UNC Hospitals' Hurricane Katrina Response Blog

A Last Look

2005-10-15T14:20:00.000-04:00

It has been about a week since our return from Waveland. For myself, this was a second deployment, thus a chance to observe the progress that had been made, and an opportunity to see people with whom I had the chance to make a personal connection with.

Since my return I've taken the time to process the experience. I've kept up with the new postings on the blog and viewed the pictures that I took. I've taken the time to sit and think about everything. I've shared the experience by talking to friends and family.

For myself, the success of the mission could never have been achieved without the combined effort of the SMAT team and the MED-1 unit. Each provided a wonderful compliment to each other. Without the one, the other would have had difficulty being as effective as we were as a whole.

I have thought about whether this experience has made me a better person. It has allowed me to be more aware of things in my life. I've appreciated all that I have and all that I do not much more. I've noticed that certain things that use to irritate me are not as important any more. However, it has become more difficult for me to accept certain things. I'm not as tolerant of behavior and attitudes that are selfish and narrow-minded. At the same time, I feel a greater amount of empathy for those who hurt, thus am more dedicated in doing what I can to help alleviate their suffering.

During my conversations with others at the camp, we struggled to find a word that could properly encapsulate the entire situation we found ourselves in. It is difficult to share this with others without the proper vocabulary. One could use words such as disaster, catastrophe, a big mess, or simply tragedy. Yet, despite the innate power these words hold, they still seem to fall short of accurately capturing the essence of what we went through.

On our last day a police officer, who, himself lived in Waveland, came in for treatment. He shared with us his loss. He told me that his home is 'gone', and what seemed to upset him most was the loss of an award that he received four days prior to the hurricane that named him as officer of the year. He quickly turned the conversation to the work he and his fellow officers were responsible for. He told me how they all made it through, despite being swept out windows and doors when the wave came. He told me that they were sleeping in tents and working twelve hours shifts, and how they were looking out for each other. For himself and his fellow officers, the time to fully mourn their personal losses will have to wait. They have a duty to perform, part of which is to provide support and comfort to their neighbors.

We talked about demobilization and how it will impact the community. There were concerns raised of whether they, Waveland and Hancock Hospital, were ready to take on the enormous task ahead. The impression shared by those who lived in the community was another cause for our concerns. Physical structures are easily repaired, but those other things that bind us to each other are not as easily mended.

Several of us have made plans to return to Waveland in a few months, and some in five years. We are all anxious and curious to see what will have happened to this town that we all came together at. We hope to reconnect with the people whom we were fortunate enough to have shared this moment with.

Waveland and the hurricane that destroyed it will be a moment in time. The experience will be captured and crystallized in the stories, photographs, and memories of those who shared it.

For myself I take these away from my time at Waveland and Camp K-mart ( aka Camp Katrina, Camp Mississippi, or K-mart General).

1. Everyone who had the chance to be involved in this great effort (in any way whatsoever) should be proud. We were part of history and we can and should remember it.
2. SMAT and MED-1 will be vital parts of any future missions. We need to take the time to learn as much as we can, so that any future deployments will not need to go through the initial difficulties we had.
3. Others may choose to describe this episode in their own way, the word I choose is catharsis.

The waters that washed away so many lives and homes has without doubt caused immense devastation. It has, however, brought with it a chance to re-build, re-assess, re-direct, and re-value our lives.

JDM

Med 1 departs

2005-10-15T08:04:00.000-04:00

Yesterday Med One departed for Charlotte around 4AM, with a brief burst of lights and sirens on departure. They shut down and broke down their facility over about 18hours the day before departure. The SMAT teams continue to provide care from 8-4 every day, as well as after hours for true emergencies. The patient volume is dropping, as expected, and our demob plan has been approved. We will be shutting down the clinic on Oct 22, and be packed up and out of here shortly thereafter. As Holli Hoffman said last night, we came in the summer and are leaving in the fall. While it can get quite hot on the tarmac during the day, it is very cool in the evening and in the early mornings.

Went down to Hancock Medical Center yesterday and met their marketing director and their CEO. They have done an amazing amount of work since the hurricane; all the sheet rock is bein g replaced on the first level--you can see how high the water went based on the level at which the sheet rock is ripped out. People coming to the meeting got lost on the first level because they couldn't see through the walls across the hospital for the first time! The ED is up and running with about 6-8 beds; not their full complement--they are seeing about 2/3 their average census to date with not as many beds, and not a fully trained ED-experienced staff. We may be able to support them a bit down there as our census drops. The Air Guard EMED unit will stay to provide them with support for their decreased services until Hancock is back on its functional feet. Hancock is hoping to have inpatient capabilities by the end of October. The amount of debris in front of the hospital is staggering. There are "stores" located on the first floor for staff and patients to find clothes, necessities, etc. People are still very overwhelmed, but each definitely react in their own way.

While this footprint here continued to grow and mature as the deployment continued, the surrounding area has not. Cars have been moved; the mud has rinsed away so some green is visible; but little building or trailers have moved in. The statement was made yesterday at our meeting that the "federal govt is moving out", and looking around, I have a hard time understanding how things are ready for that. The parking lot here will probably be prime real estate once we pull out--flat, clean, and near major roads.

Chris

First impressions

2005-10-12T14:52:00.000-04:00

After reading the blogs from a previous deployee, it is hard for me to know where to start. Things were a little tough for me initially, as the group that is here now to "see things through to the end" is made up largely of people who were in the first deployment. Watching their reunions was something--I have to admit envy from the obvious strong attachments that are present amongst these team members due to their shared experiences. They were very quick, however, to make sure that I met people and was included in conversations. It didn't take too much prodding to get people to start talking about their impressions of the "past" and the "present". Different things like, "I can see the road--0where did all the cars go" and "the smell is gone"--talking about triage lines that stretched across the parking lot, and working straight out from 6AM until close. Business now is lighter; more urgent care in origin due to our transition to the "NC Clinic", wiht 8-4 hours. Provisions are in place to make sure that people that show up outside those hours get the care they need. Demobilization plans continue, with a final "okay" from MS PH expected today. Hancock Memorial is running wiht 8 ED beds and the National Guard mobile hospital set up outside. Between the two, they have trauma capabilities, OR, xray, and blood bank. Mental health continues to be a tragedy of this hurricane; there are many more needs than can be met. Hancock did not have that capability before, and patients in true crisis, outside of the normal mental health clinic hours, have to be sent to Gulfport. PTSD is on the rise and federal and state agencies are trying to help address these issues. We unfortunately do not have a mental health professional with us for this last deployment--

My first impressions--surprised at the calm, lack of chaos; amazing amounts of debris; KMart is still not boarded up and that is a problem (the remaining odor issues). The clinical staff in the acute and triage areas are amazing in their compassion and their energy, seeing and caring for the vast majority of patients that come in. Med 1 should be starting to break down their tent and pack up tomorrow, leaving whenever they are done with that process. Their leaving will not have any impact on patient care. NC SMAT will remain, delivering care in tents until final pull out. The NCOEMS and Public Health staffs continue to run an amazingly complex operation with relative ease. The dedication to this mission is impressive. The point of the mission is to care for the people of this region, and SMAT and NCOEMS can be sure that they have not lost sight of that objective. I am proud to be here with them.

CWO

STEP 1

2005-10-10T07:35:00.000-04:00

At 4PM today the NC Field Hospital will cease to exist and the NC Clinic will take its place. The gradual process of weaning us away from this community begins. If all goes well, by the end of this week this process will be continue on to it full completion.

There is a certain level of uncertainty that some feel. Rightfully, there are some concerns if Hancock Hospital will be ready to take on the volume of patients that will continue to need help. Questions remain of whether they are adequately recovered to manage the task that they must reclaim - taking care of the citizens of this community.

Many years ago I was injured. It was a traumatic accident, which I was very luck to have had very little permanent debilitating injuries from. The people around me, my family and friends, worried about my recovery. Once released from the ICU, and shortly after the hospital, I worked hard to reclaim my life. I moved on, keeping the memory of the accident fresh in my mind. I looked ahead to the future. And, having had the experience, made some conscious decisions of the things that I intended to change. For me, the task was to not allow the accident to cripple me, physically, mentally, and emotionally. I was determined to move on with life, and have the accident become nothing more than a part of my personal history.

During this process my friends and family worried about me. They were concerned that I was pushing myself more than I should have been. They offered to continue to do things for me. They let me know that they were available to me 'for anything'.

At that time, this type of attention quickly became irritating. I was appreciative of the concern and dedication they displayed, but I wanted these people, whom I knew meant only the best of things, to just leave me alone. I was recovered and could manage on my own. I needed the chance to re-take my old life back, and continue to weave the tapestry that would be the rest of my life.

This community will continue to need help for years to come. So much has been lost. Social constructs that made everyday living possible have literally been swept away. To reconstruct their shattered lives, the people of this community will require the assistance of many many individuals and groups.

They, however, will, at some point, want to be left alone to take care of their own business. When this time comes, their appreciation for the generosity, kindness, dedication, and commitment that we have all made to help them back on the path of recovery will not have diminished. They will, for the rest of their history, remember this chapter.

The human spirit to survive is strong. We each possess compensating mechanisms to protect and heal ourselves when confronted with physical and mental assaults. We cope and move on. We live. And hopefully, we learn.

I am thankful for having had the opportunity to have been part of this effort. I take with me cherished memories. Through this experience I have gained insight. It is my good fortune that I have been able to help someone onto the road to recovery. And in the process, I have met many wonderful and impressive individuals who represent the best ideals of the healthcare profession; some have become friends.

Thank you Waveland for letting me add you to my personal history. I have come full circle. My life is richer for this experience, as I am certain are those of everyone who have been part of this team. Tragedy has bonded us and changed us. Our lives will continue on.

