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As part of the response to Hurricane Katrina, a team of UNC Hospitals' physicians and staff left Friday, Sept. 2 to travel to the Gulf Coast as part of the MidCarolina Trauma RAC's State Medical Assistance Team II. The team from UNC Hospitals is comprised of: Christine Clark, RN; Randy Kearns; Preston "Chip" Rich, MD; Michele Rudisill, RN; Ed Wilson, RN; Ben Zarzaur, MD; and Janet Young, MD. A second team from UNC Hospitals left Sept. 9 to relieve the first group of volunteers. The second team to help staff the K-Mart Klinic in Waveland, Miss., is comprised of: Alberto Bonifacio, RN; Joe Manese, Radiology Tech; Peter Milano, 5th year surgical resident; Andrew Millager, Pharmacist; Jim Rawlings, Pastoral Care; Tina Schade-Willis, MD; Renae Stafford, Trauma Attending Surgeon; Jim Starlin, Air Care Communications; and Wes Wallace, MD., attending, emergency medicine.

Monday, September 12, 2005

Slapped Down in Mississippi

We'll call her Miss Olivia, but of course, that's not her real name. She's 86 years old, full of spirit, lives alone, drives her own car and was waiting in line at the FEMA office to get her washer and dryer fixed when she "got all sick like" and "got slapped down." After 15 minutes of questions, conversations and entertaining digressions, I finally came to the conclusion that "slapped down" meant passed out. Had this happened before? Ten minutes of stories later I discovered that this had occurred previously when her "ticker thing" (translated, pacemaker) acted up. It turned out that the pacer was scheduled to be replaced September 7, but of course, the hurricane preempted this.

Were pretty sophisticated here at Med-1, arguably the most sophisticated transportable hospital in the world -- but we don't evaluate and replace pacemakers.

"Miss Olivia, we need to transport you to another hospital. You're pacemaker isn't working well and if it fails badly, you could die"

I'm not sure I want to go to."

After more discussions there seemed to be two principle objections. One, she had some things in her purse she didn't want to carry to the hospital. "They might not be safe there." And two, she was worried that her car might be looted.

We finally convinced her that her things would be locked safely away at the hospital. The Charlotte SWAT team agreed to keep a 24 hour watch on her car. In true K-Mart Klinic fashion, problem found, problem creatively and cooperatively solved. While conditions are far from idyllic here, the cooperation among everyone is exemplary. Formalities are minimalized and the attitude is take "care of the folks." Example: phone temporarily not working at Miss Olivia's destination hospital. In a refreshing change from the usual EMTALA tango, we simply sent her. We're not a hospital in the formal sense, and the destination hospital, in an act of compassionate and responsible graciousness, had already informed us that they would take whatever we sent them.

Lots of folks are rising to this immense challenge.

Miss Olivia used my cell phone to call her son. I talked with him as well. He's working in New Orleans with a government agency and could not leave, but he'd arrange to have someone meet her at the hospital.

As the Paramedics were rolling out the door, she made them stop. She called me over to thank me. "I'm so glad you folks came to help us."

So am I.

Wes

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