Monday, September 8, 2008

The Post-Katrina, Post-Gustav, Pre-Ike Post

In an effort to show that the problems we are having with the healthcare system are frighteningly widespread, I'll be posting some of the stories I receive from near and far. Here's the first one:

Mary Matthiesen, director of Conversations for Life, “Teaching Healthcare & The Public How to Talk About What Matters Most”, forwarded my friend Maggie Duval an on-the-fly message from “barefoot doctor” Michael A. Kaiser in New Orleans (from Sept 4th). Borrowing a shared computer running an aircard (no Internet access, and due to lack of power/resources), this is a front line report about aftermath of Gustav on LSU health care facilities in Baton Rouge, Houma an NO. Please forward at will…
Good morning…

Just a brief, or maybe not so brief, update.

Larry in New Orleans. Quarter apt with power and he’s staying there. 8002 Cohn, not easy to identify damage (broken windows, water leaking, trees through roof), but no power.

Here… Mike and Victor without power. The admin of HCSD [Health Care Services Division - LSU Baton Rouge] remains working out of our day surgical hospital, which is operating on generator power. That means, there are some lights, and anything that needs electricity must be plugged into a red plug, designed for critical life support systems. Therefore, there are many red plugs in some places and very few in others. That means you need a flashlight to use the bathroom at all times or to enter a patient room (where we sleep) after dark. We’ve become very good at using the few red plugs for multiple purposes from charging blackberries to running the microwave to setting up our twice/day videoconference with all our hospitals.

Like Katrina, I’m struggling for an analogy in American History.

Before the storm we fully evacuated three hospitals and mostly two others. Then after the storm (with no gas and with communication failing) we moved just about everyone back and evacuated fully a fourth hospital.

Where has this been done before?

Of our 7 hospitals…two remain closed. EKL [Earl K. Long], here in Baton Rouge is still without power. When power finally got back to the hospital, key switches were so hot and damp that the power arced and blew shit up. Estimates for repairs range from “by tonight” to 6-8 weeks. Nothing, NOTHING, happens faster than the estimates or anywhere near the early estimates.

I’m thinking a month.

Chabert in Houma essentially took a direct hit. We are still figuring out all the damage, but replacement of all the elevators alone are estimated to take 8-12 weeks. (See comments above about time estimates).

It’s impossible to accept that we will be starting a new round of FEMA negotiations and interim solutions for healthcare. We are still negotiating with FEMA and revising interim solutions in NO three years after Katrina.

In Houma, we are already working towards a military supplied facility (DMAT-have no idea what the letters stand for) to be located in an empty grocery store.

Some of the Gustav vs Katrina differences are huge, (for example one hospital vs all impacted this time) but some are so similar. No matter how much thinking and money we’ve put into improving communication (and lots of money has been spent with clear measurable benefits), communication remains a barrier. We are running the hospital system mostly off laptops with aircards as we have no real internet access. Most cell phones are useless (I have a voice mail from at least 48 hrs ago that I cannot connect and listen to). And again, in the United States of America, lack of fuel is significantly hampering our efforts. An example, a huge truck delivering medicines ran out of gas and sat on the side of the road, while we figured out how to get him fuel. I would go tomorrow to Houma and see for myself the condition of the hospital, but I’m not sure where and how long it would take to get gas.

Another, example, I spoke to Mike Sanders last night:

Mike S: I stopped for gas on the way home tonight. (He hadn’t been “home” for a week)
Me: How long did it take?
Him: Oh, it wasn’t bad at all. I only had to wait an hour.

Hmmmm. I haven’t seen or heard three minutes of the Republican convention (did hear three very funny minutes of Dave Letterman making fun of our new VP candidate), but I know the response was better, but Federal help was and is mostly missing. If we had to rely on the Federal government instead of our own planning, patients would have died in both Houma and Baton Rouge in our hospitals. And when the real story of the medical evacuation of NO comes out (I know only pieces), there are definitely deaths that resulted from Federal government incompetence and inability to deliver what they planned and promised. Geaux Obama!

(The above paragraph morphed out of control. I started to write about the lack of media attention, once “the story” of the levees breaking in NO again didn’t pan out.)

OK… other folks are waking up so I need to pass on this computer with its air card to others. I’ll go take a shower (still cold) and start another day. For those of you who believe in the concept of “barefoot doctors”, I do everything in bare feet, which I truly believe keeps me grounded.

Thanks for all the e-mails to me, and all the calls and e-mail to family and friends to check-in how I did and am doing.

Feel free to forward this on. I’m hoping that this e-mail alone leads to more Obama votes in November,


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