Book Excerpt: 'Americans At Risk"

"On August 28th, just before Katrina hit, I had hundreds of patients enrolled in my cardiology clinics at Charity. And my colleagues in other fields were caring for lots of people with cancer, kidney disease, and chronic mental health conditions. Once the storm hit, and Charity went out of commission," she said, "we lost track of heart patients that needed catheterization and other lifesaving procedures. We are now trying to make sure that the kidney patients can get to an alternative dialysis center and that the psych patients can get their medications."

So where are these patients, I asked, knowing that in New Orleans alone, no more than 100,000 of the city's former 480,000 residents had returned. The remainder were scattered in shelters or relocated all over Louisiana and throughout another thirty-five or forty host states.

Kathy responded, "Irwin, I have no idea where my patients are." I asked her what she thought could be happening to her cardiology patients, especially the ones that needed critical medications or procedures.

Dr. Hebert paused, looking at me. Her eyes filled with tears. The receptionist was trying not to look at us, but had been paying rapt attention to this intense conversation. "My patients?" she asked. "They're dying. I am just so afraid that they're showing up in whatever emergency rooms are open, out of meds and out of time."

I tried to come to grips with what this young doctor was actually saying. I know I mumbled something about my willingness to help sort this out?and I did speak with Louisiana health officials. I also asked our Operation Assist medical teams on the ground to keep an eye out for patients who had been at Charity. By March, some of Kathy's patients had shown up in the few medical facilities that were still open for business; others had been evacuated to nearby states and would be there for the long haul. But many were not found.

As I thought about what Kathy's situation really meant, I appreciated anew how badly things were going in the so-called recovery of the Gulf in Katrina's aftermath. At the time, Kathy Hebert could not have known the fates of thousands of evacuees with chronic illnesses who had been rushed from New Orleans and now found themselves in Texas, Florida, Tennessee, and dozens of other states. Like refugees fleeing war zones, these patients were arriving in their "temporary" communities without medical records or the ability to contact their physicians. On the receiving end of this exodus, Dr. Joe Mirro at the renowned St. Jude Children's Research Hospital in Memphis noted, "We received nearly 100 pediatric cancer patients from New Orleans. Our staff tried as best they could to figure out what medications these kids were on, scrambling to look up treatment protocols and find the doctors who had been caring for them before the evacuation. Sometimes we found the information we needed; most of the time we just did the best we could." ________________________________________ Excerpted from Americans at Risk by Irwin Redlener Copyright © 2006 by Irwin Redlener. Excerpted by permission of Knopf, a division of Random House, Inc. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher. ________________________________________

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