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Monday, May 8, 2006
CHAPTER 2: TWO FORTRESSES AGAINST THE STORM
The Atlanta Journal-Constitution
Multimedia
New Orleans — The news stunned Susan Sanborn on Saturday morning: Hurricane Katrina, on its way to becoming a catastrophic Category 5, was hurtling toward her beloved city like a heat-seeking missile.
The professional dancer-turned-student nurse didn’t consider evacuating. She had totaled her car and used the insurance money to pay for nursing school. Her only transportation was a bicycle. If Katrina really did have New Orleans in its cross hairs, she figured her workplace — the fortress of the venerable Charity Hospital — was the safest place to be.
Like many hospitals, the building had served as a civil defense shelter during the Cold War, and in its 60-plus years had sheltered patients — among the city’s poorest — through dozens of storms. No emergency plan had ever called for a wholesale evacuation of the 20-story hospital. Charity remained open for business, come hell or high water.
If hospital administrators called a code gray — the term used to signal a weather emergency — Sanborn planned to be there. The 37-year-old Ohio native had volunteered for the activation team, which would report to work with enough food and water to last three days. They would tend to Charity’s 347 patients in 12-hour shifts, and once the emergency ended, a recovery team would relieve them.
By Saturday afternoon, the storm’s path and intensity spurred hospital administrators to activate the code, a decision that would cost about half a million dollars in staffing and supplies. It would take effect at 8 a.m. Sunday, Aug. 28.
Another nurse offered Sanborn a ride to work. She’d have too much stuff to carry on her bike. Although this was Sanborn’s first code gray, she was in the company of experienced Charity staff, such as Dr. Ben deBoisblanc.
Since coming to the hospital as a medical student 28 years earlier, deBoisblanc had soldiered through a half-dozen code grays. A passionate, emotional man with thinning reddish-blond hair, the New Orleans native looked like the actor Ed Harris of “Right Stuff” fame. At 50, he was director of the medical intensive care unit. Staff and patients called him “Dr. Ben” — far easier than pronouncing his French name.
Several months before the storm, his wife of 20 years had left him. He was shocked; never even saw it coming. A sailor from childhood, he moved out of their home in New Orleans and onto his boat, Creola, moored at a marina on the south shore of Lake Pontchartrain.
Before leaving Sunday morning for Charity, Dr. Ben prepared the boat as well as he could, then grabbed his children’s pictures and other mementos. One prized possession was his only photo of his late father, who had instilled in him his love for the water. His father had never graduated from high school, and more than anything had wanted his son to get a good education.
As he started to take the picture off the wall, Dr. Ben felt his father’s presence. Somehow, he believed, his father’s spirit would watch over Creola. He left the photo behind.
Over the years, with every major storm, Dr. Ben had heard the dire predictions: With the right conditions, the storm surge would put this bowl of a city that sits below sea level under water. Each time Charity had braced itself, and each time the storms petered out or veered away from the city. This time, Katrina promised something more.
As Dr. Ben reported for duty on Sunday morning, he told himself he’d be on lockdown no more than a day or two. But he also couldn’t help thinking:
This could be the big one.
Three hundred fifty miles away in Houston, Sharif Omar collapsed in bed after a Saturday night spent celebrating. Tall and slim, with bushy black hair and long eyelashes, the young man was getting married the next weekend in Virginia, and his bachelor’s party had stretched past midnight.
At 26, Sharif Omar — named for the star of the movie “Doctor Zhivago,” only in reverse — was associate vice president of operations at Tulane Hospital, located across Tulane Avenue from Charity. It was his job to ensure that there was plenty of food, water and blood on hand. He also was in charge of transporting patients. It was a big job under normal circumstances, and critical when a storm threatened.
Before falling asleep, Omar checked the news: Still churning several hundred miles away in the Gulf, Katrina was a Category 3. When he awoke the next morning, it was a 5.
As traffic snaked out of New Orleans Sunday under a mandatory evacuation ordered by Mayor Ray Nagin, Omar sped in the opposite direction, sometimes topping 90 mph as police just watched. He arrived in the city around 5 p.m., grabbed some clothes at his house, then headed to the hospital. The hurricane’s initial bands of wind and rain were starting to blow in.
While other businesses boarded up their shops, the city’s hospitals prepared to hunker down and remain open. Critical patients could not be safely moved without tremendous risk, especially those on ventilators and other life-support equipment. The hospitals’ emergency power systems — gas- and diesel-fueled generators — would keep the machines going if the city’s power failed.
At Tulane, administrators made routine preparations, taking inventory and deciding on staffing for their 178 patients. Owned by the Hospital Corporation of America, the largest for-profit hospital chain in the country, Tulane was one of four HCA hospitals in the path of Katrina.
