Home > Through Hell and High Water > Archives > 2006 > May > 10 > Entry
CHAPTER 4: A DARING RESCUE PLAN -- BUT WILL IT WORK?
The Atlanta Journal-Constitution
Multimedia
Nashville — Jack Bovender immediately understood the enormity of the situation at Tulane Hospital. The chairman and CEO of the nation’s largest for-profit hospital chain had just walked into the boardroom Tuesday morning about 8 o’clock when Mel Lagarde called from New Orleans, his voice filtering through the speaker system so all could hear.
*The water is coming in.
*It was rising a foot an hour.
We’re going to lose our backup power.
Among the executives gathered at the table, the sense of urgency ratcheted up. CNN was broadcasting reports that the 17th Street levee might have been breached. The update from Lagarde, a division president, meant a new challenge.
Just the day before, Bovender and the others had been preoccupied with the company’s hospital in Gulfport, Miss. Of the Hospital Corporation of America’s four facilities in Katrina’s path, it had sustained the most wind damage from the hurricane.
Now Bovender was thinking: *The whole ballgame is going to significantly change.
*Tulane had ventilator-dependent patients, babies in intensive care.
We’ve got to get the critically ill out of there as quickly as we can.
Lives were at stake. With no power or water pressure, Tulane would need to evacuate not just its critical care patients but the entire hospital — more than 1,200 patients, staff and family members who’d taken refuge there.
It was the direst situation the company had faced in its 37-year history.
Located down a carpeted hall behind two huge wooden doors, the boardroom at HCA headquarters was well-suited as a command post, with its massive mahogany table, large flat-screen TV, computers and sophisticated communications system. Bovender, who had spent three years in the Navy’s Medical Service Corps, would be the man in charge.
Short, with gray hair and clear-rimmed glasses, the 60-year-old Bovender became both chairman and CEO in 2002. He was at the helm when HCA paid the last of nearly $1.7 billion to settle Medicare and Medicaid fraud claims stemming from a nine-year investigation by the U.S. Department of Justice.
Bovender had grown up around hospitals; his mother was a nurse. So was his wife. He’d dreamed of being a hospital administrator since he was a young man.
He had learned that the job involved a lot more than medicine and money. HCA’s facilities in Florida had taught Bovender that running a hospital corporation also meant being prepared for disasters.
Four hurricanes had ripped through Florida in 2004, leading HCA to convene its hospital leaders from around the country to bolster their readiness for storms. They concluded that medicine, food, water, diesel fuel and portable generators should be stockpiled on site and in nearby warehouses. Hospitals needed to be armed with satellite phones to ensure communication when phone service and cell service were disrupted. Increased generator capacity would help preserve air conditioning — critical to the operation of computers that run lifesaving medical equipment.
By the time Katrina hit, HCA executives felt more than ready. But they had prepared for a hurricane, not a flood.
Although the company often used medevacs to airlift critical patients, HCA for the first time would have to evacuate an entire hospital. It would need a lot of helicopters.
How many? Bovender asked.
*At least 20.
Get them.*
Bovender’s team went to work, studying a color-coded map and assessing all the corporation’s assets in the region, from supplies to hospitals.
The plan was to move Tulane’s critically ill babies, children and adults first. But it wasn’t just a matter of getting sick people out. They had to arrange for continued medical care. They had to line up receiving hospitals.
Where would they take the patients? Where would they stage medical personnel to assist in the evacuation? Where would they refuel the helicopters?
Engineers studied Tulane’s garage. Its rooftop hadn’t been designed to function as a helipad. Was there enough room to land there safely? How many cars could it normally hold? Could it bear the weight of a helicopter? How many?
Ed Jones, a vice president of supply chain operations, moved to a side room off the command center where there was a phone. He called Chuck Hall, president of HCA’s North Florida Division in Tallahassee. Although Katrina had merely brushed the state as a Category 1 storm the week before, Hall’s command center was still up and running.
*We need to identify as many helicopters as we can, *Jones told Hall.
They required a variety of types, from medevacs equipped as ambulances that could carry one or two patients on stretchers, to those that could carry ambulatory patients in seats. They needed large high-volume helicopters for staff and their families, and ones that could carry supplies.
With a cellphone in his left hand, a BlackBerry in his right and a landline phone cradled on his neck, Jones leased helicopters from HCA contractors as well as other companies.
