Lions and Tigers and, Oh My, Doctors Too

Rachel Kingston walked past a pair of growling white Bengal tigers, ducked into a plastic tent and slipped into a dental exam chair. Her hand gingerly cupping her cheek, Kingston described to the dentist how her tooth had been aching since Hurricane Katrina.

Steps away, scores of other cavity-plagued residents lined up in front of a dental X-ray machine while a bear cub slept in a nearby tree. Down the road, next to a rhinoceros playfully digging in the dirt, women in a temporary exam room placed their heels into medical stirrups for Pap smears.

The thousands of people who have gathered this week at the Audubon Zoo are not here to see the wildlife -- but to obtain medical care. The 58-acre zoo, about five miles southwest of the French Quarter, was the only site in New Orleans large enough to accommodate the weeklong free clinic.

At least 500 doctors, nurses and other medical professionals volunteered to staff the clinic, which is a temporary measure to help address the medical care crisis that has followed hurricanes Katrina and Rita.

Seven of the city’s 16 hospitals are closed; scores of medical and dental offices were destroyed. Thousands of doctors, with no place to practice and their homes destroyed have, like so many others, left the area.

The hurricanes have caused the largest migration of doctors in the U.S. since World War II, when medical workers were drawn into military service, according to research at the University of North Carolina’s Southeast Regional Center for Health Workforce Studies.

The zoo clinic was organized by the City of New Orleans Department of Health and the Remote Area Medical Volunteer Corps, a Tennessee-based nonprofit that helps bring free medical services to areas in crisis.

Some volunteers came from the New Orleans region; others traveled from across the country, including dentists from California, optometrists from Kansas and obstetricians from Delaware.

The clinic, which opened Monday morning, was visited by about 5,000 people by the end of Thursday, said Stan Brock, founder and director of the Remote Area Medical Volunteer Corps.

Thousands more are expected to be treated before the clinic closes on Sunday, said Brock, who was a co-star of the TV series “Wild Kingdom.”

Word of the free clinic quickly spread throughout the region, and hurricane-ravaged families arrived from as far as Mississippi and Texas.

Early Tuesday, hundreds of people waited at the zoo gates to register and see a doctor. The first 40 in line had tried to get in the day before but arrived after dark, when it was too late to be seen. Unable to find -- or afford -- a hotel room, they spent the night in their cars.

“I kept hearing the animals. Lions roaring. Elephants trumpeting,” said Jean Callesto, 53, a former schoolteacher who lost her job and home in the 9th Ward. “It was more comfortable than the tent I’ve been sleeping in since September, believe me.”

Once inside the zoo, patients used the animal exhibits as guideposts for finding the doctors they needed.

Pediatric health care was offered in RVs near the elephants. The endocrinologists and family practitioners were housed in an office near a wild pig exhibit. The pharmacy was a short walk from the flamingos.

Outside the dental hut, Kingston, the woman with the aching tooth, joined several hundred people sitting hip-to-hip in plastic chairs and on picnic tables shaded by plastic tents.

Three months before Katrina, Kingston, a 21-year-old single mother and former blackjack dealer at Harrah’s Casino in New Orleans, went to her dentist for a checkup.

She had two cavities that needed to be filled. “I put it off, because my teeth didn’t hurt and I thought, ‘Hey, I’ve got insurance. I’ll deal with it later,’ ” said Kingston, who is studying to be a nurse at Southeast College of Technology in Metairie. “Then, the storm hit. I lost my house. My mother lost hers.”

Kingston also lost her casino job and the insurance coverage that came with it.

The toothaches began in earnest around Christmas. By New Year’s Eve, an abscess had formed, swelling the right side of her face and making her feverish.

Now, two teeth had decayed so badly, the dentists at the zoo told her they needed to be extracted. Another tooth needed a root canal.

It wasn’t just her health that was failing.

Her mother’s supply of insulin for her diabetes was nearly depleted. And the breathing of her 2-year-old daughter, Alirian, had grown labored -- Kingston worried her toddler was developing asthma.

But they couldn’t find their doctors. Her dentist’s office number was disconnected. When she drove by his office, the building had simply disappeared.

As a result of the storms, about 4,500 doctors and medical residents were evacuated from the three central parishes of New Orleans, according to a report by the University of North Carolina. Officials with the Orleans Parish Medical Society have estimated that about 1,200 doctors have returned so far.

The decreased number of local doctors often means lengthy waits for appointments, and having to drive to Baton Rouge or farther to find care.

It’s also caused a strain on hospital emergency rooms. “A lot of people are using the emergency room for primary care,” said John “Jack” Finn, president of the Metropolitan Hospital Council of New Orleans in Metairie.

“Because of that, we have people stacked up in the hallways. It’s taking an average of two hours for the staff to move patients from inside the ambulance to inside a room.”

Given such hurdles, many patients have simply opted not to see a doctor -- even when there has been clear need to do so.

Brock’s group, which after the storms had provided emergency care in the area, petitioned the state medical boards to once again allow professionals licensed in other states to practice in Louisiana. The boards and state government officials agreed.

The framework necessary for the temporary medical clinic in place, the nonprofit appealed to dentists, nurses, doctors and mental health workers to come to the New Orleans area.

The zoo made its premises available for the clinic and hundreds in the medical field -- after paying their own way to get here -- came to give free medical care.

They have taken in stride the setting they find themselves in. So have the thousands who have come for medical attention.

“I’ve never seen a stranger waiting room in my life,” said Linda Veitch, 52, watching alligators swim by as she waited for an eye exam at the Louisiana Swamp exhibit. “I desperately needed new glasses, because mine were ruined by Katrina.”

“But,” she added, “you can be sure that I’m going to walk out of here carefully after they dilate my pupils.”