JDM

VIP visitor

2005-10-09T01:00:00.000-04:00

We've had many high profile people visit the camp. Several news organizations have done news articles on the work we are doing. Today, however, we had the highest profile guest, Geroge Bush Sr. visited the camp. This, not surprisingly, caused some excitement. It was a moment of pride to have him see our camp and hear about what we have been doing here.

JDM

I wish....

2005-10-08T11:59:00.000-04:00

I've found that being in an environment like this, it has been far easier to have meaningful conversations with others. This is not so say that such exchanges are not, and have not taken place back home. Here, however, there seems to be a greater sense of openness... a willingness to drop one's guard and let someone view the person behind the fortress.

Yesterday I had the opportunity to share thoughts with several people. I had three separate conversations that stood out and made me think. They all dealt with the simple topic of listening, perceptions, and realities.

The first conversation was with a team member who commented on how 'impressed' he was with the caliber of doctors we have had the chance to work with. He quickly amended his observation and stated that he was certain that all the other doctors on the other teams were of equally high caliber. He noted that since this was the only group of doctors he had worked with through these deployments, he could only comment of their performance. He finally said that the people he was making the comparison with were those whom he had had to work with 'back home'.

We agreed that indeed all the physicians that have joined these teams have been of an exceptional quality. It was not so much the level of their expertise that impressed us, it was their willingness to listen, help, and display the highest level of professionalism towards everyone in the team. We concluded that it would not be a surprise to either one of us if the doctors here are exactly the same 'back home' as they have been here.

Later in the day I had a conversation with two physicians. They were from different generations, but both equally of a high professional caliber. During this conversation one of them commented on how happy they were to have had the chance to practice 'real' medicine here, rather than what they had to deal with 'back home'. One said that it was frustrating to have to spend so much of ones time dealing with forms, committees, regulations, insurance carriers, and the plethora of other inconveniences that the practice of medicine carries today. They concluded that they wished that they could have as much time with the patients 'back home' as they have had here.

A group of us were latter having a conversation with one of the younger team members. We were inflicting upon her a good amount of playful teasing about the need to toughen her up. I commented that we needed to get her over to the 'dark side'. Finally, we all advised her that she needs to cherish and enjoy her youth and innocence. She, however, should not be afraid of opening herself up to the challenges of the word; those things that 'toughen' one up. We explained to her that she was fortunate that she had many years ahead of her to explore these things, and that she ought to enjoy this time and accept life for what it was - a series of challenges and experiences that may sometimes be wonderful and other times difficult.

'Back home' there are so many things that clutter our lives that we fail to hear each other through all the background noise. When a doctor seems irritated when they are working with the staff, it may not have anything to do with the person at the moment, but rather other things that complicate their lives. When a staff member seems particularly unresponsive towards the needs of a doctor, it may have more to do with having had to deal with the innumerable list of 'do's and don'ts' that they are saddled with. When a new nurse ask for help from one of the 'veteran' staff and receives a certain level of indifference, it may not have anything to do with any personal feelings that person has towards them, but rather a level of frustration of having been given yet another task to do.

There are walls that we all start building around ourselves. These walls are not necessarily meant to keep others out; they are designed to protect ourselves from the repeated injuries of life. Maybe, for those of us who have shared this experience, one thing we can share with others 'back home' is the experience of having others see pass our barricades. We worked well with each other here because we were given the opportunity to interact openly with each other.

I for one appreciate this. 'Back home' I've always tried hard to consider the person behind the 'walls'. Much like myself they have their concerns and share of daily irritations. I try hard to let them understand that I recognize this, and that working together we can accomplish more, rather than wasting our energies trying to find ways to work against one another.

In the field of healthcare the only people who are injured are those that are already in the most defenseless position - our patients.

JDM

Reunions

2005-10-07T01:32:00.000-04:00

For the members of the second deployment team, Tony came by today. He had a minor injury to his thumb, but he is happy, healthy, and moving on with life. He has seen Howard and has spoken often with him since our departure.

Tony also reports that he has agreed to pay better attention to his diet and medications. As a result of his willingness to do this, he now walks WITHOUT his cane. He was all smiles today. It was wonderful to see him.

A patient whom Jerry had helped save from a burning car during the first week the team came was also back. She recognized him and was so greatful to him. She wanted to make sure that she had the opportunity to thank him this time. Having gone through so much already during that earlier time, she had not had the chance to say thank you to him.

A patient whom we treated yesterday for a broken elbow came back in for a follow up study. She was also all smiles and was so happy to see us again. She works for the church, and is a volunteer who has come here to help the people of Waveland. She is scheduled to go home today.

A few people whom we met during our earlier deployment have come back. It was wonderful to see them again. To be honest, I could not remember all their names, but all the same, it was wonderful to see them agian.

Tony reminded me that he had promised me a fried turkey sandwich. I told him not to concern himself about that. It was just such a good feeling to see him doing so well.

Money and recognition can never compare to the reward one receives from seeing that someone one has helped is making it. All the extra long days, the missed showers, the long bus ride, and the inconviniences of having to re-arrange my life for these deployments are all made insignificant with just having the chance to see Tony's smiling face. It is good to know that he is here today, because we were here four weeks ago. No other compensation can compare to the feeling of knowing that one has made a difference is another person's life.

Can anyone think of any better reason to have done all this?

JDM

All good things.....

2005-10-06T09:40:00.000-04:00

In the movie "The Replacements", Gene Hackman, as Coach Jimmy McGinnty, said, "greatness, no matter how brief, has a way of staying with a (person)... it changes them".

Since our arrival here, there has been talk of the impending task of demobilization. Our job, a simple one really, is now near completion. We were suppose to provide the medical support needed to help Waveland recover. We were, if one would allow, the bandaid needed to protect and assist the wound that has been inflicted upon this body, Waveland, a chance to heal. Much like any good bandaid, it is coming time to peel us off and allow the body to finish the task of healing.

For those of us, and this must include all those individuals who have been feverishly working behind the scenes, we will be forever grateful for having been part of this experience. We came together as individuals and formed a community with a common purpose. This moment will change us.

A team member and I noted today that unlike our earlier deployments (this is a second deployment for us) this one is different. There is not the loss of the sense of purpose. None have waned in their dedication to provide their best. The level of compassion and humanity has not diminished in any way. However, we both noticed that as we near completion of our mission, we now have the time to stop and take stock of what we have and done.

There are shower trucks here, and therefore everyone is able to take hot showers regularly. The barricade of cars has been replaced by a chainlink fence, with an actual gate. There is greater certainty regarding supplies, meals, and other things that we had to struggle through during the earlier deployments. A routine taken hold, and normalcy is fast approaching.

Next week, when we begin our depature, this will mark the start of our demobilization phase. When we are all home, if we come together as a group once more, we stand a better chance of learning from this experience. If we, as we had done here, work with each other, will be better able to assess what will need improvement, changing, and amendments.

A scar will be left on this town and its people as a reminder of this assault. We, however, will have acted as witnessess to the true greatness of this moment. The greatness comes in the way professionals motivated by "altruism" put aside their own concerns, no matter how briefly, to practice their craft in it best possible tradition. The true greatness is how a town has fought to move pass an event that nearly annihilated it. The true greatness is having a family, a person, fight back to recover was what once their life.

For those of us who have been witness to this, we will try to share this experience with our famlies, friends, co-workers, and others who may ask us. For those of us who have been here, we can become changed by re-focusing our priorities. It can remind us of why we, a Renae aptly said, entered the profession of healthcare - atruism. It should remind us to appreciate the precious moments and people that we may have been ignoring for so long now.

Camp K-mart, Katrina, or Mississippi will soon pass into the collective memories of all those who have been here and been touched by its presence. We were part of a good thing. None of us, when we first agreed to come here thought that this was going to be something that could be considered a moment of greatness. Most of us came for the adventure, the experience, the chance to do our job. We are all the better for having been here, not for what we have done, but for all that we have witnessed.

JDM

Good Morning from KMART General

2005-10-05T08:13:00.000-04:00

GOOD MORNING. ITS THE SECOND DAY OF THE 6TH DEPLOYMENT. EVERYTHING APPEARS TO BE RUNNING NORMALLY, WELL AS NORMALLY AS IT CAN. SLEEPING CONDITIONS ARE OK. MOST OF US HAVE A COOLER PLACE TO ESCAPE THE HEAT. THE COMMAND STAFF FOR THIS ROTATION IS GREAT. THE MEDICAL STAFF SAW AROUND 180 PATIENTS INCLUDING 1 MAJOR TRAUMA. TODAY WILL BE THE FIRST FULL DAY OF WORK FOR THE NEW STAFF.

Reality checks

2005-10-03T17:07:00.000-04:00

Someone stoppped me in the halls of the hospital not long after I came back from Waveland. They said to me "you are my hero". This prompted a discussion which I answered with "the people in MS are the heroes.. the ones who sent their families away but stayed to take care of those who they knew would need their help".

Reality Check #1: It was a longer discussion than I was ready for having not totally processed/compartmentalized/organized in my head all that I had seen, touched, felt, heard and smelled during that week. In fact, I was pretty crabby the week I was back. Some people could rightly say something a bit stronger. I was back in the world of what healthcare has become... layers and layers of "stuff" between us and our patients.... scheduling, insurance companies, whether or not someone can pay, appointments, computers, bureauocracy ... much of what seems to be totally out of our control. Hurricane Katrina and the people of Waveland gave us the opportunity to truly practice not only the science of medicine but also the art of medicine which is so often lost in our daily existence. For that, I am truly grateful.

Reality Check #2: That discussion continued with the person I was speaking to being genuinely interested in what we had seen and experienced. I wasn't ready to talk about it yet. Reminded me of the stories I have heard from Veterans who come back from the war and are bombarded with questions.