A police department north of Chicago offered a helicopter used in Amber Alerts, complete with a cop trained in night vision. An HCA competitor — Sacred Heart Hospital in Pensacola, Fla. — volunteered a medevac.
Within hours, Jones and Hall had lined up choppers from Atlanta, St. Louis, Chicago, Mobile, Houston, Pensacola and Ocala, Fla. They would eventually secure 24 helicopters, including two privately owned Black Hawks that could carry between 15 and 20 people and one Russian Mi-8. Jones began hounding the Federal Aviation Administration for clearance to fly the craft into New Orleans.
He would earn the nickname “Chopper Ed.”
At Tulane, as water inched up the stairs toward the backup generators, Lagarde and Jim Montgomery, the hospital’s president and CEO, did not sit back.
Soon after being awakened in the middle of the night, Montgomery had called Acadian Ambulance Service, a company with air ambulance helicopters based in Lafayette, La. He told them he needed to evacuate 13 critically ill infants, four critically ill children and 14 critically ill adults.
In the next four hours, atop the Saratoga Street parking garage adjoining the hospital, the Tulane maintenance crew dismantled four 15-foot light poles to make way for helicopters. HCA had once sought FAA approval to convert the rooftop into a helipad. But the hospital had never gotten the go-ahead. No helicopter had ever landed there.
By the end of the day, both in Nashville and in Tulane’s darkened command center, the guiding principles were clear:
We’re not going to wait for the government to rescue us. We have to rely on ourselves. We won’t take no for an answer.
Already, they were looking ahead to what they would do with the more than 1,000 Tulane staff and their family members who had joined them at the hospital before the storm. Many had lost their homes. Where would they take them?
Bovender tossed out an idea.
What if we secured a cruise ship?
ON THURSDAY: At Charity Hospital, staff is reduced to practicing Third World medicine. Chapter 5 of 22.
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Comments
By Joe Camp
May 10, 2006 08:05 AM | Link to this
Wow. This is quite a compelling story. As a corporate risk manager and safety professional, I am intrigued by HCA’s management of the crisis.
All of us, whether in a private or public enterprise, need to BE PREPARED. Think that YOU are not a risk manager? If you have family or employees that depend on you, then you are. Don’t wait until the next tornado watch, power outage, or influenza pandemic to DO SOMETHING. Be proactive NOW, so that you are ready. Tomorrow’s very surival of those you love may depend on what you do TODAY.
By Rhiannon
May 10, 2006 08:59 AM | Link to this
This is such an engaging story. Thank you for running the series.
I agree with Joe. Personal preparedness is everything. If you don’t know where to start, visit FEMA’s www.ready.gov for supply kit checklists and a step-by-step guide to creating your family’s emergency plan.
By Harmonie
May 10, 2006 09:55 AM | Link to this
This story is very touching. I am very intrigued by the courageousness and determination of the medical staff. As a medical professional I have heard stories about what went on in hospitals in New Orleans, but reading this has made the devastation of this appear more real. I thank- you all for taking the time out to give us this insight.
By living in fl
May 10, 2006 11:47 AM | Link to this
This piece is so compelling. I reside i Florida and have not felt the full brunt of hurricanes. I actually lived across the street from a hospital in St. Petersburg and they kept power when others were without. This year I am living somewhere else that is surrounded by lakes and ponds. I am thinking about a plan to keep my family safe and what if we cannot go back home.
I am putting my info on a disk and email it to my personal email account. Hopefully, if I had to leave the state, I would be able to get to a computer and download the information.
By cheryl h.
May 10, 2006 11:51 AM | Link to this
Jane, thank you for doing the necessary research to publish this story. I was in N. O. during the hurricane & I also had to be rescued from the floodwaters. Therefore, I can definately relate to the deprivation that the characters experienced. I am extremely excited and encouraged because this story is being published! Our stories need to be told so that the U.S. will be better prepared for its next great disaster! As N. O. citizens waited for days to be rescued, I also kept a chronicled journal of events that occurred & stories I collected from others along the way as my father & I tried to flee the city. (I’m in the process of getting them published also.) All of our stories need to be heard because they celebrate the unsung heroes of Hurricane Katrina.
By Jane O. Hansen
May 10, 2006 12:23 PM | Link to this
I really appreciate your kind words. Thanks for reading and thanks for your comments. I hope you continue to enjoy the series.
