River of No Return?


Dr. Giora Netzer of the University of Pennsylvania Health System told of how a woman who had gone for days without her blood-pressure medication in the wake of the incredible havoc wrought by Hurricane Katrina suffered a stroke right before his eyes in a Louisiana parking lot.

And of how many people in and around New Orleans – also known as the "Crescent City" because of what proved to be its fateful below-sea-level rest on a curve of the Mississippi River – were afflicted with severe skin rashes that were caused by bacteria-laden water.

These gripping accounts are among thousands of such stories to emerge in the startling aftermath of Katrina, the monstrous storm that brought destruction and death to regions of the Gulf Coast states of Louisiana, Alabama and Mississippi.

But the hurricane, one of the most intense ever witnessed in the waters of the Atlantic basin, also brought out the very best in people, among them a six-member volunteer medical team of UPHS pulmonary- and critical-care physicians and nurses who spent 11 days, from Sept. 12 to Sept. 22, aiding storm victims in Louisiana – first in Baton Rouge, northwest of New Orleans, then in the town of Luling to the southwest.

When the storm struck, flooding the Crescent City and inundating other coastal areas, notably St. Bernard Parish (a parish is similar to a county) that lies adjacent to New Orleans, people fled to Baton Rouge and Luling, among other places.

"The woman who had the stroke had a blood-pressure reading of 220/150 because she had run out of her medication, and with her doctor also evacuated and her pharmacy under water, had no way to get more," explained Netzer, a research fellow and one of the six UPHS doctors and nurses.

"She was stable and seemed to be doing better the last time we saw her, as was a 15-year-old girl we treated for a facial rash because she couldn't find a doctor and didn't have regular medical care, which was the case with a lot of people," he continued. "We were there to help in any way we could."

Netzer and the other members of the UPHS team – Vivek Ahya, M.D., medical director of the lung-transplantation program; Colin Gillespie, M.D., research fellow; Lorrie Bokelman, BSN, R.N.; Lisa Douglas, R.N., critical-care-research nurse coordinator; and Dan Sterman, M.D., director of interventional pulmonary (who went on the trip for the first few days) – flew via chartered jet to and from Baton Rouge. Flights down and back were paid for partially by the Shein Family Fund for Humanity and by David Lipson Jr., publisher of Philadelphia magazine.

The team's relief efforts were initiated through a connection between Ahya and Dr. Vincent Valentine, his friend and counterpart at Oschner Clinic Foundation in New Orleans.

Valentine asked Ahya for his direct help. Soon afterward, the UPHS group was assembled and attached to Oschner's satellite clinic in Baton Rouge.

When they arrived, the team settled in to begin its work in a clinic that normally sees about 40 patients a day.

"But the need was so great we were actually treating close to 500 people a day," said Netzer.

'They Reached out to Us'
For the second week of their Louisiana stay, Fema – the Federal Emergency Management Agency – moved the doctors and nurses to Luling, in St. Charles Parish, where they spent the balance of their time working out of an RV in the parking lot of a bingo hall being used by FEMA and the Red Cross. The Penn team used sleeping bags on the floor the entire time they were away. In Luling, a Baptist church served as home.

In both places, recounted Netzer, days were spent immunizing people against hepatitis A and B, and administering other inoculations, such as tetanus, while nights were devoted to treating skin infections, rashes and other ailments, such as asthma and emphysema flare-ups.

"We also filled prescriptions, but had a short supply of drugs," added nurse Bokelman.

As she explained, "None of us wanted to stop; we just wanted to keep going tired or not, to do as much as we could. The people of Luling were absolutely lovely people, who treated us so well, and had tears in their eyes that so many had come from across the country to help, including from Philadelphia. They 'God blessed' us over and over again, and were so gracious."

Netzer agreed wholeheartedly with those sentiments: "The people also cooked for us, and even washed our clothes. They really reached out to us."

Since Luling stands on the west bank of the Mississippi, which wasn't affected as greatly as the east bank by the hurricane, survivors came there for treatment.

Bokelman told of how people came up to them many times just to talk about what had happened to their lives, and how one woman showed her a Polaroid of her house, and with tears in her eyes wondered what had happened to her grandmother's antiques.

"More than anything, that woman and so many other people just wanted somebody to listen to them and their stories," recounted the nurse.

Understood the Risk
As for what may have been learned from Katrina and how it changed people's lives, she said she hoped the affected areas and the country as a whole now understand how important it is to be prepared.

However, she continued, people also noted somewhat of a fatalistic attitude about life along the Gulf Coast: "Some said they knew there was the risk that a hurricane could wipe them out one day, and reacted by saying, 'It was just our time.' "



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