Reality Check #3: Toward the end of the discussion they said, "well, you're my hero, at least for today". Attempting to disavow any of this notion didn't work well. I mentioned that my time there was brief and I knew that I would be coming home to a real bed, hot water, good food, etc. The comeback was " Yes, but you had a choice and said yes". I said that the volunteers and healthcare workers who stayed there also had a choice and they stayed! That reply didn't work too well either. The real answer came to me as I was driving home one night with the smell of rotten flesh still in my pores and nostrils after having done a case in the OR. It reminded me of the smells in Waveland that we all became habituated to relatively quickly. What we are truly talking about here is not heroism but altruism. Healthcare workers choose to do what they do because of altruism.... whether they do it in their daily practice where they treat whoever walks in the door regardless of how unpleasant things might be or whether they travel to some disaster or third world country to do the same thing.

Reality check#4: I went for a run a few days ago and as I ran through a particularly affluent neighborhood it dawned on me that the lawns were manicured, there were green trees, birds were out and the crickets were singing and there were people walking hand in hand and children riding bikes. Pretty mundane to most people but....One of the things I did most days in Waveland after seeing patients was to venture out into the community for a run. Many people thought I was crazy "it's not safe", "who knows what's out there" "why do you want to see all that destruction after taking care of people all day" were some of the comments I heard. It wasn't easy to explain... I needed to do that, it helped me experience and understand what my patients had been been through, helped to sort out my thoughts at the end of the day. I tried to get others to join me but for the first few days, I had no takers. As the days went by, a few more people decided to come along. I appreciated their comraderie. You see, on those runs in Waveland...... there were no leaves in the trees. The only birds were occasional vultures. There were no children riding bicycles. The one manicured lawn along the route stood out in stark contrast to the devastation all around. There were no couples walking hand in hand... only the occasional people picking through the rubble of their lives or giving one another a hug for support.

And so, to those who have wanted to go to the affected areas and help but weren't able to travel for whatever the reason, I understand why. To those who have gone... don't ignore the reality checks that have come and will be coming your way.

Renae

When Race and Class Cannot be Disentangled

2005-10-03T11:52:00.000-04:00

From television it was bad, from the air it was a disaster, but from the ground up close and personal with the lives of the affected, it was hell. That which was the the dream of the majority of doctors, nurses, and other treating professionals- provding care based on need and in a system where health is parmount and obstacles to patient care like insurance are non-existent- was a nightmare for the residents of Waveland, MS. The placidity of patient care was too often interrupted by a glance outside of the guarded fence to the misery, dispair, and suffering on the faces of those that had been most affected by Katrina. The storm, for many, took possessions and personal artifacts; homes, cars, and furniture that will be recovered. For others, she took that which was most precious and difficult to recover; dignity, self-respect, and the lives of family and close friends.

The previously homeless now stand in the same lines as their once separated-by-affluence neighbors for food, assistance, and clothing. The uneducated stand beside the educated. The old and tired stand beside the young and vibrant. Majority now stands with minority. Katrina, has reduced class, race, education, age, and achievement into one class; disenfranchised.

We came to help a disenfranchised Waveland, independent of historical achievements, social class, education, age, or race. We stand proud on our contributions to their recovery, yet dysphoric knowing that some community in the near future will need our services again. We are inspired by the strength of those who persist, even when all has been lost. We continue to work hard for residents knowing that we stand beside volunteers each day that lost more than we now have.

From this hell we hope that the residents of Waveland continue to work towards a better future, strive for a higher level of functioning, and dream of a Waveland recovered from the effects of Katrina.

Dr. Christopher L. Edwards
Deployment Team #5
Camp North Carolina

Return from Rotation #4

2005-09-30T17:08:00.000-04:00

Just returned early yesterday morning from rotation #4. Wish I had the chance to write some of this while I was in Waveland, but you get so swept up in all that's going on, and our work hours in the pharmacy had us running from sun up to sun down, so I hope I can convey well enough what we experienced.

Things are running quite smoothly at "Camp Katrina". I have to give kudos to the teams before us that have turned this project into a machine that runs with the efficiency and expertise that is comparable to any of the institutions that we all hail from. Despite some early setbacks (i.e - having to spend our first night at Stennis NASA because of Hurricane Rita), as soon as the team got to work, we were working like a family. I suppose you have to bond together like that to be able to serve such a devastated community.

We took tours of the wreckage, and a local woman named Vickie, and her son Willy, showed us their home, or what was left of it....which was basically nothing but a pile of rubble. It's hard to wrap your mind around how much they have lost. A few of us got to go up in a helicopter to take an aerial view of the damage. You think when you're on the ground, that it can't possible look any worse. Then you get up in the air, and it actualy IS worse....much worse.

I can honestly say this was by far one of the best experiences of my life. There are few things I can imagine that can make you feel as good as you do when you've been able to help even just one victim. The best of human nature was well on display in Waveland, Mississippi this past week. It's a lesson for all of us to learn from.

KR

24 Hours

2005-09-24T10:00:00.000-04:00

The past 24 hours have been some of the toughest 24 hours spent here by many of the responders. As the first group cycled out with the flights arriving and departing, storms moved in from the outer bands of Hurricane Rita. While the brunt of the hurricane stayed to our south and moved on to the west, outer bands began to filter into our area. At 9am, we had a possible tornado warning. Later, we learned the first Tornado Warning was a false alarm. Nevertheless, as the looming weather was accompanied by additional watches and warnings, we were developing additional plans to deal with the changes in the weather. They included:

1. Limited closure of the facility
2. Evacuate most of the staff to Stennis Air Force Base
3. Identify a safe location to rapidly evacuate the remaining few of us here at the base camp.

We closed the hospital to all but emergent conditions, and refered all of the walking wounded to shelters until the weather passed. We located a concrete and steel storage building across the parking lot, that had survived the previous storm completely in tact. We took a group there to clean it and that was going to be an option for a storm shelter. We also needed to move a majority of the staff to a safer location. Trailers and tents are no place to be in a tornado. While the sustained winds here never reached our "bug out" level of 39 or gusts of 50 nor did the area ever enter a Hurricane Watch area, the winds were in the 20 and 30 mph range. The rain came in sheets and what little of the outer bands we received, were still a challenge to a compound of tents and trailers. We arranged for busses to transport both the group scheduled to have left on Thursday and the group that had just arrived, over to Stennis Air Force Base. Other than just over a dozen of us here, to manage an occasional patient and hold down the fort, the place was an erie quiet.

The second group coming from NC had a flight delay that turned into a cancelation due to the changing weather. Then they had a bus ride of 12+ hours only to spend the rest of the night at the NASA base at Stennis. Hopefully, they are fully rested and fed and with the weather passing, they will be here later this morning. Today we had a flash flood warning, high wind warning and tornado watch until noon. However the weather has broke and other than some winds of 10-18 mph, the sky is mostly clear. Right now, we anticipate reopening the hospital at noon.

Fortunately the bus that came, had a relief driver with him and the second group that needed to leave finally left at about 4am this morning from Stennis for what I am sure is a long ride home.

Hopefully, their experience will be as mine after my first rotation. Once you get a chance to sleep in your bed, and see your family, will you truly have the time to reflect on what has and continues to be a wonderful experience that has impacted the lives of others as well as your own.

RK

Going Home

2005-09-23T03:54:00.000-04:00

So far, we are scheduled to leave on the first flight this morning. It's now Friday and we are into the 8th day. We were supposed to leave Thursday morning. No regrets about being here an extra day because the need is so great. The problem is that as much as we all agree that we wouldn't change this experience for anything in the world, we are just as tired and in need of some rest. 7 days of straight shifts especially working nights and finding a place to sleep during 100+ degree days is difficult and just as difficult for the day shift who must work in it too.

I went up in a helicopter this week and the devastation is remarkable. Lives are splintered into millions of pieces and this is not only evident from the ground and our hospital but in the air as well. I was teary just watching it. The water has become murky and the vegetation is turning brown everyway. Green is not a common color. A few birds once in a while and eerily enough while riding with some well-connected persons in the county, we made a note that we did not see small game, pets, etc.

Hurricane Rita is bearing down with winds that have scolded us all day causing us to pull all non-secured items into trailers, pull up canopies, --- essentially close down camp except for the essential things. An evac plan has been posted with parameters and all bags have been packed earlier--just in case the winds or weather exceed wind capability. I do hope that we can make a safe flight tomorrow. Breaking down camp is estimated at 6-1/2 hours. FEMA pulled out yesterday. The food kitchen and showers next door do not plan to shut down and have taken precautions as have we. Sandbags have been moved to essential locations.

I wonder where our people living here will move to or to what they will hold on to. The winds are strong enough to make missiles out of much of this debris even without anything else happening. Persons living in tents or without any shelter have nothing and the ones with some type of shelter may not have places that can handle much more if one thinks about it.

As much as I look forward to leaving and going home and seeing my family, I cannot truly leave this place. The spirit is catching. These are the most wonderful people you can meet. I have learned and shared so much with so many. I plan to continue this kind of outreach and with find a way to continue it. I do invite all of you to begin this kind of outreach. You'll never come home the same person.

Katrina Goes Nuclear

2005-09-20T10:14:00.000-04:00

Good morning from Kamp Katrina. We're settled into our routines here, committed to providing care for this shattered community until local health care system can meet its residents' needs.

In some respects, much of what we do feels very familiar to me-- a lot of minor illness and a few serious events like strokes and MI's. So far, with one one significant exception, there has has been blessedly little major trauma. A child flipped a four wheeler during the first week of deployment here. There is, however, one major difference between patients I see in the UNC ED and the folks I see here. Virtually all our our patients are in the midst of trying to regather their shattered lives. Most do this with astounding resiliance and an altered life perspective. Over and over I hear it. "Everything we own is gone, but my family's okay. That's what's important. We'll get through this."

