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HOUSE CALL WITH DR. SANJAY GUPTA

MentalAnd Physical Health After Hurricane Katrina

Aired September 17, 2005 - 08:30   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

ELIZABETH COHEN, HOST: Good morning and welcome to a special edition of HOUSECALL. I'm Elizabeth Cohen in for Dr. Sanjay Gupta.
We're coming to you today from the River Center in Baton Rouge, a concert hall that normally entertains the masses is now being used to shelter them.

Here and at places like this across the country, victims of Hurricane Katrina are trying to put their lives back together again. But as Kathleen Koch reports, it's not just about finding a new school or getting a job. It's about trying to live with what you've seen.

(BEGIN VIDEOTAPE)

KATHLEEN KOCH, CNN CORRESPONDENT (voice-over): His nickname is Lucky. And 58-year old Charles Stewart knows he is. He made it out of New Orleans alive.

UNIDENTIFIED FEMALE: The name of Jesus Christ of Nazareth, our Savior...

KOCH: But even prayers with volunteers don't erase the scenes of bodies floating in the streets and fears his missing son, daughter, and sister may be among them.

CHARLES "LUCKY" STEWART, EVACUEE: I've been doing a lot of running and keeping my mind occupied. So therefore I won't think on these kind of things, you know. But you know, like I said, it's hard.

KOCH: Rick Danenhower used to sell time shares in New Orleans. He's lost everything.

RICK DANENHOWER, EVACUEE: I just feel helpless. I don't know which way to go next. And I'm 60-years old. And you think a big boy like me wouldn't - would know, but you can't imagine what it's like.

KOCH: Experts fear the overwhelming, unimaginable feelings of grief, loss, and hopelessness could lead to a mental health crisis among evacuees. So every shelter has teams of mental health professionals, like psychiatrist Steve Steury at the Washington D.C. Armory.

STEVE STEURY, DR., D.C. DEPARTMENT OF MENTAL HEALTH: As time wears on, and they're confronting the fact that they may not be able to go home for a long time, people are getting somewhat more distressed.

But also, this is a very resilient group. And many people have already found ways to take care of themselves.

KOCH: At the Red Cross headquarters in Prince Georges County, Maryland, evacuees are pouring in at the rate of 200 a day. Psychotherapist Janet Kuhn listens to them, cries with them, but then, helps them focus.

JANET KUHN, PSYCHOTHERAPIST: People need not to get immersed in the sadness and the sorrow of what they're dealing with. They need to keep their heads working, so that they can take care of themselves and get themselves the things that they need to get some kind of stability in their lives.

KOCH: Fragile vessels all, trying mentally, emotionally to navigate through a strange, new world.

Kathleen Koch, CNN, Washington.

(END VIDEOTAPE)

COHEN: Thanks, Kathleen.

This new world can be emotionally overwhelming. Earlier, I spoke with Julie Siri, a social worker and a volunteer for the Red Cross.

(BEGIN VIDEOTAPE)

COHEN: Julie, you've been helping people out at the shelter for nearly a week.

JULIE SIRI, CLINICAL SOCIAL WORKER: Yes.

COHEN: What kinds of problems are people facing at this point?

SIRI: I think the main concern right now is a lot of uncertainty about the future. And what we'll see - we watch - we rove the shelter 24 hours a day with a professional staff. And what we're seeing is some people not being able to sleep. And we go and we check on them. And we ask them to - you know, what's on your mind and how are you doing.

So we're looking for, you know, anxiety issues like that. We're not seeing a real strong grief reaction right now. There's still a lot of shock in place. And people are really concerned about concrete things. Where will I live? Do I have enough food? Am I going to get a job? Where's my check? So it's on a very basic level right now.

COHEN: And what do you tell them?

SIRI: What's most important is to assure them that they're going to be taken care of, that it's OK to be hopeful, that there's going to be a solution. And we try to normalize the experience that they've been through.

A very bad thing did happen. And this is real unusual. So we want them to feel secure. We want them to feel safe. And we want them to know that help is going to happen and that we're going to get this sorted out. And right now, we all have to work on being patient, because it is a big disaster.

So we're instilling truth. But at the same time, you know, trying to make it palatable and keep them hopeful.

COHEN: And what about the children? There are a lot of children at this shelter.

SIRI: Right.

COHEN: How are they doing?

