Our Generation: A post-Katrina reality check

Last August marked the beginning of my third year in practice. I was finalizing my case list for my oral boards and trying to prepare for the exam. My income guarantee was over, and I was beginning to feel the pressure of production and concerned about the growth of my practice. At times, I felt that I had hit the third year "rut" that I had heard about from some of my colleagues. Certainly, I knew many young ob/gyns who had changed jobs during their first few years in practice. As a generalist, I needed a new focus, and becoming an assistant program director gave me just that. I was excited about teaching residents and about being responsible for their training.

Then, Hurricane Katrina hit. I was not on hurricane call and left New Orleans with my four children, husband, and dog under the mandatory evacuation orders. By Tuesday morning, it was clear that this was not the city's "normal" evacuation. I was no longer concerned about production. I was worried about my job, my patients, my residents, my colleagues, my hospital, my home, and my city. I had no way to access records to contact my patients, nor could I call colleagues who were on hurricane call. There was no phone service, no cell phone service, and no Internet.

As the days and weeks unfolded, I was amazed at how many of my patients contacted me. With many, I communicated via e-mail. Some days, I spent hours at the computer calling in prescriptions and offering counseling. Many of my patients were establishing their lives in other cities and needed referrals for medical care. Contacting colleagues across the country and giving verbal accounts of my patients' medical records became a daily task. My patients wrote about how important it was for them to communicate with "my doctor," and many hoped to return to New Orleans for their medical care.

Practicing medicine in post-Katrina New Orleans is not always easy. There are no 15-minute appointments. Every patient has a story that she needs and wants to share. I am prescribing as many antidepressants as I am contraceptives and hormonal therapy. The divorce rate has increased, and there have been several suicides within our medical community. The doctors who remain are, to their patients, what these women still have. But the physicians still practicing here have their own life stressors. Many have suffered tremendous personal losses-damaged or destroyed homes, families from whom they now live apart, spouses and children they see infrequently. Some physicians lost their practices and are trying to rebuild. Others have lost colleagues and are taking on the burden of additional patient load and call.

Despite all of these challenges, I feel fortunate to be practicing ob/gyn. My patients remind me of that every day. It's a privilege to deliver a woman's baby, and it's an awesome responsibility to operate on a patient. What we do on a daily basis is physically, mentally, and emotionally demanding. Medical liability and decreasing reimbursements are frustrating. But on August 29, 2005, I truly did not know if I had lost my patients, my hospital, and my city. I am blessed that many of my patients have returned, and I am proud to be part of the rebuilding of New Orleans.

The Department of Health and Human Services has established a Web site (https://volunteer.ccrf.hhs.gov/) and toll-free number (1-866-KAT MEDI) to help identify health-care professionals and relief personnel to assist in Hurricane Katrina relief efforts. Multidisciplinary health-care professionals and relief personnel are needed and all are encouraged to visit the Web site and register to volunteer.

Stress management for health-care providers

The magnitude of death and destruction in disasters and the extent of the response demand special attention to the needs of health-care providers. Physical safety and security of providers (as well as patients) must take first priority.