Guest post from Kristopher T. Kimmell, MD
Neurosurgical Resident, University of Rochester Medical Center
Rochester, NY
On August 29, 2005, Hurricane Katrina made landfall in southeast Louisiana. Shortly after, New Orleans was engulfed in its destructive path and the storm’s surge inundated the city. Katrina’s wake left the most expensive natural disaster in United States history, with New Orleans one of the main casualties.
Katrina-related stories that emerged from New Orleans are a blend of the tragic and heroic. Many stories detail the bravery of medical personnel who stayed behind to care for the city’s sickest and most vulnerable inhabitants despite the grim projections for the storm. Notably, several neurosurgeons took on enormous personal risk to remain in the city caring for very ill neurosurgical patients. Included in this brave group were David G. Kline, MD, FAANS(L) and two of his residents working at LSU Medical Center caring for patients at Charity Hospital. Dr. Kline has previously written about the Spartan conditions for those who stayed. They had no electricity and air conditioning, limited supplies and they were surrounded by water. Dr. Kline described the stark challenges facing medical personnel in treating dehydrated patients with limited supplies — such as using coat hangers as makeshift intravenous fluid poles in a parking structure while awaiting evacuation. Across town, Miguel A. Melgar, MD, PhD, FAANS and two of his residents were caring for patients at Tulane Medical Center, while Gabriel C. Tender, MD, FAANS, an LSU Medical Center neurosurgical graduate, cared for patients at the University Hospital. All stayed on in New Orleans until all the patients could be evacuated to safety to other facilities in places, such as Houston.
Katrina was a disruptive force for the entire New Orleans community, and the medical facilities were no exception. Many closed indefinitely — some permanently (Charity Hospital) — and many medical students and resident trainees were forced to relocate to continue their training. Dr. Kline lost two LSU residents as a result of the storm when they relocated to complete their training.
Now, ten years later, the story of Katrina has not been completely written. The medical community is still adjusting to life post-Katrina. Charity, the city’s iconic hospital for the area’s large uninsured and indigent population, remains closed. However, sometimes disruptive forces led to innovative solutions. In the aftermath of Charity’s closure, the LSU Medical Center has constructed a brand new hospital facility that will help to serve the city’s uninsured, as well as provide a center for clinical research and high-level medical and surgical services. The neurosurgical training programs at LSU and Tulane have returned to their full complement and continue to adapt to the evolving healthcare systems and delivery models.
In some ways, Katrina presaged the cataclysmic changes to healthcare in the United States. In the wake of tidal waves of legislative and regulatory reform, many healthcare providers struggle to keep their heads above water. Neurosurgeons — through the advocacy of our national organizations — are striving to stay on high ground and navigate the new topography of healthcare in this country and maintain the highest quality of care for our patients. New Orleans provided an excellent venue for us to review our history and look to the future of our specialty. The Faces of Neurosurgery who provided courageous service during Katrina serve as a model of how to survive the flood and eventually thrive.