SIRI: Actually, children are very resilient. I don't think that they're really aware of what this all means. They don't really know what it means that the house has been destroyed. And some of the families really haven't gone to that place where, oh, my house is destroyed. They're still I don't know what happened to my house yet.

I have people missing. You know, so we haven't gone the next step as to the person is gone or the house is gone. We're still in this period of uncertainty. And I think what's going on for children is that just - they don't know for sure what this meant. So we're fortunate, actually.

COHEN: This is a temporary shelter.

SIRI: Yes.

COHEN: So these folks will all be leaving here at some point.

SIRI: At some point.

COHEN: What would you expect they would face psychologically in the weeks to come?

SIRI: I think that there would certainly be lots of feelings about insecurity, what's next, not being able to cope with surprise easily, a lot of anxiety, maybe some clinging behavior. Any other issues that resemble loss will have much more potent impact on them, like even losing their friends that they've made here or leaving this very safe, predictable environment, where we've got three hots and a cot to moving into a new neighborhood, being around in a new school environment. All of this newness is certainly going to add more anxiety to the situation.

COHEN: Well, Julie, thank you.

SIRI: You're welcome.

COHEN: And when we come back, we're going to go from emotional health to physical health.

(END VIDEOTAPE)

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE: Tony's at a 35 percent chance of survival without a transplant right now. So it was critical.

(END VIDEO CLIP)

COHEN: The panic one family faced searching for life saving treatment after the hurricane.

(COMMERCIAL BREAK)

COHEN: In shelters like this one, volunteers have been searching for cancer patients. They're missing their vital treatments and medications.

As I found out, some of the smallest victims of Katrina have been the children who've had to wait for treatment as their cancer spreads.

(BEGIN VIDEOTAPE)

COHEN (voice-over): Six-year-old Tony Nata has no home, no place to go, no possessions, but he does have cancer. Before Katrina struck, Tony and his family evacuated from their home in Slidell, Louisiana. The street in front of their house, a river. His father's truck, underwater. Their first worry, how would Tony get his treatment?

ROBIN NATA, TONY'S MOTHER: Where's his doctor? Where do we go? You know, who do we contact? You don't know where to turn, but you just know that it's critical. He needs this treatment. Words don't explain the frantic that you go into, the mode you go into just to know that it's his life. And he just relapsed June 30th.

COHEN: Tony's leukemia, once just in the bloodstream, is now in the membranes surrounding his brains. He needs chemo to get ready for a bone marrow transplant.

NATA: Tony's at a 35 percent chance of survival without a transplant right now. So it was critical.

COHEN: His parents found out that his hospital, Children's in New Orleans, had been evacuated. They heard from a friend about this clinic in Baton Rouge being run by Saint Jude Children's Research Hospital. They're reaching out to evacuated children with cancer. They had no idea their doctor from New Orleans, Maria Velez, would be there.

NATA: We just seen in the hallway. She was going to grab a cup of coffee. And she just hugged and kissed me. And I hugged her back.

COHEN: And there, the lucky ones. Dr. Velez has no idea where most of her patients are and she's worried sick about them. They're prone to infection. And she fears that some might have waded through the toxic New Orleans flood waters.

MARIA VELEZ, DR. PEDIATRICIAN ONCOLOGIST: It's a nightmare, because many kids I know that they need treatment, they need surgery coming up shortly. And we don't know anything about them. What about little Johnny? What about Susie? Where are they? I mean, how are they doing? Are they OK? Have they lost everything? Do they have their medicines? So it's a horrible thing.

COHEN: Dr. Velez herself is an evacuee from New Orleans. Her husband and two children are staying in Houston with friends. But she won't leave her patients.

She calculates Tony's chemotherapy dose. And she tells his family it's time to be admitted to the hospital for two days of chemo. All right. You look good, handsome. Good to go.

COHEN: In his hospital room, the nurse gets him ready. Even when Tony does get his bone marrow transplant, his odds of survival are 50/50.

His father, Tony, sr., has to leave to go salvage what's left of their house. A family separated by a storm, a family determined to save their son.

(END VIDEOTAPE)

COHEN: Tony and his family are in good hands now. But what about the thousands of people who had to leave their homes without medical records? Without the drugs they need every day?

Coming up, we'll be checking in with a doctor here at this shelter to find out how they're dealing with this influx of patients. But first, this week's medical headlines.

