My Katrina diary

Franklinton, LA, population nearly 4,000, is located about 65 miles north of New Orleans in rural Washington Parish. When Hurricane Katrina hit last year, life there changed forever.

In the following account, FP Christopher Foret details his days and nights and his battle to provide healthcare during the week of the disaster.

Friday, Aug. 2611 a.m.: It's a typical hectic Friday morning at our family practice clinic in Franklinton. We're well aware of Katrina. But at this point, the storm's projected path has it coming ashore in the Florida panhandle. My nurse, Kim, worries about the storm hitting us, but I reassure her. The last hurricane to seriously impact our parish was 20 years ago.
11:30 p.m.: The reports have changed: the latest projections now have the eye of the storm-a Category 2-passing slightly east of here. A Category 2 means lots of wind and rain, but that's just part of life along the Gulf Coast.

Saturday, Aug. 276:30 a.m.: The storm is now a Category 3, and it's shifting westward, directly toward New Orleans. I go to the local supermarket and buy lots of bottled water and batteries, just to be safe. There are few customers in the store, which means the anxiety level around town is pretty low. Then I fill the car with gasoline; that turns out to be my most important purchase.
7 p.m.: My wife, Julie, and I have dinner at a friend's house with two other couples. Everyone's in a good mood-an old-fashioned hurricane party.

Sunday, Aug. 28
6 a.m.: We're up early to barbecue chickens for our daughter's school fund-raiser. I stare at the weather report in disbelief. Overnight, Katrina has grown into a Category 5 storm with sustained winds near 160 mph, and gusts over 200, heading dead on for New Orleans. This is the storm we learned to fear growing up in southern Louisiana. I wake Julie to tell her.
Noon: At the school barbecue the anxiety is palpable. Even grown men aren't bothering to hide their fear. When we check the radio for news, it's all bad: 12 hours of hurricane-force winds, mandatory evacuation for New Orleans, catastrophic loss of life and property is projected.
My brother Gerald, an internist in Alexandria, LA, calls and urges us to evacuate to his house. "I can't," I explain, "I'm on call tomorrow." Just then, a flock of pelicans flies overhead. I've never seen pelicans this far inland.
3 p.m.: After the barbecue, I deliver the leftover chicken to the evacuees who've already arrived from New Orleans. As the winds grow stronger, we secure loose objects in our yard. My neighbor grimly predicts we'll be without running water for a week and without electricity for two. He invites us to stay in his fallout shelter. It's a concrete "bunker" with 3-foot thick walls, but it has a tin roof that probably won't survive the storm.
5 p.m.: After talking with the ED doc at our local medical center, I decide to move my family there; I'm worried about being able to get there later if there's a crisis. It's a 25-bed critical access hospital with an ICU.
8 p.m.: We arrive at the hospital and move into a spare room. Other employees and their families are there, too, and a real sense of community emerges. Katrina has lost some strength, but it's still powerful, and projected to pass 25 miles east of us. I use a roll of duct tape to protect the windows.

Monday, Aug. 292 a.m.: The wind howls, and we've lost power. We can use the backup generator only for vital functions. Our main contact with the outside world is now a transistor radio.
9 a.m.: I've finished rounds, everyone is gathered at the ED windows, marveling at Katrina's fury. I can see shingles flying off the roof of our office next door. Across the street, the entire roof rips off the optometrist's office. In the distance, 100-year-old oaks are toppling.
I'm called to the ED. There's a pregnant woman brought in with contractions. We don't have obstetrical coverage, though, and we're not equipped with modern technology for deliveries. But the weather has deteriorated to the point that EMS can't take her to the nearest hospital with labor and delivery suites. The ED doc will manage the mother, and I'll care for the infant-my first newborn in eight years.
10:30 a.m.: A man walks in clutching his chest. When the roof of his mobile home began to detach, he had a syncopal episode and a seizure. When he regained consciousness, he was diaphoretic, with chest pain. His sons put him in his car and headed for the hospital; they had to use chainsaws to cut their way past fallen trees.
The man's ECG reveals an acute inferior MI. His ECG normalizes with medication, but he continues to have pain. I call a cardiologist who has evacuated here from New Orleans, and he approves what we're doing. When the patient stabilizes, I call his family and explain that we can't transfer him.
2:30 p.m.: Occasional gusts and rain, but the worst of the storm is over. The radio reports that the eye is just east of us. Maybe we can transfer patients now to a tertiary facility. But when we try the telephone, there's no long distance. We ask the sheriff's department for an escort, but all roads are still closed.
4 p.m.: We try to check on our home. On the way, we pass downed power lines, fallen trees, and houses with gaping holes. It looks like a bomb has detonated in our town. At the bunker, our friends are okay. But the street to our house is impassable.
6 p.m.: I'm called to the ED to admit a pump operator evacuated from New Orleans. He's also had a seizure after a syncopal episode. With no CT scanner and only portable X-ray capability, we have to rely on our clinical assessment. Fortunately he's stable, so we admit him.
Our pregnant woman is tiring, and approximately 6 cm dilated. I call the CRNA who says she can't do epidural anesthesia. I call the general surgeon in town to check his availability for a C-section, but he can't get out of his house because of downed trees. I prepare by reviewing the newborn exam and Apgar score, and then retire to my room. The nurses will wake me when it's time for the delivery. Two more pregnant women present to the ED. Could there be a correlation between labor onset and falling barometric pressure?
Midnight: I'm awakened by the nurse who tells me the first pregnant woman still isn't progressing, and the ED doc wants to transfer her to the tertiary facility 25 miles south of us. Because of their proximity to the coast, however, their damage is apparently worse than ours, and there's still no way to communicate with them. We decide to send the patient there anyway by ambulance with a nurse, EMTs, and a sheriff's escort.

