Through Hell and High Water

DR. BEN DEBOISBLANC

MEL LAGARDE

Chapter 20: KINDNESS FROM STRANGERS, AND WORDS THAT STING

By Jane O. Hansen | Thursday, May 25, 2006, 03:57 PM

The Atlanta Journal-Constitution

On Friday, Sept. 2, Susan Sanborn lined up for a tetanus shot and a dose of Cipro at a hospital in Covington, La. The vaccine and antibiotic would help ward off bacteria that the Charity Hospital student nurse might have picked up from the filthy water in New Orleans.

A chartered bus then drove her to a shelter in Lafayette, La., where she received fresh underwear, new scrubs, flip-flops, toiletries, a towel and washcloth. She took her first shower in nearly a week, luxuriating in the soap, water and shampoo.

A school bus took her to a banquet hall where evacuees were regaled with a feast of Popeyes chicken and home-cooked jambalaya. Sanborn, already a slim, small woman, had lost nearly 4 pounds while marooned in Charity Hospital after Hurricane Katrina.

Her evacuation had come courtesy of the Hospital Corporation of America and a makeshift helipad across the street, at Tulane Hospital’s parking garage. Now she was in the care of HCA, Tulane’s corporate owner, which had set up shelters in Lafayette. About 1,200 evacuees, mostly Tulane employees and staff, would come through them in the next 24 hours.

Sanborn was overwhelmed by the outpouring of assistance. Someone asked for her name, Social Security number and where she wanted to go. They handed her information on how to get relief assistance, disaster benefits and, if she were a Tulane employee, a paycheck.

Where do you want to go? they asked her. She said she was from Columbus, Ohio, but joked she would be happy to stay put. I’m clean, there’s nobody here with weapons, the food is wonderful, it’s air-conditioned.

The next day, Sanborn and about 60 others boarded buses for the Lafayette Regional Airport. HCA had chartered planes to Houston and Atlanta. Anyone going farther would receive a ticket to a final destination.

At the airport, security stopped her. She had forgotten she was still carrying her scalpel. Guards confiscated it.

In Atlanta, HCA representatives met the evacuees at the gate. Anyone who had to stay overnight received cash and a hotel reservation. Sanborn was booked on Delta Flight 1630 to Columbus. Before heading to the gate, she said goodbye to the people she knew, and for the first time that week she felt lonely. Wearing scrubs and flip-flops, she started to board her flight that Saturday night, when a Delta representative suddenly pulled her aside.

Here, my dear, you have a different seat, he told her. My cousin, Katrina, upgraded you to first class.

Sanborn was confused. Oh, my God, she didn’t have to do that, she said. Later, she wondered whether he thought she had lost her mind.

Columbus was the city where Sanborn had grown up and trained to be a dancer. Other than the people at Charity, she felt she had no real family. But she did have a friend and mentor in Columbus — her ballet professor, who offered her a room until she could get settled.

One day, after arriving in Columbus, Sanborn saw a picture of one of her patients in U.S. News & World Report. He was sitting on a New Orleans median strip. What do you mean they put him there? she said to herself.

She spent hours on the Charity Web site looking for her patients’ names on the list of those who had been evacuated. All had left her unit alive, and she wanted to know they were OK. But one of her patients was missing from the list: the man she initially knew as Ebony.

Ebony and Ivory were the names Sanborn and others had coined for two elderly nursing home patients, one black and one white, brought to Charity the day of the storm. They were on ventilators, with no medical information. Sanborn had grown attached to the two men.

Later she would learn that Ebony was one of two patients who had died in the garage while waiting for a helicopter. The student nurse felt empty, sad and angry. How could the government just leave a city like that?

She spent much of her time those first few weeks watching television coverage of the hurricane. She had developed conjunctivitis in both eyes, probably from the water she had crossed from Charity to Tulane, but she remained glued to the set, and wept.

On Sept. 8, she was watching a CNN broadcast called “Angels in the Storm” that chronicled individual tales of heroism. Toward the end was a segment about the helicopter rescue off Tulane Hospital’s parking garage.

There on the screen was Dr. Ben deBoisblanc from Charity, speaking excitedly about his patients. “Two of them have already died here on this ramp waiting to get out!” he said. “In this very spot!”

The correspondent reported, “The Charity staff watches as Tulane’s people get out while their own patients are ignored.”

Sanborn immediately called CNN. She was transferred several times and finally left a message: That’s erroneous reporting. It’s not true. Tulane delayed evacuation in order to help our critical care patients.

She left her number, saying she was a student nurse who had been there. But no one called back.

Spurred on by the broadcast, the next day Sanborn e-mailed HCA. She was tired of the media focusing on snipers and guns. “There are truly no words to express my gratitude to HCA for absorbing and rescuing our patients at Charity Hospital and for rescuing me, five nurses and two children from our unit,” she wrote. “I wish you and your staff members and hospitals the very best as we all try to put the pieces back together after this tragedy.”

