Tours of Duty
When a hospitalist steps outside during a seemingly unending shift, and a city is silent but for the bark of dogs, something is wrong. When he returns not to a scheduled shift, but to an undefined “tour of duty,” something is very wrong. Such has been the case for many hospitalists and healthcare providers along the Gulf Coast since Hurricane Katrina first devastated miles of the coast in August, and then Hurricane Rita hammered home our vulnerability to natural disasters in September. These sentinel experiences offer learning points for our nation’s healthcare system. “Challenges Hospitals Encountered During the 2005 Hurricane Seasons” (p. 8) lists some of the areas in which hospitals and healthcare providers were tested.
Karen Sexton, RN, PhD, UTMB’s incident commander during Hurricane Rita, discusses evacuation options with her employees.
Half the Battle: Getting There
Eniola Otuseso, MD, a hospitalist who works in locum tenens positions across the southeast, calls Atlanta home. Her native Nigeria does not have hurricanes—their natural disasters are dust storms and monsoons—so she had never experienced one. The day before Hurricane Katrina hit, Dr. Otuseso had departed for her next job at Cogent Healthcare’s program at St. Dominic-Jackson Memorial Hospital (Miss.). Unable to take the last flight of the day, she packed a rental car and she, her 22-month-old son, and her teenage niece set off on the 380-mile journey to Jackson, Miss. Her account of the ride gives new meaning to the term “Sunday drive.”
MapQuest directions in hand, Dr. Otuseso took I-20 west toward Mississippi. From the road she called the hotel where she had reservations, only to find them canceled due to overbooking. She proceeded with nervous jitters: She had to report to work at 10 a.m. So she found another hotel, spent the night, and set out again at 6 a.m. Monday.
Then she had another problem: Although she thought she was on I-20 west, she had accidentally taken route 59 south—directly into New Orleans and the brunt of the storm. She notified the hospital that she was on the way, and promptly lost phone service. “I realized I needed to turn around and got off at the next exit, but a tree had blocked the road,” says Dr. Otuseso. “No one was around.”
She took the one-way exit back as trees fell around her. Her nervous jitters escalated to panic.
When a tree fell in front of her car, her attempted circumvention landed the car in the mud, and she ran out of gas trying to dislodge it. Miraculously, she had phone service, but the appalled 9-1-1 operators couldn’t help. Finally, a motorist and his adult passenger stopped and offered a ride. Dr. Otuseso and her wards climbed into the good Samaritan’s vehicle, and they were off again. The frequent need to get out of the car to haul trees from the road slowed their journey.
Finally, the mud was too thick and they became stuck. She managed to reach a nearby house on foot, and the owner used his tractor to move the car. He also offered them respite in his home with his wife and baby. A drenched, discouraged Dr. Otuseso and her children accepted the offer and were ferried there by tractor; her previous companions slogged on.
