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FEATURE | By David M. Roth and Garrett M. Eckerling, M.D. Katrina Relief: One Physician's Odyssey
Eckerling went with the Red Cross because he was unable, as a physician, to get a response from any federal, state, or local storm-zone relief agency. And though the Red Cross provides only nonmedical disaster relief, Eckerling wasn’t concerned about stretching the organization’s mission: His goal was to get to Louisiana any way he could. He pointed out that at the start of the relief effort there were 500 physician volunteers from throughout the United States who tried to assist, but could not deploy because of the delayed response of government relief agencies. “There was an overwhelming need that so far has outweighed that in any previous disaster,” says Eckerling, a CMA and Placer-Nevada County Medical Society member, alternate solo and small group delegate to CMA’s House of Delegates, and board member of his local Red Cross. “I just really felt I could do some good.” He flew from Sacramento on September 13, caught a few hours’ sleep at a Red Cross shelter in Baton Rouge, and was in Monroe (pop. 60,000) early the next morning where, for the next 11 days, he treated evacuees. What he found was every manner of medical condition and emergency, some of them made worse by the neglect caused by the storm, but others reflecting the state of health care in the United States where millions with chronic problems have little or no medical care at all. The massive shelter complex that housed his new “office” was the former headquarters of State Farm Insurance Company, a sprawling seven-acre complex that, post-Katrina, has been transformed into what may be the largest long-term shelter in the nation. It and its patients bear little resemblance to the rural, mostly white, environment Eckerling works in at home. “Most of the people here are extraordinarily poor,” he observes. “There is no middle class. These are people who have no place else to go, because if they did they’d be there.”
Their plight was not like that of those who suffered days of neglect at the New Orleans Superdome. “I have seen devastated lives, but few tears,” Eckerling says. “Everybody seems to be amazingly well adjusted and thankful for what they have.” Another difference is the level of security and organization. “It’s not as tight as Fort Knox, but close. There were military police with metal detectors and myriad vehicles and Monroe city police all around.” Inside, services were well coordinated. There is a “central command center.” An industrial kitchen dispenses meals. What was once a huge call center served as a dormitory, divided into sections for families, single men, single women, and couples. Each corridor carries a “street” name, and each cot has an individual address. “It’s a city unto itself,” whose makeshift nature posed unique medical challenges, says Eckerling. The physician dealt with seizures, drug overdoses, diabetic low-blood sugar incidents, and patients in need of every sort of life-sustaining medication. “Many,” he says, “have long-term, chronic problems that were not well controlled prior to the hurricane,” and in some cases their problems were as out-of-control as the storm that drove them here. A leading example was the large number of mentally ill who, after the evacuation, had been off their medications for weeks. Eckerling had to administer Valium to one resident to control an acute panic attack and send another, a paranoid schizophrenic, to a psychiatric hospital. “I have spent time as a medical resident at a clinic for the homeless in Venice, California, and that was plenty weird, but this has been an eye-opener,” he says. “Soon you come to realize, this is the new ‘normal;’ and then you start to think how bizarre that is.”
Complicating an already difficult mission was an influx of people who were not hurricane evacuees, but simply the homeless from all over the region who’d taken refuge in the relative comfort of the Monroe shelter. During Eckerling’s stay in Monroe, the Red Cross operated an infirmary inside the shelter and a mobile medical unit just outside the building, as well as outreach teams that scoured the community. Its success, Eckerling stresses, depends on the support of the local medical community: hospital emergency rooms, urgent care centers and walk-in clinics, which treated evacuees referred by the Red Cross, regardless of their ability to pay. Whether that medical community’s efforts, now strained by new mass evacuations, can be sustained at that level is an open question. After he’d been in Monroe a week, Eckerling says there was still no sign of help from local, state, or federal disaster agencies. Furthermore, two days prior to his departure, Red Cross headquarters in Baton Rouge still hadn’t made any arrangement to replace him, despite repeated alerts from Eckerling that he would soon be leaving. Another complication, he warns would-be volunteer physicians is the requirement to obtain a federal license to practice out-of-state. Eckerling tried numerous times. Finally, just days before leaving, he “found the right person at the state department of health,” but didn’t know if his application would be processed in time. Eckerling forged ahead. He made only token attempts to disguise the fact that he was administering medical care without proper credentials under the Red Cross banner. “Whenever I’d give injections I’d just close the door,” he says with a wink. Asked if he had worried about liability, Eckerling scoffs. “I’ve never been one to worry about the repercussions of what I do,” he stated. “I go off and do what needs to be done.” David M. Roth is a writer at California Physician.
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Monroe, La., Sept. 23—Two weeks after Hurricane Katrina devastated New Orleans, Garrett Eckerling, M.D., a family physician from Grass Valley, Calif., flew with a suitcase full of medicine and supplies to Baton Rouge. He was the lone physician in a group of 15 disaster health workers sent by his local Red Cross Chapter.
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