Paramedics and Firemen: The Caregivers Suffer as Well

We heard from Thomas Lahut, PA, MS, in a previous dispatch. He just returned home to upstate New York today, but before he left Baton Rouge, he provided Medscape with this report.

On Monday, September 5, 2005 I was summoned (“Please come now!”) at noon from the chapel. That’s where sleeping accommodations have been made (darkened windows, cots) for medical workers who are working late night shifts at the P-MAC (Pete Maravich Assembly Center at LSU), the temporary medical evaluation area in Baton Rouge for Katrina evacuees.

New Orleans paramedics and firemen, who have essentially worked 24/7 since the storm hit and the levees broke were finally being relieved. Firefighters from Houston are now able to replace these men and women, who have given so much, and who still remain victims themselves.

The paramedics and firemen have been bussed out in large groups from New Orleans and they need to decompress. As an urgent perk, the City of New Orleans has solicited charter airflights, accommodations, and stipends to allow these rescuers to take their families out of the area, and out to Las Vegas or Atlanta for a 5-day furlough.

They were first sent to Baton Rouge and brought to a formerly grand and now-seedy hotel “in the bad end of town,” as an initial staging point. 

These workers needed an initial medical/psychiatric evaluation -- urgently. As a physician's assistant, I worked with 4 docs and 3 nurses and we were accompanied by dozen psychiatric liaison staff – physicians, social workers, and nurse practitioners.

Also included were offerings of warm food and clean clothes. As a separate (screwed up) offering, FEMA was supposed to be present to offer coordination of low-cost loans and initiation of housing assistance for these people who gave so much. After multiple requests, with one of our docs getting quite agitated in a cell phone call to HQ, FEMA finally came, but very, very late, after many firemen had left to seek out their displaced families.

Firemen and paramedics are tough folk. They prepare for the worst, they offer excellent medical care, but they were in rough shape. They were tired, anxious, apprehensive, and dry at this time. They maintained the facade of normalcy, but when questioned directly, they made frustrated references to the Superdome; they saw death and a lot of people too ill to save. The psychiatric liaison staff was excellent.

A paramedic who had surgery days before the hurricane, and who had worked above and beyond any description for the past week, was ill appearing. She was anorexic, looked pale, BP 90/30, tachy, pale conjunctiva. She was shipped out STAT to a local hospital, and went directly to the operating room.

A fireman, carrying a puppy with big ears, was a magnet for the attention of the support staff. The pup was named “Ernie,” for the place he was rescued from: the Ernest N. Morial Convention Center -- the Superdome.

Psychiatric issues of depression, substance abuse, memory problems, difficulty sleeping, and feeling estranged could only be transiently and superficially addressed. The burden of that work will be passed to future clinicians.

The clinic broke for the evening; tomorrow, another bolus of rescuers will present again.