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LSU orthopedic faculty and residents ‘survive the storm’
The orthopedic department cared for patients in Charity Hospital, Kenner Regional and in evacuation centers during Hurricane Katrina.
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Orthopedic faculty and 20 residents at Louisiana State University in New Orleans dedicated their time and abilities to caring for patients and evacuees during Hurricane Katrina, despite being personally affected by the storm.
As the chairman of the orthopedic department at Louisiana State University, Barry Riemer, MD, had the difficult task ensuring faculty and residents were safe. “Some of the residents and some of the faculty were working under some extraordinarily difficult circumstances in buildings with no plumbing, no electricity, no water,” Riemer told Orthopedics Today. “Some of these facilities, for example, had ventilator patients but no power, so somebody had to squeeze a bag to make them breathe 24/7.
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“We had people carrying patients up and down 12 flights of stairs in buildings with no lights, no power, no ventilation. Residents and faculty both became so dehydrated at times that they needed intravenous supplementation … This was a truly amazing period of time for them.”
Several LSU residents and one faculty member were among those physicians who stayed behind in Charity Hospital until the city was evacuated. Another faculty member stayed with residents at Kenner Regional Medical Center until the storm cleared. “They really stayed through the midst of it and made sure that all of our in-patients were safely evacuated,” LSU faculty member Evalina Burger, MD, told Orthopedics Today.
Once the hospitals were evacuated, LSU faculty and residents moved to evacuation centers in Baton Rouge, La., Lafayette, La. and Houma, La. They volunteered to care for patients, sometimes working up to 18 hours a day. “The numbers vary and they were hard to get a handle on, but they were probably seeing in the range of 800 patients a day,” Riemer said.
“It was truly inspirational to see how some of these residents in particular carried themselves through all of this,” Riemer said. “We have several residents who have lost literally everything, absolutely everything.
“Not only did they lose everything, their families lost everything … It’s bad enough to have your home flooded and completely destroyed, but all their aunts, all their uncles, all their cousins, all their siblings have had everything destroyed. So there’s no place you can go even to say, ‘get a picture of me when I was three years old.’ The personal tragedy of this is amazing and the character of the people to carry on in the face of this is remarkable, just plain remarkable to see.”
Patient care
Most patients needed medication refills or had chronic medical disease. Not many, Riemer said, had orthopedic injuries. “It’s a very interesting phenomenon because in most natural disasters, there’s a very heavy incidence of orthopedic injuries from buildings collapsing and automobile accidents …,” he said.
According to Burger, the most common orthopedic injuries included bad ankle fractures, children with displaced fractures and some fractures that had not been treated for three weeks.
Courtesy of Evelina Burger |
Once evacuees were allowed back into the city and began working on their homes, Riemer said more orthopedic injuries were coming in to the hospitals. “What we’re seeing now … is a much higher rate of orthopedic injuries from people fixing their homes or cutting down trees,” he said.
Although it is hard to tell just yet, Riemer predicted that the cost of Hurricane Katrina to the LSU orthopedic department will be a millions of dollars. In the meantime, they are depending on department reserve money. With the help of Robb Sellards, the program director, the orthopedic department has already restored the residency program and the curriculum.
The department has also found new housing for many displaced residents. “The community has been absolutely wonderful,” Burger said. “We have 35 people or families in the Lafayette and Baton Rouge areas who immediately opened their homes to all of the physicians in the orthopedic department.”
Neither cell phones, landlines or the university server were working, so the LSU orthopedic department found other means of communication, including text messaging; they also created an online chat group for meeting notices and scheduling.
“LSU has an extremely strong teaching program and residents who finish their training at LSU with Charity Hospital are held in very high esteem,” Burger said. “I think that our program will be as strong as ever [after this tragedy] … New Orleans is going to come back and we will be very well situated to serve the community.”
Donations from unlikely places
“One of the problems we also had was ‘what do you do for books?’” Riemer said. “Everybody left with what was on their backs and a little bag, thinking they’d be back in a couple of days. They don’t take books and educational materials at those times, so we’ve had to collect books and collect clothing for people.”
Riemer solicited donations from corporations, while others offered to donate clothing and books. Glen Lipton, a fifth-year resident at Drexel Medical School in Philadelphia, contacted computer and publishing companies for donations. The Montana State Orthopedic Society also organized a collection and donated a check to the LSU orthopedic department.
“Just the thought that people have gone to that extent in a completely unsolicited way, with absolutely nothing in it for them, it just means the world to everybody here,” Riemer said.
The hardest part now: giving people a purpose. “We don’t know for sure where the medical care is going to be needed,” Riemer said. “This level of uncertainty is not a comfortable thing for either residents or faculty at this time. One of our greatest challenges going forward is going to be keeping people in a fluid situation, feeling like they have a home and a purpose.”
Ethics was one issue that became apparent in the aftermath of Katrina – and one that the orthopedic field will need to discuss, Riemer said. In particular, the issues of applying care in such a situation and prioritizing care. “There’s going to be some interesting questions asked in the next weeks and months about how to handle some of these issues,” Riemer said. “It’s going to be a very educational process for quite a while.”
“I’ve had so many calls of offering to help, offering to house people,” Reimer said. “[They said,] ‘If you need a break, just come here. Send any of your residents here. We’ll put them up for week. It’s not a problem.’”
Riemer feels that even though there will be major changes in demographics in New Orleans — many people and physicians left and it is not clear if they will return — the orthopedic community will remain committed to patient care. “We may find that a good orthopedic community is going to bond … and become a still stronger orthopedic community,” he said.