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The SOM responds to Hurricanes Katrina and Rita

September was a month like no other as we witnessed the devastating losses suffered by people in Louisiana, Mississippi, Alabama, and Texas from Hurricanes Katrina and Rita. We are all deeply moved by the monumental outpouring of assistance to evacuees and displaced students, a heartwarming response that has exceeded any other time of crisis in this country. I am especially proud of the SOM's faculty, staff, students, and residents, whose assistance to those in need after the hurricanes was quick and decisive. Our thoughts and prayers go out to family members and friends directly affected by these disasters. Here's an overview of our response to date.

August 29--Hurricane Katrina slammed into the Gulf Coast, creating a 90,000-square-mile swath of destruction. Heavy rains and broken levees later caused massive flooding in New Orleans.

August 31--The SOM, affiliated hospitals, Emory Healthcare, and the University inventoried and immediately implemented their efforts to begin to meet the medical needs of evacuees.

September 1--Hundreds of faculty, staff, and students volunteered and worked exhaustively in Emory Healthcare facilities and at Grady Memorial Hospital and neighborhood clinics. Military transport planes loaded with evacuees and patients began landing at Dobbins Air Reserve Base in Marietta, where Emory teams worked with the American Red Cross and others to triage patients and offer medical assistance.

Labor Day Weekend--Medical evacuation planes continued to land at Dobbins. Dr. Matthew Graber (Emergency Medicine), other faculty and residents, and a team from the VA Medical Center, which was the field coordinating center, tirelessly greeted, screened, and processed evacuees. More than 70 M2 and M3 students volunteered. "Approximately 2,500 medically fragile patients were triaged throughout the weekend," reported Mr. Thomas Cappello (Director, VA Medical Center).

Despite the number of evacuees going through Dobbins, the triage process was very well organized. Dr. Debra Houry (Emergency Medicine), one of many faculty at Dobbins, worked with resident Dr. Chris Klingenberg. "As patients came off the planes, they would fill up rows of seats," Dr. Houry said. "Each doctor took one or two rows of patients to evaluate. I helped a family of 20 who had managed to stay together for four days in New Orleans. They wanted to stay together even when one family member needed to go to the hospital. The spirit in these patients was amazing, despite their ordeal. They were all very thankful for the care they received."

Over the weekend, Emory Crawford Long Hospital admitted 35 inpatients and 11 walk-in patients, many of whom were treated by a special Katrina team supervised by Dr. Valeri Akopov (Hospital Medicine). Emory Hospital admitted 18 inpatients and seven walk-in patients. Wesley Woods Center admitted two, and another went to Budd Terrace. More than 25 hurricane-related patients received care at Emory HCA hospitals. Grady Hospital admitted nearly 50 evacuees and cared for numerous outpatients. Grady's neighborhood clinics treated and assisted many walk-ins.

Meanwhile, Drs. Alex Isakov, Eric Ossmann, and Philip Shayne (Emergency Medicine) quickly recognized that many evacuees who did not go through the formal medical evacuation system would end up in Atlanta shelters with unmet medical needs. They developed a plan to staff the first Atlanta shelters with faculty and residents, with vital support from Grady Health System pharmacists and staff. When evacuees moved to the Georgia Tech Coliseum, the Emory/Grady team followed. Emergency Medicine fellows Drs. Tori Carroll and Melissa White with faculty Drs. Bryan McNally, Pat Capers, and Lisa Mack worked alongside Red Cross nurse volunteers to provide evacuees with medical evaluations, prescription drug refills, and specialty referrals.

Dr. Hogai Nassery and other Family and Preventive Medicine faculty at Grady as well as colleagues from Morehouse School of Medicine scrambled to meet the extra demands at Grady's community health centers. "These medical faculty provided vital 'low-intensity' but essential medical services," said Dr. Isakov. "They directed evacuees to community clinics for access to the health system and prevented deterioration of their medical conditions that would have resulted in increased congestion in the city's already overloaded emergency departments."

