As Houston-area citizens evacuated or hunkered down at home in anticipation of Hurricane Harvey, doctors like Mary L. Brandt, MD, FACS, packed a bag and headed to work.

“I came in on Saturday morning [Aug. 23] – I was on call – and so I packed a big suitcase and a big bag of food because I anticipated I would be here until Thursday,” Dr. Brandt said in an interview, “So I became part of the ‘ride-out crew.’ ”

Hospitals were hit hard by Hurricane Harvey, and many struggled against the effects of the Category 4 storm, which made landfall then stalled over Texas for almost a week, pummeling the area.

A contingent from the Texas Army National Guard and Texas Task Force 1 escort a woman in labor after an emergency airlift to a local hospital in Beaumont, Tex., Aug. 30.

Preparations began well before the hurricane arrived. As weather experts and government officials warned of the storm’s imminent arrival, Houston’s Texas Children’s Hospital wasted no time making necessary plans in addition to the safeguards their facilities already had in place, Dr. Brandt said.

“We all know this [flooding] could happen, so all the facilities in the medical center have flood gates, and generators are out of the basement so that there is not any risk of losing all electricity, but then the issue becomes the staff,” Dr. Brandt said. “They can’t get to and from the facility, and that’s particularly true if they live in the periphery of Houston, which is common.”

The situation was the same for many area hospitals. Just 2 miles away from Texas Children’s Hospital, SreyRam Kuy, MD, FACS, associate chief of staff at the Michael E DeBakey VA Medical Center, and her colleagues prepared to run the hospital with a skeleton crew.

“We were preparing when it was still a tropical storm, and we talked to the staff ahead of time to let them know this would be a marathon, not a sprint,” Dr. Kuy said in an interview. “We had people staying in the hospital ahead of time because we were worried that when the hurricane hit, we would not be able to have people return.”

But when Harvey made landfall with Category 4 intensity, many medical facilities were caught by surprise.

“We didn’t know how bad it would be, I honestly don’t think anyone in the city or the state had any idea of how tremendous the impact would be, particularly with the flooding,” Dr. Kuy said. “We had staff going 5, 6 days here at the hospital, working continuously, sleeping on the floor, and because of that, we were able to perform multiple emergency surgeries during the disaster, including laparoscopic treatment of ruptured appendicitis and replacement of an infection aortic graft, which required massive transfusion.” The VA hospital broke from its core mission of caring for veterans, treating “homeless folks and nonveterans who were brought here by the Coast Guard, or the ambulances, or by air.”

At Texas Children’s Hospital, Dr. Brandt and her colleagues were dealing with similar situations, staying on their feet and moving quickly as rescued patients arrived by air.

“We were near the area that was flooding really terribly, and so the Coast Guard had been coming in and bringing kids,” Dr. Brandt said. “Sometimes, we knew what was coming and sometimes we didn’t. It was pretty much controlled chaos.”

Staff shared responsibilities, often taking on tasks far outside their usual roles.

“We didn’t have enough people working the cafeteria, and so, at one point, I put on my hair net, grabbed a ladle, and served in the lunch line,” Dr. Kuy said.

Throughout the storm and flooding, medical professionals fought through exhaustion and depleting supplies, all with little or no knowledge of how their own homes and families were faring.

“We had people here for so long, and they had no idea what was happening in their own homes,” Dr. Kuy said. “They were watching on the news, seeing the reports and watching their own neighborhoods flooded.”

Dr. Brandt and her colleagues would watch as reports came in of what was happening beyond the hospital walls.

“We have some meeting areas, we would watch the weather together and that goes from the janitors to the head of the hospital who was in the hospital with us,” she said.

Despite the chaos outside, morale did not waiver for either Dr. Kuy’s or Dr. Brandt’s crew.

“I remember walking throughout the hospital, doing my rounds, checking up on the units. I went to talk with some of the staff nurses, and what struck me was as I walk in I see these big smiles on their faces, I absolutely did not expect that,” Dr. Kuy said. “They had been in the hospital for 5 days, they were exhausted. It just makes me so proud to serve along these kinds of people.”

As travel became possible, Dr. Kuy and other area physicians – as well as volunteers from across the country – began to shift their focus to evacuation shelters, treating ambulatory patients there.

“The response has been phenomenal,” said Dr. Kuy. “I met an ER doctor from North Carolina who came to volunteer, we have FEMA [Federal Emergency Management Agency] doctors from all across the state, and then of course, all the people from the different VA [hospitals].”

Pediatricians have sent their support as well, offering time and supplies to help take care of the patients at Texas Children’s Hospital, Dr. Brandt said.

At presstime, volunteers were still needed. The Texas Department of State Health Services opened a web portal for volunteer opportunities, and lifted restriction on out-of-state doctors from practicing medicine without state registration.

While there is still much that needs to be done to recover, those on the ground said that they feel an overwhelming feeling of community as people face what will inevitably be a tough road ahead.

“Houston has a reputation and a culture of helping neighbors and it has been astounding to watch what’s happening,” said Dr. Brandt. “No matter how tired people are or how stressful any cases are, everyone’s morale stays high.”

ezimmerman@frontlinemedcom.com

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Hurricane Harvey tests Houston physicians’ mettle