By Mark L. Horn, MD, MPH, Chief Medical Officer, Target Health Inc.
The editors of On Target have been generous in affording me a regular platform to address readers. I have tried to return their favor by focusing on timely topics of broad interest upon which I can hopefully shed some light. In most instances these informal, admittedly self-imposed rules render personal experiences unsuitable for discussion.
This week, however, will be an exception. A personal experience has converged with a regional disruption and warrants mention.
The morning after Hurricane Sandy visited us in the ‘tri-state area’ my wife and I returned from the hotel where we had gone to spend the night in anticipation of the storm to find several large trees intimately engaged with what had been our roof. The house was obviously uninhabitable (a status soon officially confirmed by our Borough), and we instantly became itinerant homeless.
The ongoing saga has been transformative in many ways; among these are an enhanced sensitivity to the suffering of so many in our region who have been more severely hurt than we and an enormous gratitude and appreciation for the critical assistance offered by so many – assistance which, for the first time I can recall as an adult, we genuinely needed, and accepted. (For some inexplicable reason we never asked “Why us?”, although as we cope with the various insurance and contracting issues that question may well surface.)
More broadly, as a member of our local medical community, the apparently successful efforts to transfer and care for so many acutely ill, hospitalized patients requiring emergency evacuation from major medical centers suddenly deprived of the critical systems is a source of pride. Since many major institutions, including Bellevue Hospital and the Manhattan VA (both of which I recall with genuine affection from my medical school days) remain compromised, other institutions have stepped up in the emergency. At this writing stability seems to have been achieved in an admittedly strained system.
At a more personal level, I witnessed the commitment of many individual physician friends, often living in dark cold houses with no hot water, to quickly reopen their offices and maintain patient care. Virtually everyone complained about the discomfort, but their real focus was on offering care in a most difficult situation. Parenthetically, some of the comments about the inability to access electronic health records in this situation suggest some attention be paid to how to best back up these increasingly critical systems.
While in many ways the system worked, some questions warrant consideration. Among these, it seems there were multiple failures of emergency generators. The hotel where we stayed experienced a failure, and the wonderfully responsive and considerate staff told us that they’d called the repair service and gotten voice-mail. This is common, frustrating, irritating, but overall trivial generally, but it seems almost an oxymoron when an emergency system fails in a critical situation and one cannot access help. Similarly, even now there are reports of elderly people in apartments without elevator service who are having difficulty securing the basic necessities of life. This seems an entirely predictable occurrence after a major storm, preventable with proper planning.
So, while the overall report card is mixed, as best I can tell the health care folks, writ large, seem to have handled the emergency well.
On Target editors permitting, I shall keep the readers posted on our personal and regional progress, please keep us all in your thoughts.