December 11, 2006
Photography by Tulanian
The administrative group of Tulane University Hospital and Clinic met the Saturday before Hurricane Katrina arrived, beginning a familiar series of routine hurricane preparations.
Putting the crisis plans into place, administrators discharged all patients who were well enough to leave the hospital on Tulane Avenue, leaving 180 patients still hospitalized.
After the hurricane passed New Orleans on Monday, first inspections revealed minor damage -- awnings blown off, a few broken windows and some roof damage, but overall the downtown facility held up well. Even though the hospital was on emergency generator power, administrators cheered that the hospital had "absorbed the best punch that nature could throw and we seemed intact," says Jim Montgomery, president and CEO.
But a few hours later, at 1:30 a.m. on Tuesday, Montgomery awoke to the biggest crisis of his life when he learned that flood-water was rising in the boiler room at the rate of a foot an hour.
"We had seven patients on ventilators whose lives would be in jeopardy, and we had to move fast to get them out," Montgomery says.
The hospital was without boats or a helicopter pad. It did have a rooftop parking deck sturdy enough to support a helicopter, but it was occupied by four light poles. "What happened in the next four hours was nothing short of a miracle," says Montgomery.
The hospital's maintenance staff removed the light poles, an ambulance service agreed to lift out critical patients, and hospital administrators quickly made plans to take them to sister hospitals administered by HCA (Hospital Corporation of America). Just after sunrise on Tuesday, helicopters landed on the hospital garage roof and began transporting patients. By then, the water was rising more slowly, at the rate of one inch per hour.
Initially, Montgomery had no idea why the water was rising. "We had to assume that it would keep rising and we would lose power," Montgomery says.
Without electrical power, the hospital would have no lights or air conditioning as the heat soared into the 90s, no elevators, no telephones or other communication systems, no oxygen or suctioning for patients -- in essence, the hospital would lose everything that is vital to good care.
As physicians and nurses began to triage patients, hospital staff determined what vital supplies needed replenishing. In the meantime, HCA worked frantically to coordinate transportation to rescue the remaining patients and eventually the staff -- a total of about 1,200 individuals.
"Our staff performed like clockwork and it was a beautiful thing to observe. Our success in this week is simply measured by the fact that we didn't lose a patient during this trying time," Montgomery says.
Late on Tuesday the hospital ran out of fuel, the generators shut down, the elevators stopped working and the building began to get hot. To evacuate patients, employees carried them down dark stairwells to the second-floor garage walkway, careful to keep I.V. lines, oxygen and intubation tubes in place. Once over the walkway, the employees placed patients onto the back of pickup trucks, which then proceeded up six stories to the garage roof.
By the third day, everyone was feeling stressed. The city sewer system was backing up and spilling out, creating an acrid smell that made it difficult to breathe. No water pressure meant no baths. At night, weary healthcare workers slept on the roof because it was cooler than inside the building. They survived on strawberry Pop Tarts, honey oat bars and canned tuna.
In time, workers from the Louisiana Department of Wildlife and Fisheries came to the hospital on boats to help evacuate patients with chronic conditions that the hospital had taken in from the Superdome. At first, small helicopters landed on the roof, then Black-hawks appeared that could move up to four patients with some additional staff.
The flight coordinator determined that a Chinook helicopter could land on the makeshift helipad as long as the double rotors kept moving so its full weight wouldn't rest on the roof.
Within a few hours, everyone had been rescued from Tulane University Hospital and Clinic.
"This was the worst and most difficult challenge I have ever been involved with," Montgomery says, "but at the same time I don't think I've ever felt as great a sense of accomplishment."
Tulane University, New Orleans, LA 70118 504-865-5000 firstname.lastname@example.org