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Looking to assist in the rescue effort, Dr. Gauvain and a friend, Rob Baldin (right), met up with Tim Corwin (left), who owned a boat. They are shown walking the boat into flooded areas looking for those in need of evacuation.
Courtesy of Taggart Gauvain, MD

AAOS Now

Published 11/1/2017

On Call

'Listen, if the truck gets swamped, buddy, I'll buy you a new one'
Taggart Gauvain, MD, an orthopaedic surgeon, proved his versatility when he joined Houston's improvised version of the "Cajun Navy" —the volunteer rescue force of Louisiana-based boaters that assembled after Hurricane Katrina and then towed their armada to Houston—to help in the Harvey flooding.

Dr. Gauvain related how much of the informal rescue efforts in Houston coalesced organically through text messages and social media. As Hurricane Harvey pelted and drenched the region, the rising water line remained below Dr. Gauvain's home in the Shadow Creek neighborhood of Pearland, which is about 15 miles south of downtown Houston, but others in Pearland and adjacent Friends­wood weren't as lucky.

"There was a group of us communicating through a neighborhood Facebook page," he recalled. "People would say, 'Hey, we need help,' 'We're trapped,' 'We're flooded,' or whatever, and then we started picking people up. We had a couple of Jeeps to go into areas where the water wasn't too high. Soon the automobile rescues had to be called off and we began to discuss ways to get people out, which meant us going in by boat."

Meantime, physician duties also beckoned. At Memorial Hermann Pearland Hospital, the on-call orthopaedic surgeon had been unable to get to the facility, where a patient with an open tibia fracture needed care.

"They called me on Sunday night," Dr. Gauvain recounted. "The rain was coming down so hard, we couldn't see any of the roads. I said, 'Give him antibiotics, give him DVT prophylactics, splint him, and put him on the floor. As soon as I can get there, I'll come in and take care of him, but I can't get there right this second.' As a surgeon, when you think about an open fracture, that's a real problem. My plan was to get there by car or on foot, but I was trapped in by water at that moment.

"On Monday morning, the nurses were calling with increasing complaints of pain and swelling from the patient.  I was becoming increasingly concerned about the potential for compartment syndrome, but I didn't have a truck that could get across the flooded streets. I had to call my friend and ask him to drive me in his truck to the hospital. He agreed and we were driving on medians and up on sidewalks because the roads were so flooded. We almost lost the truck two or three times. I just kept telling my friend, 'Listen if the truck gets swamped, buddy, I'll buy you a new one or Memorial Hermann will sponsor you for a new truck.' We continued forward using any road we could pass on to get to the hospital, but we were able to get there." The flooding was up on doors of the truck at some points.

As it turned out, the patient had an injury that had been splinted in a poor position, with an impending breakthrough of the skin of the fracture edge over the anterior tibia. "What they were calling an open tibia the night before turned out to be an abrasion, but the guy was in a bad position in his splint. If he didn't get reduced and put into a better position, he would have ended up with an open tibia. It was going to work its way through the skin. There was white blanching skin at risk on the front of the leg."

Looking to assist in the rescue effort, Dr. Gauvain and a friend, Rob Baldin (right), met up with Tim Corwin (left), who owned a boat. They are shown walking the boat into flooded areas looking for those in need of evacuation.
Courtesy of Taggart Gauvain, MD
Taggart Gauvain, MD, guides a canoe as he, with other neighborhood volunteers, went house to house. They rescued about 10 people in need of help and ferried them to a high-ground rescue point at an elementary school.
Courtesy of Rob Baldin

And then another flood-related problem arose: "We didn't have any intramedullary nails or anything in house at the hospital, so I ended up doing an external fixation procedure on him to stabilize his leg and relieve the pressure on his soft tissue."

After tending to the patient, Dr. Gauvain returned home as waters continued to rise, imperiling many residents. Through Facebook and texting within his network, he quickly partnered with someone who had a small boat.

"I went and picked up a guy who had this old 1940s, little aluminum boat. I think it used to belong to his father. We picked him up in front of his house and threw the boat in the back of the truck. We were able to get about two or three blocks away before we had to ditch the truck and put the boat in the water," Dr. Gauvain said. 

"We were able to meet up with a group of 10 to 12 other neighbors at a local elementary school which became our staging point and high ground for boat rescues into the heavily flooded parts of the neighborhood. It was a very neat experience because none of us—except one of my friends who came with me—really knew each other. It all came together through social media. It was one of those things that was in the moment. It was a community effort. We said, 'Let's do whatever we can do to help people out,'" he added.

The crew spent much of the day on rescue patrol, offering help to trapped residents trying to escape the waist-deep water.

As the week of the deluge proceeded and the on-call orthopaedist was still unable to get to Memorial Hermann Pearland, Dr. Gauvain, a foot and ankle surgeon, "ended up being de facto on-call guy."

"They started calling me with everything that came in," he said. "I took care of an open distal radius fracture that came in. My partner was stuck in Seattle due to the storm and one of his total knee patients came in with an infection. I washed this knee out and did a poly exchange, but, you know, we work as a team over here. I was happy to help out. With my patient from Monday, I took off the external fixator and put an intramedullary nail in him on Thursday. I ended up doing a total of four surgeries during the week of the storm."

Dr. Gauvain reflected, "For me, the main part of the story of Houston was everybody coming together and helping each other in the neighborhoods. I mean, that was the most amazing thing. It was my duty and job to take care of the injured people who came into the hospital by being a team player and helping where I could. But helping my neighbors get out of their homes and getting them to safety at a recovery center, that was a really neat thing to be involved with."