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AAMC Reporter: August 2007
A Word from the President:
Resilience and the Long Road to Recovery
Last spring, by serendipity, I was the invited commencement
speaker at both Tulane University School of
Medicine and Baylor College of Medicine, two schools
that share a unique bond because of Hurricane Katrina.
It was Baylor, as part of the South Texas Alliance of
Academic Health Centers, that took in over 300 Tulane
students within days of the storm. Not only did I have
the opportunity to see how both schools were faring
two years post-Katrina, I also came away with new
insight about our resilience as professionals, as institutions,
and as an academic community.
My visit to Baylor became all the more memorable
when a bomb scare disrupted the medical school graduates'
all important day. I witnessed the same agility that
had enabled the school to quickly accommodate so
many Tulane medical students two years earlier. One
minute, we were preparing for the pomp and circumstance
of the carefully planned ceremony at Houston's
Jones Hall, and the next, we were taking directions from
Baylor President Dr. Peter Traber (the very personification
of resilience) standing atop a planter outside the
hall, bullhorn in hand.
In less than an hour, Commencement 2007 was recast
as three over-lapping mini-ceremonies held in auditoria
on the medical school campus. The school's ability to
recover and "save" commencement moved one graduate
to write that "...like our Katrina response, I feel that
this moment is not so much memorable for the catastrophe
that incited it, but rather the quick thinking,
generosity, and perseverance it inspired."
At Tulane, I was deeply moved by the graduates'
remarkably positive attitude, despite a medical school
experience marked by one of America's worst natural
disasters, subsequent uncertainty about their future education,
and eight months attending school in another
state. Their sense of joy at having reached this momentous
day was all the more triumphant and, for me,
exemplified by the traditional Dixieland band leading
their processional and recessional. It was the most exuberant
ceremony I have seen, and left no doubt in my
mind that, as emphasized by several students and faculty
members, "Tulane is back."
There is no doubt, however, that major challenges remain
for Tulane and for Louisiana State University at New
Orleans (LSU-New Orleans), which also was hit so hard
by Katrina. Years of irreplaceable research has been
destroyed, and there is deep concern at both the local
and national levels about the future of the region's
teaching hospitals and health systems. As I learned
during my Tulane visit, there remains great uncertainty
whether the city of New Orleans will regain its original
size, further complicating the tough decisions to be
made about rebuilding hospital infrastructure. It is
against this background of major clinical stress that
efforts by Tulane and LSU-New Orleans to protect their
learners have been particularly remarkable.
In addition to my personal observations, evidence is
emerging on many fronts to show the different forms
resilience and recovery can take. For example, this
month's issue of Academic Medicine is devoted almost
entirely to disaster recovery at academic health centers,
with a particular focus on the experiences of our Gulf
Coast institutions after Hurricane Katrina, and a month
later, Hurricane Rita. Among the many riveting firsthand
accounts are the University of Texas Medical
Branch Hospitals' handling of an emergency evacuation,
efforts by LSU-New Orleans and Tulane in maintaining
their educational enterprises, the relocation of Tulane
residency programs, and the role played by Baylor, as
part of the South Texas Alliance, in supporting Tulane's
medical school undergraduates and house staff. This month's Reporter Viewpoint illustrates
another type of resilience in the important work
by LSU's Health Sciences Center to address local mental
health needs.
Still more evidence of resilience and recovery is found in
data regarding medical school enrollment and full-time
faculty at Tulane and LSU-New Orleans. While initially
these schools experienced some fluctuation in applicants
and matriculants, enrollment overall has remained fairly
stable, with both reporting increases for academic year
2007-08. In the case of full-time faculty (who, as more
"permanent" residents of New Orleans, experienced
far greater disruption to their lives), initial losses felt
immediately after Katrina are now being reversed.
All the above convinces me that academic medicine is far
more resilient than perhaps we realize. Often we speak of
"threats" to the academic medicine enterprise in terms
of possible funding cuts, unfolding policy battles, or
ongoing health care system issues. What these, and other
Katrina-like experiences (where even the lives and personal
safety of students, faculty, and staff are at stake)
show us is our remarkable capacity to handle adversity,
large or small. They also are vivid reminders that we
must always put our concerns about various so-called
"threats" to academic medicine into better context.
As a community, academic medicine has been relatively
fortunate with regard to natural disasters or even acts of
terrorism, but it does not mean we live in a protected
medical ivory tower We need only remember six years
ago when tropical storm Allison caused severe flooding
at the Texas Medical Center, and a decade ago when the
Red River's overflow destroyed research labs at the
University of North Dakota Medical School.
Additionally, while we have not experienced a tragedy as
terrible as the one at Virginia Tech last April, we all too
frequently hear about physical attacks, firebombs, and
other threats of violence by certain activists directed at
our research labs. I personally will never forget the dislocation
of an entire medical school commencement by a
bomb threat. And sadly, like the nation as a whole,
we are left uneasy by the possibility of a terrorist attack
always looming in the back of our minds.
If, as evolutionary psychologists maintain, we are biologically
wired as humans to "bounce back" and to be
resilient after difficult times, the same would appear to
be true of our individual institutions, and our academic
community as a whole. As commencement speaker at
Baylor and Tulane two years after Katrina, that was the
message medical students delivered to me.
Darrell G. Kirch, M.D.,
AAMC President
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