We've all been waiting for the onslaught of chain saw injuries which almost always follow hurricanes, but they're not coming. Two days ago the reason why became apparent to me. The Mississippi highway patrol offered to take me up in one of their helicopters. The view from above showed damage more complete than I had understood from the ground. For a decade or so in the late 1980's and early '90's, when the risk of thermonuclear war with the Soviets seemed palpably possible, I was very active in Physicians for Social Responsibility, an organization dedicated to reducing the risk of nuclear war. I spent a great deal of time educating communities about the medical consequences of nuclear war, laying out in stark terms the damage they would see. Now, through the polycarbonate windows of the chopper, I saw a scenario that seemed weirdly nuclear in its power-- rows of stripped bare foundations; splintered and uprooted trees, all bowing in the same direction; railroad tracks at right angles to the ground. This is why there were few chain saw injuries. There was nothing left to save. No houses to release from oaken clutches. The houses were simply gone.

Wes

Reflections

2005-09-19T02:01:00.000-04:00

It's been a few days since arrival, some moments seem forever in passing and others seem to go too fast. The devestation seen on arrival is almost too much for the senses and pictures do not do it justice. New Orleans seems to get the news but the home front of this natural disaster is 90,000 miles and Waveland and Bay St. Luis is just a representation. I wish that everyone could see this firsthand so that they would never forget just how fortunate and precious life is and how much help these people really need.

The people I have met who live here are a remarkable group of people. They are strong, courageous, loving, and giving. They would give anyone the shirts off of their back. I have seen someone give away her own tent to someone whom she considered less fortunate than she. These people have nothing. Basic infrasture is gone. Electricity, water, sewer. Schools for the children beginning is a rumor that many of the parents often ask me about when they bring their children in to be triaged. Really that is not a concern right now. What do you wash your children in when the water is contaminated when you need the water for drinking, cooking and other life necessities? Curfew is still 8pm and rumored to be extended to 11pm soon so people put off medical care for two days or so until they can get out. There is a wonderful kitchen next to us serving two meals a day--we get our two free meals a day there too if we choose (or from NASA if we want--brought in. I go in to sit with these people and listen to their stories. They are all individual but the same. "I lost everything, my house is gone, my car, my business, my job" Sometimes they lost their family member. Getting insurance to pay now is difficult. Anger and depression is setting in. More are deciding to leave and some are staying either because they don't want to leave or they just can't because they have no where to go or can't afford to go. They never complain about anything to us when they come into the clinic. Always thanking us for anything they receive.

I work with a great bunch of people. This team is awesome. The people who volunteer are fantastic. I haven't met a single person with a poor attitude. Everyone is always upbeat. We all listen to one another, talk to one another. We work so much you would think we would be tired of one another but that is not true at all. We all believe in this and it shows. We all express the same thing. How can we feel bad about ourselves or our situations or have bad attitudes when there are persons, our neighbors, our friends, right here, who have lost so much.

This opportunity to serve this great area of need is medicine doing what it was meant to do. This is medicine without the bureaucracy. Well, perhaps there is bureaucracy, but it is getting out of the way so that we can do the job we need to do right now. We see our patients, treat our patients, give them what they need. I don't ask them what their insurance is or fill out tons of paperwork. We work together as a team right here. We are a team, close knit group. Everyone pulls together. No one has a "job". Everyone has the same job, "get it done". IV needs started, pick up antibiotic from pharmacy, organize the supplies, pull trash from the compound, make the coffee, etc. We just do it. We do it and do it fast and efficiently.

The KMart General as well are called now even with a mail box as of today is flourishing. Generators whirl daily to power Med One running the CT scanner and XRay, lights and the little town we call home. We sleep in the same tent as the hospital behind the patients rotating often overlaping one another but not ending until the work is done. We have mental health set up, an eye clinic and dental clinic have set up just outside, an immunization clinic has set up outside of the clinic compound. The cars have been hauled away and an official fence with wire has been rolled around the hospital to keep looters and people out who might try to steal drugs, etc. Security is tight with ATF, US Marshalls, Police, National Guard but they are starting to scale down slightly. EMS send the patients to us and spend quite a bit of time here with us just like a regular ED.

This is an experience that will change your perception of nursing forever and teamwork forever. You will never be the same. You will never accept the ordinary and will want to be extraordinary.

Return from the front

2005-09-16T13:49:00.000-04:00

I woke up last night having to go to the bathroom and was disoriented about being in the dark. I could not understand why I was having difficulty rolling out of my cot. My brain tried to remember where the port-a-john that I preferred to use was located. It took a few minutes for it to register, but I was in my room, on my king size bed, back in North Carolina.

My best friend, during a phone conversation, said to me that she was having difficulty comprehending what I had shared with her of my experiences. She said that she could not 'imagine' what it was that I had gone through. She asked me why, if it had been so physically taxing, that I had volunteers to return.

I drove to my office to check my e-mail. I'm certain that there will be pages of them, and most would not be interesting. My thoughts, however, keep returning to Waveland.

I wonder how Jeff and Tim, Jen, Alex, Randy, and all the others who flew home with me are doing. Are they still asleep in their beds, or have they gone on to return to the normal chores of daily living? Whom among our group had to return promptly back to work the next day, or had to complete that errand that had to be put off, or start that task that had to wait yet another seven days? I wonder how they are all doing. And my thoughts again return to Waveland.

I think about those people whom we left behind, Wes, Kyle, Dave, Littlejohn, and the rest of our team. Is Wes able to get sleep during the days yet? How much trouble are the generators giving Kyle again? What new images has Littlejohn captured with his cameras? Is the sweet flavor of that cherished cigar still lingering in Dave's mouth? I think about them and wonder how they are and envy them for still being at Waveland.

I wonder about the new team that took our place. Have they seen the beach yet? Whom among them have not yet had sleep since they left their home? Are they settling into a routine that will help them cope with the demands of the next seven days?

Then I think about Tony. The last time I saw him he was smiling and eager to move on with life. He was still waiting to see Walter, but he knew he was out there also waiting for him. He promised me a fried turkey sandwich when I returned and a bag of the local coffee. He told me that after drinking their coffee that I would know what coffee should taste like. He told me that he was looking forward to having me return, and promised to show me around his town and New Orleans once things have returned to normal.

I've just spoken to Chris, who has to be praised for all the work she has done. She told our group before we left that she would rather be going down with us, but her work was here. I can't imagine all the hours, challenges, and sacrifices she has already made. When all of this is done, I hope that the hospital works very hard to recognize the critical role Chris played in this effort. Those of us who have gone to Waveland have had to contend with physical challenges, but Chris has had to deal with the often more demanding mental exhaustion that must come with her role. I can't thank her enough for having provided me with the opportunity of being part of this undertaking.

And again my thoughts return to Waveland. It may have been merely by coincidence that we were sent to a place whose name seemed to be the harbinger of its own demise. It may be simple happenstance that we set camp at the parking lot of K-mart, whose slogan is 'the saving place'. Yet, whatever forces joined together to cause us to come together and learn about human devastation and the simple joys of recovery, I count myself fortunate for having been there.

I hope to return to Waveland, be it on a second deployment or as a tourist. Waveland will always be a place tied with my own personal sense that I have reached a pinacle in my career. Waveland will always be a place that reminds me that our profession, that of helping patients, can and should always first consider the only person that matters most in the equation of health care management - the patient. Waveland will always be the place where I found doctors, nurses, pharmacist, and any of the other varied professionals, who still have pride in working to the best of their abilities to help patients.

Until my return I think of Waveland and cherish all the memories I gained from my experience there. Good night Wes, and I hope that you are getting sleep. Good luck Kyle, and I hope that the generators are working well and you are able to find a more steady supply of fuel. Dave, I hope that you will have the chance to smoke another Cohiba soon, and savor the good conversation that goes along with a good cigar and having good friends around you. Good luck Tony, and I look forward to having that cup of coffee and fried turkey sandwich with you. Thank you Waveland for letting me be a part of your life.

JDM

Back Beyond the Railroad Tracks

2005-09-15T06:14:00.000-04:00

Beyond the Railroad Tracks.

Today, four physicians and one of our nurse leaders visited Gulfport Memorial Hospital to say thank you. Dr. Ward and the other Emergency Physicians have been very helpful in accepting in transfer any patients we asked help for. While they suffered some damage they never closed. Some days they saw 500 patients a day, over twice their normal volume.

As a token of our gratitude, we brought them a box of “Meals Ready to Eat” or in military jargon MREs. We did have an ample supply, as they were not a local favorite. The Gulfport ER staff in turn seemed to appreciate the gesture, but probably knew all to well themselves the MRE's reputation for inducing constipation. The taste is really OK. Margaret, the hospital ER charge nurse said they were all very thankful for the NC field hospital’s presence. So it turned into mutual admiration meeting.

While touring their ED I talked at length to one of the other staff members who told me about the “barnacles”. It is a term of affection, applied to those citizens of Mississippi who are very permanent residents. They will be rebuilding. Many did not leave during hurricanes in the past, nor did they leave for Katrina. The common wisdom was that it was safe to ride out the storm if you evacuated back beyond the railroad tracks. Those that did that in Camile were fine. The tracks run parallel to the coastline, which in Waveland is about ¼ miles back from the beach. In comparison, SMAT – EMED 1 is located twice that distance from the water and still killed a half dozen. A picture of the same railroad tracks after the storm shows the fallacy of that approach.

Repetitively we heard from our patients about how fast the water approached. Before they knew it, they were climbing for the roof. Sadly, the same wall of water that threatened their lives 2 weeks ago may also be their financial ruin. Most homeowners have fire and wind damage. Flood damage is a separate policy, not uniformly purchased. Water damage from a leaking roof torn up by high winds is covered. Damage from an 18 foot wall of water created by wind is not. I suspect the “barnacles” that survived Katrina will stay this time as well, if they can afford to.

sam spicer

(Dr. Spicer is an emergency physician from Wilmington, NC. We are honored to have him as a guest blogger on this site. His contributions to the second deployment to Waveland were immense. WW)

UNC Hospitals' Hurricane Katrina Response Blog

2005-09-14T23:17:00.000-04:00

Imagine:

That sleeping in a tent is a luxury......

