Hospital Descends Into Misery

The darkened corridors of Charity Hospital of Louisiana seemed less a refuge for the injured and ailing Thursday than a chamber of horrors.

Three days after Hurricane Katrina slammed the city and knocked out power to the 12-story medical center, anxious patients and sleepless physicians were almost indistinguishable from each other, weary from sharing harsh and unsanitary conditions.

“The workers are to the point of collapse,” said Star Page, a respiratory therapist.

With electricity out, only the crudest forms of medical treatment were available. Patients on ventilators were supplied life-giving oxygen using hand pumps. Sewage backed up in all the sinks.

Outside, floodwaters lapped at the steps of the hospital. The basement morgue was underwater. There was neither refrigeration nor air conditioning. A newly filled body bag was stored for days in the sultry emergency room.

Hopes for an orderly evacuation of the hospital were disrupted Thursday morning when sniper fire threatened National Guard troops who were ferrying patients to a nearby heliport by truck.

The troops withdrew, saying it was too dangerous.

Here on the front line of the regionwide public health emergency that has followed Katrina, the scene at Charity Hospital was a grim example of the dire conditions medical professionals face -- and the limits of their heroic efforts.

The medical staffers working at Charity, part of the Louisiana State University Medical Center, arrived for work at 7 a.m. Sunday knowing that they would staff the facility through the worst of the coming storm.

It was a warm and sunny day. “It always is before a hurricane,” said Lauren Williams, a neurology nurse.

When the winds came up, staff members watched from the windows. As it intensified Sunday night, they decided to move patients from their rooms to the hallways, away from windows, creating a tangle of stretched breathing tubes and power cords.

Then windows started to shatter. “It was raining glass,” said Ray Campo, a surgical care nurse. The storm prevented the arrival of relief shifts.

The power failed, but hospital generators replaced it -- until rising water took out the main generators, then the emergency backup.

The air conditioning shut down. Patients wielding oxygen tanks started breaking the windows that had survived the storm seeking relief from the sultry heat.

“That’s when the real problems began,” Campo said. Without electrical power there were no elevators, and hand ventilation -- employing rubber, football-sized breathing aids -- for oxygen patients was required.

“Once you lose the juice, we’re bagging them by hand; we have been doing that on and off for 2 1/2 days,” Campo said.

As the floodwater rose, patients were moved to the second floor, mostly into an auditorium where supplies were concentrated.

The hospital sewer system stopped. Buckets in the hall were used as latrines. Doctors were unable to scrub.

New patients managed to reach the building only to find it was unable to function as a hospital. They were turned away.

One woman came into the emergency room Monday with her son, recalled nurse Page. She said the elderly woman came from a nursing home and required a ventilator. The hospital could not help her.

The son “disconnected the tube and said that he did not want her to go through this,” Page said. She died. Her body remained in a body bag in the emergency room days later.

Another patient came in from the Superdome on Monday with a head injury. No brain scan could be done. He had regained consciousness by Thursday but was still unable to communicate with the medical staff.

A number of the patients are not known by name. The medical staff has assigned them numbers instead, designated them, for example, Disaster 7 and Disaster 8.

Improvisation is common. On Thursday, Page was using a battery-operated suction device to keep a tracheotomy patient’s breathing tube clear. A diesel generator keeps small fans churning and a coffee pot warm.

Evacuation was welcomed by staffers and patients, but no one knew where patients were destined.

Although National Guard troops abandoned the effort, other rescue workers took up the transfer later in the day. An armada of aluminum boats filled to the gunnels with patients and nurses, some holding their I.V. racks, transferred the ailing to a helipad, the Superdome or other gathering places for transit to care elsewhere.

Some may have ended up at Louis Armstrong New Orleans International Airport. Departure and arrival lounges there were converted to sprawling hospital wards. Stretchers with patients were stacked on baggage conveyor belts.

Throughout the afternoon, evacuation continued -- one stretcher at a time -- to a fleet of military aircraft waiting to fly them to hospitals beyond flooded New Orleans.

Ronald Metoyer, 43, grimacing in pain, sat in a plastic airport chair wearing an elaborate brace around his head.

He broke his neck in a fall early in July, trying to trim a neighbor’s tree in advance of Hurricane Cindy.

When Hurricane Katrina arrived, Metoyer was recovering at home. Now he was awaiting evacuation to “somewhere in Dallas,” he said.

Iona Mitchell sat with her frail, 102-year-old mother, concerned that the ordeal might be fatal for the woman in her wheelchair.

“She hasn’t rested her head on a pillow for three days,” said the weary daughter. “The Lord has led us to a spot where we can make our way out, but I am so worried.”