05-SEP-A-12
NEWS FROM DONALD THROUGH THE NEW CELLPHONE TOWER BOOSTERS AND ATTEMPT TO GET MESSAGES OUT THROUGH THE FEMA COMMAND POST
AT THE ANNE ARUNDEL COUNTY EMERGENCY RELIEF MOBILE UNIT GENERATORS PARKED INSIDE OUR GUARDED MARTIAL LAW PERIPHERY
AS WE SET OUT ON DAY #4 IN THE LINCOLN SCHOOL FOOD/WATER/ICE/HEALTH CARE CLINIC
September 10, 2005
Today is the second day of my ELDP missed classes and the day after Donald’s cardiac catheterization yesterday. It is also the fourth day of our operational clinic in the Lincoln School and the sixth day of my mobilization for the Maryland Emergency Preparedness Volunteers that finds me a Major in the Maryland Defense Forces on the front edge of the first response team to be on site and inventing the system and mobilizing the resources to address this largest natural disaster in our nation’s history. The effort is spending two billion dollars a day, and I presume I am not a major part of that, first as a volunteer freebie, and second since I am not that eager to consume more than my fair share of the MRE’s!
I had tried to get the messages out on the first night that the FEMA command post was set up by the Anne Arundel County Emergency Response Unit through their wireless connections to the internet. I had sent out several messages which never were received, since they seemed stripped of vital parts of their email address in transmission. I did not get any of my original messages to the Cohort 16 of the ELDP, but through one member who was kind enough to send me a message through which I could “reply” I got the word back to them that I was here, missing them and the sessions they were in there (discussing the Organizational Learning that I am witnessing her first hand) and that I would hope they might forward to the group a few of the partially finished papers I had attempted to get done for the course this weekend. They are all cheering me on, according to the response form Elizabeth Ross, and many expressed the wish that they were able to contribute some personal effort as I was doing here.
IMPORTANT CALL BY CELL PHONE
TO DONALD AFTER HIS CARDIAC CATHETERIZATION
There has been very spotty cell phone reception and ability to call out until today. In the parking lot in front of the erstwhile Meadowcrest Hospital (now my “hotel” after all our scavenging raids and cleanup operations) the tent for the FEMA command post staffed now by the Anne Arundel County Emergency Relief teams has erected cell tower boosters, delayed by the need to secure the periphery in which they had planned to erect them. With that crew comes a group of plumbers, electricians and maintenance men who also were called in to try to re-electrify our Lincoln School and to unstop the plumbing plugs of the Hospital—handier people to have along than bariatric surgeons! With their help and the new boosters, the cell phone reception is so good I could call Donald and get a clear signal immediately.
His leg was sore form the site of the arterial puncture, but he seemed in good spirits. The news he said was bad: he has a very bad valve and they recommend that he have it replaced as soon as possible. He has a lot of aortic regurgitation and a DVD was made of the catheterization and he will burn one for me. He did not know the gradient across the valve, and he will ask a bit more about that sort of data, but he had been advised to have a mechanical valve inserted and he was already on the internet looking up details about Coumadin. This might change rather dramatically what it is that he does for a living, but it would be potentially longer lived than a porcine or bovine xenograft valve.
He had been advised by the North Florida Cardiologist to seek out the advice of the new cardiac surgeon down form New York who had joined the group at that “cardiac factory” but also in an unusual move he also recommended a fellow named Martin at University of Florida in Gainesville. He is seeing one of these on Monday and the other on Tuesday and he will let me know what it is that they are advising. If it is soon, I may be able to get over to see and go through the procedure with him at whatever time he elects to have it done.