UNIDENTIFIED FEMALE: CDC director Dr. Julie Gerbeding says the government is making a large batch of this year's flu vaccine available to Hurricane Katrina evacuees amid concerns that overcrowded shelters are a ripe environment for the virus to spread.

Sonati/Pasteur, one of the makers of the vaccine, has donated 200,000 doses to those affected by the hurricane.

And the federal government has instituted a large scale online medical records database in response to the hurricane disaster. Thousands of people in the southeast United States who left without any medical records, forcing doctors to make educated guesses about which medications their patients were taking and what treatments they were receiving. The database will bring together records from thousands of national pharmacies and healthcare organizations, to aid doctors in the affected areas.

Christy Feig, CNN.

(COMMERCIAL BREAK)

COHEN: Welcome back to HOUSECALL. We're coming to you today from the River Center shelter, the largest shelter in Louisiana. Now almost half of all Americans are on some kind of prescription drug. Now you can imagine if people were picked off their attics or swimming for their lives, that they probably weren't able to bring their prescriptions with them.

Well, we're talking today with Dr. Janis Tupesis, who's an emergency medical physician who's from the University of Chicago. And you've been treating people here for five days. Are people showing up knowing that they're on something, but not quite sure what they're taking?

JANIS TUPESIS, DR., UNIV. OF CHICAGO HOSPITAL: Absolutely. I mean, we're seeing all comers, people that have completely forgotten all the medications that they've been on. Some people are coming in with empty pill bottles. And actually some people managed to get the one thing that they did remember to take was all of their medications. And so, we're seeing all comers right now.

COHEN: And what do you do when someone says, I just don't know what I'm taking? How do you handle that?

TUPESIS: So interestingly enough, there's a medical clinic in the River Center itself that's being staffed by the Louisiana Department of Public Health. And so, we're basically starting from scratch.

They're going. They've being evaluated in the clinic there. And so diagnosis that are relatively easy to make. So asthma or heart failure, they're actually prescribing medications from the clinic right there.

The local pharmacies have been great. So what's happening is they are -- if we don't have the medications in stock here, all of the CVS, the Walgreen's, the Rite-Aid pharmacies are taking anybody's prescriptions. They're filling them and then actually bringing them back. So usually, it's like a 24-hour turnaround. But most all medications we're able to get from the local pharmacies.

COHEN: Now thousands of people have come in and out of this shelter. Is it difficult with a relatively small staff to take care of them all?

TUPESIS: It's a challenge, yes. And so, I think the thing that we're finding right now is especially coming from Chicago, we felt there were going to be a lot of acute emergencies. And most of the really, really acute things have already happened.

So in the first 10 days. Now we're seeing more diarrhea illnesses, respiratory infections, people that haven't had their medications. So people with diabetes or asthma that we're just trying to get their really, really chronic medical conditions sort of back in check right now.

And so, yes, it is -- there are anywhere between 2,000 and 6,000 people here at any one time. So a relatively small number of volunteer physicians.

COHEN: Now you mentioned diabetes, which is an increasingly common disease in our society. How are they handling and managing their blood sugars under these conditions? TUPESIS: Again, it's a challenge. We're -- we said before, flying by the seat of our pants. What we're doing is a lot of this is becoming preventative medicine and health education. And so, we're trying to do public service announcements, doing -- we have a group of eight of us that came down from the University of Chicago -- you know, nurses, registered nutritionists. And so, we're giving little mini lectures on how to eat, how many times you should check your blood sugar, what kind of things to look out for.

There's actually like an insulin clinic in the clinic itself. So people are going down two and three times a day to get their insulin shots.

COHEN: And long term, what do you think these folks can expect medically? They're not going to have their own doctor for quite a while.

TUPESIS: Right. We're trying to tap them into local resources right now. The people that know their medications, we're trying to give them, you know, a month's worth or two month's worth. And so interestingly enough, everybody here -- most of the people here have every expectation that they're going to be going home soon. Whether that's true or not is hard to tell, but they're saying I'll see my doctor when I go home in the next week or two.

And so right now, what we're trying to do is focus on their immediate medical needs. And unfortunately, I don't know if we can give a good answer for what's going to happen in the months to come.

COHEN: Well, Dr. Tupesis, thank you. And good luck with your work here ...