By Gina
May 10, 2006 04:56 PM | Link to this
Jane,
Thank you.
I am left with chills as I read this series. The city of New Orleans has come to mean so much to me because of the people with which I have met and formed lifelong relationships. Your story is a testament to what makes this a truly unique and wonderful city — its people.
Again, thank you for letting their light shine through your words.
By Chip Young
May 10, 2006 05:01 PM | Link to this
You had done a great deal of research for this article,,,shows how some were prepared and lots were not…I use to own the largest ambulance service in Atlanta for years…Atlanta South,,had to downsize a lot and sell the remaining service several years ago, because of no one wanting to pay for services,,,typical health care in America,,this is why most hospitals are in such trouble these days,,My hats off the the HCA Hospital chiefs for using the helicopters, I use to have two of them and they could save more lives than all the ambulances I ever had. One other great help was from the folks from Arcadian Ambulance in Louisana, They are one of the best and biggest private ambulances services in the area. The CEO was on the FOX news several evenings during the aftermath of the hurricane to explain what they were doing to evacuate patients. He also brought up that his communications center was up and running because he had the forsite of knowing the power and other services would be out for weeks,,He used a radio system that did not use computers to operate on like most government systems,,,way to complicated when the power goes out, Where were the government services during this disaster, under water like most other services…I really liked the guy that stole the school bus and went back to his neighborhood and got his neighbors and drove to Houston with them,,,now that guy should have been in charge of FEMA,,,typical government services that fail when really needed…I know from experience with them too,,,by the way they came to my florida warehouse and bought trucks, furniture , clothing and other things for the needy families in New ORleans area, we gave them a good deal on everything, thinking we were helping the victims,,,,well that was in October of last year,,,we have yet to be paid, other airboat operators that went to New ORleans to help rescue people off their rooftops have not been paid either,,,just the other week a camper dealer near our offices had to go out of business because FEMA never paid them for all the trailers they came to buy. so look out if FEMA comes to buy anything from you,,,run,,,,that is another story that you should look into,,,Billions of dollars going out and they cannot pay us little guys….CHIP YOUNG TYRONE GA
By Martha Peppers
May 10, 2006 05:54 PM | Link to this
Splendid work! You have done Mr. McGill proud.
By Tina Brewer
May 10, 2006 07:47 PM | Link to this
This is not a story about the past, with only blame left to assign. There is still today many people in the “Zone” as they call it, waiting for iunsurance checks, waiting for contractors, unemployed, their jobs gone and their sanity at risk. There are people living in hammocks in trees or sleeping in abandoned vehicles and moldy buildings. They are many just paralyzed by all that has happened. Many say they need to help themselves, and they do, but depression and frustration has taken it’s toll. I know this because I have relatives who went there to work, to help, and they have sent me pictures and told me what they have seen, IT’S NOT OVER YET. Many “refugees” need psychological help, they don’t know where or how to begin to rebuild. Those who were already on “the check” (Soc Security, Medicaid, Welfare, food stamps, etc.) and did not own anything have now less than nothing, still looking for more public assistance, etc. It has only worsened their public assitance dependence. And most important: WHY REBUILD BELOW SEA LEVEL???????? This will happen again. It just doesn’t make sense. Galveston Tx was once a tourist mecca, but they gave it up after a really serious hurricane. It’s the same as people building next to the Mississippi River: why should ourr insurance go up to replace that which is sure to flood again and again? Come on people, let’s make sense and move away from flood plains, sea walls, levees, dams, volcanos and other beautiful natural areas. THERE WOULD BE NO DESTRUCTION IF PEOPLE HAD NOT BUILT THERE TO BEGIN WITH. Sure, it’s hard to leave your home, but can’t you hear what Mother Nature is telling you? Tax money (working citizens’ money) should not be wasted this way. Let’s re-settle people away from these beautiful areas that hold disaster for us bipeds. That would be money well-spent. And let’s don’t forget that these people need not only food, clean water, housing, and medical care. They need Post-Tramatic-Stress counseling!
By Beverly Militello
May 11, 2006 01:45 AM | Link to this
Jane thank you for writing the struggle that was faced at these hospital’s. I’m a Critical Care RN in Atlanta. I actually took care of patients that were med evaced out of the hospitals and the airport. I have always gone though mass casulty drills, but when actually confronted with patients with their mass casulty tags on, it takes on a whole new prospective. I have also now had the pleasure and privilage to work with displaced nurse’s from New Orleans and have heard their overwhelming stories of what they had to deal with. I don’t know if you heard, but unfortunatly Charity Hospital is now condemed due to the damage it sustained, hopefully they will rebuild. That hospital was a true life line for New Orleans Citizens.
