05-SEP-A-11
A NEW DAY AND CLINIC #3 AT LINCOLN ELEMENTARY SCHOOL, MARRERA LOUISIANA,
WHERE THE ARKANSAS NATIONAL GUARD,
FRESH BACK FROM IRAQ HAS ASKED TO NOT BE RELIEVED IN THE GUARD DUTY FROM ESCORTING US AND SECURING OUR RELIEF MISSION—
AS I REMEMBER ALSO WHAT IS HAPPENING
AT GAINESVILLE FLORIDA ON A DAY WHEN DONALD UNDERGOES CARDIAC CATHETERIZATION
September 9, 2005
I am skipping school today. I had sent both phone calls and emails to try to get through about my being missing in action, but had today found out that most of the emails I had tried to send last week also went “missing in action.” So, my Cohort messages were returned and I had attempted to transmit my papers into the ELDP courses I would be missing—all of which went missing themselves. So, I will also be trying to reach the Gainesville news of Donald’s Cardiac Catheterization and the interpretation of the results that would suggest he may or not need a new aortic valve and how urgently that might be recommended. I will see what transpires in both Gainesville and Ashburn where I have things going on that concern me, but I also am tied down to a very military post requirement here in the martial law that governs this parish. The Meadowcrest Hospital building we have taken over is actually a claim by the martial law that has seized it. When police form the West Jefferson Hospital accompanied several of the skilled plunderers to carry out some of the equipment which they did at 3:30 AM, there was a near –confrontation between two opposing forces which are supposed to be guaranteeing our safety each with drawn guns and unauthorized entry. So, that is the kind of standoff we are sparing the large contingent of volunteers who will be coming behind us as we keep refining the efficiency of this mission, most of which has been characterized today as rewriting all the rules that were just set in place a few minutes earlier at a similar “high level command” meeting, then reversed only after it had been communicated to “get us all on the same page” –as the pages are turning in a whirlwind..
To be specific about where I am in “home and school” I am in Gretna Louisiana at Meadowcrest Hospital (now a “Hotel” only) in Room 321 which is GRET= 29* 53.06 N, 90* 01.39 W
At “School” I am at Lincoln Elementary in Marrera Louisiana, also part of the marital law jurisdiction of Jefferson Parish at LINC = 29* 53.22N, 090* 05.40W, or HOME = 973 miles at bearing 43*.
I had done some further cleaning of the area including using the bleach bottle we had to sterilize the area where the large dead dog had lain in a puddle of gore which still caused retching on the part of the passers by who came for MRE’s and water as well as medical care. After that I got a chance to see some patients and to write a few prescriptions which are sent out to the few pharmacies that are reopening to take care of all the self-inflicted illnesses that come form excesses of all kinds, from hypertension to GERD to obesity and cardiac complaints and diabetes—a walking laboratory of the “Metabolic Syndrome” which plague the offices of all Family Physicians and internists and especially seem to afflict senior nurses. All of these preventable conditions require chronic medications, so that anyone shut off from them for the past weeks is likely to be ill. We have some stock medicines which we can simply give them, but I can also write prescriptions which will be honored with my name and Maryland license number as well as my DEA registration so that the pharmacists can dispense these meds “free” for a month to the patients, and the pharmacy will be reimbursed by FEMA. That is just a small part of the two billions dollars a day this relief effort is going to cost from now to the foreseeable future, and in comparison to the similar outlay of funds, Iraq and Afghanistan make this look like a fire sale bargain.
But, there is a lot of waste in bringing this much good stuff quickly to an unstructured and uncertain environment, but only after it is here can we straighten out some efficiencies in the system—all of which needs to be done soon, before some very precious stocks of our stuff are discarded only because they were misappropriated to the wrong settings rather then the right ones at an earlier time now “BK”= “Before Katrina”. Almost everyone now employed is a FEMA employee and that rank listing will likely grow longer. But I am still a volunteer and I lean lightly on the system, but the cost of each patient seen so far must be on the order of each Iraqi terrorist killed: it would not bear accounting. But, along the way the people are encouraged to see we are doing something and they may be encouraged to start back to working for themselves on recovering –the only sustainable community resource. It is time to get back to work. I suggest being a lineman for the County!
