Through Hell and High Water

CHAPTER 22: TRIUMPHS, TEARS AND CHANGED LIVES

By Jane O. Hansen | Saturday, May 27, 2006, 03:22 PM

The Atlanta Journal-Constitution

New Orleans — On Tuesday morning, Feb. 14, the sun shone in a crisp blue sky as dozens of people wearing scrubs and business suits gathered on the rooftop of Tulane Hospital’s Saratoga Street parking garage. In a few hours, Tulane would resume business, the first hospital to reopen in downtown New Orleans.

There to celebrate were Tulane staff and Hospital Corporation of America executives. They laughed and hugged, some seeing each other for the first time since Hurricane Katrina had changed their lives more than five months before.

“You smelled worse than me,” a physician said to a paramedic. “There’s a certain aroma missing. We’re all clean.”

Suddenly a helicopter appeared on the horizon, hovered above, then landed in the middle of the garage roof, its deafening rotor wash knocking some people nearly off their feet. The crowd roared when out of the aircraft stepped John Holland, the Georgia medical pilot — “The Man” — who had served during the rooftop rescue as air traffic controller.

Holland brought with him the huge American flag that had been draped over the hospital the week its employees and patients were stranded inside. Solemnly, he helped carry the flag on a stretcher across the roof and into the arms of those who would rehang it.

A champagne toast followed. Then everyone went downstairs to a tent outside the emergency room to await the arrival of Mayor Ray Nagin. The celebration was quintessential HCA. The tent was decked out with palm trees, chandeliers, hanging plants and refreshments. A Dixieland band played as more than 200 medical staff, seated on bleachers, did the wave. When the mayor arrived, the crowd hooted and hollered. Nagin and Mel Lagarde, the HCA executive who had helped run the Tulane evacuation, embraced.

“New Orleans is back!” Nagin shouted. “And we’re going to take it to the next level with HCA driving us all the way!”

With a snip of giant scissors, Nagin then cut the green ribbon stretched in front of the emergency room entrance. The ER, operating rooms, ICU and one-third of the hospital’s beds were now open. Full service is expected to resume in late summer or early fall.

Across the street, Charity Hospital — and its future — stood in stark contrast. A Georgia consulting firm has concluded the 67-year-old building is “unsalvageable” and not worth the cost to repair. There are preliminary plans with the U.S. Department of Veterans Affairs to build a new public hospital on a 37-acre plot of land a few blocks away. It will not bear the Charity name, and could take more than five years to complete.

In the meantime, a reduced medical staff is offering emergency medical services out of an old Lord & Taylor store next to the Superdome. A scaled-down trauma center has temporarily opened in leased space at another hospital.

As the Tulane party spilled onto a side street, “Big Charity” looked forgotten and forlorn, like an old grande dame whose glory days had passed. There was no music, no celebration. No workers had labored to clean her up or bring her back to life. Rather, Charity was alone, like a sick patient who has finally been taken off life support.

In the end, Tulane got all 178 of its patients out alive. All were safely transported to other hospitals. Among them was a 15-year-old boy on life support who was awaiting a heart transplant. He has since gotten a new heart at Texas Children’s Hospital in Houston and is doing well. The rescue operation involved 231 helicopter landings and cost HCA at least $2.7 million.

Six of Charity’s 347 patients died before they could be evacuated. Two were nursing home patients who died in the Tulane parking garage while waiting for helicopters. Four others — all critical — died in the hospital the first two days after the storm. An unknown number of patients, like Preston Johnson, died after their evacuation. But so many more lived, thanks to the countless doctors, nurses, pilots, administrators, family members and others who put patients’ lives above their own.

Mel Lagarde and Ben deBoisblanc were on opposite sides of the street during the storm. Each had been terrified patients would die. Each stayed until the end, protecting his hospital — Lagarde at Tulane, Dr. Ben at Charity. They didn’t know each other, yet their lives were intertwined by Katrina, and since have taken similar turns. Each has begun to rebuild his life, with a new sense of purpose.