By Tracie
May 11, 2006 10:09 PM | Link to this
Dear Tina Brewer, Obviously you are NOT a native New Orleanian….please do not comment on whether or not we should rebuild in New Orleans! My home was in St.Bernard Parish (100% devistation to every structure), and we lost everything. You can not even imagine what it is to try to pick up the pieces of what is left of your life, and start all over. But wait….not just your life, every member of your family has lost everything too. The life you once knew…..chatting outside with neighbors in front the house, block parties, dinner by Maw-Maw’s every single Sunday…..it’s gone. It’s all just a memory etched in your heart and mind. And help each other? All we can do is offer love and support to each other because everyone is dealing with cleaning the mud and mold from their own homes. And the very personal belongings that I have kept for an entire lifetime are now being shoveled out of the house with the mud and muck, and put out to the curb as trash…..my valuables, things that were the most endearing to me, are now laying out in the open for the world to see and the trash truck to haul away. And having taken all that was familiar to me in my life, now I should just relocate elsewhere? Start over, without family, no friends, no job, no life-line? I don’t think that you realize that people who grow up in New Orleans never move far from home. Home is where your family is. Are you proposing finding housing and careers for ENTIRE families? Do you propose everyone should leave California? Or Oklahoma? Or Tornado Alley? How about every other coast line?
We are all still just trying to rebuild our lives, please don’t judge us on WHERE we do it.
By Tracie
May 11, 2006 11:19 PM | Link to this
Jane, As a person who has lost every single worldly possession in this disaster, thank you for this heart-felt story. It’s nice reading a story without a “media spin”, and speaks the plain truth….I have shed so many tears already. To Tina Brewer, Don’t be to hasty with your “no rebuilding New Orleans” comments. This is my heritage and my home, please do not question why it was even built in the first place…it’s insulting to me. I am from St.Bernard Parish, Louisiana which experienced 100% devistation in this disaster. It was NOT THE HURRICANE which destroyed us, but our very own government. It was the corps of engineers who built those levees that failed us, and assured us that they would protect us. The corps KNEW that the levees were in shambles and were not being properly maintained. Hurricane Katrina did not destroy New Orleans, as explained in this story, it was AFTER the storm had passed, the NEXT DAY that the levees began failing. I was born and raised in New Orleans,as was every single member of my family. I have lost every single thing that I have worked my whole life for. I can not begin to describe how it felt to gut my home that contained my precious memoribilia, to shovel all my special momentos out with the mud and muck and haul it to the street if it were trash. These things that meant so much to me, now sit in plain view for all the world to see, and wait to be hauled away as nothing more than garbage. My awards and trophies, my brand new wedding dress, wedding gifts (we had just gotten married), photos, every piece of my history. Things that can never be replaced. But I will rebuild my life here, because home is where your family is….your heritage….your friends….your memories, because that is all that is left. As if my life has not been destroyed enough already, should we start completely over in a strange place, with no job, and no security? How do you propose to move generations of families who know no other way of life? There are no guarantees…..natural disasters happen in every state of this country. Funny thing is, what happened to New Orleans was NOT a natural disaster, it was a MAN-MADE FAILURE. Thanks for letting me comment.
By MCL
May 13, 2006 09:30 AM | Link to this
“Tax money should not be wasted this way (working citizen’s money)”???? This quote was taken from Tina Brewer’s comments above. First of all, is she implying that the people of the Gulf Coast were not working citizens??? I can assure you Tina, I am a doctor and my husband was a teacher, and we were both “working citizens,” residing in New Orleans, and lost everything, homes, jobs, family spread out all over the country We are talking about a major AMERICAN city here, and you don’t think we should rebuild it? But is it OK to “waste” taxpayers money in Iraq, or is it OK to “waste” taxpayers money to help big corporations to continuously line their pockets by giving them huge tax cuts? Can’t you find a million ways taxpayers’ money is misspent? But to help people in need who were wronged by a government agency, you think this is a waste? Shame on you Tina, and I hope in your lifetime you never have to go through a similar thing.