Pamela Wible, MD is a Family Practice physician who recently spent time at The Houston Astrodome to assist victims of Hurricane Katherine. Here is her moving, and at times graphic account of what she witnessed.

Self Deploy of Self Deplore

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 sweet 57 year old woman named Beulah Chester. Beulah was covered in a rash and as she scratched her limbs viciously, she related the horrors of her past week.

Beulah, a piano teacher from the New Orleans 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 then 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. Beulah 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 others 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, single handedly 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.

- Pamela Wible, MD
Eugene, Oregon