One day last October, six weeks after the hurricane, Mel Lagarde was feeling the pressure to find the right people to chair his committees. The list of positions stared at him in large letters from a chart that hung on the wall.

After Katrina, Lagarde’s life took on a complexity he never imagined. On Sept. 30, the mayor named him co-chairman of a commission to help rebuild the city.

Sitting in an HCA office in Covington, across Lake Pontchartrain from New Orleans, Lagarde grew tearful as he recalled the images of his city under water: “Pictures can’t capture the death, the smells, the sounds,” he said. “You were speechless, breathless.”

Soon after his evacuation, Lagarde settled into life as a bachelor, his wife and children scattered. Their house in New Orleans was uninhabitable. A vacation home in coastal Mississippi had been leveled.

It was OK for the time being to live alone in a hotel room, because the rebuilding of the city is a “daunting task,” said Lagarde, who met four times with President Bush before the commission turned over its final report in January.

Last week, the newly re-elected Nagin asked Lagarde to chair the implementation of the plan. “Nobody’s ever done anything like this; 9/11 was a 12-block radius in a town that was mostly still operative,” Lagarde said. “We’re looking at models from World War II where entire cities were obliterated.”

Lagarde doesn’t like to talk about the week he spent at Tulane Hospital or his role in what happened. But he feels the experience helped prepare him for this next phase of life. He’s more comfortable not always being in control. He feels a deeper connection to people, to his city.

“It has made me have a profound bond with the people who were here with me,” he said. “To a certain extent, it bonded me to the city in a different way.” He choked up before continuing.

“It’s fragile now,” Lagarde said softly. “It needs help. There’s so much devastation. There are people whose lives have been destroyed.”

After the storm, he was at the helm of a sinking ship. Yet he and others saved it and pulled others aboard in the process. “You were part of something you never want to go through again,” he said. “But you’re proud to have been a part of it.”

His biggest regret from that week was not getting to know the Charity staff. Even after their sickest patients were gone from Tulane’s rooftop, and they had the chance to leave themselves, Dr. Ben deBoisblanc and others returned to Charity.

“I thought in a world of heroic events, this was like another completely selfless act,” Lagarde said. “To this day, I would love to meet that staff. I would love to tell them, whatever it’s worth, what an honor it was for me to be there and have seen that act.”

He and Dr. Ben didn’t get along on the rooftop. The impassioned Dr. Ben didn’t much like the calm, “cold” corporate executive. At one point, he referred to Lagarde as a “son of a bitch.”

Like Dr. Ben, Lagarde understands that one person’s perception is not necessarily another’s reality. “No one person has the complete view of everything that happened,” he said. But Lagarde saw something in the physician:

“I would hope that when I am acutely ill that I have a doctor like Ben deBoisblanc taking care of me,” Lagarde said. “I want that passion. I want that patient advocacy. I want that person fighting for my life like he was.”

Months after the hurricane, Dr. Ben went back to living on his beloved boat, Creola, in a Lake Pontchartrain marina. He had left the boat the day before Katrina hit and reported to work at Charity. A picture of his late father, who had instilled in him his love for sailing, was one of the few items he left behind. The photo was irreplaceable, but Dr. Ben had a feeling his father would watch over the vessel. Of about 300 boats in the marina, Creola was one of a handful still floating after the storm.

After Katrina, his 14-year-old son was in Houston, his 16-year-old daughter in north Louisiana and he was back on the boat, alone. Several months before, his wife of 20 years had left him. His children have since returned to live with her.

It has been a tough year for Dr. Ben. “My wife left me, I turned 50 and I spent a week in hell.”

But it has also been a year of triumph. “One of the remarkable things about having a mission is that it completely takes your mind off the fact that you haven’t bathed, you’re hungry, you don’t have water, people are dying,” Dr. Ben said. “We had a focus.”

Dr. Ben cried when he left Charity, knowing it might be for the last time. “Even if we built a new facility, part of me would die in that building,” he said. To him, Charity is more than a stately public hospital that has been the lifeline for generations of poor New Orleanians.

“It has a heart and a soul,” he said, “and to abandon it just doesn’t seem like an appropriate way to put it to rest.”

