Two years after Katrina, New Orleans orthopaedists are rebuilding their practices and their city

When Hurricane Katrina struck the Gulf Coast—and New Orleans, in particular—in August 2005, it destroyed entire towns and displaced thousands. After living through the desperate conditions following the hurricane, when civil services came grinding to a halt and much of the city was under water, AAOS members had to put their personal and professional lives back together.

AAOS Now talked with several New Orleans-area fellows to see how life is for them two years after the storm. Not everyone who lived there before has returned, and those who are home again continue to face challenges. Still, many are finding that New Orleans is coming back and even attracting new residents. For more about the challenges, see “It’s not always easy in the Big Easy” on page 46; to read about one fellow who is practicing medicine elsewhere, see “Making a fresh start” on page 47.

Coming back home
Donald C. Faust, MD, and his family returned to New Orleans after a temporary stay in Lubbock, Tex., following Katrina. Luckily for him, neither his office nor his home was damaged badly by the storm.

Even though 6’ of water flooded the area surrounding his building, his office’s location on the sixth floor meant that he still could see patients. “A lot of tenants are fighting with insurance companies—their buildings are still closed,” says Dr. Faust, who also notes that keeping his employees on the payroll was another factor that allowed him to return.

“If I had lost my employees, I couldn’t have come back because there’s no work force to hire anymore,” explains Dr. Faust.

In addition, two of the three hospitals where he has surgical privileges—Touro Infirmary and Children’s Hospital—remained operational. Because he has a referral practice, many of his patients travel fairly long distances for his care, anyway.

“If I had a strictly local practice, I wouldn’t have been able to return,” says Dr. Faust. “There are not only fewer residents in this area, but fewer orthopaedists, as well. So, that reduces competition.”

Another orthopaedic surgeon who has returned to New Orleans is J. Ollie Edmunds Jr., MD. Dr. Edmunds had been a professor of orthopaedic surgery at Tulane University School of Medicine for more than 30 years. When Katrina hit, he moved to Nashville with his wife and took a position as a visiting professor of orthopaedic surgery at Vanderbilt University. Because Tulane was recently able to rehire Dr. Edmunds, he resumed treating private patients and working at Tulane in June 2007.

Like Dr. Faust, Dr. Edmunds was able to return to New Orleans because his house was on high ground, and therefore didn’t sustain serious damage.

“My wife and I feel guilty, because compared to many others, including half of my partners (whose homes were flooded or destroyed), we’re really lucky,” says Dr. Edmunds. “My partners and many patients and employees came back to find they had nowhere to live, and many watched the demolition of their homes. They lost everything.”

Some neighborhoods—like that of Ben F. McKown, director of the Louisiana Orthopaedic Association (LOA)—have yet to be rebuilt.

“I lived in a middle-class, relatively affluent neighborhood, which remains in a state of disarray,” says McKown. “It was gutted. It reminded me of a ghost town movie set from an old western film. We have whole neighborhoods where 50,000 or 60,000 people used to live that are still ghost towns.”

Moving to the city
Felix “Buddy” Savoie III, MD, is confident that New Orleans will rebound from Katrina. Dr. Savoie was in private practice in Mississippi when Katrina hit. His practice was affected by temporary power and gas shortages, but wasn’t damaged by the storm.

Even so, Dr. Savoie left Mississippi and moved to New Orleans to help rebuild the orthopaedic community in New Orleans and the city itself. He is now chief of the Tulane Institute for Sports Medicine and a professor of orthopaedics at Tulane University.

“New Orleans is one of the truly unique places in the world, and the orthopaedic community is a courageous one,” says Dr. Savoie. “If the wonderful orthopaedic surgeons here came back and are trying to practice, then it seems like we all should do what we can to assist them.”

Dr. Savoie says that he has been pleasantly surprised at the number of patients he has seen since starting at Tulane on June 1, 2007, and has also been impressed by their character.

“I did not expect to be busy at all, so I have been surprised by the number of folks and the wonderful spirit of the people here. It is a true blessing to be here and to try to help,” he says. “This is a great city with wonderful people.”

Rebuilding residency programs
Raoul P. Rodriguez, MD, is not only professor and chairman of the department of orthopaedic surgery at Tulane University, he’s also Tulane’s orthopaedic residency program director. During the storm, residents called him the “cornerstone,” because he kept everyone together, “maintaining a thread of solidarity and familiarity.” He was among the last to leave the city, evacuating with his residents aboard Black Hawk helicopters.

While Tulane was closed due to hurricane damage, the medical school relocated to the Baylor College of Medicine in Houston. Residents were temporarily reassigned to different programs in 10 southeastern cities. In July 2006, the residents who chose to come back returned to Tulane. Dr. Rodriguez was waiting for them.

Although the residency program had to be scaled down (from 30 to 11 participants), “we’re hoping that as the number of open patient facilities increases, we’ll be able to add more resident positions in the near future,” says Dr. Rodriguez. Tulane has 10 full-time faculty members now, and continues to recruit more.

Drs. Edmunds and Rodriguez don’t just talk about the difficulties the Tulane residency program has faced; instead, they focus on what it has achieved—and what it continues to achieve following Katrina.

“We have about one third of the residents, and half the patients that we used to have; however, the number of surgical cases per resident has almost doubled since Katrina,” says Dr. Edmunds.

“Orthopaedics is the busiest department in the hospital,” says Dr. Rodriguez. “Our educational program is going full-speed. In fact, the residents performed better this year on their in-service exams than they have previously; we’re very pleased with that.”

“Tulane orthopaedics has always been a leader in our field,” agrees Dr. Savoie. “I accepted the position here because, if Dr. Rodriguez thought I could help preserve that reputation, I wanted to do so. He is a great man and has shown a lot of courage in staying here and helping rather than leaving or retiring.”

The Louisiana State University (LSU) residency program was also affected by Katrina, but according to Barry Riemer, MD, chair of the LSU department of orthopaedics, it recovered quickly.

“We had our teaching program up and running within 10 days of the storm,” says Dr. Riemer. “There was a rebuilding in terms of faculty and physical resources, but a lot of it would be better described as a redeployment. We’ve found places to teach residents and have deployed residents to those sites with very good teachers, and have been slowly moving them back to New Orleans. The case load per resident has probably increased a little bit compared to before Katrina.”

The LSU program continues to recruit more participants, such as a husband and wife team from New York who recently agreed to come to New Orleans.

“What we have now is a place where you can go and start a process to truly make a difference in medicine, and that’s a nice feeling,” says Dr. Riemer.

Jennie McKee is a staff writer for AAOS Now. She can be reached at mckee@aaos.org.