Monday, September 15, 2008

Unstable

Sunday was a good day. Sunday was an awful day. It was a day of going to our house for 2 hours to see that nothing had been damaged. It was a day of the hospital’s most frightening challenge of the entire storm.

Did we really need a thunderstorm with heavy rains on Sunday morning? Rains were so heavy that there was localized flooding of roads all over Houston, mainly because the rain still had no place to go but up. It felt like getting kicked while you were already down. I got four hours sleep on the cot in my office and woke up to my phone ringing – the Incident Command Center calling with some urgent task or another. The OU cap I threw on in a hurry on my way to the Board Room drew howling complaints from our Rehab Director (UT Class of “Who Cares When”) all morning.

By 12:00 noon, the situation was secure enough in the hospital that we re-opened the ER and set up a check – out system where a limited number of Directors could leave the hospital for a couple of hours to check on their homes, get fresh clothes and (if lucky) take a hot shower in a familiar place. I left the hospital at 3:30 pm for the first time since early Friday morning. It was a peculiar feeling driving home with hardly any cars on the road, no traffic lights, no businesses open, trees and power lines down on every street. Some trees were stripped bare of all their leaves. Only a few signs remained intact in front of businesses. I was struck by how little movement there was. There was no wind, barely any cars, no people out walking or riding bikes. Even the leaves – which were quite literally everywhere – were wet and heavy on the streets, and didn’t move even for the occasional car that passed over.

I got to the house and several of our neighbors were out cleaning up, trimming tree branches, removing plywood from their windows, or just sitting in lawn chairs because it was too hot to be inside without electricity. Kids were busy playing and running about, either oblivious or indifferent to their environment and how changed it looked to me. There was no damage to our house, only plants that looked like they had been blown around by 110 mph winds. I was happy to use my own bathroom (sorry, but it’s true) and the shower was hot and so relaxing I believe I fell asleep for a minute.

I threw some clean clothes in my gym bag and headed back to the hospital. The ride back was as unreal as the ride home had been, and I pulled into the hospital parking lot feeling exhausted and dreading the pace of activities that awaited inside. As I walked up to the main entrance, it became apparent that the lobby was pitch black. We had been on generator power since Friday night, and had a diesel tanker top off all our tanks Saturday evening. Still, I knew the generator had failed for some reason. I got inside the hospital and more or less felt my way to the HR department just down the hall from the entrance and unlocked my door to retrieve my flashlight. I then ran to the Command Center to check in and ask where to go to help. The CEO told me to go to the Heart Hospital. Critically ill patients had been relocated there, and the CNO had radioed for extra help bagging (using a handheld balloon pump) patients whose ventilators had lost power when the main hospital generator went down. I went to the Heart Hospital across the street – still functioning on its generator – and saw no one. I went back toward the main hospital on the walkway over Medical Center Boulevard, looking for a way to help.

I’ve worked in hospitals since my senior year of college at Phillips, back in 1986. That psychiatric hospital had a contract with the county to accept their most mentally ill arrestees. That exposed me to extraordinary circumstances of human suffering due to psychosis and schizophrenia. I’ve seen things and heard stories in my 20+ years of working in hospitals that were shocking, outrageous, terrifying and miraculous. None of it prepared me to witness the evacuation of our Neonatal Intensive Care Unit.

On the main hospital side of the crosswalk, I saw people stationed on each corner of each hallway with flashlights or green glow sticks. As I moved through this eerie black and green maze, I heard shouting. “Clear the stairwell!” “Stand aside!” Everyone parted to make room at the entrance to the stairwell. I aimed my flashlight on the floor with everyone else, and out from the stairwell door emerged three bodies, moving quietly in unison. The doctor was holding a 2 or 3 pound baby in his hands, flat on her back, right in front of his stomach. He was not looking at anything but the baby, but he walked straight ahead deliberately. On one side, a nurse was giving this impossibly small baby chest compressions with one finger. The nurse on the other side held a balloon pump, giving it barely perceptible squeezes to keep air moving in and out of her lungs. As quickly as they appeared out of the stairs, they disappeared around a corner, their path lit by nurses and techs and cops and security guards, all lining the halls, shining their lights, helping the only way they could but feeling helpless nonetheless.

