‘Everybody May Not Make It Out’

I hear med school is so grueling to get through, and yet there’s such a shortage of doctors. I can’t see that making it so hard to become a doctor is the best course.

I’m sure there are plenty of people who would like to take a shot at medical school who would make fine doctors if they could handle the physical demands. And if there were enough doctors, and nurses, then it wouldn’t be so hard on everyone and they wouldn’t be “forced” to weed out the weak ones.

I consider myself very fortunate. I’ve only run into one doctor that I think shouldn’t have been in the practice. All the doctors I’ve seen over the years have been pretty exceptional, and the little local hospital we use is wonderful.

It is too bad that the world does not know of the heroic work of the Coast Guard (and others) which made more than 33,000 rescues, most of them by helicopter. This is a resuce of Herculean proportions.

Amen. local, state and federal responses were botched at most steps along the way, but no sane person can question that the USCG was damn-near superhuman. They got their assets out of harm's way before the crash, then got them into (or back into) the zone in a hurry.

Before the next disaster, it's worth taking a mine out of finger-pointing to take a look at what the USCG got right. They did credit to their motto, "semper paratus" -- always prepared.

Katrina actually hit MS much harder than LA. New Orleans was really only side-swiped

Apples and oranges. The storm hit the MS coast harder, both in wind strength and storm surge -- but those were relatively sparsely-populated areas, where nearly everyone had cars and most had access to a truck, so it was easier to et out of Dodge.

The vast majority of the damage to NOLA was not from the storm, but from the collapse of the levees. It flooded an urban core with a well-established mass transit system, Lots of people without cars. The Lower ninth Ward was simply not the same kind of place as Bay St. Louis or Pass Christien.

That is not to excuse the local authorities from responsibility. The challenges in New Orleans were something that NOLA should have known about and prepared for. All those school buses, which were destroyed at a cost of millions and could have saved the lives of thousands, should have been pressed into service -- most of the usual school bus drivers would want to flee with their families, but you can't tell me that the Louisiana National Guard didn't have enough drivers who could operate them.

The Superdome and the Convention Center should have been embarkation points, not shelters. One of my more radical ideas: Car dealers in New Orleans should have just handed the keys to residents and asked the to drop off the cars in Baton Rouge or Biloxi or even Memphis. What's to lose? They took a total loss on the cars in their lots.

Get every river barge and every Amtrak car in town ready for the evacuation. It wasn't just the school buses -- every but of rolling and floating gear destroyed in NOLA was a lost opportunity. Save lives now, figure out the compensation later.

My other radical notion is based on the fact that Wal-Mart stores in the storm zone had ice and bottled water ready to sell before FEMA had ice and water ready to give away. The solution: Contract out emergency operations to Wal-Mart. The whole company has built its success on tight logistics and inventory control. Why try to reinvent the wheel?

Every car, bus, truck, boat, train, every vehicle lost n NOLA could have been used to save lives. NOLA needed a Dunkirk. But there was not enough advance planning, not enough authority to adjust on the fly, and not enough flexibility to keep an eye on the ball. The Red Cross and other charitable groups brought caravans of relief that were turned away by government authorities that hadn't gotten the right paperwork. That has to stop.

If I used my own money, or raised enough money, to bring truckloads of water and tents and medicine, I would have been stopped from doing so by men with automatic rifles. Instead, we have thousands of FEMA trailers that are lined up and sinking into the Arkansas mud because, two years latter, folks still haven't figure out how to distribute them. That has to stop.

If someone is bleeding to death from the femoral artery, you apply a tourniquet -- figure out how o save the leg later.

We need a way to speed response. If that means limited immunity, if it means changes to the insurance structure, these are all things we've got to look at. If we need an act of Congress t ensure that my effort to bring good food to the hungry means that I won't be sued out of existence if someone chokes, than damn it, let's get some legislation.

Bookmark.

You make some excellent points. The first responders MUST be those initially on the ground in the disaster area because until it’s deemed to be safe to enter the disaster area, not the Red Cross, FEMA nor any other relief agency will be permitted to go in, putting the lives of their employees or volunteers at risk.

While no one could have foreseen the damage Katrina inflicted on NOLA with the levee breaches, it’s indisputable that had Nagin and Blanco ORDERED (not just recommended) total evacuation of the city well in advance of the storm hitting, many more lives would have been saved and the resources used to rescue able bodied people off rooftops could instead have been used to rescue people unable to help themselves, like hospital and nursing home residents.

A helicopter rescue is painstaking and dangerous compared to driving into a neighborhood and loading 50 people on a school bus once every half hour.

One positive in Katrina is that places in NO that should NEVER have been developed in the first place will hopefully, not be redeveloped.