Jack Bovender, CEO of HCA, would be one of the first to read the student nurse’s e-mail.

The CNN account was one of several media reports in which Charity officials criticized Tulane Hospital’s treatment of their patients.

A Sept. 11 article in The Philadelphia Inquirer quoted Dr. Ben: “We sat there from 7 a.m. Thursday until 7 p.m. trying to keep these patients alive … while HCA landed helicopter after helicopter after helicopter to carry off healthy people. I had to physically restrain some of the residents who went ballistic.”

Some of the most critical comments came from Dr. Dwayne Thomas, CEO of Charity and its affiliate, University Hospital. In a Sept. 14 broadcast, he told CNBC, “In actuality, HCA did not assist us in evacuation at all.”

In a Sept. 19 article in The New York Times, “a quietly furious” Thomas blasted Tulane: “To load able-bodied staff before you let patients off a roof is reprehensible.” Thomas, who now refuses to comment, was never at Charity that week, nor was he on the Tulane garage roof.

Months later, some bad feelings remain.

Since Hurricane Katrina, HCA administrators have refrained from criticizing the government for failing to rescue Charity, or Charity for sitting back and waiting. They have said that as a private hospital, Tulane has far more resources than the public hospital. It would be unfair to make a comparison. But they are quick to defend what they did for Charity’s sickest patients, and they bristle at Thomas’ disparaging remarks.

“Let me make something clear,” said Mel Lagarde, the HCA executive in charge that week at Tulane. “At no point in time did we ever turn away a patient from this hospital. At no time did we say less acute patients are going ahead of critical patients. That would never enter the minds of anyone. The last thing we wanted was for someone to die.”

Hospital administrators had nothing to do with the triage of patients, he said. That was handled by physicians whose sole goal was to save as many lives as possible. Dr. Norm McSwain, trauma director at Charity, was one of those who helped decide who went out first.

McSwain, who as chief of trauma surgery for the Tulane medical school had affiliations with both hospitals, blames criticism of Tulane on “smoke and mirrors.” By making Tulane the bad guy, he said, Thomas could deflect criticism away from the state.

“The true story is the government didn’t show up,” McSwain said. “Nobody showed up — not the state, not the federal government, not the local government. Nobody showed up to evacuate Charity’s patients.”

Had it not been for HCA, McSwain said, Charity’s critically ill patients would not have been rescued, at least not in as timely a fashion.

There were heated arguments on the rooftop. Jim Montgomery, president and CEO of Tulane Hospital, says he had words with Dr. Ben when Charity brought over not just patients on stretchers, but those who could walk.

“We were hot, tired, sweaty, hungry, all the above, and yeah, it was frustrating,” he said. “But at the end, when you turn around and think about it, you knew you had to help them. And that’s what has irritated us — their somewhat aggressive attitude in trying to say we didn’t.”

In the end, Lagarde said, “We were able to accomplish for them what they were unable to do on their own.”

As time has passed, the harsh remarks about Tulane have dwindled. At a slide presentation to medical students and residents two months after the storm, Dr. Ben steered away from criticizing Tulane.

But the already strained relationship remains fragile between the public and private hospitals. Like thousands of others in New Orleans, those inside the hospitals lived through a disaster of near-biblical proportions, and chaos at times reigned. Tulane “was a different world” from Charity, Dr. Ben said. “It’s a parallel universe.” In recounting what happened, “Everybody’s telling the truth. It’s just a different perspective.”

From his perspective, a breakdown in communication on the rooftop and the lack of a command-and-control structure higher than Tulane or Charity led to a “Lord of the Flies” struggle to survive. It was the haves vs. the have-nots, and Charity got in Tulane’s way.

“They had their own responsibilities to evacuate their own patients, their own medical staff. And basically, they helped us when they could, but we were more of a nuisance than anything.”

Still, his perspective has changed with time, at least partially. “It’s become obvious to me that they did care a lot,” he said recently. “The truth is probably somewhere between those two perspectives. It usually is.”

About a week after sending her e-mail to HCA, Susan Sanborn got a call. Bovender, the CEO, had instructed his human resources department to track Sanborn down.

The woman on the phone asked Sanborn her plans. Sanborn told her she hoped to get her associate nursing degree at a state school in Ohio, where she now lived. The woman told her HCA wanted to offer her a scholarship and encouraged her to go to Mount Carmel College of Nursing, a private school in Columbus where she could get her bachelor’s degree.

Sanborn was stunned. You understand, I have nothing to do with y’all, she said.

On Sept. 20, Sanborn wrote another e-mail to HCA: “This will not be an eloquent letter because I have not yet sorted out my feelings,” she wrote. “However, I must in some small way, again acknowledge the great gift you have given to me. In time, I will have the words I need in order to thank you properly. In the meantime, know that I am crying. And these tears are the first I’ve shed in several weeks that are not out of grief, but out of joy.”

ON SATURDAY: Two mothers go on. Chapter 21 of 22.

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