We all stood motionless for a few seconds, and then everyone was off in a dozen different directions. More babies came down the stairs, but I didn’t see any more that needed the same level of attention the first baby needed. By the time I worked my way upstream to the NICU, it was nearly empty. “Brad – check the unit and make sure there’s no one left.” Rushing, flashlight darting from here to there, the unit looks like a crime scene. “I need lights in the supply room!” Rushing, pointing my flashlight at IV tubing, tiny packages of diapers, an amazing assortment of supplies, all being tossed into bags to take to the Cath Lab Recovery area across the street where the NICU beds and their fragile occupants now called home.

More rushing. “Where should we go?” “How can I help?” Then, minutes later, a call on the radio: “All Directors report to the Command Center.”

[Continued tomorrow.]

Sunday, September 14, 2008

Ike Makes Landfall on Me

(Hey it's Austin. I have been told to inform everyone that last night when he sent this email at 2:00 AM he was in no kind of good mood. Not to worry however, he says he is doing much better now after a good nights rest.)

It’s 2:00am and I’m falling asleep on the keyboard, but I wanted to touch base really quick because today was an exhausting, busy day - up running around like crazy in the middle of the night, a brief nap at 5:30am and then running around like crazy the rest of the day. I sat down at 4:00pm to take a “chair nap” – chair next to wall, pillow behind head, feet propped up on another chair – but I hadn’t been sitting for 10 minutes when the walkie talkie snapped, “Come back Brad.” “Brad?” “I’m here,” I cursed, and then got up, put on my tennis shoes and went back to settle the most recent petty crisis I had been assigned.


Today I got completed frustrated with all the busy-ness. I was exhausted, sore, running non-stop at the beck and call of the Incident Command Center in the hospital. At the height of my irritation I ran into one of my favorite nurse managers, and she was sobbing. A nurse of hers had just learned that her house had collapsed into the flood waters on Galveston. Her husband had been one of the Islanders who did not evacuate, and now the nurse was distraught with worry that her husband might be dead. This manager is one of my “Chief Morale Officers”, with lots of energy and a great smile, so seeing her in such grief was unsettling. And then, for the next 15 minutes, everywhere I walked I either heard or overheard people repeating similar stories of damage to their homes, sudden homelessness, family members they could not reach. Many were expressing the shock of realizing they didn’t know if they were better off knowing what had happened to their homes or NOT knowing.

As I walked back to the Incident Command Center, I was reminded of the scene from “Titanic” when Rose finishes telling her story of all the lives lost to the sea, and it is obvious on the faces of the treasure-hunters that they “get it” for the first time. It had suddenly dawned on me that all of the stuff we’ve been doing has not been about managing this “incident”. We have asked these scores of employees to focus their energy on caring for those who are suffering and in need, during an historic natural disaster that has caused many of them horrific personal loss. Because of our mission to care for this community, these folks subordinate their own personal needs to the needs of the many. And they have done it magnificently, all the while knowing that some degree of personal catastrophe waited for them outside.

And I cried for the first time since this all started.

Saturday, September 13, 2008

After the Storm....

We got through the storm fine here at the hospital. No flooding, no structural damage to the hospital. Lots of leaks and mess to clean up though.

Our neighbor's friend drove by her and our houses and said she couldn't see any obvious damage. There was no flooding.

We are very busy today preparing for admissions through the ER and transfers from other local hospitals that sustained damage.

That was some storm!

My First Hurricane...

(Hey it's Austin. Just for the record, I got the email from my dad at 3:27 AM. Something tells me that he didn't get a whole lot of sleep last night...)

Got about 90-minutes of sleep when the walkie-talkie I left on near my cot started crackling with life. “Call back Engineering.” “Call back Heart Tower.” “All hands to the Heart Tower.” “Brock is outside restarting the generator.” “We’ve got to get these chillers back online.” Our backup generator went down at 1:00am, so the A/C in the heart hospital was down, too. That had to be restored, so there was lots going on. Fully awake by the activity, and aware that there was probably plenty to do, I got up, threw on a cap and grabbed a flashlight.

Water is coming in from the roof of the main hospital from all over the place, and it is leaking into the heart hospital in a few places, too. Several trees in our parking lot are down, and a wooden fence behind our hospital was knocked all over the place. Everything is wet but there is no standing water anywhere. There is so much wind that the water if being pushed off the streets and hurled sideways through the air. There is a roar in the air that sounds a little like road noise when you are going 80+ mph in an old car, plus whistling, cracking and breaking noises mixed in for full effect.

The eye passed a little to our west, so we got only a 30-minute break from the winds, which was enough for the smokers to flock to the ER and burn off a couple of quick smokes. Someone suggested we should have brought a brisket with us - between the heat and the smoke it would have been done before the back eye-wall passed over.


