Through Hell and High Water

CHAPTER 8: STIFLING HEAT, SLIPPING MORALE, SURPRISE PATIENTS

By Jane O. Hansen | Saturday, May 13, 2006, 03:21 PM

The Atlanta Journal-Constitution

New Orleans — At Charity Hospital, Susan Sanborn held tight to her sanity by keeping up with her job.

As a student nurse, the petite woman with curly auburn hair was in charge of bathing patients, cleaning their bedpans and changing their sheets in her unit on 4-Central. By Wednesday, Aug. 31, she had only 10 sheets and two clean hospital gowns left. The toilets were so gross, someone put up a sign saying, “For the love of God, please do not use this toilet anymore — go to Port-A’s for crap (or at least another floor).” It was signed “The new management.”

Sanborn’s domain was the “hopper room,” where she emptied catheters and bedpans into a huge receptacle. She obsessively calculated how many days she had left before even the hopper overflowed.

What am I going to do with this urine and feces? she asked herself.

Sanborn, 37, had gone into nursing as a second career after fleeing a bad relationship and moving from one hurricane-prone area to another. A professional modern dancer with an undergraduate degree in psychology, she’d lived in Florida where she did dance therapy in shelters for troubled children. In New Orleans, she was working on a geriatrics psychiatric unit when her supervisor asked whether she’d ever considered becoming a nurse.

Wow, you think I could do this? she had asked him.

She applied to Charity’s school of nursing and quickly fell in love with the hospital’s patients, staff and program. The doctors and nurses took time to teach her. She felt respected and was allowed to practice her skills. She never dreamed she’d become such an expert in packing bullet holes — one of the benefits of working in the city’s only Level 1 trauma center.

She was eight days into her last year of nursing school when Hurricane Katrina hit.

As her patients’ anxiety level rose, Sanborn tried to comfort them. They repeatedly asked for water, but many just wanted attention. An 83-year-old woman who had been in an automobile accident asked whether her doctor would be angry if she sucked a peppermint. Her mouth was so dry. She had nothing but her bathrobe and nine peppermints. Sanborn said sure.

The heat inside the hospital was so unbearable that doctors and nurses — sweat dripping off their noses — heaved oxygen tanks through sealed windows to let fresh air inside. As diesel for the portable generators began to run low, they siphoned fuel from trucks and ambulances.

Morale was slipping. More than 24 hours had passed since the state command post in Baton Rouge had sent word that the federal government was on the way.

Four patients had died, although all had been very critical before the storm — a woman with end-stage cancer, a young man with multiple injuries from a motorcycle accident, a man who had overdosed on cocaine, and an elderly woman from a nursing home. With the basement morgue flooded, staff put the bodies in upper stairwells.

A prayer meeting led by the chaplain on the emergency room ramp Wednesday afternoon lifted some spirits. It became as much a pep rally as a prayer service, and they would repeat it every day. Someone would speak a thought, say a prayer; then they would hug and cry. Some people had no idea where their family members were — or whether they’d survived. As the energy mounted, they clapped and sang gospel songs and “We Shall Overcome.” Doctors, nurses, janitors, family members swayed to the music as if they were at a Baptist revival.

On Sanborn’s unit, nurses made a banner and hung it out the fourth-floor window. Maybe someone would see it. On a sheet, in huge purple, red and blue letters, they wrote: “FORGOTTEN BUT NOT LOST!”

Throughout New Orleans that week, many were forgotten and lost. A National Guard unit found some nursing home patients and brought them to Charity.

We can’t take care of these people, Sanborn thought. We want you to take people away, not bring us more.

Sanborn’s unit got two of the patients. Both men were on ventilators, had tracheotomies and couldn’t speak. They also had catheters and feeding tubes. No one knew what was wrong with them, what medications they needed, what kind of treatment they had been receiving. Were they on insulin? The staff couldn’t read the names pinned to the clothes of the two men. Because one was black and one white, they named them after the Stevie Wonder/Paul McCartney song “Ebony and Ivory.”

At first, Sanborn felt certain they wouldn’t survive.

Not knowing what else to do, nurses gave them Ensure — a high-calorie nutritional drink — through their feeding tubes. They gave them water every four hours and Ativan to relieve anxiety.

There was no room for them in the open ward where staff had crammed the other patients to take advantage of the limited working equipment. So they put Ebony and Ivory on the “dark side” of the unit, across the hall, where there was no light or working devices. Sanborn felt it was symbolic. They’d been abandoned to the water and now they were being abandoned again.

She quickly grew attached to the two elderly men. Ivory in particular seemed aware of what was going on, and he and Sanborn developed a rapport.

Oh, it’s time for lunch, she would say to him, making light of the hospital’s shortage of food and water. Today it’s vanilla Ensure. He rolled his eyes at her.

As a bonus for you, there’s water. And guess what? This water is not from the street. It’s from a bottle!

He smiled at her. He seemed to enjoy the banter; it helped them both.

Then Ebony, who medically had seemed the stronger of the two, took a turn for the worse. Sanborn couldn’t get his blood pressure, suggesting his heart had stopped beating or was so weak she couldn’t get a reading with a blood pressure cuff. His temperature soared to 104 degrees. The nurses knew he needed intravenous fluids, but his veins had collapsed and they couldn’t get in a line.

A group of surgical residents — doctors in their final years of training — ran up the stairs and began the more complicated procedure of threading a line into Ebony’s femoral vein in his groin. Midway through, a doctor burst into the room.

What are you doing? he demanded. I thought we agreed all these people from the boats are DNR [medical code for “Do not resuscitate”]. He ordered them to quit wasting their time.

The residents and nurses grew very quiet, recalled Sanborn and two others who were there. They didn’t say they would do what the staff physician ordered. And they didn’t say they wouldn’t. The physician left, they completed the procedure, and they began giving the man IV fluids. By the end of the day, Ebony’s blood pressure was back up to 92 over 48 — not normal but he was alive.

Ebony and Ivory were going to survive this, Sanborn told herself. They had to.

ON MONDAY: On the rooftop at Tulane Hospital, “The Man” arrives. Chapter 9 of 22.

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