That you work in a local ER of a 500 bed hospital...
the only one that remains functional in a six county area during and after the storm, that you have been there since the storm caring for 3 x the normal numbers of patients AND that you are living there because you, your family and the majority of the healthcare workers working with you are homeless....

That patients first thank you for being there and doing what you do AND in the same breath apologize for coming to get medical care because they are taking your time away from someone who needs it more than they do.....

That your patient who is a local red cross volunteer AND also homeless, tells you that that their loved one, boss, a person on the street had to talk them into coming to see you because they didn't want to take away time from doing relief work.....

That despite the fact that people have been spending their days wandering from makeshift tent to tent, standing in the squeltering heat for hours on end, in search of food, shelter, healthcare, government assistance and phones to try and reach loved ones, they manage to smile and say "At least we are alive" and "thank you for what you are doing" and "what can we do for you?".....

That you took care of someone, sent them to a hospital for an operation and that they returned days later with treats as a care package for you....

That a handshake, a hug and a smile are often the best and the most appropriate medicine you can provide.....

That home is no longer where the building and foundation are, where the mailbox is, where you hang your hat or take off your boots, its not even where the pictures are because you had no time to get them BUT....

That home is now where you find community in the truest sense of the word, where people who were once strangers are now your brothers and sisters and kin who offer you hope, sustenance, a smile, a human touch.....

That you have gotten more out of an experience than you could ever give back.....

That you don't have to imagine.
That in spite of the devastation: physical, emotional and economical, all of this is reality.....
That this reality exists here and now in Waveland ......

Renae

UNC Hospitals' Hurricane Katrina Response Blog

2005-09-14T22:47:00.000-04:00

What To Bring to Kamp Katrina

2005-09-14T08:53:00.000-04:00

Getting ready to be deployed here to Kamp Katrina? Let me give you some useful information on what you need to bring, and perhaps more important, what you don't need. Though Chris Ogden or others will need to confirm this for you, there is a good chance you will fly in, missing a delightful 13 hour bus ride. Additionally, you'll likely have a 40 pound weight limit on what you can bring. No need to waste it on useless stuff.

You don't need heavy boots, a canteen, a sleeping pad, mess kit, BDU pants or many of the items you might have needed if you came to a debris filled disaster area. Thanks to those who came on the first deployment, this place has become luxury camping. You'll sleep on a spring suspended cot topped with a foam pad. There are several options for sleeping quarters. Some us sleep in a large, air conditioned tent which extends from and surrounds MED-1. It's at least 12,000 square, probably more. Other folks sleep in a series of air conditioned gear equipment trailers used to haul gear here. There also non air conditioned tents, if you prefer. It gets cool at night, especially in the air conditioned spaces. Bring a light weight sleeping bag.

You don't need to bring food, or drinks. There's plenty and the quality is acceptable, lots of snacks, too.

Comfortable working clothes are fine. Scrubs work well. Shorts are now condoned. You'll probably want a hat. Several of us look lobsterish. If you may work at night, bring a sweater or sweatshirt. I became uncomfortably cool working a night shift. Wear comfortable shoes that you like to work in. You'll be walking on a parking lot tarmac. Running shoes work. Clogs work. You choose. The hazardous debris has been cleaned up.

Fueled by excitement, weird hours and a love of chemical toilets, the greatest health problem for the staff here has become,... ah... constipation. Metamucil anyone? Seriously, if this is ever an issue for you, some kind of fiber pill or suppliment should be considered. The experience here could stay with you longer than you'd like.

The only chemical experience here is the toilets. There the standard issue used on construction sites. They're well maintained. We have showers here. Well to be honest, it's a chemical decontamination tent. One for guys and one for gals. The sign says "Male Shower." No hot water. Water sitting in the tanks has been in the sun for a while it's just on the cool side of warm. I've never found it gasping cold.

Now cell phones work. If you don't have them to call home, phones are available here. We've got Wi-Fi access, too.

Got to go. More patients are waiting. Look forward to seeing you Thursday.

Wes

Home

2005-09-14T06:23:00.000-04:00

Our group is winding down its tour. We will begin the journey back home in roughly 24 hrs. Home = Beds = Hot showers = Laundry machines = Regular toilets = normalcy. What a bittersweet thought home is.

I now know what the first group felt when we first arrived. One person scheduled to leave the day after were arrive told me that they would "love" to stay, but they were so ready to go home. She seemed so sad and her eyes seemed to tear up when she told me this.

Home holds for us so many wonderful things. Home is where family and friends are. Home is where our "stuff" reside. Home is where we have a sense of security. Home is where we know we have some control.

Yet, for the people who have been fortunate enough to be here, part of us will always be home in Waveland. We have connected to this place and the people here. Camp K-mart has become home for us. We know that at some time this place will have to be turned back over to the businesses that use this parking lot. Yet, when I return to Waveland, I should want to visit home. I will, like in my home in North Carolina, know the spot where I slept, ate, relaxed, and hid when I needed to be alone.

My hope is that for those people who called Waveland home that they can return home. It will be a painful journey for them. Home, where their family and friends were, where their "stuff" was, where they had a sense of security, can be nothing more than a pile of rubble. Home will never be the same again because it will forever be tied to this nightmare. I hope that as they return and we continue to do our part to help in their recovery that we can help restore that good sense of home this place once held for them. Maybe we will become the friends and family that can provide them that sense of security that they have lost. Maybe, when I return home to Waveland, someone whom I've been fortunate enough to meet here will see and recognize me and say, "Hey there's what's his name who use to live over there at Camp K-mart."

JDM

Home Briefly . . .

2005-09-13T22:36:00.000-04:00

Good evening,

Early this morning I arrived home (2am) from the Bay of St. Louis (Waveland) MS after spending some 10 days with our NC SMAT Field Hospital. I will be here for the next several days, return there for a week and have a few days off before spending several quality days at MUSC.

I thought I would share a few tidbits of information from my perspective. Once we received our assignment, we arrived in Waveland MS Sunday the 2nd. We saw our first patient on the 3rd and as of my last briefing yesterday morning; we had seen some 1400 patients.

The local hospital is closed, after being flooded (3' of water) throughout the first floor which comprises more than 75% of the patient bed location. Right now it appears it will remain closed for the next eight weeks. During my time there, I met meet with the local hospital CEO each day to cover progress and work to transition our operation back into his hospital ASAP. A part of our plan to help him recover their hospital includes honoring their traditional referral patterns and allowing their staff/Medical Staff to see patients once they can address some of their personal needs.

The most severe cases include numerous MI's and one head injury from a four wheeler accident involving a 12 year old. Both Dr's Rich and Zarzaur, along with the staff on duty at that time, worked well together. The patient was flown by the USCG to the level 1 trauma center at Jackson, MS. Today, his prognosis for a full recovery is excellent.

The devastation is catastrophic.

While there are some areas that continue to emit putrid odors from all sorts of sources, I suggest that you don't believe some of the wire reports, at least from our perspective. The primary problems are lack of good sanitary practices due to a lack of running water for showers, washing eating utensils and general hygiene. While at some point the insects will return, they are not a problem now. During my 10 days there, I saw a mosquito on Saturday and a fly on Sunday. Any idea what the lifespan is of a small flying insect in a sustained wind of 150+ mph for several hours? I slept under the stars several nights without insect repellant in southern Mississippi, now what are the chances of that a year from now!

There were lots of extraordinary efforts throughout the week to get the hospital up and running. Those first few days were filled with getting the lights on, finding water, diesel and food. To know that an accomplishment today includes adding a second shower facility is great news and should be wonderful for morale. (Maslow would be pleased!) My other trip away from the hospital each day was a 20 mile midnight ride to the NASA station up the road, so I know I am.

I will rotate into the hospital every other week until the mission is completed either returning for another stint as the Incident Commander or as a Liaison to the local hospital. Regardless, I should have more time and will provide another look from downtown Camp K-Mart, “the saving place”.

Randy Kearns

2005-09-13T22:24:00.000-04:00

From our Memorial Service on Sunday.

Let us pray,

Four years ago today, four teams from the terrorist group known as Al Qaeda used passenger planes to attack America. Shortly before 9am, the first plane struck the North Tower of the World Trade Center with a second striking the South Tower minutes later. Within the hour, a third plane had struck the pentagon and a four attack was averted only after hijackers were overpowered by the heroic actions of several passengers.

By noon, thousands of Americans including more than 250 firefighters, police officers and medics were dead as the towers fell.

Today, we stand at ground zero for Hurricane Katrina, a storm that may very well have claimed the lives of more than 10,000 Americans by the time the final death toll is known and one of the greatest natural disasters in the history of our country. As we look into the faces of these families here at the Bay of St Louis and southern Mississippi, and think back to the events of 9-11, we can only imagine just a portion of the horror these people have seen and felt.

We stand here at the flag of our country, our homeland and the symbol of our resolve to overcome those forces that have harmed the citizens of our great nation. Regardless of the cause, whether by the brutal actions of terrorist or natural disaster, this country will do what must be done. We pray for the safety of our troops around the world, the victims of this tragic and catastrophic event, and pray for the safety of everyone who has selflessly gave of their time and talents to make a difference in the lives of our neighbors here in Mississippi. All these things we ask in your name,

Amen.

Footnote: The flag was donated by someone who came to the hospital shortly after we were open. Several enterprising members rigged a rope over one of the light standards and a flagpole was created.

Also, after looking more closely at this photo, do you know what is special about this flag?

Randy Kearns

Hearing with open eyes

2005-09-12T23:25:00.000-04:00

I envy the first group that arrived in Waveland. I don't know if I would have wanted to endure the reptile and disease infested mess they had to wrestle with, but nevertheless I envy them.

Today the new second shower facility was installed and made operational. The checkpoint actually now has a gate. We are getting more and more of the supplies and equipment that we need to effectively do our jobs. A small community of federal agencies, charitable and church organizations, and medical support have joined the once desolate town of what has been called 'camp K-mart'.