Transformers are blowing all around us, lighting the entire sky with a teal blue flash that is both unexpected and highly unusual looking. The firefighters in the heart hospital lobby told us the Clear Lake Hilton has six feet of water in it, the front facing of the building has been torn off, the building is generally getting ripped to shreds and all the guests are gathered in the stairwells for safety. Water from the storm surge has come up as far as the road in front of the Hilton, which sits on the bay but is several miles inland. It is only a mile or so to NASA from there, which makes me wonder how they are faring.

Random images. A Midlothian police officer is guarding our ER Entrance with an AK-47. The Command Center had two huge pans of chicken tenders everyone was eating at 2:30 in the morning. A Nassau Bay firefighter told us their HQ had measured a wind gust of 112 miles per hour. A housing addition near Shelley’s work was reported to have all of its homes flooded.

It’s 5:30 and I had a shower just a little while ago, hoping it would make me feel more alert. Did. Not. Work.

I bet I can catch another hour’s sleep before sunrise, when we will – for the first time – be able to see just what Ike has been up to all night.

Friday, September 12, 2008

Ike Speaks

We’re getting our first rain of the storm just in the last 30 minutes. The wind has knocked out power to both hospitals, but the generators are working great. We brought in an extra generator this week that is able to run the AC in the main hospital, so my office is cool and comfy. I’m going to take a nap here shortly because things will start hopping in a couple of hours.

I walked the crosswalk over Medical Center Boulevard just a little bit ago, and the lobby in the heart hospital is half-full of people hanging out and watching the storm in the 3-story glass lobby. The rain is whipping the trees – the oaks and maples more than the palm trees, whose branches are definitely all pointing in one direction but which still seem to be taking it all in stride. Walking back across the walkway, Ike growled at me. Ok, maybe not AT me, but he growled most assuredly. The noise he made wasn’t loud or sudden, like thunder. And it wasn’t a high-pitched sound, like wind rushing through a narrow space. It was a low, angry growl. It sounded like an enormous amount of air and rain, slashing and expanding into noise. Ike is probably already howling at Galveston and those lost souls who decided to “ride this one out”.

The hospital is full of paramedics, firefighters, cops and guardsmen who having been working their butts off for the last 72 hours and finally get to rest until the danger of the storm passes. Then they will be the first-responders to God only knows what. They have had the effect of making our employees and guests feel a lot safer.

Sleep sounds very good to me now. Love to all.

A Quick Note

Power is beginning to flicker on and off, so I’m not going to try to say much right now since it is highly likely my computer will shut off. Hate to leave you hanging with half an anecdote or the set up to a joke but no punch line…

It is getting windy now. Heavy cloud cover is moving in overhead, and they are some of the fasting moving clouds I believe I have ever seen. Gusts of wind feel very strong, but the sustained wind does not feel that threatening. I keep passing by TV’s with pics of Galveston, and it just looks the same to me. It’s starting to get dark.


Not much craziness to report, people are generally on good behavior. Tonight will be interesting when the turf battles start over rooms which are supposed to be assigned but have been taken by squatters. That will all happen about the time the weather gets nasty, which will be a discomforting soundtrack.

National Guard trucks are parked in our parking lot up front – quite a few of them. It comforts me that we are on a high spot for the city, but is strangely alarming at the same time. My job is a breeze compared to what those guys and gals will be doing over the next 24+ hours.


Do not worry about me – everything here is fine.

The Big Guy With the Clipboard

Well I can tell you already this is not going to be like Rita! The activity level here is intense - the pace frenetic, (a word which here means wildly excited or frantic). We had a meeting in the cafeteria at 11:15 to brief visitors and family members on their responsibilities while they are visitors here, and it was a little overwhelming seeing how many of them there are! Something like 500 visitors, and going up!

We have plenty of staff in house for the patients, plenty of supplies and plenty of food, but too many extra people! Oh, and pets! Do not get me started on pets. We have a warehouse in our heart hospital that is filled from one end to the other with pets in kennels. We had to assign extra staff members to sit outside the kennel to check people in and out, get information about what pet belongs to whom, etc… You know the folk wisdom which says animals can sense when a storm is coming? Well this whole warehouse sounds like it’s full of anxious pets before a hurricane is about to make landfall.

We’re watching – you probably are too – the live footage of the storm surge in Galveston. It is strange to recognize all the landmarks they show, and stranger still to think my boys were playing on those beaches two weeks ago. It is also important to note that the eye of the storm is still 160 miles out and the hurricane force winds have not yet made it to Galveston. They are going to get nailed.

