Sep 17, 2008

Voices of Ike -- This is no place for people

[Editor's note: Thankfully, we are beginning to hear from physicians in Galveston, helping to put that great medical city back together. Here is a long post from UTMB Senior Vice President Ben Raimer, MD.] 10 am, Wednesday, Sept. 17, 2008 Galveston pediatrician Ben Raimer, MD

I have been on the island since Monday. Sharon, David and I weathered the brunt of the storm in Austin. The 400 UTMB employees who remained at the university transferred all remaining patients (including the prison) prior to the storm, shut down the Galveston National Lab (by the book), transitioned students, residents, and other personnel to safety, and then weathered a full day of battering wind, rain and water. The first floors of several buildings did flood, along with several parking garages. Overall, UTMB is located on one of the higher points of the island. Some of you will remember that University Blvd. actually sits on top of one of the early seawall extensions. There is, nevertheless, a significant amount of damage to equipment due to water and also due to the currently lack of power and dehumidification equipment. MRI's and other technology do not do well in the corrosive environment. Structures are intact and with a bit of cleaning (which is ongoing), will rapidly return to use. The entire island seems to have been submerged, except for a small area that was spared north of Avenue P. The Strand had over 8 feet of water in the street, and Shearn Moody Plaza which houses many of our UTMB services on 25th and Strand had about 6 to 7 feet in its first floor. 23rd Street had water all the way up to P, with the First Baptist Church across from Rosenberg Library as well as Trinity Episcopal Church both receiving water (FBC had a foot in its sanctuary). Sharon and I have an old building on 23rd and Strand that has apartments upstairs; many of our medical student friends as well as our son David (a UTMB resident) live there. There was 5 feet of water in the first floor, and one of student (Adam) had his car totally submerged in the garage to the building. There is mud, silt, debris (and a few dead fish) in the streets and buildings along 23rd. The East End Historical District lost a lot of its vintage trees to the water and wind. Major structural damage to the historical homes is evident as one drives by. I am told that our favorite restaurant, Rudy and Paco's, at 21st and Postoffice took on 6 feet of water at the peak of the storm. I am sure Paco will shop vac the place and be serving that great meatloaf sandwich in a few weeks. UTMB staff under the direction of Dr. David Callender are the real HEROS. Dr. Callender's calm leadership style and his ability to deal with a myriad of issues in an organized and orderly fashion certainly make him the perfect individual to guide the institution in this challenging period. His concern for people, their welfare, and their future mold his decisions. He seems to always be able to evaluate the situation, no matter how complex or difficult, solicit input from his talented staff, and make just the right decision for the moment --- ever mindful of the future that we plan to create. Today he has focused on the systemic issues of getting the campus back in operation as well as relief for a very tired staff. And, hats off to City Manager Steve LeBlanc and that wonderful "school-marm" Mayor Lyda Ann Thomas. Those two leaders have worked tirelessly day and night to assure the safety of the city, the assistance of those in need, and the recovery efforts. The mayor's calm and planful manner certainly gives the city's citizens hope for the future. Recovery would be easier if people heeded the mayor's words and realized that this is no place for people to be living at the moment. I cannot muster up much sympathy for those complaining of the lack of water, food or other amenities at the moment. All were ordered to leave, and transportation was provided. Not to chose that option and gripe later about one's own choice --- well, you know how I must feel about that. They need to get to safer circumstances as soon as possible; I hope that will occur within the next 24 hours. The public health issues without potable water are enormous. We must remember the health issues that make it an unsafe place to be. The city is trying to focus on restoring utility services, so the distraction of having to be a bed-and-breakfast for so many people is not good. And, if one adds in the distraction of having to direct police and fire personnel to chasing individuals with criminal intent around the island --- then that too is not good. Recovery resources are providing food, water, ice, and other services at designated locations (mainly Ball High School). First responders have been great. The outpooring of resources and people to step in and start the recovery is one of the best things about America. Volunteers! Tractors are moving trees, sea debris, and clearing roads. Day by day there are visible changes for the good. At UTMB: The research enterprise is stable. The National Lab was safely shut down without a problem. The structure was built for weather like we had (and more) so it is just fine --- nothing that a bit of soap and water on the first floor cannot correct. Dry ice and emergency generators continue to preserve specimens of value to future research, and the entire research enterprise team have done an extraordinary job in maintaining all systems. A federal team of HASMAT-type vets are also assisting with animal health (so far they are happy campers). It is too early to determine the status of machinery and technology; we can only hope for the best. Damage assessments are being performed by outside consultants. The clinical enterprise is shut down in Galveston, but our patients can call 409-772-2222 for assistance, and tomorrow three Community Based Clinics will be open to see their usual patients. Our Transplant Program is shifting its outpatient services to a mainland site, and will relocate surgical services temporarily to St