Commentary

A Month After Hurricane Sandy, Physicians Recall Experience


 

It’s been a month since Hurricane Sandy slammed into the East Coast, affecting 24 states and causing major damage in parts of New Jersey and New York. Several hospitals are still recovering from the storm, and some areas have set-up tents or mobile units to care for patients.

As of Nov. 28, Bellevue Hospital Center, Coney Island Hospital, Long Beach Medical Center in Long Island, Manhattan VA Medical Center, and NYU Langone Medical Center, were in the process of reopening their emergency departments first, and then the hospital, most by early next year.

While the hospitals slowly recover, personal accounts of physicians who helped evacuate their patients, or found themselves at the receiving end, are emerging.

"It was one of the most intense nights of my life," recalled Dr. Lawrence Phillips, director of nuclear cardiology at NYU Langone Medical Center. "Nothing I’ve done as a physician has been similar to this." He led the evacuation team on the cardiac floor, triaging and transporting patients from the 11th floor to the lobby.

Dr. Phillips lives a few blocks from the hospital and had no power for 2 weeks. "For me, it was like being without my real home and my work home. So it made the world a bit disjointed," he said in an interview.

Dr. Danielle Ofri recalled how patients were safely evacuated one by one from Bellevue Hospital Center, in an article published in the New England Journal of Medicine (Nov. 14, 2012 [doi:10.1056/NEJMp1213843]). But that also meant that the hospital’s 4,000 or so faculty and staff were dispersed throughout New York’s five boroughs. "The preternatural quiet of the hospital was unnerving. But the overwhelming feeling was one of sadness. Grief, really. The adrenaline surge of the evacuation had receded, and we were all left grieving – for our scattered patients, for our disrupted educational programs, for our stilled hospital," she wrote.

Dr. Smadar Kort, director of the echocardiography lab at Stony Brook University Hospital, lost power at home. Her hospital had power and received a dozen or so evacuated patients.

Dr. Kort, who is the governor of the American College of Cardiology’s Downstate New York Chapter, spoke with this news organization at the American Heart Association’s annual meeting in Los Angeles, about a week after the hurricane. She and many staff members still had no power at home and were unable to fuel their cars to get to work. [Watch the video for the full interview.]

In Manhattan’s Beth Israel Medical Center, which became Lower Manhattan’s only major hospital operating in the immediate aftermath of the hurricane, the emergency department chairman, Dr. Gregory Husk, had to get creative when suddenly 27 patients awaited dialysis in his ED (N. Engl. J. Med. 2012 Nov. 14 [doi: 10.1056/NEJMp1213844]). When the hospital lost its paging system and the intercom, the chief medical resident, Dr. Reza Samad, and his team downloaded a telephony app through the available wi-fi and used it to send urgent text messages. Duty-hour limits were no longer a major concern. "Like the boundaries defining a resident, a medicine ward attending, a housekeeper, a surgeon, and a social worker, the lines defining work shifts had blurred," Dr. Sushrut Jangi wrote in the perspective.

Dr. Irwin Redlender and Michael J. Reilly, Dr.Ph., reflected on the storm’s aftermath, and preparing for future disasters. They pointed out that two factors leave the health system and the population more vulnerable to future disasters: an aging and fragile infrastructure and climate change (N. Engl. J. Med. 2012 Nov. 21 [doi:10.1056/NEJMp1213486]). "Since these two powerful factors represent imminent threats to the public health, it’s fair to ask what role our profession will play in influencing the political process to ensure that we invest in upgrading critical infrastructure and implement policies that will slow the process of climate change," they wrote.

Looking back on his experience of Monday night, Oct. 29, when the hurricane made landfall, destroying homes, flooding streets and basements, and leaving millions without power, Dr. Phillips of NYU Langone Medical Center said, "a lot of what I did that night was not practicing medicine that was taught in school. I had my stethoscope around my neck all night, but used it maybe once."

All the training for crisis management, learning to cope calmly under emergency codes, and learning team-building skills, "a lot of if ended up being a unique preparation for the storm," he said.

That night, physicians, nurses, transport staff, residents, and medical students worked side by side to evacuate the hospital.

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