30 minutes ago I went outside for the first time since 6am this morning, and it had gotten noticeably cooler and the wind was gusting. But I think I’ve played golf in stronger wind than that when we lived in Amarillo, so I not ready to say the conditions are “deteriorating”.

Highlight of the storm so far: the nurse manager and nurse supervisor who stopped me this morning in the lobby to tell me all about their first ever helicopter trip, escorting patients to a hospital on the far west side of Houston. They were like kids who had just gotten off a ride at the Kemah Boardwalk!

Safely In the Hospital

Got to the hospital this morning about 6:00am. There were not many cars on the road, but a pretty steady flow of traffic heading north on I-45 from closer to Galveston. The gas stations and fast food places that are usually open that time of morning were closed, but lots of lights were on so it didn’t seem too strange. Businesses and houses are intermittently boarded up, some looking like they were done by professionals and others with sheets of plywood slapped up haphazardly covering parts of windows and doors but leaving other parts exposed. The real serious businesses have the roll down metal storm shutters fastened tight against whatever Ike is bringing us.

Woke up this morning to news media saying the National Hurricane Center had issued a warning for residents of Galveston Island to evacuate or face, and I’m quoting here, “certain death”! Wow. I guess if you combine a 16 foot high sea wall with 20 foot storm surges (and 10-15 foot waves on top of the surge) you get “certain death”. Their big problem – as is ours frankly – is Galveston Bay, which sits between Galveston Island and the Clear Lake area.



If you look at all the little cities that surround Galveston Bay, you will get a pretty good idea which areas were under a mandatory evacuation. They are saying that a 16-20 foot storm surge could push into the bay, which will cause major flooding all around our area, but also will push up the backside of Galveston and meet the storm surge coming in from the seawall side. That’s roughly what happened in 1900, which cause such massive loss of life and property.

On the map above, the little “A” marker is where the hospital is located. We are at 29 feet above sea level, which makes us one of the highest spots in the Clear Lake area. In fact, several of the local governmental agencies have requested use of our parking lot to park their vehicles since we are at such an attractive elevation compared to our surroundings. Our house is roughly where the “a” is in the word “League City”. Are biggest risk is from wind damage, but since our house is only a few years old, it was built under pretty strict requirements to withstand such a thing. I can remember the inspector pointing out some of those things to me, like extra stabilizing bars on the garage door, and special sealant around the edge of the roof shingles. We’ll see.

It was only a little breezy when I got to the hospital, with the palm trees rustling but not give any clues that were a few hours away from 50 miles an hour winds, and less than a day away from 100 mph winds. We got down to 143 patients as of midnight, with staff and family in the hospital until Saturday morning. I’ll keep you posted.

Thursday, September 11, 2008

The Ike Chronicles

Greetings from the boarded-up study of our humble house in League City. We are about 48 hours from Hurricane Ike making landfall - as of 4pm today he was headed straight for Galveston. The hospital is busily evacuating patients in an effort to get down to no more than 80, which will allow us to care for all our patients in the new heart hospital, which was built to stand up to a Category 5 hurricane. I thought that sounded like an extraordinary plan personally.

Our next door neighbors were here this afternoon, so Shane helped me finish getting the 2nd floor windows covered. He just came by to tell me they had changed their minds and were evacuating to Cypress tonight, and possibly further north tomorrow. They didn't see the reason to stick around for a possible category 3 hurricane, and I can't blame them.

My plan is to take my cot, sleeping bag and supplies to the hospital tonight, come home for a decent night's sleep, and then go to the hospital early Friday morning with clothes to last 3 days. Probably won't need to spend the night more than Friday and Saturday night, but can't be sure at this point. I am heartened by the prospect that three different guys asked me to be sure to bring my poker chips when I come for the storm. With any luck, I'll win a little cash money over the next few days.

I'm peaceful knowing the windows on the house are boarded up and my family is all safely north of harm's way.

Check back from time to time for updates on Webster, Texas. I can't access this website from my hospital - darn filters! - but will be emailing Austin updates to keep everyone current.

Monday, August 25, 2008

School Pics - 2008

No matter how negligent I am about updating this blog with family information and pictures, I feel compelled to post "back-to-school" pics (as well as Halloween costumes). So twice a year - at least - you can count on something new.

Here are my big boys - an 8th grader and a kindergartener. Enjoy!