But in the week of August 28,Hurricane Katrinawould test that relationship and the clinicians’ limits of compassion, patient advocacy and professionalism. Trapped within the confines of their hospital with 18 seriously ill patients, Dr. Berggren and the two teams of nurses and support personnel who stayed behind first lost power, then food and very nearly their hope. In the overbearing humidity, the darkened central stairwell, the only passage to other parts of the hospital, quickly became a treacherous obstacle course, slippery from human sweat. Vending machines, smashed open with bare hands, stood empty in small puddles of blood. The air grew increasingly rank as people, lost in dark hallways, began defecating and urinating wherever they could.
Dr. Berggren and her team were finally rescued six days later, but only after every one of their patients on 9 West had been evacuated first.“Not a single patient died, and nobody on our team left until our patients were safely out of Charity,” Dr. Berggren said in a recent interview.“We got every single one of our patients out.”
Below are excerpts from my interview with Dr. Berggren, now an associate professor of medicine and the director of the Center for Medical Humanities and Ethics at theUniversity of TexasHealth Science Center in San Antonio.
Q.How did you end up at the hospital during Katrina?
A. As the assigned physician, I was expected to be there. Normally we would have also had a team of doctors-in-training and an entire support staff. But no one else showed up that Sunday morning other than the nurses and support personnel who had been trained in disaster response.
This happened all over New Orleans. Sometimes it was the senior physician who didn’t show up, and the doctors-in-training were left to care for patients without supervisors; sometimes the senior physicians were left without the support of doctors-in-training.
Q.Why do you think the other doctors didn’t show up for work?
A. I had to ask myself at first why people who had been so passionate about patient advocacy had not bothered to show up. But with disaster preparedness, people have to evaluate their own suitability for being a first responder— and not necessarily in terms of medical or technical skills. If you have a conflict of interest that relates to what is most dear to you, you are not necessarily going to be your best self as a responder.
Some people who stayed behind were the sole caregiver for an elderly person; some had children left with a baby sitter. They broke down after four or five days. Their loved ones were lost, and that created such hugeanxietythey couldn’t function. I was lucky because I knew my husband and children were safe. I think if I didn’t know where my family was, my ability to be reasonable, empathic and compassionate would have gone out the window.
Q.Did you ever fear for your own life?
A. We had heard on the news that if theleveesbroke, the water could be 20 feet deep and filled with toxic chemicals, so I did feel that something serious could happen. But none of us felt deeply frightened the first day. We felt safe in Charity. We had a nice team of people. And there was more patient interaction than usual.
When the storm hit, things changed rapidly. Water came through the seams of closed windows, and we had an inch of water on the floor. We heard an eerie screeching— almost like human screaming— that was, I think, the sound of metal scraping against metal. Then the lights went out.
For a day, we were able to keep the patients’ treatments going using the hospital’s emergency backup power. But as time went on, we lost that power and all the machines switched over to batteries. Eventually, those batteries went out.
At first I was busy switching patients over to treatment plans that wouldn’t require power, but most of patient management the rest of the week had to do with constant communication with the nursing staff, keeping people calm and trying to keep to some kind of routine.
In the end, I didn’t spend a lot of time worrying about the 20 feet of water with toxic chemicals because there was so much to be done. As a physician who could do something good for people, I felt it was time for me to step up to the plate. That sense of purpose propelled me for the next six days.
Q.The Superdome, only four blocks away from Charity, was racked with chaos and violence that week. Did the same happen on 9 West?
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