From a Doctor on the Front Lines of New Orleans

DISPATCH FROM NEW ORLEANS - September 1, 2005

"Personally, my family and I are fine. My family is safe in Jackson, Miss., and I am now a temporary resident of the Ritz Carleton Hotel in New Orleans. I figured if it was my time to go, I wanted to go in a place with a good wine list. In addition, this hotel is in a very old building on Canal Street that could and did sustain little damage. Many of the other hotels sustained significant loss of windows, and we expect that many of the guests may be evacuated here.Things were obviously bad yesterday, but they are much worse today.Overnight the water arrived. Now Canal Street (true to its origins) isindeed a canal. The first floor of all downtown buildings is underwater. I have heard that Charity Hospital and Tulane are limited in their ability to care for patients because of water. Ochsner is the only hospital that remains fully functional. However, I spoke with them today and theytoo are on generator and losing food and water fast.The city now has no clean water, no sewerage system, no electricity, and no real communications. Bodies are still being recovered floating in the floods. We are worried about a cholera epidemic. Even the police are without effective communications. We have a group of armed police here with usat the hotel that is admirably trying to exert some local law enforcement.This is tough because looting is now rampant. Most of it is not malicious looting. These are poor and desperate people with no housing and no medical care and no food or water trying to take care of themselves and theirfamilies. Unfortunately, the people are armed and dangerous. We heargunshots frequently. Most of Canal street is occupied by armed looters who have a low threshold for discharging their weapons. We hear gunshotsfrequently. The looters are using makeshift boats made of pieces ofstyrofoam to access. We are still waiting for a significant national guard presence.The health care situation here has dramatically worsened overnight. Many people in the hotel are elderly and small children. Many other guests have unusual diseases. ... There are (Infectious Disease) physicians in at this hotel attending an HIV convention. We have commandeered the world famous French Quarter Bar to turn into an makeshift clinic. There is a team ofabout seven doctors and PAs and pharmacists. We anticipate that thiswill be the major medical facility in the central business district andFrench Quarter.Our biggest adventure today was raiding the Walgreens on Canal under police escort. The pharmacy was dark and full of water. We basically scooped the entire drug sets into garbage bags and removed them. All under policeescort. The looters had to be held back at gunpoint. After a dose ofprophylactic Cipro I hope to be fine.In all we are faring well. We have set up a hospital in the French Quarter bar in the hotel, and will start admitting patients today. Many will befrom the hotel, but many will not. We are anticipating dealing withmultiple medical problems, medications and and acute injuries. Infection and perhaps even cholera are anticipated major problems. Food and watershortages are imminent.The biggest question to all of us is where is the National Guard? We hear jet fighters and helicopters, but no real armed presence, and hence therampant looting. There is no Red Cross and no Salvation Army.In a sort of cliché way, this is an edifying experience. One is rapidlyfocused away from the transient and material to the bare necessities oflife. It has been challenging to me to learn how to be a primary carephysician. We are under martial law so return to our homes is impossible.
I don't know how long it will be and this is my greatest fear. Despite it all, this is a soul-edifying experience. The greatest pain is to think about the loss. And how long the rebuild will take. And the horror of so many dead people.Hopefully their collective prayers will be answered. By the way, suturepacks, sterile gloves and stethoscopes will be needed as the Ritz turnsinto a MASH."