It is all amazing. The first night we arrived we found a system of two pans in place to provide proper washing facilities. Equipment had just arrived, but were not yet in use. MRE's were the next best things to grandma's apple pie. The reminders of Katrina's power were still our neighbors. How things have change in the short span of a few days.

Progress is a wonderful thing. It brings with it warm showers, better and faster gadgets, and more things to occupy free time. Progress makes life more comfortable. In a few weeks, with the shops all boarded up, the camp even more established, and the stories of horror passing into distant memory, this place, once a testament of how frail we truly are, will seem all too 'normal'.

Someone told me today that a person who wanted to wash their clothes was annoyed that the one washing machine, something found on the streets, was not working. Another person was unhappy that showers were regulated to being open only between certain hours. And little annoyances have started to creep in.

It is a blessing that the people here are focused on bringing relief to those who are in need. This morning, everyone heard that extra hands were needed to clean camp when they saw others picking up brooms and collecting garbage. Doctors were changing garbage bags. Nurses took up brooms and swept. Others carried in supplies, or volunteered to get things done.

I hope that as things reach normalcy, the goal of our mission here does not become drowned out by the chatter of civilized conveniences. I hope that the fact that the storefronts have been boarded up will not mask the truth of what has happened here. I hope that with the creature comforts of the modernized world people will not loose track of what it is that we are doing here.

I envy the first group that arrived. They had the luxury of having experienced the full horror of this event in its full glory. They will remember. They will be changed. They will take with them, in its raw from, the lessons of this event. I wish that I could have been with them, despite the fact that I am not sure that I could have been as strong as they were.

Slapped Down in Mississippi

2005-09-12T22:05:00.000-04:00

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

Helping the helpers

2005-09-12T06:38:00.000-04:00

A lady told me that she was frustrated about having gotten hurt. "I came here to help, not to be here having to be helped myself", was her complaint. I wanted to tell her something wise, but all I could come up with was to reassure her that we would do all we could to treat her injury.

Not too long after, a young soldier came with a complaint about his foot that had been bothering him for a few days. He was more stoic about his "hospital visit", but nevertheless he seemed equally frustrated. He had a job to do and this minor injury was preventing him from doing it.

All around us are people who've lost all that they have. We watch them and at the same time we try to empathize with them, yet somewhere deep inside we are so glad that we are not in their place. We focus on our jobs, telling ourselves that this is the best way we can help. We loose ourselves in our jobs, ignoring minor discomforts. What does it matter that we have to endure cold showers, or sleep in tents that are either too cold or too hot? How could these minor inconveniences compare to what the residents of this town have already experienced?

Katrina is a historic event not simply because of its awesome power, but because of the varied stories that will be told about it. Katrina is the devastating event that it is not simply because of the path of physical destruction it has left in its wake, but also because of the countless minor injuries, both physical and emotional, that it is inflicting on the residents of this town and people who have come to help.

Volumes of analysis will be written about this event. These will discuss the impact on the environment, the local economy, the physical and mental health of the surviors, or even how the beloved live oaks will react to this devastation. Katrina will touch countless lives, including those who have come to help. It should remind us that as humans we can be so easily hurt. Yet what is more important, it should remind us that despite the annoyances of daily life we as a species are programmed to come to the aid of each other. In times of great need, our primitive brain takes over and the instinct to help those that have been injured take over. Maybe it is because deep down we all realize that we are all truly connected and that protecting the other person is as much an act of protecting ourselves. We are willing to endure more in the name of helping another.

This is what I know, Katrina has united us as a nation, but also should help each of us connect to our own humanity. We can be hurt. We will be hurt. No amount of steel and cement or professional training can completely protect us from forces beyond our control. It is fortunate, however, that as a species we have built within our genes the desire to help each other. We may be here working hard to help the residents of this town with their physical injuries and needs, but they are helping remind us that there are things so much more important in life. One of these is that as a species we have it written within our genes the desire to protect and help each other.

JDM

City Hall

2005-09-11T18:45:00.000-04:00

Mike's a deputy with Rowan County sheriff. He was dispatched here shortly after the storm to assist with rescue and law enforcement. "Law enforcement and rescue is what I do. It's all I know." He looks like a character out of an action movie. His close cropped gray blond hair and tan sun wrinkled hair contrast with his intensely blue eyes. He offered to take me on a tour of the devastation in his four wheel drive truck. I'd seen pictures and listened to news reports, but they did not prepare me for what I saw. The nearer to the the beach front we drove, the more complete he devastation became.

Initially, houses with blown out windows and damaged roofs, yards full of debris were interspersed with completely collapsed houses. A short distance closer to the beach, the walls of the houses were completely collapsed, frequently with the roof, relatively intact, lying a few yards away to the side. A few hundred yards closer to the ocean, there were only foundations and windrows of the detritus of shattered lives. There were no large pieces. The only identifiable items were toilets and sinks.

Ironies are everywhere. Town center a few miles back from the beach was a war zone. The only thing of substance still standing was a monument to the people of the town who rebuilt the town after Camille in 1969. Town hall was only a foundation. But over this foundation flew a blue tarp and a card table. It was now the center of relief distribution.

Early this morning I saw a middle aged woman whose chronic obstructive pulmonary disease was worse because she'd lost all of her medications. She told me an incredible story. "We thought we had it made when we survived the wind. But then the water began to rise. It rose so quick. My two daughters and I had to dive under water to go through a window and get out of the house. We pulled our two dogs with us. We all made it to the roof and survived, but we ain't got nothin' left.
She thanked me profusely when she left. It's almost always the same, incredible stories and profound gratitude.

Wes

The New Kids on the Block

2005-09-10T10:23:00.000-04:00

We're the new kids on the block, the new group that just arrived from UNC this morning at 2:20 a.m. It's a long car/bus ride from Chapel Hill via Charlotte Atlanta, Montgomery and Mobile. Most of us began driving about 6:30 a.m. yesterday, joining with other teams from around the state in Charlotte.

In Charlotte, we registered and received a briefing on what to expect on site. (Clearly we were in debt to the folks who put Camp Katrina in order. Big progress. Lots of round the clock work.) There was a brief talk from the Critical Incident Stress Management folks. This has the potential to move us in unpleasant ways. It has the potential to bring out our best natures as well.

Somewhere around 11:30 a.m., we crammed about 100 folks and a small warehouse of gear into two vans and two buses, nicknamed "with oil" and "with mustard" for their roomy accommodations. Charlotte filled the rear view mirror.

Given the pace with which we moved, we were on target to hit Atlanta at rush our. Charles, our bus driver, was the man with a plan. He made couple of phone calls and the Georgia HP, lights rotating, took positions behind us and in front of us. We had ourselves a convoy. Somewhere south of Atlanta we stopped by for some health food at MacDonald's. This engendered a brief period of panic from the employees who transiently confused 100 folks wearing SMAT caps with 100 folks wearing SWAT caps.

Some VCR tapes that Charles brought filled the evening. Between movies, riders with too much time to think of what they should have brought, coalesed. Someone produced a lap top with a wireless card found the nearest Walmart. Two buses and two vans found their way to the Mobile, Alabama Walmart parking lot. What are all those other folks doing here at 11:30 p.m.?

Kamp K-Mart functions 24 hours a day. As we dragged our supplies wearily from the bus, we were descended upon by eager UNC colleages who gave us a tour of this amazing place. They were tired but wired, filled with incredible stories about this place. I flopped on a cot just outside the main hospital truck. My first night shift was already in progress.

Wes

Winding Down

2005-09-09T11:20:00.000-04:00

Things are really changing now. We seem to have reached critical mass and the growth of our encampment is now exponential. Added to our coffers are now a veterinary clinic, a FEMA truck with another satellite dish, the Department of Health, a CT scanner (to come today), and a News and Observer camper. You know it's time for a mission change when you can get wireless (like now) and Domino's delivers. Thirty pizzas last night. People are starting to excercise again, running down by the beach road. More and more people are returning to the area, and it's beginnning to look mre like a town again than the DMZ. Yesterday I and some some others were taken on a tour of the region by Brian and his son in a local church bus. Words do not describe the environment. They are all cliches. Utter devastation. Warzone. Third world. Ruins. Nothing. When we drove down the beach road, there is an appreciation for how beautiful it must have been. Live oaks, pines, some palms. That's looking mostly mostly to the left heading SE. Look the other way, and it's quite another story. The scene is like the black and white films I remember seeing in elementary school about Nuclear Explosions. Nothing is there but foundations. It looks like a forest of pilings. Completely cleared. What is unusual is the shear lack of anything. No beds, no mattresses, no refrigerators, no lamps. Nothing. Don't know where it all went. The water was clearly up in the trees as the debris clinging to the limbs indicates the water line. And it's up there. This area was entirely under water. You can tell the eye went throuogh because the wind damage appears to have been from several directions. Trees, including some of the 3oo year old live oaks, are not uprooted or blown over, but snapped in half like matchsticks.

We've now seen nearly 800 patients and I suspect we'll be very near 1,000 by the time we leave. We're keeping data which will be very interesting to review and analyze. A bit of beauracracy is springing from the no-paperwork zone. Forms for just about anything you may want to do are appearing in droves in MED-1. Helo transport, ground transport, you name it. I can't wait to get home, but this experience, and the people, and the faces, will always stay with me. Maybe it's because of the journey here, or maybe just luck of the draw, but as a group we've really created a team. I've made many friends - friends I will miss. Peter, MIke, Ben and I are heading out from Mobile tomorrow. We'll split in Atlanta. They'll then head to Wilmington and we'll make our way to the Triangle. Can't wait to see Melissa, Jackson, and Berk. One more day at the Kmart Klinic.

On the beach road, there lies the foundation of what used to be a church. Now there is nothing that remains but the alter and beyond it a view of the Gulf from where Katrina came. On the alter sits a lone offering plate which continues to fill amid the devastation. I have no doubt that this community will rebuild.