In today’s TP a very pertinent article.

http://blog.nola.com/times-picayune/2007/08/exnagin_aide_pens_tellall_book.html

Ex-Nagin aide pens tell-all book about Katrina
Posted by Gordon Russell, Staff writer August 25, 2007 10:23PM

Of the wild rumors to circulate across New Orleans in the chaotic days after Hurricane Katrina, one of the more preposterous was the tale that Gov. Kathleen Blanco exacerbated the flooding by ordering helicopters sent to attempt repairs on the 17th Street Canal to instead rescue a politically connected minister and members of his congregation in eastern New Orleans.

But Mayor Ray Nagin apparently was among those who believed it, according to a new book by Sally Forman, Nagin’s former communications director, who was at his side during the storm and much of its aftermath. Forman self-published the book, which she said is based on voluminous notes she took while working for Nagin. The book is the first on Katrina written by someone who was with the mayor throughout the disaster.

Forman, the wife of Audubon Nature Institute chief executive Ron Forman, resigned her post because her husband decided to challenge Nagin in last year’s mayoral election. He finished third.

That the outrageous helicopter tale would find so prominent an adherent is typical of some of the anecdotes in Forman’s book, which reveals a pervasive level of mistrust among City Hall staffers and other officials.

Nagin and his staff weren’t the only ones to regard others with suspicion, according to the book. As misinformation spread in the wake of the storm, the bumbling response by all levels of government led to a circus of finger-pointing and recrimination.

Forman’s book, titled “Eye of the Storm,” touches on the blame game, but it is most revealing in its description of the mayor and his inner circle, because that was the world she inhabited. It offers a rare peek behind the curtain of an administration that likes to keep its inner workings private.

Nagin has never gone public with his theory about the governor calling off the helicopters; he did not respond to questions this week about whether he still believes it happened. The story was never formally investigated, perhaps because no one publicly alleged that it occurred.

snip

You are right. Obviously the two areas are not really comparable. My point was that the media generally portrays Katrina as having scored a direct hit on NO. Had it done so, we might have had tens of thousands of dead, and perhaps less forceful criticism of the administration for its response. Who knows?

The old-fashioned earth levees all held, I believe. The levees that failed were the new, modern concrete ones. They failed well before reaching the stress they were supposed to be built to withstand.

This implies that somebody screwed up, either on design, construction or maintenance, and is therefore responsible for the disaster. Had the levees not failed, the damage would have been minimal.

Oddly, I’ve seen very little in the media on this subject, except in the weeks immediately after the storm. I suspect the reason is that the media doesn’t want to divert attention away from “Bush’s failure” during the response to the actual cause. The way it has been played, the implication is that the administration knew in advance exactly what would happen, and chose to let it continue in order to kill as many black people as possible.

Or possibly there’s just been an effective cover-up.

BTW, I like your ideas. Would require extensive changes in liability and insurance law. For instance, Katrina could have swerved at the last moment and missed NO, or the levees might have held. Then your car dealers would be up a creek.

Dramatic action such as you propose is generally only justified by hindsight. This is much like 9/11, where the very actions that could have prevented it would never have been considered justified or legal until after it had occurred.

The great lesson I take away from Katrina is that it takes about three days for an entitlement society to fall apart.

Fantastic interview, very strong woman and doctor. Dr. Pou specifically says that she never intended to cause death, only to deal with pain and anxiety.

She also gives a testimony to her faith, which evidently made her stronger.

May the Lord help anyone who is forced to do battlefield triage, especially under conditions that include the type of betrayal I suspect she was feeling.

I’m afraid that a huge part of the problem was the corporate medicine environment.

bump for later

“Oddly, I’ve seen very little in the media on this subject, except in the weeks immediately after the storm.”

Corps chief admits to ‘design failure’
Thursday, April 06, 2006

http://www.nola.com/frontpage/t-p/index.ssf?/base/news-5/1144306231230500.xml

I disagree with your opinions about this case.

I think that Dr. Pou killed these patients without justification.

There is a related thread currently in process on this topic that provides more details. I'll ping you to it.

.

While no one could have foreseen the damage Katrina inflicted on NOLA with the levee breaches,

Actually, the levee breaches were discussed by guys from the NWS some years before Katrina. I have a hurricane video that discussed that very thing and had computer simulations of what would happen if the levees broke.

They can't say that they were unaware of it. Anyone with an ounce of common sense could have figured this would happen some day and the levees that keep water out can keep it in.

Just some related info from a physician that worked in a prison system.

http://www.freerepublic.com/focus/f-news/1475310/posts
Personal Email Excerpt About Prisoner Transfer Due to Katrina

All because SOMEONE thought building a city below sea level could work.

*shakes head*