Yale docs help in Miss.

When an old man with emphysema asked cardiologist and Yale professor Brian Swirsky for batteries, the doctor hesitated.

Swirsky was afraid the man wanted to power a radio to hear the news — a low priority in Gulfport, Miss., where Hurricane Katrina left thousands without electricity or medical care. But Swirsky was moved to learn that the man needed to replace batteries from his inhaler, because he had lent it to many other ill people that week.

“There he was, sharing with other people the one thing that was keeping him alive,” Swirsky said.

The man was one of hundreds of Hurricane Katrina victims Swirsky’s team saw before returning to New Haven Sunday. For a week, the physicians toured the devastated city of Gulfport and the back roads of Louisiana, after arriving in the area by jet Sept. 5 with water and various medical supplies donated by the Hospital of St. Raphael, Yale-New Haven Hospital and Milford Hospital.

The eight doctors — including Kevin Twohig, John Irving and Jim Morgan, University professors of internal medicine, orthopedics and pediatrics, respectively — slept on office floors in Gulfport Memorial Hospital during the week. They treated patients with respiratory infections, asthma, diabetes, infected wounds from swimming through dirty floodwater, and a range of preexisting health problems for which patients’ regular treatment was cut off because of the hurricane.

Swirsky said the Federal Emergency Management Agency initially approved the trip but never contacted the team of doctors to finalize their plans, so the physicians took matters into their own hands.

“By going under the radar we were able to be highly effective,” he said. “We were not directly under anyone’s control. We were able to find out moment to moment where there was serious medical need, where there were pockets of desperate people.”

When they first arrived in Mississippi, the team was frustrated by bureaucratic hurdles that prevented cooperation with Disaster Medical Assistance Teams. Swirsky’s team was useful in relieving overworked Gulfport Memorial doctors, Twohig said, but they wanted to do more on the front lines.

As a stroke of luck, Twohig said, the physicians were soon able to join forces with members of a Missouri ambulance company who had been told “go find corpses” since they lacked trained doctors.

“We had physicians but no ambulance,” he said. “They had an ambulance but no doctors, so we linked up.”

What they found in Gulfport and the surrounding areas were crowds of people without transportation, electricity, medicine or sanitary shelter, and without a way to report serious health problems other than word-of-mouth.

“It was the third world in America,” Twohig said. “We would sweep through the projects, fishing for people, telling them we had medicine and doctors. In some of the places we were it looked like a nuclear bomb had gone off.”

With the ambulance and support of Gulfport Memorial, which gave the Yale team emergency staff privileges, the doctors were able to reach ill people who could not travel to the hospital themselves, Swirsky said.

The emergency room at the hospital was so overcrowded, Twohig said, that even ill infants had to be sent back to shelters right after treatment.

Swirsky’s team distributed medication, relieved exhausted doctors at Red Cross disaster stations set up in parking lots and schools, and helped families in flooded homes, shelters and condemned housing projects.

The doctors saw many indigent patients with illnesses resulting from poor preventative health habits, Twohig said, and symptoms were exacerbated by staying in cramped shelters with other sick people. One four-year-old boy with a viral infection that Morgan treated had been abandoned by his methamphetamine-addicted mother and was found wandering in a lot with a drunken man before state troopers found him.

But the devastation was not limited to marginalized populations, Twohig said.

“A lot of the doctors we were working with had lost their own homes,” Twohig said. “They were homeless, and still working in the hospital … the hurricane really affected everyone.”

Pediatrics and OB/Gyn professor Joshua Copel has been trying to organize a similar trip to help Katrina victims, and he said the U.S. Department of Health and Human Services has been slow responding to his and colleagues’ offers to volunteer.

“We’ve gotten about a half dozen people in the department who have volunteered,” Copel said. “We sent their names to the Health and Human Services hurricane help Web site, so now we’re just waiting.”

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