All were the responsibility of Mel Lagarde, president of HCA’s Delta Division. Lagarde decided to base his command post at Tulane because it was centrally located. From there he would help the hospitals secure resources through the company’s headquarters in Nashville. He too was familiar with the decades-old models that predicted total devastation if a big enough storm overwhelmed the city’s levees. He had a particularly bad feeling about Katrina.
Lagarde looked younger than 48, with a boyish face and dark hair parted on the side. A graduate of the Tulane University School of Public Health and Tropical Medicine, he had become a hospital CEO at 26, one of the youngest in company history. He was division president by the time he was 37. Like Dr. Ben, he was a New Orleans native. But after more than two decades with HCA, he epitomized corporate culture; he knew how to follow unspoken rules and respect the hierarchy, which he himself had climbed quite high.
It was little surprise that he and Dr. Ben would eventually collide.
Sunday night, as the winds intensified, residents and nurses on the day shift at Charity gathered in the on-call room on the 16th floor. Off-duty, they cooked hot dogs, ate chips and dip, and played poker. There was nothing they could do but try to relax, so most avoided television coverage of the storm and played video games on the Xbox.
At about 3 Monday morning, both hospitals lost power and the emergency generators kicked on.
Katrina made landfall at 6:10 a.m. with 125-mph winds. Palm trees were uprooted; light poles broke in half; trees bent to the ground.
As the storm’s eyewall passed through the city, the windows at Tulane bowed inward. Staff moved patients out of their rooms and into the hallways. Jim Montgomery, Tulane’s president and CEO, looked across the street and watched Charity’s awnings rip free of the moorings and fly away.
If God’s ever angry, we’re going to lose big, he thought.
The storm blew out windows on Charity’s upper floors and destroyed the roof over the operating rooms. Charity was so old that its ORs had been built on the top floor of a 12-story wing, some say to take advantage of sunlight.
Now the hospital was without an operating room, sterilization equipment or critical laboratory equipment. Doctors and nurses could no longer do blood or urine analyses or conduct other tests. They converted an outpatient clinic on the second floor into a makeshift operating room.
On student nurse Sanborn’s unit on the fourth floor, staff secured sheets over the windows to protect patients from flying glass. They couldn’t see out, but they could hear debris bouncing off the roof. They heard windows on the floors above them blow out and shatter on the ground below.
In the sixth-floor medical intensive care unit, where Dr. Ben cared for critically ill patients Hunter Reeves and Preston Johnson, water poured through the ceiling, pulling down tiles and light fixtures.
Suddenly, the emergency power shut down in their wing. Medical staff knew the drill: They ran to connect bags to ventilator patients — including Hunter and Preston — and began squeezing them, manually pumping air into their lungs. Later, the staff ran extension cords to a Coke machine outlet in a wing that still had power. At least for now, they were able to restart some ventilators.
Soon after the eye of the storm passed through, Dr. Ben’s team mopped up the inch-deep water. With power temporarily restored, calm settled over the ICU.
At Tulane, Mel Lagarde surveyed the building. The hospital had suffered minor roof damage and broken windows, but not much else. He turned his attention to Garden Park Medical Center in Gulfport, Miss., the HCA hospital that had sustained the most structural damage.
By midday on Monday, Aug. 29, the sun peeked through broken clouds, and hospital employees poured out of their safe harbors to inspect the surroundings. Sharif Omar and others walked five minutes away to the Superdome, where parts of the roof were gone. The Hyatt Regency hotel reminded them of the federal building in Oklahoma City after the bombing, its face sheared off, curtains flapping in the breeze like surrender flags.
The damage to the city was evident, but nothing close to the doomsday scenario the models had predicted.
Many people said the same thing: New Orleans had dodged another bullet.
From a walkway, Sanborn saw a homeless man curled under the steps of the historic St. Joseph Catholic Church on Tulane Avenue. It struck Sanborn that the church had somehow protected the sleeping man in the storm, as if surrounding him with a magnetic field.
That night, the student nurse ducked outside to smoke a cigarette at the bottom of Charity’s emergency room ramp. Her hospital was on emergency power, but the rest of the city was black and quiet. There were no cars, and the stars shone like never before. Sanborn sat on a bench and curled her feet beneath her. She figured the worst was behind her. The recovery team would arrive in a couple of days, and she could go home.
About 10:30, Sanborn stood up to go back inside. For the first time, she noticed it: Where the ground had been dry, she stepped into water.
Where had this come from?
ON TUESDAY: The white noise falls silent — a frightening realization. Chapter 3 of 22.
