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AAOS Now

Published 11/1/2017

On Duty

'A city of four and a half million became a city of several islands'
It was the water of Hurricane Harvey, not the wind, that caused most of the billions of dollars in destruction, and the experiences reported by orthopaedic and other medical personnel speak to that fact. At the Memorial Hermann trauma center at Texas Medical Center—one of two Level 1 facilities in the region—the days of the storm were mostly quiet, even uneventful for what by some measures is described as the nation's busiest trauma center.

The manageable volume was partly attributable to the fact that ambulances and helicopters were not able to operate during the intense phase of the storm, but the monster rain event simply did not extract a high toll in bodily injuries.

"The volume wasn't like it would be for tornadoes or earthquakes or anything else in that initial phase. Plus, no one could get there," said Joshua Gary, MD, an orthopaedic traumatologist at Memorial Hermann. "There weren't a lot of things to do emergently from an orthopaedic standpoint during the storm; people really couldn't move around the city. The city was so isolated and people were trapped by the flood waters."

The Memorial Hermann facility weathered the storm, thanks to comprehensive readiness planning and lessons learned from previous severe weather events.

"A lot of work was done here and at our other Level 1 center, Ben Taub Hospital, after tropical storm Allison in 2001, like installing flood doors at different points throughout the facilities," Dr. Gary said. "That really made a big difference this time. It enabled us to keep the facilities open and functional, even though there were some minor flooding issues at Ben Taub Hospital. We didn't have to shut down or move patients out."

Dr. Gary said Memorial Hermann had planned effectively to have personnel onsite as the storm approached and then inundated the city. A staffing challenge arose as "a city of four and a half million became a city of several islands" and replenishment troops could not get in.

"Even through Wednesday, people weren't able to easily move through the city, so the biggest challenge was getting new staff in to relieve our people. It also was a challenge to move patients to the hospital through normal flows," Dr. Gary said. "A lot of the heroes from the hospital side were professionals that stayed there for 96 hours straight—you know, the residents, some faculty and operating room personnel, and nurses. They stayed and took care of patients and did it with a servant's heart.

"There was very limited OR capability because of the lack of teams. I ended up doing one case on Monday," Dr. Gary added. Until the reinforcements arrived, orthopaedic coverage was being handled by a resident, Nathan Rogers, MD, whose shift stretched from Saturday to Tuesday. Dr. Gary; Timothy Achor, MD; Chip Routt, MD; and two other residents, James Shaw, MD, and Brennan Roper, MD, made it to the hospital on Monday morning of the Saturday-to-Wednesday storm.

Dr. Gary noted that much of the work done by medical professionals to care for people in need was done outside the confines of the hospital and the "normal" scope of practice.

"There are numerous stories of doctors getting outside of the orthopaedic and medical zones to help any way they could. We have 90 providers in our department, and we're just starting to learn what each and every individual did. Their efforts went well beyond the duties in our department in orthopaedics."