A Last Look

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

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

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

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

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....

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

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.....

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