Excerpts from the notes of Dr. Glen Geelhoed who
went to work to help the victims of Hurricane Katrina:
September 16, 2005 // Dr.
Geelhoed usually travels to developing countries and works in dangerous and
miserable situations.
"When we arrived at the Lincoln School there was a
very large and very dead dog lying on the sidewalk where the people have to
line up to get their water ice and MRE’s.
That “body count” was the only one identified for the school and was
hauled away—but the malodorous memory lingers on. In fact, I have gone out to the street and
scrubbed with a mob, since disposed of, with bleach and every cleaner we could
commandeer, and still the smell lingers on. It is only now that I realize that
there were more than one or two bodies in the area, and the smell persists
probably from some rodents we have not identified and other small creatures
which had sought refuge in the front and entry areas of the school, and the
pickup of debris has not changed that death stench in each place. That was the way the hospital smelled when
first we opened it, and both school and hospital have been “policed” by details
of our brigade to the point that the smell is down and we could almost welcome
in the following permanence residents to start the long takeover process
whereby they could start functioning as a school and hospital again, with the
unpaid conscripts for the cleanup brigade turning attention to other problems
that need fixing."
"A WHOLE SERIES OF PATIENT
PROBLEMS THAT DESCRIBE TRAGIC LIVES—BEFORE, DURING AND SINCE “KATRINA”:
The Lousiana COCKTAIL” AND BARELY
COPING THROUGH DESPERATE
CIRCUMSTANCES
I have noticed a pattern. People keep coming to me for low back pain prescription refills, and they are all on an unusual hardly rational group of prescription nostrums administered in chronic refillable doses of seriously abused drugs. After the tenth patient comes in with “Soma 350 mg po tid, Xanax 1 mg po q4-6h anxiety and Hydrocodone 5/ 500 mg q 4—6 h.” Why on earth are you taking this and for how long?” I ask. “I don’t know; he put me on it 12 years ago when I had my low back pain and I have been coming back to the pain clinic for refills ever since. Are you sure you are not going to give me my Oxycontin?” “Absolutely. Count on it; I have never written for the most addictive drug on the street and never will. I will give IV morphine before any of the agents you seem to be hooked on and I am not here to cultivate further drug-seeking behavior.”
Let me tell you about a patient. One is a thin fifty year old woman who has a
lot of troubles. She came to get her Louisiana Cocktail of pain meds refilled
and told me she had tried to make an appointment to have her teeth fixed (she
has only one upper and two lower teeth in a sea of putrid periodontal
disease. When I took her out to get the
free food we have stacked up next to the gate, she went with me instead to get
the baby food and pureed canned goods.)
She was worried, she said, about a lot of things in her life just now
and had no time to go through the elective things, like a spot on her leg she
had been putting cream on for the last four years but has not gone away and is
spreading. I agree, this seems to have
been a postponable lesion for her, but now I was going to move it up to number
one on her priority list, and we would see that she got it taken care of
today. I took only a quick look and said
“This is a nodular melanoma, and it has spread through the dermal lymphatics
but also into the nodes in your groin, and you will need to have an operation
to remove this. That operation must be
done within the week and if they will not do so over at the West Jefferson
Hospital to which I am sending you with this note, I will do the excision here
in Lincoln Elementary to be sure you get started on the treatment and can
guarantee that the lesion is in the hands of the pathologists.” “They won’t pay me no never mind. I got no insurance and tried to get Medicaid
but they refused me, and it don’t matter anyway.”
What is the reason she would not get to a
hospital and pay attention to this life-limiting risk? “It’s my son, my only child, and they don’t
seem to know what is going to happen to him.”
How so? “Well see, he is in jail
and he is a multiple offender and is up for another violent crime and when the
Hurricane came they took him at night for security and moved him to a place
north in
and they only let him call this
morning. He did not even know there was
a Hurricane and what damage it done, and that the
small house is flattened and I am living in an abandoned car. I asked him if he had heard from a court
appointed attorney, but I have no way they can get in touch with me nor I him
and if he had not called my sister when I was over there talking about how we
get the other people out of the wreckage of our house, I never would have known
that he has been forgotten about up there.”
I got the social service number started on the business of her son, and
wrote a tough letter to West Jefferson with my credentials on it, assuring them
that if they did not address this woman’s metastatic melanoma today, I would do
so in Lincoln Elementary School and let the media know that a Maryland team was
doing what had been neglected in Louisiana until the disease had spread and
added my phone number. It got the job
done, since she came back saying they had taken her into a big DMAT tent and
everyone came to read my note and poke her in the groin and tell here to her
complete surprise that it was a malignancy that had spread and “Why did you
wait so long?” Because she had a dozen
social problems that were bigger than a trivial hickey on her leg that did not
go away, is why. At least her admission
for the operation will “medicalize” the four dozen other social problems which
can now draw attention only to make her disposition at discharge.
Glenn Geelhoed MD is
Professor of Surgery and International Medicine
at
Society for Panetics
This material by Glenn Geelhoed on the front lines of hurricane
Katrina, as he tells about encountering the death stench at the
COMMENT:
Bob is "spot on" in his analysis. My summary statement was that these are devastated people leading tragic lives--and that was before the storm.
Remember I had just
returned the week before
The "
There are predators out there in that hidden jungle lurking to pounce on the vulnerable--and not just the pretty young Brianna, who is on Depo-Provera after six years on birth control pills--now age 16. Even the poorest are a "market" that can be mined. One of my contributions, if any, beyond talking with the patients in trying to protect them (I shall forward a series of pictures of my visits with Brianna and her mother, as she now says she would like to get into a school and try to become a nurse)is through another form of prevention. I asked that the former prescription pill bottles be brought to me, and collected the recurrent names of the ghost prescribers for me to report to the local, state, DEA, BNDD, and National Clearinghouse so that unscrupulous prescribers cannot jump across arbitrary lines to find another pool of poverty--another easy market to "mine."
In a prior Panetics article, I had written of the
"Restoration of Pain." Perhaps
that is my job. Especially
here--in
Here, in a counter-intuitive move "reduction of inflicted suffering" would require a lot fewer, rather than an ever-increasing number of addictive drugs and behaviors.
I am toiling away in multiple "Panetics Laboratories" in the "Third Worlds"---whether in, or across any geographic or political boundaries. The great differences among people in this "new millennium" seems not to be in the nationality they claim, religion they follow, language they speak, or certainly nothing as trivial as the color of their skin, but the brutally simple divide between the haves and have-nots. This is the "Panetics of Poverty."
GWG