Dr. Curtis Lewis (Radiology, Grady Chief of Staff) helped coordinate evacuee care at Yancey and North DeKalb clinics. According to Dr. Bill Sexson (Associate Dean), faculty, residents, and students provided care for patients there with asthma, diabetes, and other chronic disorders as well as for dialysis and transplant patients who needed medications.

Drs. Peter Ash, Nadine Kaslow, Michael Compton, Glenn Egan (Psychiatry and Behavioral Sciences), and other faculty and residents volunteered their time throughout the holiday weekend at Red Cross centers, Dobbins, the Georgia Tech shelter, the Salvation Army Druid Hills shelter, and other sites. Drs. Shannon Croft and Ray Kotwicki and other faculty and staff established a Grady mobile team to visit various sites. They offered emergency psychiatry support for evacuees with post-traumatic stress syndrome, depression, and other tragedy-related problems and helped those with pre-existing psychiatric disorders. They gave Red Cross providers essential contact information to call for psychiatric consultations.

Emory Hospitals set up a patient information number for family and friends needing to find evacuee patients within the Emory system. Staff offered social service and pastoral care support, and donations of clothing and personal care kits poured into the hospitals. "We boxed up goods and loaded a 24-foot panel truck with about $20,000 worth of baby formula, food, water, diapers, toiletries, and other necessities from my church's members and the community," said Ms. Barbara Peck (Medical Imaging), one of many volunteers. When her husband and pastor drove into Hattiesburg, Mississippi, "One lady started to cry when she saw we had not forgotten the elderly," Ms. Peck said. "They were probably feeling the effects more than anyone else."

Over the weekend, Dr. Bill Eley (Executive Associate Dean) and Dr. James Zaidan (Associate Dean) determined how many displaced medical students and residents from the disaster region the SOM could take. Many faculty and staff offered to house students and residents in their homes, many without rent for up to a year if needed. Tulane University students subsequently continued their education in Houston, LSU-New Orleans students relocated to Baton Rouge, and residents were placed at medical institutions in their area.

Dr. Arthur Kellermann (Chair, Emergency Medicine) led all medical coordination efforts, and Mr. Gary Teal (Senior Associate VP, Health Affairs) and Dr. Claudia Adkison coordinated the administrative response for the Health Sciences Center and the SOM. Drs. Thomas Lawley, Adkison, and Kellermann and Ms. Linda Womack (Government and Community Affairs) met with Gov. Sonny Perdue's staff to urge further state coordination of relief efforts. Rollins School of Public Health and the Nell Hodgson Woodruff School of Nursing also were integral members of the Katrina response team.

September 6--The American Red Cross established "super centers" for evacuees in College Park and Lawrenceville. Mr. Al Blackwelder and Ms. Kelli Gress (Emory Crawford Long Hospital) and Drs. Isakov and Ian Greenwald (Emergency Medicine) coordinated Emory's efforts in College Park. Dr. Mark Williams (General Hospital Medicine) was responsible for Emory clinical needs and physician staffing at Dobbins and the Lawrenceville center. Dr. Ruth Berkelman (School of Public Health) directed Emory volunteer activities, and Dr. Charles Harper (General Medicine) led clinical efforts at the shelters. "The Emory community quickly realized how rapidly they could pull together in response and provide a very coherent and cohesive approach to delivering care to all the evacuees," said Dr. Williams. "Another impressive aspect of Emory's response was how many people spontaneously volunteered and put in a lot of effort to find how they could help. That was quite gratifying."

September 7--Emory Hospital "adopted" the Salvation Army shelter on North Druid Hills Road. Dr. Harper provided medical oversight until the shelter closed on September 17.

Week of September 12--The M1 and M2 classes began to raise funds that eventually totaled $2,014. Of those funds, $1,666 was matched by Best Buy, bringing the total to $3,680 to support the Red Cross. M3 and M4 students also took part in fund-raising activities.