TUPESIS: Thank you.

COHEN: ... at the shelter.

Now coming up, on HOUSECALL, we're going to be talking about people who are returning to their homes. Dangers lurk there, as well. That's next on HOUSECALL.

(COMMERCIAL BREAK)

(BEGIN VIDEOTAPE)

KELLY COLLAHAN, CNN CORRESPONDENT (voice-over): As people return to their homes in the wake of Hurricane Katrina, health officials say to keep your body healthy, take precautions.

Number one, heat. No electricity means no air conditioning. And with temperatures in the 90s in the Gulf region, heat illnesses could be a problem.

Experts say it's extremely important to stay hydrated. And keep an extra eye on the elderly and young children since their bodies are not as adaptable to the heat. Number two, check your food and water. Boiling contaminated water is an option. But if you can't boil it, use 6 drops of bleach per gallon. And let it stand for 30 minutes before drinking it. And keep in mind, contaminated water should not be used for washing hands or brushing teeth. Refrigerated food is most likely ruined and experts say you should trash any food that's come into contact with flood waters, as well.

Kelly Collahan, CNN.

(END VIDEOTAPE)

COHEN: Thanks, Kelly. Coming up on HOUSECALL, a doctor documents flood waters rising, nurses collapsing, and patients fighting for their lives at a small hospital outside New Orleans. Stay tuned.

(COMMERCIAL BREAK)

COHEN: Now the incredible story of a doctor who managed to evacuate his own patients only to be told he couldn't help others. As Thelma Gutierrez reports, surviving Katrina was only half the battle.

(BEGIN VIDEOTAPE)

THELMA GUTIERREZ, CNN CORRESPONDENT (voice-over): It was a stunning sight. Chalmette Medical Center outside New Orleans literally drowning in flood water. Inside, patients too sick to be evacuated. And only three doctors and a small staff too dedicated to leave them behind.

BANG MUI, DR.: We were completely forgotten at the time.

GUTIERREZ: Dr. Bang Mui was chief of staff at this hospital. He took the photos from a window on the second floor. Soon, the first floor was under water. Food had to be rushed to the second floor. The parking lot, a lake. Then, some 300 evacuees began the show up by the boat load.

MUI: Yes, Some of them came up with dogs, cats and even chickens.

GUTIERREZ: All in a hospital without electricity. Nurses worked by flashlight. The air was thick and hot. At times, it became too much.

Five of the nurses call us with dehydration, exhaustions. And two of them had panic attacks.

GUTIERREZ: After three seemingly endless days, help arrived. Dr. Mui and his Katrina family were finally rescued and taken to the New Orleans Airport, where they were overcome by the sight of hundreds of sick people on the ground.

MUI: Our people in the wheelchair, people lying on the floor and all of them are very sick. GUTIERREZ: Dr. Mui and his staff immediately offered to help. But he said FEMA officials said, no, because of liability concerns.

MUI: They told us that, you know, if you could help us by mopping the floor.

GUTIERREZ: And so, they did, as people died around them.

MUI: At that moment, most of us was just sitting there and I start crying. And that's -- that is that bad because we felt like we could help, but they were not allowed to do anything.

GUTIERREZ: Finally, he and his wife came to Houston with thousands of other evacuees. That was the moment the Dr. Mui says he realized his previous life, the one that took a lifetime to build, was over with.

MUI: These are our belongings. That's it.

GUTIERREZ: Cash strapped, unemployed, and homeless, they had to ask for help and live here with a friend. Is it hard for you to ask?

MRS. MUI: Yes. I'm kind of like when I apply for food stamp, you know? And I never did before. So yes, it's hard.

GUTIERREZ: This is the second time the Muis have had to start all over again in a new place. The first time was after the fall of Saigon, when they were separated for five years. Now, this, just as they were looking forward to retirement.

MUI: I don't think I can face it again.

GUTIERREZ: You look tired.

MUI: Yes. I'm tired. Exhausted in a way.

GUTIERREZ: Thelma Gutierrez, CNN, Houston.

(END VIDEOTAPE)

COHEN: We're out of time for today. Make sure to watch HOUSECALL, as we continue to update you on the struggles and triumphs of people who are surviving in the wake of Katrina.

Thanks for watching. I'm Elizabeth Cohen. Stay tuned now for more news on CNN.

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