affected by the tragedy of preventable mortality. Surely, we must do better in the future. Preventable mortality from cancer, especially among the underserved, will also continue to dwarf the horror of Katrina.

The twin tragedies have another commonality that is especially poignant in Dr. Gurtler’s "Katrina’s Lessons," and that is that the worst in life can also bring out the best in people. Jayne celebrates the heroism and determination of the first responders at a high school turned field hospital ... the police, National Guard, and medical personnel. Not a single life under their care was lost because of their dedication to the important tasks at hand.

It is an important lesson, indeed.

Gregory A. Curt, M.D.

Senior Editor

Received September 7, 2005; accepted for publication September 7, 2005.

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