The Katrina medical response team moved to a maintenance phase, with Emory faculty, staff, students, and housestaff continuing to care for inpatients and offering medical and psychiatric consultations, medications, and other support to evacuees with chronic conditions in the shelters.

September 30--By month's end, Emory and its affiliated hospitals, including Grady, had admitted more than 150 Katrina evacuees as inpatients and treated more than 800 people as outpatients. Additionally, Emory also admitted a dozen inpatients displaced by Hurricane Rita. That was in addition to the hundreds of patients in Atlanta-area shelters aided by numerous faculty, staff, and student volunteers from the Schools of Medicine, Nursing, and Public Health, and Emory Healthcare. As of October 1, two residents from Tulane temporarily transferred to Emory for 120 days. Other temporary transfers from Tulane and LSU-New Orleans were also expected.

Postscript--The volunteer efforts of our faculty, staff, residents, and students were unprecedented in terms of the number of people they assisted in a short period of time and their widespread collaboration with colleagues across Emory and at local and state agencies. "The response of the SOM--indeed, everyone in the Woodruff Health Sciences Center--to the twin challenges of Hurricanes Katrina and Rita was tremendous," said Dr. Kellermann. "At a time when we were already working very hard to meet the needs of our own patients and referrals, everyone kicked their efforts to another level to provide care for thousands of incoming evacuees. The entire effort was characterized by teamwork, goodwill, ingenuity, and a strong sense of compassion."

Although the situation for evacuees is now more stable, many still need assistance. To date, the University has collected $10,000, and additional donations are welcome. To help support the medical-related needs of evacuees in Atlanta shelters and health care facilities, visit www.alumniconnections.com/donate/emory.

We have tried to recognize some of you in this publication but could not include the names and contributions of everyone. To all of you in the SOM, thank you for giving so generously of your time, expertise, and spirit.

Extraordinary care for evacuees

Dr. Charles Harper (General Medicine) worked alongside School of Nursing faculty member Dr. Maureen Kelley to provide care at the Salvation Army's Druid Hills shelter. "The first day at the shelter, we saw exhausted people who were out of medicine, dehydrated from diarrhea, or had insomnia, bronchitis, cough, or cold," Dr. Harper said. "Outside of medical needs, people needed to decompress. They had suffered horrendous experiences."

According to Dr. Kelley, "The relief effort was collaboration at its best--all units working together with a common goal to help individuals in the community who needed our help and, all the while, confronting the human condition. Emory-connected nurses (staff, faculty, and alumni) provided a 24-hour presence at the shelter, which created a strong connection with the families housed there. The Salvation Army is an amazing organization; it never forgets human suffering."

An indescribable experience

Dr. Shanthi Sitaraman (Medicine and Pathology), who volunteered at a Lawrenceville shelter on September 13, described the experience as "an eye opener." At first, I was overwhelmed with grief seeing hundreds of displaced adults and, sadly, children. I saw a range of patients from otitis media to anxiety attack to acute myocardial infarction. The stories from these people are unbelievable. What moved me was a mother who described her journey with her 3-month-old baby from the New Orleans Superdome to Atlanta. It just should not have happened."

Crisis and opportunity

Hurricane Katrina was a life-changing experience for many, including faculty like Dr. Nadine Kaslow (Psychiatry and Behavioral Sciences), who befriended a 2-year-old who arrived at Dobbins from New Orleans, where the flood waters claimed her mother's life. "It brings tears to my eyes to reflect upon the sadness, pain, and loss that Precious and her godmother and all of the other [evacuees] on their plane experienced," wrote Dr. Kaslow. "But I suspect the tears also are signs of my respect for the tremendous resilience and courage that I encountered when interacting with the children, adolescents, adults, and older adults whose lives were forever impacted by Hurricane Katrina."

Thomas J. Lawley, MD
Dean, Emory School of Medicine








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