I told him about the situation here, which had surprised him since I had told him last Saturday when he called and we had our longer talk that I might be going. What he did not know is that I was already here in Louisiana. The Gainesville Police volunteers are in Biloxi Mississippi. He was surprised to hear about the scope and magnitude of the drill here, since we are the first responders and making it up as we go along. We are in the thick of it, as he knew when I could tell him I was talking with him and looking at the darkened skyline of New Orleans directly in front of me across the river. I am in Gretna at the Room 321 of my “Hotel” and I am in Marrero a few miles west—all along the west bank of the Mississippi River all of it looking over at the Crescent of New Orleans with the large Lake Pontchartrain at its back. The convoys of heavy equipment and materiel are still rolling along the highway next to us, each with armed guards. Troop convoys with helmeted heads hanging out to get a view of what kind of devastation in our area of hurricane blowdowns is visible, while heavy flatbed trucks of OD colored earthmovers and front end loaders and backhoes and graders are coming along with big trucks of stockpiled MRE’s water carboys and still more emergency trucks and supplies are rolling by. Donald could hear the overhead choppers and the huge diesel and fuel consuming vehicles all around me with their engines ruining and their flashers going with occasional escort sirens blaring. I am in what looks like a post-suicide bombing evacuation zone in Baghdad. But, there is a more upbeat note about this situation, and a number have reflected how this is actually fun. Our guards seem to prefer this to taking shots at whomever they are supposed to be prepared for with the clumsy and heavy equipment packs and the ever-on the shoulder M-16’s on the ready. They are talking to me about their home towns and asking me if it is true that there are as many people where I come from as the 300 people in their whole town? I said—maybe on half of one floor of the average building, I reckon.
Donald might try to access the internet and the email messages I had tried to forward him from this site to see if it will distract him form the other news he has had today, and I will talk with him again.
PHOTO OPS OF A GROUP IN ACTION
AND IN INACTION
We had a group photo shot of our entourage form the roof of the hospital showing us all lined up in between cordons of the emergency vehicles each with all their flashers going and engines running as a US flag was suspended form an Army front end loader and the Maryland flag beneath it. Already this color photo poster is pasted on the front door next to the guards who check the arm bands and familiarity of appearance of those who come and go. The photo may be all that some had wanted to come here for, since many had left today—including my roommate who had left a note on my pillow apologizing that he had not had a chance to say farewell. The master sergeant has come around to check to see who is where and advises I may be moved on Sunday to re-shuffle teams according to the transitions that have rotated some of us out and leaving some teams short of any experienced doctors. I will see where they assign me next—you know, “I’m in the Army now” so there does not need to be a rational explanation of anything at all, according to Major Major and Milo Minderbinder—all these decisions are made above my pay level—which is easy to do for someone who is a volunteer. So the photo op is a rather impressive array of Maryland personnel and equipment—all here “first with the most.” I stood next to the Montgomery County Expedition vehicle and thought that this state—which has five and a half million people—about the size of one borough in New York City—may be smaller and therefore more agile than other states, at least we were here first, and set down the precedent of what it is that comes behind us. We invented and test drove this wheel.
What have I done most often so far? Besides getting ready to see patients, as opposed to seeing them, I have stood after hurrying to wait and responded “HERE!” a dozen times each day in mandatory wait around roll calls. It gives the internal feeling of progress and a fell good organization, whatever may be the disorganized state of the people out there in Jefferson Parish—we here are a well drilled team who have come to help them if we never get to actually do it, we have at least set up a smooth transition for those who will have to do that part of it! Fortunately, I will be here long enough that I will be seeing the patients myself as well as directing other team members who will be learning the art—the same as in the Kashmir or in Haiti, or in Somaliland, or in Ethiopia, or Sudan or anywhere else we have set up from scratch to do what we can.
