A Tale of Two Hospitals

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DURING THE PAST TWO WEEKS, we’ve watched as the nation’s 35th largest city—New Orleans—and a metropolitan area encompassing more than 1 million people has literally ceased to exist. Today this region is effectively a ghost town and former residents are scattered throughout the United States.

This event is unparalleled in American history. The closest natural disaster I can relate to this event is the San Francisco earthquake of April 1906. The earthquake, and the fires which followed, destroyed three-quarters of the city and left 300,000 people homeless. Thus, the impact of Hurricane Katrina on Louisiana, Mississippi, and Alabama is without precedent. It also is a warning for all laboratories and pathology group practices. Emergency planning and disaster response scenarios should receive more attention and resources.

I offer, as an example of good emergency planning, the experience of Tulane University Hospital and Clinic (TUHC), owned by for-profit HCA Inc. Last fall, HCA had a “hurricane lessons learned” meeting in Orlando, Florida. This was to develop emergency plans using the experience of the three hurricanes which hit Florida that year. With Hurricane Katrina approaching, HCA executives created a crisis-management team at corporate offices in Nashville to identify needs, model scenarios, and provide resources to its hospital, located not far from the New Orleans Superdome.

When the hospital began to flood, “we were unable to get any governmental help in evacuating,” declared Norman McSwain, M.D, who is a Professor of Surgery at Tulane and Trauma Director at Charity Hospital, located across the street from Tulane and operated by the state of Louisiana. HCA’s response was to charter 20 helicopters from various sources. Knowing that communications would be a problem, they flew ham-radio operators into New Orleans to coordinate the airlift! In the next few days, HCA airlifted 200 patients and 1,200 staff and family members from TUHC. HCA also used the helicopters to evacuate patients and staff from Charity Hospital.

I make two observations about the tale of these two hospitals. First, it is a heartwarming example of American initiative and ingenuity at its best. Second, it’s a sad comment about the failings of bureaucratic government agencies. Despite access to immense resources, these agencies cannot make bold decisions and act expeditiously, as did HCA in this disaster.

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