Tuesday, Aug. 308:30 a.m.: I'm finally "off call," and I can go home. The streets to our house are still blocked, but we take a back route through a cemetery. A few trees have fallen in our yard, but none hit the house. Our utility pole is twisted in two, and the transformer is lying in the flower bed. Some friends stop by with a chainsaw and a winch, and help us clear a path to our house. We begin cleaning up.
11:30 a.m.: I go back to the hospital to check on my admissions from yesterday. All are stable. Because fallen trees have severed our water lines, we don't have enough water pressure to flush toilets or wash hands. After much discussion between the administration, medical staff, and the mayor, we decide to shut down and divert all patients except for real emergencies. We don't realize that this situation will last for another week.
5:30 p.m.: Back at home we spend the afternoon cleaning up the yard. When we finally quit, I get my first shower in two days. We eat by candlelight, listening to radio reports on the horrific situation in New Orleans. We feel helpless and heartbroken for our region.

Wednesday, Aug. 31
7:30 a.m.: I make my rounds at the hospital. My cardiac patient informs me that he had chest pain while walking yesterday. I realize that we can't keep him simply because we have no idea when we'll be able to arrange an orderly transfer. After conferring with one of my partners, we decide to let the man's wife drive him to the hospital in Alexandria, in north central Louisiana.
I explain the situation to the patient and his wife. I give them nitroglycerin paste, oxygen, and a dose of metoprolol, and tell him to stop at the nearest ED if his chest pain recurs. I also give him a letter with admission orders to any ED doc. I'm worried about sending a patient on a 200-mile trip two days post MI, but desperate times call for desperate measures.
11 a.m.: The generator we ordered for our home finally arrives, and it provides some electricity for our refrigerator and freezer. We have very little gasoline, and there's not much available in town. Luckily, friends arrive from Baton Rouge and let us siphon some from their gas tank. Later that day, my brother Gerald arrives with food and six gallons of gasoline, which gives us six more hours on the generator.

Thursday, Sept. 1
8 a.m.: Conditions at the hospital are critical. Supplies are running out, with only two days' worth left. We can't provide ED service, and EMS is in triage mode. Expectant mothers will be delivered at home by the paramedics. Dialysis patients are on their own. People on home oxygen can't get refills.
The situation in town is deteriorating, and rumors are rampant: the generators are failing; we're on the verge of losing water; the water supply is contaminated. Banks and grocery stores are closed. People are running out of food and fighting over gasoline at service stations. With rumors of looting, the anxiety level is increasing, and nearly everyone is carrying a handgun.
My brother and I decide we have to do something. I figure I would be more effective informing people outside our area of our plight, and trying to get donations of supplies.
10 a.m.: I go to my office and empty our sample closet and bring it all to the hospital. At home, we gather all our antibiotics and the beef from our freezer and bring it to the Red Cross shelter. Then we start packing. I tell Julie to pack some pictures and other valuables in case we have nothing to come back to. I figure that if there's looting, a small town doctor's home would be a likely target.
My brother and I plot a course to his home in Alexandria. We're conscious of our gasoline supply because we don't know where we'll be able to buy more. Hearing radio reports-later proved false-of rioting in Baton Rouge, we decide to take the long route via Natchez, MS.
1 p.m.: About 30 miles north of home, we finally get cell phone service. We call the state EMS office and a regional ambulance service and plead for help. They say they'll try, but offer no guarantees. In terms of medical supplies, it appears that all of southeast Louisiana is in the same position. We manage to find gasoline across the river from Natchez. Five and a half hours after leaving, we finally reach Alexandria-normally a three-and-a-half-hour trip. We luxuriate in my brother's air-conditioned home, then confirm a radio interview for 7:30 the next morning.

Friday, Sept. 2
8 a.m.: The radio interview went fairly well, and the calls come in. One man volunteers a truck and a trailer. A lady offers another truck. Doctors call in offering drug samples and supplies. Individuals donate food, diapers, and personal hygiene products. We go around picking things up. When I call the nurse supervisor at our hospital to tell her the good news, she says they need body bags. They're for elderly people who died not because of injuries, but because of the conditions they endured after the storm. I call the coroner of the adjoining parish, but he can only spare 20 bags. "They're all going to New Orleans," he explains.
7 p.m.: We can do no more here in Alexandria. The support has been overwhelming. All the supplies are inventoried and loaded, and we're ready for the trip back home.

Epilogue: Back in Franklinton, we spent 21 days without electricity, and it took months to repair all the roofs and downed power lines, and clear all the fallen trees. Many people here suffered severe damage to their homes. But compared to the devastation in New Orleans and the Gulf Coast, our losses were negligible. After nearly a year, life here is close to normal, but normality has changed. The Parish lost more than half its trees, and the population has increased by 10 percent, due to the influx of refugees from the Coast. So, there's more traffic now, and the stores are busier. But there's a palpable anxiety as the next hurricane season approaches. Katrina was the first big one to hit our area in 20 years, so statistically we're not due for another one soon. But who knows? At the hospital we're getting prepared, just in case.