He’s committed to seeing a new Charity take its place, whether the old one gets a face-lift or a new hospital is built. “The option I can’t accept is we don’t need it anymore.”

He realizes the patient population in New Orleans has declined, and no one knows how many people will return. Only about 161,000 — or a third of the city’s population before the storm — have moved back. The pool of doctors, nurses and medical residents has also shrunk.

Although he has not completely resolved for himself what happened on the Tulane rooftop, Dr. Ben was surprised — and humbled — that Lagarde said he would choose him for his doctor.

“It was a difficult time,” he said, tearing up. “I think he understood my passion. For him to say such a kind thing tells me he’s a first-class guy. Like I said, if we could do it all again, we’d all do things differently.” He later added he appreciated “everything everyone did, from Jim Montgomery to Mel Lagarde. But they’re absolutely right. We were totally out of our league. Totally.”

He said the harsh comments about Tulane by Dwayne Thomas, CEO of Charity and its affiliate, University Hospital, were also born of passion.

“I’m a white kid from a middle-class family,” Dr. Ben said. “I believe in what I do, but I don’t live in the other universe.” Thomas, who is black, “grew up in the other universe. I see it as haves and have-nots… . But when you look at the have-nots in New Orleans, most of them are black, and Dwayne feels that pain.”

Thomas may have been “speaking on hearsay” when he said Tulane did not aid the evacuation of Charity, Dr. Ben said. But that’s no different from the media reporting rapes and murders that later turned out to be rumor.

“Those were believable rumors by people who wanted to believe them,” Dr. Ben said. “The stereotype of poor black people in southern Louisiana is they must be murderers and rapists.”

Similarly, he said, it may have been easy for Thomas to believe that the private hospital’s employees were evacuating themselves before his public hospital’s patients. “I could imagine hearing that just burned a hole through him.”

One incident in particular rankled Thomas - but it involved patients from University Hospital, not Charity. He told The New York Times that he put babies from University in boats with their mothers and doctors, “but they were turned around at gunpoint by Tulane police.” Tulane officials say it never happened. But Dr. Brian Barkemeyer, a neonatologist at University, saw six nurses leave with babies, and he saw them return. “They told me when they approached Tulane, guards with guns turned them away.”

Whatever happened, Barkemeyer said, “It probably happened at the hospital security level. I don’t believe it would have been mandated from above.”

When Dr. Ben heard about the babies, he understood Thomas’ outrage, and how the heat of the moment can affect a person’s viewpoint.

Since his evacuation, Dr. Ben has kept a set of keys in his pocket. They belonged to a patient who dropped them as Dr. Ben loaded him into a helicopter the final day of the airlift. He never learned the man’s name, or whether he survived. “They somehow connect me, I guess, to my past — to all those experiences that I had. And I sort of look at them as a bridge to the future.”

Just as that man’s future was uncertain, there are unknowns in his own life. A critical care pul- monologist, he is working in intensive care units in two far-flung hospitals — one public, one private. He remains on the LSU medical school staff.

Other than the end of his marriage, he calls his week trying to save Charity “the most phenomenal experience I’ve had as a human being.”

“I don’t have post-traumatic stress disorder. I’ve never felt more alive. I feel like it’s awakened something inside of me. I have post-traumatic elation disorder.”

Before that week, he was a “techno-geek” working in a technologically driven environment. Patients had become little more than a diagnosis. “When we lost the technology,” he said, his voice catching, “it was as though the patient emerged. The human being had been covered by this veil of technology, and we peeled back the layers and all of a sudden we reconnected.”

There were so many heroes and heroines that week, he said, people who have now lost their jobs. He doesn’t see himself as a hero. “I’m just a schmo schlepping through life.”

There were no bad guys, he said, just a lot of individuals trying to do the right thing in a very bad situation. Together, they achieved something remarkable.

“The story of triumph in our days there was that none of us would have chosen to walk away, to abandon our patients,” he said. “It was so crystal-clear what our responsibility was — that we had been entrusted with these patients, with their lives, with their futures. And that was a trust we were not going to break.”

It was the essence of Charity.

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