Geographic circumstances: I was on duty at Children's Hospital of New Orleans during the hurricane and flood and now practice 80 miles north of New Orleans.
About the author: Since Hurricane Katrina, I completed my residency in internal medicine/pediatrics at Louisiana State University Health Sciences Center/Children's Hospital of New Orleans and subsequently served an allergy/immunology fellowship also at Louisiana State University Health Sciences Center/Children's Hospital of New Orleans. Louisiana will always be my home, and its children will be my patients. I currently work at Our Lady of the Lake Regional Medical Center in Baton Rouge, Louisiana, in a combined academic and private allergy/immunology practice.
Five years later, I hesitate to go to that place where I have hidden “HK5” (Hurricane Katrina, category 5) in my mind, but it is important to revisit the lessons I have learned. In the aftermath of the storm, there was rebuilding of the city of New Orleans, rebuilding of the hospital infrastructure, rebuilding of my own home, rebuilding of relationships through personal stress, and reclaiming that lost part of my heart. In the end, I have to live by a popular New Orleans motto that says that “soul is waterproof,” but it does not mean that mine was not weathered. The issue often forgotten is that physicians must also be recognized as human beings.
I cried often. I gave up from time to time. I blamed others. But, then I watched others persevere, and I did the same. I dried my tears. These last years have been spent in some part recovering who I am and deciding whether I could go through this again.
To be truthful, I spent a dear amount of time in the last year of my fellowship deciding if New Orleans could still be my home. Many factors played a role in my ultimate decision to return to my childhood city of Baton Rouge, but I never wavered on staying in south Louisiana and serving the children of this area. This state was responsible for my training as a physician, and I owe my patients to continue to learn from them and, in return, apply my knowledge to them.
To assess what I have learned in the past 4 years and whether I have truly dealt with my emotions, I used my thoughts from a 2006 Pediatrics supplement article1 as a point of reference.
LESSON 1: WHAT TO PACK WHEN WAITING OUT THE STORM
“I packed only a bare minimum, invested in water and microwaveable meals, and, by sheer luck, decided to pack some important documents just in case.”1 Well, I would not have changed bringing clothing, water, and the important documents. I would bring ready-to-eat foods instead, because power is a luxury. I would bring batteries, a flashlight, and a fan; a battery-operated fan in a powerless, hurricane-prone city in the middle of summer is a necessity. I would have all hygiene requirements including toilet paper, because there can be no assumption on how long a hospital can support you in terms of supplies or how long you will be asked to stay there. From my home, I would pack my diplomas, important pictures, and memorable letters. Trust me: you can never get these items back. I now have all of my important computerized files on a hard drive that can be easily transported without the computer itself.
LESSON 2: “HOUSTON, WE HAVE A PROBLEM”—COMMUNICATION IS KEY
“Cell phones were working only sporadically and were sometimes useless. The hospital telephones worked in house but had difficulty with outside messages because of overloaded circuits. We were isolated from the world… .”1 The worst emotion in a situation like this is the feeling of isolation, that you are on a piece of land surrounded by water, and you are at the mercy of time for someone to discover you. This is the reason to have a battery-operated cell phone charger. Because electrical outlets in the hospital were typically being used to operate more important machinery, cell phone chargers took a backseat to scarce and precious generator power. If I had had more contact with family and friends, perhaps the panic would not have pervaded my thoughts.
LESSON 3: “KNOWLEDGE IS POWER”—KNOW YOUR PATIENTS AND/OR HAVE ACCESS TO DETAILS
“I gathered the information for all of my patients regarding their needs and ability for transport… in the event that evacuation was possible.”1 This is a process I would have started earlier, especially in an ICU. It is only fair to those accepting your patients that they be summarized either in writing or verbally. From my perspective now as a clinic physician, I have the protection of an electronic medical record that is accessible from outside the hospital. This is another point in favor of transitioning to electronic medical records universally. As an allergist/immunologist I have patients who receive monthly infusions, which are organized through infusion centers so that locations are available nationwide in the event of evacuation and patients can be guided to alternative centers.
LESSON 4: “SOUL IS WATERPROOF”—THE DISTRESS IS TEMPORARY
“As we drove, I had a vantage point to assess the area in which I live. All that could be seen was water. [I]t was as if the area was a war zone. In fact, it was a war zone, with martial law in place, families displaced…, homes leveled to the ground, and disease and famine imminent.”1 It took a while to feel that the despair would only be a moment in life rather than defining it. The facts that helped were that (1) no children were lost during those days at Children's Hospital New Orleans, (2) a house can be rebuilt even better than it was before, and (3) our field is full of amazing people who were not just willing but eager to help. The amount of support given to the New Orleans pediatrics community from the nation's hospitals was heartwarming. Over time we have developed a hierarchy of disaster preparedness that should make the process of evacuation from any major city less chaotic if it is necessary. Hospital communication is now available with government offices so that individual needs can be more readily assessed. Also, generators and wells have been established to provide for cooling and potable water. I do not want to see this state endure another catastrophe like Hurricane Katrina, but if it is to be our future, history will not be doomed to repeat itself.
- Accepted March 25, 2011.
- Address correspondence to Sandhya Mani, MD, Section of Allergy and Immunology, Our Lady of the Lake Regional Medical Center, 7777 Hennessy Blvd, Suite 408, Baton Rouge, LA 70808. E-mail:
FINANCIAL DISCLOSURE: The author has indicated she has no financial relationships relevant to this article to disclose.
- Mani SD
- Copyright © 2011 by the American Academy of Pediatrics