2011 by Ros s J udi c e , PL L C

The Kat r i na Di ar i e s :
F i r s t Hand Ac c ount s f r om
Me di c s and Mi r ac l e Wor ke r s
Acknowledgements
Many people contributed generously to the creation of this book, and I am grateful
to them all. Thanks to those who helped edit the text and suggested ways to im-
prove it. Terry Daniel played an important role in the rst draft. Thanks also to her
assistants, Chrystal Wadsworth and Annette Brown.
Thanks to the stranded medics that helped in the Superdome: Stephanie Korzyk
(New York), Mark Gerano (Ohio), Vickie Kock (Ohio), Sean Schuman (South Da-
kota), Duane Quakendosh (South Dakota), Phillip C. Yellow Hawk (South Dakota),
Deanna Lassegard (South Dakota), Rob Menacher (South Dakota), and Will How-
land (Louisiana National Guard).
Thanks to stranded physician, Dr. Tran Vo from New York, for helping our medics in
the Superdome.
Thanks so much to my family who have been a continuous source of support
throughout my life, and especially during the trying times of Hurricanes Katrina and
Rita. Special thanks to my three brothers - Ronnie, Roch, and Remi - who jumped
on a helicopter at a moments notice...to help me at the Superdome. Seeing them
arrive at the helipad conrmed what I already knew - I have a great family.
Thanks also to Robin Roughton Judice, my wife, who not only supported this writ-
ing project, edited the book, but also kept me emotionally grounded during the af-
termath of these storms.
Thanks to my dad, Ronald Judice, Sr., for proofreading and editing the book, and
for teaching me to be courageous.
Thanks to the men and women of Acadian Ambulance Service who inspire me
every day with their compassion and professionalism. For reaching into the misery
of Hurricane Katrina and pulling so many people out of despair, I dedicate this
book to them, and to all the rst responders and EMS personnel that pulled together
to help.
2
Contents
Introduction 4
Prologue: The Lay of the Land 8
By Air, Land, & Sea 16
Life and Death on the Interstate: The I-10 and Causeway Cloverleaf 25
The Children 32
The Elders 39
Rescuers in the Storm 45
Sick, Disabled 59
The Animals 64
Superdome 67
Crime 80
St. Bernard 87
Organizing Chaos 90
Difcult Communications 103
Reections 107
Epilogue 113
3
Introduction
There have been dozens of books written about Katrina, the Category 5 hurricane
that leveled long stretches of the Gulf Coast from Florida to Texas and decimated
the city of New Orleans in August 2005. The story has been told countless times by
survivors, politicians and journalists who were there on the front lines, witnessing
the devastation as it happened. Their stories express the unimaginable horror of see-
ing the bodies of dead men, women, children and animals oating in the putrid
oodwaters. They tell of personal loss, grief and devastation. They shine a harsh
light on poverty and politics. It has been ve years since Katrina, and most of us
have heard it all.
But this story is different.
We are the paramedics, EMTs, doctors, nurses, administrators, support staff and
volunteers who were on the scene before, during and after Katrina. We were pre-
sent from the pre-storm evacuations, during the storm, and throughout the surreal
and unexpectedly tragic aftermath. The accounts you will read in these pages are
told rst-hand by healers...the people who treated the wounds of the traumatized
and injured, held the sick and dying in their arms, and did their best to create a ha-
ven of safety in the midst of terror and chaos.
Katrina gave us an extraordinary new! perspective on the work we do.! We are ac-
customed to school bus accidents, murders, heart attacks, suicide attempts and
human suffering of all kinds. We are used to pulling mangled bodies out of multi-
vehicle car crashes, but we!never imagined that Katrina would require us leave our
ambulances and ofces and face the unknown to care for a sea of suffering New
Orleanians. We also could not anticipate that some of the people we were trying to
help would end up shooting at us, or that we would run short of supplies, medicine
and equipment.
In the Emergency Medical Services (EMS) business, Katrina is what we call a mass
casualty incident." But we -- along with most everyone else in the southern states --
never expected it to elevate to such a desperately critical level. Medics compared it
to being in a combat zone, and many of the military medics who worked alongside
us said that they'd never seen anything like it.
From 1998 to September 2010, I served as the medical director of Acadian Ambu-
lance Service, Inc. (Acadian).
1
Acadian is based in Lafayette, LA 135 miles west
4
1
At all times pertinent to this narrative, the author served as medical director of Acadian and continued as
such until September 2010 - hence the use of the terms we, us, and our when speaking of Acadian
and its staff.
of New Orleans. Most of us rode out the hurricane in our own homes. After the
storm passed, we walked outside to nd blue skies and gentle winds blowing, just
like any other summer day in Louisiana, and it seemed that the area had emerged
relatively unscathed. But that was before we knew that the levees had broken and
the low-lying areas of New Orleans were beginning to ood. There was no electric-
ity or phone service, so news of the ooding didn't reach us until the next morning.
As I packed to accompany our paramedics into New Orleans to begin our medical
relief operations, I threw my video camera into my dufe bag with the intention of
videotaping some of the work wed be doing. I didnt realize at the time that I
would be way too busy to carry a camera around. In fact I didnt even open the bag
until three or four days later. I was disappointed that I had not been able to docu-
ment something that most people never see the medics point of view.
Then I got an even better idea. I sent one of my employees in Lafayette to purchase
ten digital voice recorders from a local electronics store. I handed one of these re-
corders to each of my key staff members with these simple instructions: record your
experiences and impressions. They in turn passed the recorders on to others so that
the rst hand accounts would be captured.
The stories in this book are transcriptions of those recordings. I recognized that this
was a disaster like no other, and I wanted to make sure the world knew how it
looked through the eyes of the emergency medical personnel on the scene. Some
of the people you'll meet in these pages have worked in EMS for decades. Some
lost their homes, their possessions, and their pets in the storm. Most worked 20 or
30 hours non-stop in the Superdome, on the freeway underpass that became a
makeshift triage
2
center, in helicopters, in ambulances, in boats and in our ofces,
doing whatever needed to be done to meet the needs of an entire city of refugees.