Chip

K-Mart K-Linic

2005-09-08T14:11:00.000-04:00

We are an up and running field hospital More like a field city. Although the National Guard camped with us have named us Camp Katrina, the locals have their own name. We're officially the K-Mart clinic. Where you going to find a doctor? The K-Mart clinic. Right above our little community looms a huge red BigK K-mart. Patients coming in. More and more every day. A soldier wrecked his truck last night and brought to us in the back of a Humm-V ambukance. Lots of rashes. We named the most common, a boot rash, "Katrina Rash." The spirit down here is hard to describe. Wal Mart is two blocks away and in ruins. Regardless, they have set up the regional pharmacy in the parking lot. All of their prescriptions, if adorned with the "Med-1" words on the bottom, are being filled for FREE for a week. The patients here still can't get used to not having to show an insurance card or pay. Usually it's the other way around. We all do our best to give our friends what we can. Next door, the Reverend's mission continues. He's doing an incredible thing. Without them, life around here would be even more difficult. Real home-cooked meals and boxes and boxes of clothing, toys, housewares. By the way, the are from the Christian Life Church, 25550 Canal Rd, Orange Beach, Alabama. I've already given them my cash - and I am testimony that it goes to good use. The guys around her continue to amaze me. they drove through town yesterday and asked anyone around if they could "borrow" their destroyed washers and dryers. The brought 4 back, and they're now in the compound working like they were new. Generator power and Firedepartment water. Yeterday a man drove his fairly new class C motorhome over to the church are and got out. He said he was going to sell it anyway as he gave the keys to someone. He said to put it to good use and left after saying he'd find another way home somehow. Stephen Nodine, a county commisioner from Mobile, has been in out with a helo bringing much needed supplies. Usually it's guaze and staplers, but last night he brought a cooler full of Lobsters and Tenderloin. The church is planning on firing it up tonight. We're in the process of working with GE and Hancock hospital to acquire a mobile CT scanner. Should be in today. Everyone's genuine caring and generosity is beyond imagination. Just back from NASA/Stennis. Showered, shaved, feel great. Noble has a pet Alligator he feeds while he waits. He named it "Tripod." Must have lost one leg in an epic Mississippi Alligator battle. The SWAT team "neutralized" another that was getting a little too curious. Ben and I are planning to fly home Saturday to RDU as the new team arrives. The bus was an experience, but nit ine I want to repeat right now.
Chip

Wednesday

2005-09-07T09:09:00.000-04:00

Funny, but everyone is so focused that I had to ask three people before anyone new what day it was. Wednesday. And that was only because he cheated and had a digital watch. We're begining to settle into a routine of sorts. The helipad is really busy now, sometimes 2 at a time. It's rfeally loud here. Between the generators and the helicopters overhead, we're finding that we're all hoarse from talking. A couple people can't talk at all. Patients continue to stream in, but mostly during the daytime/evening because of the 11pm curfew that was imposed in the region. MI's, acute abdomens, fractures. Lots of pharyngitis, rashes, lacerations, sprains. Uncontrolled diabetes because people have run out of insulin. One guy had a terrible skin injury to the inside of both forearms from clinging to a tree for literally hours as the water rose. Every person here has an incredible story to tell - they were part of it, right here, in the eye of Katrina. Had to airlift patients yesterday to Mobile and Jackson. First trauma last night. 12 year old rolled his ATV. I was very proud of the resuscitation. Lots of teamwork. Very quiet, calm. Survey, FAST ultrasound exam, labs, blood gas, and packaged to go in probably 10 minutes. Sent to our friends in Jackson by the Coast Guard helo. Learning something about that. Whe you go to take patients to the pad, come back in before liftoff for anything bigger than the Hueys. The CG Dauphine really kits up the dust - and that's some nasty dust. Worked on a call schedule, but it doesn't really work because everyone is adamant about just working until the work's done. And there's a lot of work. So, everyone is pretty tired, - in a good way. Asked the MS epidemiologist to come by yesterday. Strange rash circling. We all think it's fireants and he agreed. Lots of MRSA around so we're sure to cover it. The OR is up and running. Three cases yesterday. Mostly things like soft tissue infections and the like. But we can and will do more if we need to. The teamwork here is truly something to remember. The support staff have done an incredible job of keeping things running. They have a call schedule to refuel the generators so they just run run run. They've hardwired the remaining parking lot lights to our generators. Because the lights were above the water, we can run them at night - brilliant. One person worked through the day yesterday to hand-build a shower from PVC and garbage bags. Pretty nice. We have 2 huge bladders in the back of the hospital that contain water for our use. We first run it through our own purification system. The local firetruck comes twice a day to assure we're full. Most important: we now have coffee. And diet cokes. For the more complex orders, Noble the busdriver is the go-to man. He's worked his sonnections with the outside world through his nextel so he can get you anything. Contact solution, a 6-pack of Iron City Light, a bucket of Fried chicke. You need it, you go find Noble. We're beginning to landscape now. Nice pretty potted tree from somewhere now adorns the triage entrance. We're learning so much about so many things it' s hard to imagine.
Chip

Helo Site Cleared

2005-09-06T09:08:00.000-04:00

Up and running. Sat Com now reliable. Also have 42 inch plasma screen TV in the OR. For digital Sat rediography, but also works nicely to watch CNN or any other of 300 channels. Things are going well. Saw well over 100 patients and another 150 or so (I hear) for things like med refills. We are now the stewrds of the stragecic national stockpile. An 18 wheeler dropped off a lod of supplies that filled half of our hospital. Yesterday we clrrae the LZ for helicopters. Amazing. The national guard plowed the lot next to us. We have acces to three helo's, so I askedx if they plow over the light posts for better landing safety. Response: ABSOLUTELY. Down they came. When nothing remained but the concrete posts, they brought a jackhammer. That left only a field of debris which goes on the "Bad" side of the equation when helo's move. Solution? The NC Rowan County Search and Rescue brought their bayou fan boat. Left it on the trailer, and directed it around the site like the world'a largest leaf blower. Absoluelt amazing. Now we're looking for paint for the big "H". Regardless, our helicopter came already this morning with supplies (GIA's etc) that we had asked for from Mobile. Things are great. Looking forward to another exciting day. Will try to figure out how to download pictures.
Chip

Media coverage

2005-09-05T17:18:00.000-04:00

Well the phone has been ringing off the hook here in North Carolina. Private citizens are calling asking for your help, others are offering theirs. The media is very interested in the efforts of the team. Unfortunately, they are still fixated on the roadblocks that were temporarily encountered. I have tried my best to describe the current situation, where you are, who you are, and what you are doing to redirect them. Everyone here is rooting for you and are in full support. As the people there likely have not seen much news lately please let them know that there are relief efforts of all shapes and sizes occurring all over the country. We just spent two hours standing in line at Mapleview Farms in Hillsborough to support their fundraiser. Today they are donating all proceeds to the relief effort. The people just kept coming and the lines snaked around the property. Lots of smiles and very few complaints! I will take the liberty of speaking for all your families and friends at home--we miss you very much and are so proud of your dedication and efforts!

Melissa

on site

2005-09-05T15:19:00.000-04:00

Will try to be more brief. Just wrote a page and 1/2 and the wind blew the satellite com on the roof. We're here and it's up and running. Has been an exhausting few days but we're happy to be here. You may have guessed from the media reports that things were a little rough for a while. We were having much trouble finding an appropriate place to depoly. Our initial mission was to support the Regional Med Ctr in Boloxi. However, they had done an incredible job of restructuring and had gottem back on their feet. On our inspection of the site, we felt there was no mission. At least the kiond we felt we could and should respond to. That's when we hit a roadblock. Our calls to redeploy to an area of need fell on deaf ears. Thanks to hard work and persistance, we managed to create a redeployment to the eye of the storm. Many thanks to Jeff Guy at Vanderbilt who was very helpful and instrumental in getting our plight out. Bottom line - eveyone dod the right thing and we're in the eye of the storm. We deployed to ground Zero, a little place called Waveland between gulfport and New Orleans. The eye went right over us. The devastation here is complete. We arrived at night and wirked through the night into the morning to set up camp. We're in a demolished strip mall in front of a Super K. Unbeleivable. You won't beleive the pictures. Our SWAT team and a local demo truck pulled flooded cars from the are and piled them to creae a sound perimeter. We put the SWAT team in PPE and they crawled around the buildings scouting for our perimeter protection. They found 8 bodies on the roof. Apparently the flood waters rose above the roofs. 40 bodies in the Walmart next door. Alligators and coppermouths. But we're safe. Really. Can't Pee without a guard with an M-16. Ben is doing recon in a helo looking for refugees. I just got back from the DMAT sytem depllyed at New Hanover Hospital. Destroyed. I managed to get some sterilization equipmengt and TA-55's. Business is booming. As word gets out, more and more patients are arriving. Bowel obstructions, MVC's, dehydrated children, wounds, lacs, you name it. Taking lots of x-rays, sending out free meds. Since we're here, infrastructure is being built around us. When we arrived, there were whole families in the parking lots. A liitle city with nothing. Now a tent city is being buit next us. CNN is here, helo's flying over constantly. I'm going to work now on arranging a LZ for the helos. I'm happy we're here. A rough couple days, but now eveything is moving right along. Happy to be here. Love to Mel, Jackon, and Berk. By the way, our first patient was a puppy with dehydration and some nasty skin disease. Doing O.K. on a cardboard box under the hospital.
Chip

Article by the Associate Press

2005-09-05T11:10:00.000-04:00

I opened the Richmond Times this morning and there was an article about the team! Unfortunately, it was highlighting frustration with Louisiana officials about getting the team there. I am not sure when this interview with Dr. Rich occurred in relation to Ben's latest posting, but am sure that setting up in Gulfport, especially as a trauma center, will be very valuable even if the team cannot get into Louisiana. AS with all articles, some of the facts weren't quite right, but it was amazing to see our effort was picked up by the AP, probably due to the imbedded reporter. There is no posting today yet, so I am hopeful that they may be setting up in Gulfport.