Joseph's Hospital. Dr. John Bertini, a UTMB Alum and practicing urologist and head of the board of directors of St Joseph, has offered space for UTMB training programs. Other area hospitals, and programs in other states have also expressed their desire to assist in the recovery efforts. General surgery and anesthesiology will likely do some shifting to St Joseph in Houston. Other specialist will be deployed off the island into the community clinics as soon as that team can assure that utilities and support staff are in place. It is likely that hours will be extended to accommodate all of the UTMB doctors (they are eager to get back to their patients ASAP). For our patients, this means that clinical services will be back up and available on the mainland before weeks' end. Thank God for the amazing resilience of our health professional staffs! The educational enterprise has also moved into its disaster recovery mode, and students will be getting notices regarding resumption of their studies, locations for electives, and other instructions. Residents will also be deployed to nearby locations until services are operation that permits continuation of their programs on campus. Residency director Dr. Tom Backwell and Associate Dean Dr. Steve Lieberman have been working around the clock to confirm student and resident placements. Hats off to them and to their staffs for their efforts. Communication systems should improve today; FEMA is reportedly putting up some cell towers in the area. UTMB web is up and being updated regularly. Unless you have really important business in Galveston ... you should stay where you are are in a safe place until you hear otherwise. Exploring for yourself will not accomplish anything other than a long wait in lines, and you will be most likely turned away at this point. For those of you who have a pressing question about something, please email me and/or call me and I will try to help. Also, for students and residents (and faculty), you can call the UTMB general number and receive assistance. The dean's office numbers work, as do those in other areas. Remember 409.772-2222 for patient questions and/or general information. Patient records (EMR) should be back in operation by tomorrow or Friday so that mainland outpatient clinics can operate normally. The ER is open and staffed by federal HASMAT teams. All UTMB clinical personnel have been relieved of duty and asked to focus on recovery activities. The major jobs right now on the island are the restoration of power to the whole island, the restoration of potable water to the island and campus (there is no water at all ... not a drip from a faucet) --- so you can only imagine the sanitation issues that we face. There is no natural gas so one cannot boil water (hot showers and flushing toilets left the island with Ike's arrival). We stink --- what can I say. No amount of deodorant or aftershave will hide that fact. The UTMB campus has been secured so we feel reasonably safe. Yesterday after the "Look and Leave" policy was implemented, a lot of folks were allowed onto the island. 40% stayed in spite of the curfew and the orders. Last night also turned into a scary situation as intruders attempted to get into buildings around the island --- for purposes that only you can imagine. I was greeted today when I arrived on campus at 0630 from my home with police officers with machine guns! That's right --- machine guns! Our major priorities here now are security for our personnel and for the contract personnel who are doing the campus clean up. I am rethinking my plan to stay at home at night; I may camp out in my office from this point forward ... or until the "bad guys" go away. I understand that our city officials have "re-thought" their "L/L" policy and are now focusing on getting intruders out of two. We understand (cannot verify) that there were gunshots and the like around town last night. There is not a lot of stuff left to take; we only have 60,000 residents in this town and it is not like the island is home to incredible wealth. The Moody Mansion is about the only "mansion" in town, and it is filled with Sears furniture from 1890 Catalog (Mr. Moody was thrifty). They can have my 20 year old Sony TV; I may go home and put it into the drive way with a sign on it. I would also appreciate it if they would take the large garbage can filled with rotting meats, cousin Ann's delicious black-eyed peas, and the okra from cousin Lavelle's garden. Oh, and yes, they are welcome to the soon-to-be rotting carpets that Dave and I pulled from the house that filled with 16 inches of water. I would like them to get it out of the yard before the mold gets to the point that I'll need a lawn mower to deal with it. Overall, Galvestonian's are an optimistic group of people. They are the real survivors ... the people who will make their way into the future, step by step, with a successful plan. Islanders are resourceful, they work well collaboratively, and they work for the greater good of the community. Islanders understand that we are here because we choose to be here. The Rabbi and Pastor at First Baptist have already had a conversation about what worship places are usable, and how they can share --- not unlike the conversation between Rabbi Cohen and Dr. Harris some 108 years ago after that un-named storm claimed 8000 lives. We understand the risks, and we also understand our responsibility. And our faith keeps us focused on why we are here. After the 1900 Storm, the dean of the UTMB Medical School suggested to the UT System Chancellor that the school should close. The Chancellor's response, "The University of Texas stops for no storm." After 108 years, the message is the same. We have not stopped, and we do not intend to do so. This recent testing of our meddle has only reaffirmed our vision to create the future of health care for our people. It will be better; it will be relevant; it will be innovative; it will be strong. It will last through any of life's calamities. Ben

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