As daylight broke Tuesday over the University of Texas Medical Branch here, a helicopter circled overhead and morning-shift workers began to stream in down below. This was no ordinary day, however. The helicopter was bringing workers from the Federal Emergency Management Agency, rather than patients, and the crews arriving for work were wearing hazardous-materials suits instead of hospital scrubs.
Three days after Hurricane Ike devastated this island community, along with much of the Texas Gulf Coast, the teaching hospital that has survived hurricanes for more than a century was once again getting back on its feet.
The island is under mandatory evacuation, and its leaders describe it as uninhabitable. There is no electricity, running water, gasoline, or groceries. But for hundreds of employees still working this week at the university center, which includes medical and nursing schools, a teaching hospital, and a research facility, the recovery is well under way.
In the main administration building, mattresses and cots are set up in cubicles for staff members who haven’t gone home since Ike struck. Some have no homes to return to, and no hotels within hours where they could take a shower or cool off. Although air conditioning was working in parts of the medical center on Tuesday, there was no running water for showers or for flushing toilets.
Signs of Damage
Campus officials say it could be a month or more before the hospital resumes regular operations and is able to bring all of its students and residents back. In the meantime, administrators are working on temporary placements for 557 medical residents and about 2,400 medical, nursing, allied-health, and graduate students. The hospital has about 12,000 employees, 8,000 of whom work in Galveston.
The destruction Ike left behind is evident in all directions. Outside an emergency-room entrance, a half-dozen palm trees lie on their sides, alongside a white boat named “Tranquilo” that washed ashore.
Yellow tubes snake into soggy buildings, pumping in air to dehumidify rooms that had been flooded with up to three feet of water. For the past few days, crews have been pulling up soggy carpets, hauling off debris, and replacing broken windows.
Within a few blocks of the medical center, live oak trees that were ripped from their roots are toppled onto homes.
On Tuesday university officials said they had just learned it could be as soon as within two days—rather than the two weeks they were expecting—before some power is restored to the medical center. However, it could be weeks before the entire island’s power is back on, along with other essential services.
Medical-center crews are focusing on getting the infrastructure, research, and educational programs back in place while a federal Disaster Medical Assistance Team temporarily takes over patient care. Patients are either treated and released, or transported to other hospitals. Officials say they are optimistic that by shaving some time off vacations and study periods, the medical center will be able to allow all of its students to complete the year and graduate on time. But that’s going to require some juggling and cooperation from the state’s other medical schools.
A Necessary Dispersal
Department heads are working on finding temporary placements where medical residents and clinical students can practice for at least a month. Even if the hospital reopens sooner, it won’t have the patient base those doctors-in-training need. A resident in general surgery, for instance, has to perform a certain number of gallbladder operations, and a resident in ophthalmology needs to operate on a certain number of cataracts.
“I’ve gotten calls from administrators at programs as far away as Washington, D.C., offering training sites,” said Thomas A. Blackwell, associate dean for graduate medical education. “Lots of offers have come from Louisiana. They know what this is like.”
The school will also have to work with Medicare to make sure the $30-million a year it receives for residency training follows students to their temporary placements.
The allied-health school is considering working with the University of Texas Health Science Center at San Antonio to place some of its students, and the nursing school is looking for options to allow its students to continue some of their studies online.
Temporarily handing over patient care to the federal team allowed the hospital to give breaks to clinicians who had been working around the clock since a few days before Ike arrived.
“Nobody wanted to make the decision, but it was an obvious one that had to be made, just like evacuating the hospital,” said Garland D. Anderson, executive vice president and provost.
Two days before Ike struck, its target appeared to be far enough down the coast that the medical school might be able to avoid the kind of costly and difficult evacuation it had made for Hurricane Rita in 2005. “As it got closer and closer,” Dr. Anderson said, “we said, This is too big a storm. We have to evacuate.” On Thursday, all 260 of the patients in its teaching hospitals were transported to facilities in Austin and San Antonio (The Chronicle, September 12).
Help for Storm Victims
During and immediately after the storm, the hospital’s emergency room treated more than 100 people for a variety of ailments and injuries. Among them were people with chronic illnesses who had been off their medication, patients suffering chest pain or asthma, and many people suffering from emotional stress.
Dr. Anderson, who was wearing the blue scrubs he has lived in for the past several days, laughed when he was asked how many hours he has worked each day since the storm. “I don’t remember— more than 12.” His palms were sweaty and he had dark circles under his eyes as he slumped in a chair, recounting the past several days.
He said that in the aftermath of the hurricane, the medical center lost not only city power but some of its emergency generators.
Doctors, residents, and other staff members hauled equipment up dark, slippery stairs, using flashlights. The lack of electricity and the flooding required them to relocate entire units, including the pharmacy, up and down as many as eight floors. At the height of the storm, members of the group had to move their emergency-operations center after they heard a loud explosion and smelled smoke that was wafting into the building from a nearby boatyard that had caught fire. They had to move it again when a generator failed.
Rescuing Research
A failed generator also forced them to haul temperature-sensitive laboratory specimens, animal cages, and supplies up and down stairs. “People’s life work is sitting in a corner in the freezer. It’s very vulnerable when the power goes off,” said Michael J. Megna, the medical center’s facilities-planning and emergency-preparedness officer. “You never know what breakthrough might be sitting on a table that could be washed away.”
Some 225,000 pounds of dry ice was delivered to the hospital to help safeguard research and medications.
Temperatures in the buildings soared into the 90s in areas that did not have air conditioning. Phones weren’t working, so runners carried messages between buildings. In the medical center, as in the city itself, conditions are still far from safe or sanitary.
Galveston Mayor Lyda Ann Thomas has warned the estimated 20,000 residents who ignored evacuation orders to leave, saying the city faced a potential public-health crisis. Among other things, officials are worried that all of the standing water could result in an outbreak of mosquito-borne diseases.
At the medical center, campus employees and contractors lined up for tetanus shots before heading back out into the muck to resume cleanup and repair work on the hospital grounds.
Pamela G. Watson, dean of nursing, had just returned to her Galveston home on Tuesday and found that it had been flooded with three feet of water. She will probably be staying in a hospital room on the campus while she works on getting the nursing school back on its feet.
Many of the plans the medical center implemented came about as a result of lessons learned in Hurricane Katrina, said David L. Callender, president of the University of Texas Medical Branch. “We have, unfortunately for the people of New Orleans, benefited from their misfortune, and we owe them a great deal.”
