Early this morning, J. and I arrived at a major medical center to conduct an interview and photo session about their new "patient safety science initiative", which uses computerized patient simulator mannequins in simulated working environments to teach medical, surgical and trauma response techniques to individuals and teams of health care professionals. It's a relatively new type of medical training, borrowed from military and aviation training systems which model various real-life situations so that people can learn and practice without endangering themselves or the public.
At 7:00 am, the medical center employees were streaming in from the parking lot, and in the lobby corridors we passed doctors and nurses, security guards and out-patients, all carrying paper cups of coffee and heading toward their first appointments of the day. Our contact person, an anesthesiologist who has this as a special interest, met and ushered us through the maze of staff-only corridors to the rooms where dummies lay in hospital beds, ready to be examined and intubated and connected and recuscitated with all the high-tech gear one would find in an emergency room, an intensive care unit or an operating suite.
It was impressive, and as the nursing supervisor of this unit explained, it has been the most effective training she has ever used in 20 years of teaching nursing. She and the anesthesiologist explained the various uses they envisioned for this type of training, which works especially well for teams of people who collectively handle trauma and emergency situations. They stopped talking at one point and paused. "New Orleans is going to change the way hospitals think about emergency preparedness. We train for the possibility of being a destination for victims of various kinds of disasters." (Some of their funding - including research grants for computer simulation models of disaster scenarios - comes, not surprisingly, from Homeland Security.) "And we train for situations like an in-house fire - but until now, that has meant, OK, we evacuate and close off a corridor or a section while we contain the fire. No one has ever considered what it might mean to have to evacuate the entire hospital."
So of course when I came home and saw this story (scroll down) and this one on the internet about Charity Hospital in New Orleans, I couldn't help thinking about the brightly-lit clean corridors, the quantities of medications and supplies in stockrooms, the stacks of fresh linens, the bright-eyed professionals getting ready for the day, and, outside, the helicopter pad and the ambulance being unloaded at the emergency entrance, its wide portico resembling a hotel with valet parking.
I haven't words to describe what is happening in New Orleans, although it is all to easy to name my own emotions: shame, sadness, shock and anger. Reading these articles about Charity, I really cannot believe that this level of breakdown is happening in my country.
Knox Andress, an emergency nurse who is regional coordinator for a federal emergency preparedness grant covering the state, said it's impossible to overstate the critical role hospitals are playing for people who remain in the city.
"They're running out of their medications, they're running out of money. They're having social issues and where do they go? They go to the hospital. The hospital is the backbone of the community because the lights are always on," he said.
When hospitals can't take care of people and the rescuers need rescued, there's no social fabric left, Andress said.
When are we going to wake up, and make taking care of one another the single most important priority? What have we come to when waging war and amassing money become so much more important than taking care of "the least of us"?
"Hospitals are trying to evacuate," said Coast Guard Lt. Cmdr. Cheri Ben-Iesan, spokesman at the city emergency operations center. "At every one of them, there are reports that as the helicopters come in, people are shooting at them. There are people just taking pot shots at police and at helicopters, telling them, 'You better come get my family.'"
