Joanne Conroy, MD

Trees

In the Eye of the Storm

As Hurricane Matthew barreled toward Charleston, South Carolina, on Friday, I reached out to several of my friends still living there to make sure they had an exit strategy. I spent 22 years in Charleston, and was working at the Medical University of South Carolina (MUSC) during two major hurricanes, Hugo and Floyd. It seems that whenever a hurricane threatens portions of the United States, we must re-learn all of the same difficult lessons. I wonder why there is no playbook on surviving hurricanes and other natural disasters.

Hugo

During Hurricane Hugo, I was not on call so I evacuated to the Quality Inn Suites three miles inland. First lesson learned: Three miles is not far enough away for a category 4 storm! My then-husband (a yacht broker) and I stored the “good car” at the MUSC garage in a protected area, and drove the 1980 Cutlass Supreme to the hotel with two meowing cats in tow. Many people were hunkering down in their homes, hosting hurricane parties. We had not had a large storm in Charleston in years.

The first half of the storm was pretty uneventful—until the atrium roof of the hotel collapsed and the alarm went off as the wind started roaring. We listened to the marine radio and heard chilling calls for help from boaters. People had taken their boats up the Cooper River in a vain attempt to protect them. (One of our friends had done that with his 40-foot, restored but uninsured, sailboat. He admitted afterward that he would never do that again.) Trees were flying through the air like spears.

We stopped walking the hotel halls as the winds picked up over the roofless central atrium and the windows at the ends of the corridors began to shake. Plaster fell from the ceiling at the height of the storm, followed by the eerie calm of the eye passing over us. We went outside to look up at the sky. There was not a breath of air or drop of rain. As the storm picked up again, I went back inside and immediately fell asleep, leaving the outcome to fate.

The next morning, my husband and I drove out to our condo on the Intercoastal Waterway before the National Guard descended. We were the only ones on the road, swerving between downed trees and electrical wires. We pulled into the parking lot. There was our 40 foot sailboat still tied to the dock. Unfortunately, the dock was in the parking lot, 200 feet from the water. Cars were tossed into the ponds on the property like toys, and marine equipment had been twisted into modern sculptures. Nearly 20 people died in the storm and its aftermath.

We recovered slowly. MUSC didn’t get power back for a week, and we only did emergency surgeries. The hospital nearly ran out of food and doctors had to use sterile water to wash their hands before surgery. Staff stayed to care for patients for 72 hours at a stretch. There were so many heroes: Maintenance workers risking their lives at the peak of the storm to cover shattered windows with plywood in the neonatal ICU while nurses moved babies into the hallways. Staff ventilating patients for hours. Teams problem-solving and ultimately commandeering my department’s Nextel phones so they could communicate when the electricity and paging system failed.

Floyd

Hurricane Floyd was a very different story. It made landfall 10 years after Hugo, but the population was still traumatized. The roads became impassable during the massive exodus from town. It took over 17 hours to go fewer than 100 miles west. (The authorities should have reversed the inbound side of the highways, making every road outbound.) By that time, I was chief medical officer at MUSC. As my current husband took up residence on an air mattress in my office, I spent days holding blankets over patients as water poured through the ceilings and triaging those who had turned back from the clogged highways to seek shelter at MUSC.

Lessons Learned

  1. The best way to get your staff to come in and work for an indefinite period of time is to make sure that their families and pets are safe. During Hugo, we had a hard time getting people to stay even if they were on call. During Floyd, we welcomed families and pets instead of excluding them. We had a cat room (the Department of Medicine conference room was never the same), a dog room, and an “other” pet room. We had whole families bunking down in departments. I had 13 providers and their families in the anesthesia department, ready to work no matter long they had to stay.
  1. Truck in a lot of food. We had to ration food during Hugo. You need to feed people who are working 72 hour shifts. Chocolate cake and fried chicken taste good hot or cold.
  1. Expect the unexpected. I received calls from families who had not evacuated with people on ventilators! Make sure everyone who requires oxygen or electricity has an evacuation plan, but don’t count on them transporting the patient to safety.
  1. During the storm, water will come in from everywhere. We had water pouring down the elevator shafts. It rains horizontally during a hurricane.
  1. Your smokers will find a place to smoke… in spite of the weather and in spite of the rules. In the center of the storm, they were all smoking on the loading dock, holding on to the door so they didn’t blow away.
  1. You will see wonderful examples of community outside the facility. In Charleston, people had to line up for water, ice, and food. There were no arguments or fighting, just a general sense of community. People shared what they had. I purchased a home after my condo was unfit to live in; three other families moved in and lived with us for the next nine months because there was nowhere left to live. We had 30,000 displaced households. That is what communities do.
  1. You will see incredible heroics and wonderful examples of humanity from clinical staff, security, housekeeping, and families—things that make you proud to be part of the organization.

Human disasters and weather emergencies test the mettle of an organization and of its community.  The bombing in Oklahoma City, the September 11 attacks in New York, the Boston Marathon attacks, and countless hurricanes, earthquakes, and fires have tested our communities’ ability to put aside our own need and simply care for others, regardless of race, religion, age, or beliefs. A simple act of sharing helps people. Enveloping ourselves in the arms of families, friends, and sometimes even strangers helps us begin to survive the aftermath of these tragedies. I am always proud when I see staff and providers coming in to care for and protect patients in these incredible circumstances… sharing and caring in the best way they know.

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