DAY # 3 OF CLINIC OPERATIONS AT LINCOLN
ELEMENTARY SCHOOL
Each day the number of patients we see doubles over the previous day, and those who had previously come for MRE’s and bottled water and ice, are now realizing they have also got free health care available. This brings an influx of patients who are the wreckage of American excess in calories and inactivity—each with “metabolic syndrome” and a dozen pill boxes in a plastic bag to have each and every one refilled for a month free with my MD license number on them and my DEA narcotic number as well. The constellation of each one of these patients is 1) Hypertension, 2) diabetes, 3) coronary artery disease, 4) asthma, 5) Hyperlipidemia, 6) Gout, 7) Kidney failure, 8) GERD (Gastroesophageal Reflux Disease), 9) Anxiety/Depression, and 10) Morbid Obesity, compounding the concurrent problem of osteoarthritis. This means they get a bucket full of medicines form our stock and a month’s supply free from any drugstore, FEMA footing that bill. Each are getting MRE’s at home, and will have water, home health workers, ice delivered to their door, and bottled gas if they request it. Each has stores about not being able to locater some family members, but assuming they all got out (“No news is good news.”) There are many who are actually now eager to go back to work, since the one advantage of a power failure is that they have been rapidly weaned off TV. A number told me that they had seen neighbors coming in to tape the refrigerator/freezers doors shut and had pushed them out the door for someone to pick up rather than opening them up to reveal their putrid contents. “Tell me about that” I almost wanted to say, with images of every single refrigerator/freezer in my house now destroyed and carted out—including the newest and top-of the line units. But, I did not, since I have had less significant personal loss than they—except for one very impressive discoloration and bruising all across my thighs and shoulders where I had a full Viking unit come crashing down on me!
I will go through several more of the endless briefings and staff meetings of each day, as the supply line is actually working rather well, and as the operation we had to invent before it is running is actually picking up so that our successors will have a better time running the units rather than setting them up. I have heard the leadership (if that is the right term for the people in charge whose first and most usual response is that we are in a very “fluid” situation right now and they will get back to us when they know more) say that our proudest achievement may be that we invaded a derelict abandoned hospital and in twenty four hours had turned it around to the point that it made a safe and adequate hotel to house us, and may eventually have an ER where we can begin to see patients after eth peripheral teams are back to referring people somewhere.
Everywhere people are playing soldier in an environment where I see the biggest hazard is that emergency vehicles in convoys and running red lights with sirens and flashers going may plow into each other. And those deputized to guard us, make a great show of body armor and fully automatic weapons with extra live clips strapped on. This morning we had a photo taken of us form the roof of the hospital as we stood in the parking lot, between the rows of emergency vehicles with all their flashers going and an “Operation Lifeline” handmade flag displayed, while the heavy equipment front end loader behind our group raised up the US flag above the Maryland flag—a photo that they will distribute to each of us. One of the urgencies for doing the photo now, is that as we begin to get operationally busy, a dozen of the crew have decided that they are not longer needed and will go back. One older woman who is highly specialized and essentially useless in this environment was quite annoyed that she had asked repeatedly to go down into New Orleans inner city “to see it,” and no one had responded to her request to get in there. There she would simply impose a burden on everyone around her to keep her from killing herself as all other s who know their way around there have already been evacuated. “What would you DO there that could help them when there are already highly trained SAR teams who have exhausted what they can do?” I asked her. “No, well, I came down here to SEE what it was like and I will go home without getting what I had wanted out of the large number of facilities here.” She had wanted to accompany me on my African international mission—most probably for the same reasons, as an adventure tourist, so I hope she is not surprised and annoyed to learn that she would be the last candidate for accompanying me anywhere.
I have experimented with several kinds of the “MRE’s” in their clever self-heating packets. Most everyone in New Orleans by now must know about these devices, and possibly many have been opened and tossed aside by now. I had one woman ask me to help her and get a box of them into her care, and when I carried a case of them out to her dropped by the big FEMA army truck, I noticed she had ten cases in there already—so groceries for the next several years are being stockpiled privately by some—who no doubt have not tried these before. Several civilian versions are actually quite good, and they seem high in calories—exactly what I started out saying the average sedentary American here does not seem to need. Nutrition advice is not a real “starter” here, except we tell everyone not to brush their teeth with tap water. WE have more than enough calories ourselves. I have no refrigeration units at home of any kind that are functional myself, so I should fully sympathize with these folk!
My roommate, an Indian Gujarat-born surgeon form Ellicott City MD has gone back today leaving a note on my pillow apologizing that we did not have a chance to say farewell directly, since his father-in-law at home is suffering from a terminal cancer. I had wanted to check today with the folk at the ELDP which is in session and also will call later tonight to learn what is happening with Donald after his cardiac catheterization.
I have go to know many of the Arkansas National Guard guys, each of whom is about half the age of my sons, as they are packing heavy weapons around in guarding us when they would rather be getting ready for duck and deer hunting in their Arkansas home. The Sergeant whose name is Darien Mickelson is a duck and pheasant hunting guide with yellow labs for his trade and uses the 65 days of the season to guide clients coming up this October. Who knows, I said, I may be one of them in the near future. He deserves a good waterfowling season since he had missed the last two in Iraq. So, an unusual cross-section of Americans, from patients to relief workers have been tossed together in an unreal world scenario, much less structured at the start than we have made it now with our patterning what seems to work. As we signed up to get the portrait of the group photo, a second sheet was appended with no heading. I asked what is this one for? This is the sheet that tells you are interested in staying full time as a recruit in the Maryland Defense Forces—we could use you, you know!
Like Cincinattus, I have come forward when my country needed me, and I am serving, but when that urgent need has passed and it is routinized into a controllable situation, I will be moving on back to my own somewhat minimally more controlled situation, and seek no need for titles and staff meetings and –oh yes, one more roll call to add up to the tenth so far today!