“If this old ninny-woman, Fate, cannot do better than this, she should be deprived of the management of men’s fortunes. She is an old hen who knows not her intention. If she has decided to drown me, why did she not do it in the beginning and save me all this trouble. The whole affair is absurd. … But, no, she cannot mean to drown me. She dare not drown me. She cannot drown me. Not after all this work.”
—Stephen Crane, The Open Boat
Stephen Crane, the famous 19th-century American author of such works as The Red Badge of Courage, also penned a short story entitled The Open Boat during his illustrious career. The tale is a fictionalized narrative of a traumatic experience in his life. A ship on which he was a passenger sank during a storm off the coast of Florida. He found himself one of four survivors drifting in a tiny open dinghy struggling to stay alive in a tumultuous sea and pounding surf.
As Crane shows in his story, his characters’ salvations depend upon whether or not they will adapt to their surroundings and help their fellow human beings—not whether or not they can conquer nature.
I couldn’t help but think of Crane’s story and its inherent intimations after digesting firsthand accounts from medical staff on duty in ICUs during the recent traumatic experiences of Hurricane Katrina. The circumstances seem so unique and foreign in our modern age of delivering expeditious, accurate, and technologically supported medical care. I invite all physicians to bear witness to these incredulous stories and cleanse their own complacent perceptions, tabula rasa if you will, of functioning as a practitioner of 21st-century healthcare. These tales harken back to a not too distant time in medical practice.
Charity Hospital in New Orleans is one of the oldest continuously operating hospitals in the country. Along with University Hospital, another public facility just up Gravier Street in the Crescent City, Charity dispenses the lion’s share of all medical care in the city to one of the most uninsured populations in the country. Both hospitals are staffed and run jointly by Tulane and Louisiana State University (LSU), whose medical schools sit contiguously with Charity on opposite ends and lie unfavorably in one of the Big Easy’s topographical low points. Here are first-hand accounts from hospital staff who endured Hurricane Katrina from the confines of Charity and University hospitals.
Ben DeBoisblanc, MD, an LSU pulmonary attending physician, was assigned to Charity Hospital’s ICU. What follows is his chronicling of the events surrounding Hurricane Katrina.
“Prior to landfall it was obvious that Katrina had all the characteristics of the hurricane experts for decades had predicted would be the worst natural disaster in U.S. history: A category 5 storm hitting a city that is largely below sea level and completely surrounded by water. We were able to reduce our ICU patient load in Charity Hospital to about 50 prior to the storm hitting.
“After evacuating our own families, our emergency activation team set up to provide medical support for the remaining patients. During the storm windows blew out in the ICU, flooding it with about two inches of water. The power went out, but the emergency generators kicked on and all seemed well.
“But an hour later for some unknown reason we lost all power and began bagging our patients in total darkness. We were able to restart the backup generators late in the day on Monday, which allowed us to start cleaning up the mess in the ICU. Although the city was without power, we were high-fiving each other over a job well done. The day crew went to sleep late Monday, but was suddenly awakened at 3 a.m. on Tuesday to help bag patients when the emergency generators went out again. As dawn began to break we began to understand why: Water was pouring into downtown New Orleans from every direction and had flooded the generators that we located on the first floor.