Sep 19, 2008

Voices of Ike - A wonderful community of physicians

1:05 am, Friday, Sept. 19, 2008 Austin internist Frierson-Stroud, MD

The care of the coastal evacuees is evolving in both subtle and dramatic ways. I had a front row seat again today. I went by the Convention Center first. The Exhibit Hall was no longer subdivided into pods. A sea of cots coated the now essentially wide-open room. Another room was similarly set up. The hospital beds were essentially gone. This is due to the fact that the patients with medical needs had been moved to the U.T. J.J.Jake Pickle Research Center. When I walked in, at the Research Center's Common building, I found the now about 44 patients (down from greater than 90) in what is normally the basketball court. The nurses' stations were on center-court. The pods, A-G still, were placed in a circle around the center. Cardboard boxes held the charts. Again, the nurses, part of the City's Health Department, brought the patients to my attention. Most had already been initially assessed but one gentleman had just arrived. We had to convert his insulin in the same manner as on my previous day. Most of the problems were pretty routine. Meds were refilled (some have been there the week and others are running out of their meds).

Patients were also referred to vscular and orthopedic surgeons, neurologists and internists. Having seen before/after pictures of Galveston, patients from the island were referred to the clinics for longer-term care. I was later joined by a pediatrician who felt a bit like a fish out of water. However, she did a wonderful job providing primary care. She bonded with the DON, usually involved with pediatric immunizations, over vaccines. The saddest patient to minister to was a young woman who had a C-section about 3 weeks ago. Her incision had dehisced. She was getting home health to care for it, but she needed a VAC. She had a stony demeanor that was daunting. She didn't have a family according to her. This made me wonder where the baby was. I was, frankly, afraid to ask her if it had survived. Fortunately, the pediatrician was able to tactfully ask her. With relief I found the baby was with a friend. I looked for Mrs. K but she wasn't there. I hope she's gone home or to a nursing home. The 400+ pound woman was also not to be found. I recognized a few of the patients, including my old psychiatric patient. He's still a handful. The gentleman with the staph infection was still there although he spent a lot of time in the TV area. The cots for the most part were higher off the ground thanks to pads including air pads. The narrow cots were occasionally taped together to make the bed a more comfortable width. Hospital beds were mainly along the edges. One of the patients required a transfer to the hospital to rule out a DVT. Another was taken to a nursing home. The attrition will continue as the days go on. They are requesting volunteers thru September 25th. I'm hoping to drag a medical student with me the next time I come. I recognized the handwriting of one of my colleagues. He'd been there a few days before. I always thought he was a nice guy. Now I know. As my shift drew to a close, I was happy to be relieved by a former hospitalist. I knew the patients would be in capable hands. I took him on rounds as I showed him the ropes especially pointing out the problem patients. This crisis continues to bring out the best in the medical community. A radiologist who is a med school classmate (the second one I've seen since this started) was dropping off donations at the Convention Center. The pediatrician who left her comfort zone and family to come help those in need. The unknown number of physicians who have selflessly volunteered to care for their fellow man. Many, including the two I worked with today, are novices to this type of medical care. People like this reinforce what a wonderful community of physicians we have here in Central Texas.

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