MY FOURTH DAY IN LINCOLN ELEMENTARY (SCHOOL) CLINIC
The troops around us are making some connections and a few of the amenities of life such as electricity beyond the reach of the generator are coming back on, and a rumor has spread that the elevator will be functional. The endlessly repeated meetings are going on for the purpose of Make-Work activities, and we have a “Kitchen Duty” for Bravo Team coming up tonight, right after a caterer is coming in to allegedly furnish us with a hot meal. Last night the same caterer had furnished us with a box lunch which was a ham sandwich with cheese. There are endless supplies of caloric snacks around and we will probably all gain enough weight to resemble our patients here shortly since we are limited in our activity (cannot go outside the perimeter boundaries of our parking lot and the hospital and only then on certain floors, and we cannot do what should be done in such situations—get out and RUN for example. I am getting stodgy here and should run soon after a week without a running step let alone a mile or more. And we are given a lot of the best products of America---Honeybuns, Krispy Kremes, and the salty and sugary stuff of the next door “Snack Shack.” The big problem is that there is no breakfast, and therefore we start out the day hungry and graze along all day then use one of the MRE’s followed almost immediately by something similar form the American Red Cross. There are trucks now form German, Swiss and Belgian Red Cross which I saw while waiting for our escort today and a group came over to drop off diapers and infant formula all form California, while we were taken to our clinic this morning after an unnecessarily long period of standing around in a bus that came form California and was driven by a driver form Indianapolis, as we were triple checked by a volunteer (now paid by FEMA from Ocean City MD) We are still a Maryland contingent which gives us all bragging rights and others are joining in since we seem to have thrashed through the confusion of the early situation to come up to some kind of operating base. On the TV last night the subtitles on the news keep advertising our sites and telling the people what they can get there—everything from immunizations to ice, water in bottles, food, and home health services if needed. We had a queue of about fifty people awaiting our arrival this morning which we did answer to and served their needs.
I had a woman who had a problem with her left breast and anterior right abdominal wall. The “Storm messed up my house,” but she is OK, she thinks, except that she needs an inhaler for asthma and a couple of meds she was taking that have run out or cannot be found in the ruins of her house. What she did not know is how this mass got in her left breast and how it hurt so much. I put in some local anesthesia and opened it up draining out a big blood clot and a soupy mix which I recognized as the kind of “steering wheel injury” called “Fat necrosis” in women who have had a blow to the breast. After all the fuss she put up earlier, she was one happy camper going out, since I opened the abdominal wall small abscess also. So she announced to all as she left “I had to have surgery—and Boy! Am I glad I did, since I was one hurting puppy before I came here and now it don’t hurt no more!” So, we may have changed at least one person’s day today, amid the 86 that I saw. Almost all need meds filled, and apparently besides that FEMa sponsored meds, Medco is also supplying all maintenance drugs free for a period of a week. So they will honor my presicripstins with my name, license and DEA number on each pad I write.
During the “down time” of the day, I managed to write labels on the Eritrean photos in the albums I had carried down with me, so I did get that large operation completed while down here as other things are unrolling largely without my control or pushing them. .From a brief email check at home, I do not have any forward progress going on there since the house has not yet been cleaned by C & C after the Environmental Solutions Inc has inspected it, and now the Viking has to be hauled away as trash as well as the two that are already gone from the basement. But, that will be unlikely until I am there. Until that time, there is not refrigeration at home, even thought he big blowers, air scrubbers and dehumidifiers are still soaking up my electricity to no apparent purpose.
I have learned a lot about the Military Mindset as a number of people are “Playing Soldier” here to no apparent purpose except organizing a large and expensive undertaking with an internal organization no matter what it does to help those we allegedly came to help. But, that was a necessary first step, and some of those are being transferred back now, so I may be able to get in a full week’s work in the wheel we have invented before I, too, will be “rotated out.” I would like to see more results of this massive mobilization that may actually result in a remarkably improved health status of the people afflicted, but if they go back to the way they seem to have been just before the storm hit, they were suffering a lot of degenerative disorders largely due to abuse of too much food, alcohol and other addictive substances and were kept alive by a whole lot of half way measures, which when interrupted, constituted a crisis of facing life without the multiple crutches. We will have to salvage in that way, but we are unlikely to change the habits of sponsored unhealthful practices that have been a way of life. It seems to be a military way of life as well with the passage of time, expenditure of resources and numbers games of the process being measures of success, since the end result in the target group is so difficult to assess.