On this humid afternoon, the rebuilding process feels more like mere survival at the Medical Center of Louisiana Emergency Services Unit. The setting is no gleaming medical office. Here, as many as 200 patients a day wait on small plastic chairs in a corner of the former Lord & Taylor department store for precious time with a physician. Clinicians see patients in doorless "rooms" framed by temporary cubicle walls. In a former merchandise loading dock, patients undergo CT scans in a trailer. Upstairs is dental care, a steep walk up the long-silent escalator.
Though the conditions seem primitive, the clinic run by Louisiana State University's charity hospital system represents progress. Healthcare in New Orleans has evolved from the triage in parking lots immediately following Katrina. Last September, the unit opened in MASH-style tents in the Ernest N. Morial Convention Center after Katrina roared through the city and flooded LSU's Charity Hospital and University Hospital, the two still-shuttered campuses that form the Medical Center of Louisiana at New Orleans. When the convention center needed its space back in March, MCLNO's emergency services unit moved to the vacant Lord & Taylor building across from the Louisiana Superdome.
The unit treats about half of Charity and University's combined pre-hurricane volume. Staffing and limited technology are significant concerns. And the unit is designed to treat only minor medical emergencies, so some patients must be stabilized and transferred to the few hospitals that are open. Still, the facility represents a small step forward. The city's providers have learned to appreciate such small steps. As Katrina's one-year anniversary approaches, the New Orleans healthcare community has only begun to unravel a monumental challenge that will take not months, but years to overcome.
"Overall, the country doesn't get what we are going through," says Jim Montgomery, president and CEO of Tulane University Hospital and Clinic, which partially opened in February after flooding had shuttered the facility. "The infrastructure was totally ripped asunder. You can say this for this community, this state and any individual organization: It is like a huge jigsaw pule that is torn apart with thousands of pieces, and you have to pick up every one and put it back together."