Chris Ogden

Link to AP article: http://www.cnn.com/2005/HEALTH/09/04/katrina.sick.redtape.ap/

From the home front

2005-09-04T20:04:00.000-04:00

I am trying to field all the volunteering requests that are flooding the trauma program office. Setting up instructions on our MidCarolina RAC website has helped. I can't imagine what this would be like on this end without email! I am anxious to hear what the team reports back as to anticipated continued needs for personnel, but by reading the postings, can see that the needs will continue to be many for the coming weeks or longer. I know that everyone on the first deployment must be exhausted already, but are proud to be part of the effort. We are all proud of you as well. Please let me know of any thoughts that any of you may have for the next round of SMAT members that come down, or who you might like me to approach. I am thinking about you all constantly--everyone here is.

Chris Ogden

Galloping to Gulfport

2005-09-04T17:45:00.000-04:00

We have just departed Camp Shelby and we are on the way to Gulfport, MS. The convoy passed a car crash on the way out of Camp Shelby. Although traffic was backed up there were no injuries. At this time we are taking an unexpected bathroom break. One person had to go so the whole 31 vehicle convoy had to stop. As soon as we stopped, several others suddenly had to go as well. In the meantime Chip and I have been working on a plan for Trauma Resus. The hospital in Gulfport is completely off line at this time. There is a DMAT on the ground that is seeing 400 patients a day and there is no trauma capability in a 6 county area. We will be the new Trauma Center as well as acute care hospital in Gulfport. We should be there later this afternoon. Once we are up and running we will update again and we will try to post pictures if possible. As we are finding out, plans can change rapidly.
Ben

Decamping Shelby

2005-09-04T14:20:00.000-04:00

Yesterday was an important day to decompress and rest. With fuel issues and the mechanical clinks of the convoy meant we travelled all night straight through, and then had to set up camp. Everyone was eaxhausted and hungry. No 80 hour work week down here. Myself and four other medical people went ahead to Gulfport and Biloxi yesterday evening to plan. The devastation was unbeleivable. En route to Biloxi Regional Med Ctr, we drove past rubble piles as big as the buildings they used to be and downtrodden souls wandering about the streets. The Governor of MS has requested our presence in Biloxi, so that is where we're heading now. Although Biloxi Regional is getting back on line, we will deploy there and provide support until we are moved - if we are moved. The logistical coordination between FEMA, the states and everyone else is a serpent with no head. I've been on thw cell non-stop. The Army fed us, fueled us, and we're heading out of Fort Shelby, straight South 70 miles to the Gulfcoast. I'm writing this from inside the ICU in the 18 wheeler. Air Conditioned! 98 outside. I've offered to be the ICU go-to person, but I think the IC has seen through my superficial ploy for a cool comfortable environment. We're all very much a team, each of us doing a bit of everything. Hopefully, when we encamp in Biloxi, we'll set up the sat-com. Good news as I'm getting Treo fingers. We're all still so proud to be bringing North Carolina's unique resources to our ailing friends here on the Gulf Coast. Time to head back out from my happy cool little ICU to the heat of MS. Excited to head back today with the whole team.
Chip

one more thing

2005-09-04T12:26:00.000-04:00

Another issue with placement of the hospital has to do with the helicopter service. There is so much debris on the ground in Biloxi that there is a real risk of flying objects penetrating the hospital tents or even the ambulances. We may end up in Gulfport if there is less debris. More later.

Waiting

2005-09-03T17:04:00.000-04:00

We pulled into Camp Shelby this morning. We expected food, beds, showers and fuel. Still waiting on fuel and food. There is a tremendous fuel shortage down here and the expected shipment has not yet arrived. While we wait an advance party including Chip has gone ahead to Biloxi. They are looking at the needs of the hospital there as well as a spot for us to set up. The officials here wanted us to look into setting up a forward trauma unit in Biloxi next to the hospital that was damaged in the storm. Once the assesment is made and the logistics worked out we will be back on the road. It is possible that this placement will not work out, and back up plans are being made. Despite an overnight bus trip with two stops due to blown tires, we are all ready to get on with this mission.
Ben

Biloxi Bound

2005-09-03T04:03:00.000-04:00

Getting to be a long night. And to get longer. One flat already, another change needed on Duke's rig. In GA racing down the highway with Troopers leading the way. No speeding tickets tonight. Received plans. Heading to Camp Shelby in MS which is field HQ for FEMA. They plan to feed us and give us a turn in the beds for an hour beforw sending us through to Biloxi. Our mission is to staff the Biloxi hospital which has been completely inoperable since the storm. No OR capability at all. Sounds like Ben and myself will be busy. Have radio'd ahead to have them pull all supplies not wet. Regardless, we should have everything we need. Pulling through Atlanta just after 1 am. Running out of Treo juice. Will try to charge with FEMA resources.
Chip

Convoy

2005-09-02T23:02:00.000-04:00

Spirits are high as we are finally making progress. We're barreling down the road in a convoy that stretchea as far as the eye can see . Lights are flashing . Incredible support along the way. People stopping to cheer us on as we move along. So far only one naked truck driver. Really. The things you can see from a bus. Just joined by a huge Guard convoy travelling with us. One stop already, just into SC to fix the breaks on Med-1. The trucks we have are really straining to pull the massive trailers, loaded to the ceiling with supplies. We're all so proud to be a part of such an effort. Already missing Melissa, Jackson, and Berk. Latest is we're staging in Jackson and onto deeper South. Maybe New Orleans, maybe Gulfport. People in droves waving anything they can find out their windows. Great stuff.
Chip

Leaving For The Gulf

2005-09-02T18:24:00.000-04:00

We are on the bus heading out to Jackson, MS. Thanks to modern technology we are able to post while we are riding down the road. We must look impressive with 2 tractor trailers, multiple SUVs with trailers and a police escort as we head south on the highway. The plan is to go to Jackson with the possibility of going further south. There is a chance that we will be able to divert before Jackson, but we are excited to be on our way to help. Earlier today we were joined by a vascular surgeon as well as another anesthesiologist adding to our ability to provide complex care. We will update again when we know where our final destination is (if we have cell access).

They are off!

2005-09-02T16:29:00.000-04:00

The MidCarolina RAC SMAT team left early this morning to rendezvous in Charlotte with other SMAT teams from NC. They received briefings and waited for the "go" from the coast. Finally, at about 4:15PM, the word came from HHS to leave for Jackson, Missippi, where they will either receive further instructions to either move on to another site or set up there to begin receiving patients. The medical center at the university there has been hit hard with incoming patients, so there would be a lot to do there and that may be what happens.

Will update as I get other news! All is well!

Chris Ogden
Trauma Program Manager

2005-09-02T12:37:00.000-04:00

We have made it to Charlotte, near CMC at the Medic facility. There are about 70 of us here, from all walks of life. We've been through the cattle herding process, having received new "Hurricane Katrina" I.D.'s. I was immunized against HepA and Tetanus. For the record, I got the last hepA dose, so if Ben gets sick it'll be my fault. No worries, though, because we also were oriented to our new home, MED-1. An incredible facility with two OR's, ICU beds, and room for 110 patients in the attached tent facility. We are travelling with our own SWAT team to keep us safe. My new best friends. MED-1 has the ability to do just about everything from general surgery to thoracic. Fully loaded - from complete OR sets, an autoclave, ultrasound, digital X-ray and satellite directed communications. There are 6 docs - Ben, myself, an Orthopedic traumatologist, an anesthesiologist, and 2 EM docs. Lots of nurses, EMT's PharmD's - the works. We're likely heading to a staging facility in Baton Rouge, but we're not sure. After seeing the facilities, meeting the people involved, and bearing witness to this incredible effort, Ben and I are very proud to be a part of this.

Ready to leave

2005-09-02T06:51:00.000-04:00

Slept well last night, but some thoughts of today's journey. Averything is packed. Ben just pulled into the driveway. Packing supplies into his Mom's truck. Waypoint in Alamance. Then off to Charlotte for the big leg of the trip.
Chip Rich

Deployment Preparation

2005-09-01T20:30:00.000-04:00

It's been quite an exciting and busy day. Have had the opportunity to reflect on our mission. We all feel very proud to be a part of such a great community, state, and relief system. All of our gear is packed and ready to go. Just got a shipment of OR supplies from UNC. Gloves for Ben and myself, staplers, PPE, the like. It's hard trying to prepare for something so uncertain, but the SMAT-2 team has really done an outstanding job, wuth the support of those around us. Just gave an interview with NBC 17, to be on tonight at 11pm. Not responsible fo the content. Jackson and Berk, my two sons were quite a part of it - as was our fat dog who kept barking from the deck. "Let me in." The kids and my wife Melissa are very excited too, if a little scared. The plan tomorrow is to meet in Charlotte around 10am to deploy with our gear and the other SMAT members from around the state. There will be about 70 of us - nurses, docs (Ben Zarzaur, myself, and 4 others we hear), paramedics, and the like. We will be staffing a mobile hospital complete with OR beds and fully stocked. Plan 2 12 hour shifts with 3 docs each, 2 sets of staff. May have to be modified based on what we find. Logistical nightmares abound though. No fuel guarantee south of Atlanta - we've been working on plans to take our own to feed the generators and get us back. Hopefully the National Guard and local Law Enforcement will meet us to provide a modicum of security. Plan to find a nice piece of land in New Orleans, high and dry to set up shop. Communication will be hard. Towers down as we hear from the DMATs who are there now. We will have Satelite phones for emergencies. If we can maintain a connection, I'll try to keep everyone up to date. Long strange trip ahead.
Chip Rich

2005-09-01T17:45:00.000-04:00

UNC Health Care