Nurses evacuated from AP report on Katrina
September 9, 2005 -- Today many press organs ran a harrowing piece by Associated Press "medical writer" Marilynn Marchione about the plight of New Orleans hospitals after Hurricane Katrina. The Yahoo! headline, which was typical, was: "Doctors Emerging as Heroes of Katrina." Consistent with this headline, the AP piece depicts physicians as having done virtually everything of note for the patients at Charity, University and Tulane hospitals in New Orleans during the worst hours of the Katrina aftermath. Apart from a passing reference to RN's and EMT's, and one sentence about a Pennsylvania paramedic, the piece is all physicians all the time, with many references to what "doctors" did, and multiple quotes and/or description of no less than eight named physicians and a medical student. Not one nurse is mentioned. The lengthy piece is practically a primer on the ways a press account can deify physicians and scrub out all references to non-physicians in the delivery of care to hospital patients.
"Disasters always spawn heroes." This bit of reporting introduces the only section of the story to mention specific non-physician health workers. According to the story, many of the heroes of early September in New Orleans wore "hospital scrubs that said MD, RN and EMT," since thousands of these health workers stayed with patients in "devastated hospitals" after Katrina struck and thousands more rushed to help. The piece then names four of these heroes, including "Barry Albertson Jr., 42, a paramedic from Easton, Pa., who missed his 7-year-old son's first peewee football game to join a caravan of ambulances making the 30-hour trip to New Orleans." That's it for the non-physicians.
Ready for the physician part? The other three heroes are "legendary" trauma surgeon Norman McSwain, who "waded through fetid floodwaters" to alert the world to Charity's plight, Pennsylvania ED physician Rich Tabor, who paid his own way to Louisiana where he went door to door with rescue workers, and Lee Garvey, an ED physician who "dropped everything" to "staff" a mobile hospital that cared for patients in devastated rural Mississippi. Jessica Lee is a University OB/GYN resident whose story basically frames the piece. She and the other "doctors" tried to care for a patient who was nearing labor in the dark, sweltering conditions, though "doctors" had been giving her drugs for days to try to delay it until evacuation. We learn about Lee's sacrifice in volunteering to work for a colleague, how "doctors" without equipment could not determine vital things about the fetus's condition, how there was "no running water for doctors" to scrub their hands before an emergency C-section, how "we" spent a lot of time calming hysterical women in labor, how a gunshot victim's death "illustrated the violent backdrop against which the doctors worked," and how Lee and her patient were airlifted to another hospital for an "emergency C-section that Lee and another doctor performed." We also hear about medical student Susan Seo, who "helped carry patients down four flights of stairs" to an ICU. Meanwhile, "attempts" to evacuate patients were foiled by gunfire, and patients "were moved" to higher floors to escape looters.
Tulane physicians Lee Hamm and Tyler Curiel went to see how they could help the more distressed public hospitals, University and Charity, where Curiel's wife, physician Ruth Berggren, worked. Curiel "was trying to rescue patients by boat." Berggren told CNN that "I" came down with "my patients" all the way from the ninth floor, and that "[w]e" loaded them onto boats. At Charity, "[d]octors" were counting drips in IV lines, while "bystanders squeezed oxygen bags every five seconds to keep patients alive." Hamm says that "[t]here were lots of very young physicians doing very heroic things." Indeed, "[d]octors managed to move 150 patients on boats to the freeway" where ambulances were waiting. We hear that University resident Stacy Holman assisted in a birth by holding a flashlight while "one" of her colleagues delivered the baby. We also learn from a rescue driver that, as the military finally completed the evacuation of the hospitals, "the doctors" were "the last to come out the doors. They would not leave until all the patients were out." As for the legendary McSwain, he took a leading role in seeking help for the hospitals from the media, and he also notes at one point that one Charity patient "was being hand-ventilated." He also gets the melodramatic last paragraph: one of the last out of Tulane, he "would have turned out the lights," but the hospital was already a "dark, waterlogged corpse. As was the city he left behind."
No nurse is named or cited in Ms. Marchione's article; indeed, the word "nurse" does not appear. The vague reference to RNs is almost worthless given everything else described above. We do not doubt that physicians did heroic things, as the article proclaims. But we cannot believe they did everything all by themselves. Consider some of the blatant and subtle ways that nurses have been scrubbed from this story. On many occasions when nurses and others surely played a significant role in a given activity, the activity is either described in the passive voice (this just happened) or we read that it was done by some vague group, such as "we" or "bystanders." On other occasions, we hear that the physicians carried people here and there, counted IV drips, gave drugs and the like--activities in which it is very difficult to believe that nurses did not play a key role. Did Garvey really staff the mobile hospital by himself? Was it really only "bystanders" who bagged patients? It is nurses whose job it is to keep patients alive 24/7, and since that is the main activity described in the article, it is impossible to believe that nurses had no significant role here. (An earlier, much shorter piece by one of Ms. Marchione's own colleagues includes several quotes from nurses on the ground, suggesting that they did play a central role at Charity and elsewhere.) With regard to the deteriorating conditions, it appears that either they affected only physicians, or else it is only of significance that physicians could not use machines or wash their hands. Evidently only young physicians did very heroic things, only physicians made notable sacrifices for their patients, only physicians took bold and innovative steps to cope with the conditions, and only physicians did not want to leave until their patients were evacuated.
We have contacted Ms. Marchione regarding this story and are working with her to try to create more positive media on nursing.
Specifically, she has asked to interview nurses regarding the many nursing homes that were inadequately evacuated during hurricane Katrina. If you are a nurse and you have expertise in evacuations, disaster preparation or nursing homes in general, please contact us at firstname.lastname@example.org so that we can refer you for an interview with Marilynn Marchione. Thank you.
You can see this story on PhillyBurbs.com web site.