President's Fund Recipients Recount Hurricane Experiences

Waves swamped their clinics. Wind collapsed adjacent structures onto their buildings. The storm surge swept away their homes. In the midst of the storm and its aftermath, they cared for patients, working without electricity, light, clean water or supplies. They organized community response to the community need. They opened clinics.

And for that, eight family physicians were honored Aug. 29 when AAFP President Larry Fields distributed funds from the AAFP President's Challenge: Physicians' Disaster Assistance Program. Here are some of their stories.

Despite the approaching storm, Bryan Bertucci, M.D., and Bong Mui, M.D., stayed at their posts at Chalmette Medical Center, a 194-bed hospital in Chalmette, La. Although most patients had been evacuated, 47 remained, and an additional seven patients were admitted the night of Aug. 28. As Hurricane Katrina made landfall Aug. 29, Bertucci, Mui, a third physician and the remaining medical center staff members were caring for 54 people.

By morning's end, water had overtaken the hospital's first floor, cutting off electricity, water and telephone service. Bertucci and Mui worked against time, continuing their rounds by flashlight, caring for patients who required power for suctioning, oxygen support and intravenous infusion and providing medical support to staff members who became dehydrated and psychologically stressed.

Late in the afternoon on Aug. 29, more than 400 Hurricane Katrina survivors began arriving. Pulled onto a second floor balcony by lifelines made from hospital sheets tied together, the evacuees -- wet, scared, hungry and thirsty -- lined the hospital's corridors.

Help arrived Aug. 30, when all the evacuees, 10 hospital patients and half of the nursing staff boarded boats for dry land, where they were loaded into trucks and taken to the jail, which still had electricity and where jail cells became hospital rooms. On Aug. 31, the remaining 40 patients at the medical center were transferred.

By then, eight patients had died because of the stress, heat, and lack of suctioning and oxygen.

As Bertucci boarded the last evacuation boat, he glanced at the parking lot and his office across the street, where 13 feet of water submerged his car and lapped at the second floor of his clinic. He, Mui and Cuong Le, M.D., also of New Orleans, had lost their homes, their patients, their clinics and their jobs.

In the jail, patients lined the halls, lying on mattresses, resting in wheelchairs, leaning on crutches, tethered to IV bags taped to nearby walls. Using the prison pharmacy and supplies, Bertucci helped treat between 300 and 400 patients a day for dehydration, lacerations, abscesses, heart failure, pulmonary diseases and mental disorders. More than 9,000 evacuees -- some in underwear and carrying all their earthly possessions in their arms -- paraded past the jail on the way to ferryboats that would carry them to safety. By Sept. 2, helicopters had transported patients and hospital staff from the prison to nearby hospitals.

Bertucci's response to the disaster: "I guess I have become philosophical: How blessed I was to have all the things I had to lose in the first place," he said. "My father always said with a good education, you can always have a shirt on your back, food on the table and a roof over your head. After Katrina, I realized he didn't say what kind of shirt, what kind of food or what kind of roof.”

With his town, his neighborhood and the medical practice he shared with Bong Mui, M.D., destroyed, Cuong Le, M.D., had no options for remaining in New Orleans. That doesn't mean he won't return. Although he moved temporarily to New Roads, La., -- where he continues to care for patients -- Le spends many of his weekends at his New Orleans home, cleaning, stripping down and rebuilding.

The office where Alix Bouchette, M.D., practiced in Gretna, La., survived the winds and avoided the floods of Hurricane Katrina, but fell victim to its neighbor. Crushed by the collapse of the building next door, the office and its equipment and patient files were totally destroyed. Undaunted, Bouchette reopened a smaller clinic on Nov. 10 and plans to rebuild a larger office in a new location. Until then, he can care for 35 patients a day.

Committed to caring for patients first and worrying about the administrative requirements of rebuilding after Hurricane Katrina later, Robert Kenny, M.D., reopened almost immediately after the storm. Although his office remained under water, Kenny converted the apartment above his clinic into an office so he could continue to care for patients. His dedication to ensuring continuity of care for his patients backfired financially, though. By maintaining patient services before the New Orleans government had regained its footing, Kenny did not qualify for assistance from the city. Undaunted, he continues his practice in a sparsely equipped office marked by a high water line that measures the destruction of his clinic. Today, Kenny cares for a patient census equal to the one he had before the storm.

William "Sid" Ross, M.D., of Moss Point, Miss., had cared for patients and taught medical students and residents at his medical clinic throughout his career. But when Hurricane Katrina destroyed his office, his dream home -- built 10 years ago -- became a temporary medical home for Hurricane Katrina survivors. Recognizing the increased and ongoing need for primary health care among hurricane survivors, Ross cleaned up the least damaged area of his home and converted it into a temporary office. There, he met immediate post-Katrina health needs until he could begin offering services at a nearby free clinic. Although his losses exceeded his insured costs of approximately $1.4 million, Ross was able to recover his patients' records, and today he practices with the Coastal Point Family Health Center.

While the rain was still pelting the Gulf Coast, social activist Malik Rahim of Algiers, La., met with emergency medics to establish a first-aid station for hurricane survivors. The only available location was Masjid Bilal Mosque where Rahim worshipped. A groundswell of people, including Ravi Vadlamudi, M.D., volunteered. Expecting to provide only emergency care, Vadlamudi, Rahim and their colleagues soon realized people most needed primary care for chronic conditions, such as hypertension and diabetes. Vadlamudi said he stayed on at the clinic over the months "because of the desperate needs of the people I was seeing there." In less than a year, the temporary service became the Common Ground Health Clinic, a nonprofit organization established across the street from the mosque. Today, Vadlamudi serves as the volunteer medical director in addition to providing care for patients in his own practice.