As medical professionals, we all encounter tragedy daily -- car wrecks, shootings, strokes and sudden deaths. But nothing prepared us for what we witnessed at the Superdome during Katrina.
I served as the physician medical director for Acadian Ambulance Service, which was the medical contractor providing EMS services at the Superdome. It was Acadian's tradition to staff the first aid station at the Dome during hurricanes, since it was a shelter of last resort for people who were unable to evacuate the city. I was there for two days.
Though many of my personal memories remain buried, some scenes are still vivid: Diabetics in crisis, elderly people in heart failure, mothers in labor, and schizophrenics with paranoia and hallucinations. Cancer patients wanted to know where they were going to get their chemo. Dialysis patients looking for direction. Thousands of people needing help all at once.
There was no playbook. When protocols failed, we had to invent solutions. For instance, one of our air ambulance flight medics evacuated six newborns from a flooded hospital using a cardboard box padded with blankets. Everywhere, improvisation replaced procedure, and courage replaced certainty.
Our small first aid station was meant to handle minor illnesses and injuries and occasional heart attacks. Relief came when a FEMA Disaster Medical Assistance Team set up in the smaller New Orleans Arena next door. Together, we improvised a system: triage patients in the Superdome, stabilize critical patients in the arena, move them across the raised walkway to the Superdome helipad, and then fly them to Baton Rouge.
At first, helicopters made 90-minute round trips to LSU's basketball arena, which had been converted into a field hospital. But the demand to move large numbers of people out of the Superdome was overwhelming. The breakthrough came when we realized the Interstate 10/Causeway cloverleaf outside of the flood zone could serve as an ambulance staging area and helicopter drop-off. Helicopters could cycle patients out of the Superdome in minutes instead of hours, and ambulances could take them directly to more distant regional hospitals. As fast as the helicopters could land on the helipad, we would fill them with sick and injured people for their flight out.
The conditions inside the Superdome deteriorated rapidly. In the chaos of medical evacuations, families were torn apart, with no system in place to track where loved ones had been flown or which hospitals had received them. Rumors swept through the Dome -- whispers of violence, of rapes, of failing generators about to flood. The National Guard urged us to strip off our orange vests and conceal our stethoscopes to avoid being singled out. Fear for our own lives grew palpable. I wondered if this was what soldiers meant by the "fog of war."
Those days in New Orleans were heartbreaking, yet what stands out most in my memory is the grit and determination of my colleagues -- paramedics, nurses, doctors and support staff. One co-worker persuaded three 18-wheeler drivers to push through floodwaters to Charity Hospital, where they loaded 48 patients and several staff members into the backs of those trucks and carried them out of the city. Employees from Acadian's maintenance department waded through 4 feet of filthy water, hauling coolers filled with hamburgers so we could have a meal while working at the Dome. I could tell a thousand stories like these -- people sacrificing and pitching in with whatever they had. Even my own family found ways to help: Three of my brothers flew into the Superdome to assist with patient care and establish satellite communications.
A lot has changed in the 20 years since Katrina and Rita. Unfortunately, the standing of health care professionals seems to be eroding. Online criticism is now routine. Public cynicism toward science has grown louder. Meanwhile, our health care system remains deeply flawed -- profit-driven, bureaucratic and nearly impossible for the average patient, or even the average physician, to navigate.
Beyond the core duty of caring for patients, today's health care workers face crushing workloads, chronic staffing shortages, endless paperwork and the dictates of insurance companies and profit-focused administrators. They endure verbal and physical abuse, punishing hours and the moral injury of knowing what their patients need but being unable to provide it. Layer onto that the shocks of pandemics and the increasing frequency of natural disasters, and it becomes clear: Working in health care today requires extraordinary commitment, resilience and sacrifice.
I don't think about Katrina every day, but forgetting is impossible. The memories remain etched in me like a watermark -- faint at times, but always present. It's hard not to envision another catastrophe that could once again plunge us into chaos. In the years since, I've come to call myself a "practical prepper." I trained as a ham radio operator, stockpiled food and essential supplies and never leave home without my "get home or go" bag, packed with three days' worth of gear. I've made peace with the idea that disasters are not a question of "if" but "when." And when that moment comes, the truest resource we will have is each other -- our neighbors, our colleagues, our community.
Ross Judice, M.D., served as chief medical officer of Acadian Ambulance Service from 1998 to 2010. He is the author of "The Katrina Diaries," a firsthand account of medical responders' experiences in the aftermath of Hurricane Katrina.