Images of third world chaos confronted us on television sets throughout

the world last week. Mostly african-american and impoverished victims

of Hurricane Katrina remained stranded in New Orleans and throughout

the small towns of the gulf coast. Seemingly paralyzed first world

spectators sat fixed to the TV. The suffering crowds in the New Orleans

Superdome chanting "Help, help, help!!" became vividly imprinted in my

mind.



As a physician I was willing to help though several official

communications by email indicated I was not needed and warned

physicians "Do not self-deploy...".  Though I received these warnings

on a daily basis, I went with my conscience, my intuition that I was

needed, and I "self deployed" to the Houston Astrodome where the

victims were finally being bussed after surviving hurricane, flood,

starvation, dehydration and near asphyxiation from bureaucratic red

tape delays and inefficiencies.



The Houston Astrodome and surrounding buildings were prepared to accept

up to 25,000 victims and the impressive "Astrodome Health Center" was

created overnight. The makeshift hospital/clinic in the Reliant Arena

included over 20 exam rooms, a pharmacy, radiology, lab, 24 hour

observation, quarantine sleeping quarters,  and specialty sections

including pediatrics, orthopedics, social work, mental health and more.

Staffed by Harris County Hospital District, the local doctors and

residents helped as they were able.  Volunteer doctors and nurses from

out of state were a welcome relief, placed on 12 hour shifts with the

locals.



When the buses began to arrive, only one internal medicine doctor was

available to triage.  Bus after bus lined up and though half the people

were too faint to walk, they crawled off the bus so that others behind

them could get out.  Each person had a small plastic bag containing all

their worldly possessions covered in human waste along with the

poisonous gumbo that now surrounded their beloved hometown.  The stench

was overpowering.  Their skin looked as if they had been dipped in

hydrogen peroxide, especially the babies.



As patients were triaged to hospitals, others were rehydrated, fed and

helped to small green cots which completely covered the Astrodome

floor.  Supplies were readily available and the refugees soon parted

with their tattered bags in a large pile at the entrance to the arena

as they realized their basic needs would be met.  Though barely alive

and heartbroken from their tragedy, they were peaceful, kind and

incredibly polite.



I spoke to the doctor who was the first to care for the refugees and

with tears in his eyes he recounted some of his experiences in those

first few hours.  A busload of dehydrated hospice patients arrived

amidst the others without medical records,  medication or food for

days. He queried a gentleman about a curious severe sunburn limited to

the very top of his head.  The gentleman revealed that he stood two

days packed so tightly with others on a small dry piece of land. They

were so densely packed together that a deceased man beside him was even

unable to fall.



Then there was a couple caring for 22 children during the storm as

their apartment was considered the safest in the area. The couple then

witnessed the complete destruction of the surrounding homes and deaths

of the childrens' parents. Flood waters forced the couple to place the

newly orphaned children on large pieces of furniture.  Then 2

inflatable swimming pools were used to float away to higher ground.



In the corner of our makeshift hospital I pulled back the yellow

plastic curtain with the taped piece of paper indicating room 9 and met

a a sweet 57 year old woman named Beulah Chester.  Beulah was covered

in a rash and as she scratched her limbs visciously, she related the

horrors of her past week.



Beulah, a piano teacher from the New Orlenas edgewood neighborhood,

raised 102 foster children over 18 years and was caring for two boys,

one mentally retarded and the other autistic, when Katrina hit.

Initially relieved by the light damage she then noted the rising flood

waters after the levees ruptured.  She and the boys were forced to the

second floor as she watched her beautiful organ and piano submerge

along with a lifetime of photos and memorabilia.



Her neighbors screamed for hours and the stopped. Had they drowned she

wondered.  Later as she hitched a ride on a small boat out of a second

story window with her two boys, she noted a deceased  neighbor being

tied to her home to preserve her identity. Stellah and her boys were

soon deposited on a dry patch of I-10 and told to wait for rescue buses

along with others.



She witnessed countless horrors at this I-10 bus stop without food or

water for 2 days.  A man arrived after losing his entire family and

proceeded to climb the overpass and jump to his death in front of the

"rescued" crowd.  He lay face down floating in the now bloody waters

surrounding his head as nightfall enveloped the eerie scene.  People

were screaming and other were seizing  as Stellah tried to help and

find a safe spot for her family to rest.



A woman arrived the next day with a small baby wrapped in a blanket.

When Beulah went to peak at the baby the mother warned not to wake him.

Beulah paused tearful as she told me the baby was as blue as my scrubs.

 She eventually was able to tell a passing police officer who took the

baby from the shrieking woman and drove them both away.  Their safe dry

patch of I-10 was surrounded by the unbearable odor of sewage, death ,

and suffering.



She related the arrival of the buses and the transport to the

Astrodome, the kindness of the people who have cared for her in

Houston.  "The last time I got this rash was when my mother passed,

it's my nerves." Despite her traumas, Buelah had a beautiful smile, was

incredibly polite and appreciative during our time together. I was

amazed by her resilience.  It was easy to treat her rash, insomnia, and

replenish her diabetic supplies.  Though more difficult, I was honored

to hold her hands tenderly and allow her to begin the  process of

grieving a tragedy.



I remember a famous French Quarter musician known in room 8.  He was to

meet up with other musicians for a hurricane party the night of the

storm. Sudden chest pain sent him to the ER instead. After a diagnosis

of gastric reflux he was discharged but unable to leave due to the

rising water. The ER moved to higher ground and eventually he was

evacuated to the Astrodome with no possessions, CDs, all his music

lost.  He was here now to evaluate his diarrhea and to see if he needed

to be quarantined. He also needed basic medical care for glaucoma,

diabetes and with his guinness book of record toenails I suggested

podiatry as well.



I saw many skin infections, chemical burns, diarrhea, and injuries.

Some patients required admission for infected joints or pneumonia.

Identifying chronic medications was challenging with lost medical

records and pill bottles swept away.  Most were on something for

"sugar" and  "pressure."  I noticed the prescriptions from the

Astrodome Pharmacy all had "Prescriber: Katrina, Hurricane" noted on

the bottles.  Can't say I have ever seen anything like that before!

Despite the high rate of diabetes there was always a large box of

krispy kreme doughnuts on the diabetic supply table beside the

glucometers. Comfort foods I suspect.



I met so many heroes. Glen Beverly, an apartment manager of the St.

Peter Claver Apartments, singlehandedly floated to safety all his

tenants on a Winn Dixie freezer door.  I discovered creativity and

strength in the face of disaster, bravery, courage, and most impressive

the resilient fun loving and open spirit of the survivors who worked

collectively to save one another, placing the needs of others in front

of their own.



At the Astrodome Health Center I served as family physician, social

worker, orderly, and friend.  When not caring for the patients, I was

comforting the survivors from cot to cot on the Astrodome floor,

passing out handmade soap, aroma therapy lotion, angel wings, lavender

eye pillows, gifts from my hometown including money from a benefit

garage sale on my street.  The children were so curious and playful

checking out my stethoscope and listening to each others hearts. I came

to share my skill, offer an open heart and a helping hand.



For me it was a simple case of self deploy or self deplore. Leaving the

comfort of the known and jumping in to help was the least I could do.

Our leaders should disentangle themselves from their red tape and come

out of their large offices and do the same.