AAMC Reporter: January 2005

Jonathan B. Perlin, M.D., Ph.D., Acting Under Secretary for Health, Veterans Health Administration

Viewpoint: "Heroic Efforts in the Eye of the Storm"

The past hurricane season was remarkable due both to its severity and the frequency with which storms battered the east coast and the Gulf of Mexico. In five weeks, the two regions were battered in rapid succession by five tropical storms or hurricanes: Bonnie, Charley, Frances, Jeanne and Ivan. For many residents, the process of recovery continues today.

As is often the case, the adversity brought out the best in human nature. I am proud that many Department of Veterans Affairs (VA) employees, working hand in hand with our academic affiliates, were among those who went above and beyond the call of duty to help their fellow citizens. More than 800 healthcare workers volunteered on 24 hours' notice to help support VA facilities in the affected areas.

Many more VA employees and affiliated faculty in those areas also rose magnificently to the occasion. It would be impossible to overstate my gratitude to these heroes for ensuring uninterrupted, excellent care to veterans under the most difficult circumstances. As devastating as the storms were, they did not result in a single breach in care for our patients.

In West Palm Beach, which was struck by Hurricanes Bonnie and Charley, employees and their family members averted a crisis by mopping continuously to keep 100-plus mile-an-hour wind-driven rain from entering the building and threatening essential utilities. When the medical center's water supply was dangerously low, they transported water from a nearby lake by bucket brigade so that sanitation could be maintained.

One employee and his wife celebrated their 35th wedding anniversary while sheltering at the medical center. Cramped quarters did not deter them from marking the occasion -- or from serving veterans. Asked what they would like as a gift for next year's anniversary, they simply answered "running water."

Another employee did not tell his supervisor that his home had been destroyed, because he didn't want to be removed from the critical work of keeping the hospital running. Still another stayed on duty to care for veterans despite the destruction of her own home, reasoning that "the mess" would still be there later.

In Miami, during Hurricanes Frances and Ivan, many University of Miami medical residents rotating at the Miami VA medical center put the needs of veterans first. They remained at VA for extended hours, helping out wherever possible with patient care. I had the unique privilege of thanking these young heroes for their service when I visited Florida immediately afterwards to see what damage the storm had caused.

Later, when Ivan hit the Gulf Coast, our employees again rose to the challenge. Once again, good preparation and devotion to duty ensured that all our patients were safe and received good care at our Gulfport and Biloxi facilities in Mississippi.

That preparation also served the larger community very well. With Ivan already beginning to strike -- in the face of heavy rain driven by winds of 40-50 miles per hour -- VA senior staff and residents from the Tulane Medical School and Keesler Medical Center braved the elements to go to the nursing home, evaluate patients and evacuate 30 of the most vulnerable patients to the VA medical center in Biloxi. The rest were transported to and cared for by our colleagues at Keesler.

Of course, VA employees and affiliated faculty did not perform these heroic acts in isolation. In many cases, we worked side by side with private, local, state and federal partners who were equally eager to help in a crisis.

One critical lesson of VA's experience with storms and hurricanes is the importance of developing new partnerships and strengthening existing ones before an emergency takes place. I encourage my fellow AAMC members to develop such partnerships in their communities now and not wait until the next disaster occurs.

The Veterans Health Administration and our country's medical colleges have a responsibility to be leaders in our communities, exemplars of excellence in a world where "good enough" all too often means just getting by. Pride in our profession, the knowledge that our decisions can mean life or death for those who have entrusted us to fulfill their healthcare needs, and the oath that we and our forebears have taken since antiquity, all require us to do whatever we can to help others in every possible situation.

Perhaps it is unfortunate that it sometimes takes a storm, hurricane or other crisis to shine a bright light on the heroism and selflessness that occurs each and every day throughout the healthcare profession. However, heroes emerge in the darkest of times, and I rejoice in the exceptional performance of VA employees, our affiliates and others in response to the brutal storms of the last hurricane season. Their response proved to me that VA, our medical schools, our profession, and America will be able to handle any future crisis that comes our way.

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