The intent of the book is to document both the deep compassion and the frustration
of Acadian's responders. The stories told by these medics and staff will shock you
and touch your heart with their expressions of brotherly love, human kindness and
human vulnerability. Although I am extremely proud of my Acadian colleagues,
there were countless others who helped with equal dedication. Some of those in-
clude the Coast Guard, the National Guard, FEMA, hospitals, EMS, medical profes-
sionals, civilian helicopter companies, churches, civic organizations, local busi-
nesses and local re & police departments. Then there were the friends, neighbors
and average folks who helped by cooking meals for our medics, bringing us clean
clothes, offering their boats, tools and manpower and assisting us in a hundred dif-
ferent ways.
5
2
Triage is the assignment of degrees of urgency to wounds or illnesses to decide the order of treatment
of a large number of patients or casualties. Medics are trained to triage patients in disaster situations.
The stories being published herein have not been conrmed or endorsed by Aca-
dian as to their accuracy or content. Acadian takes great pride in the work and
dedication of its employees, not only in times of disaster but every day that they
commit themselves to a mission of service. In looking back on the days and weeks
and months following Hurricanes Katrina and Rita, there was an overwhelming de-
gree of humanity, persistence, skill, integrity and endurance that was displayed in
the eld and at home. The faces of those whose lives were touched and who
touched every member of the Acadian family in the wake of those storms will never
be forgotten.
We walked with angels during that time. We were reminded that material things
can be washed away, but that the human spirit is eternal.

Ross Judice, MD
6
Supe r dome & Ar e na
I mage s s our c e : Googl e Ear t h
Gr e at e r Ne w Or l e ans
Ai r por t
Caus e way
& I - 10
Supe r dome
St . Be r nar d
N. O. Eas t
F i r s t Ai d St at i on
i n Supe r dome
He l i c opt e r
L andi ng
DMAT
i n Ar e na
Prologue: The Lay of the Land
As you read, you will see numerous references to locations such as the Superdome,
the Arena, the I-10/Causeway cloverleaf, St. Bernard Parish, Lafayette and other
sites that gure prominently into the story. You will also read medical terminology
that you may not understand as you read the rst-hand accounts from medics. This
prologue will provide a valuable key to understanding the sequence of events and
some of these references. A day-by-day timeline is set forth at the end of this Pro-
logue.
Acadian Ambulance has had the rst aid station and standby contract with the New
Orleans Superdome since 2004. During football games, rock concerts and other
events at the Dome, a core group of our medics is based in a small rst aid area
on the middle level of the Superdome, while others are scattered around the sta-
dium. When it became clear that a monster hurricane was due to hit New Orleans
on Monday morning, the city ordered a mandatory evacuation and set up the Su-
perdome as a refuge of last resort for people who needed a safe place to take
shelter from the storm.
As the contracted medics for the Dome, we manned our usual post on Sunday, and
because the high winds could potentially blow out the glass doors at all the Domes
entrances, we parked an ambulance in front of each door to serve as a wind barrier.
Then we watched the Dome slowly ll with people, mostly the poor, elderly and
indigent who didnt have cars to take them out of town or money to stay in a hotel
on higher ground.
Besides the medics stationed at the Superdome, other members of our staff were
busy evacuating patients from hospitals and nursing homes and taking them to
other hospitals in safer areas. The evacuation effort went smoothly given the mas-
sive scope of the effort. By Sunday night wed moved most of the patients and re-
turned to our homes to hunker down with our own families until the storm passed.
Coincidentally, the annual EMS Expo and conference was being held in New Or-
leans that weekend. This is North Americas largest gathering of emergency medical
personnel, and there were perhaps 2000 paramedics, nurses, doctors and other
emergency medical practitioners in town. Acadian had quite a large presence there;
many of our staff members were in attendance. We were also exhibitors at the expo
and provided speakers at the conference.
Throughout the conference everybody watched the news and kept abreast of the
storms movements. By Saturday night the winds had changed and Katrina was
heading directly toward New Orleans. When the mandatory evacuation was an-
8
nounced, some conference attendees managed to get early ights out. Many others
found themselves stranded at either the hotel or the airport once all the ights had
been cancelled. Car rentals were the next option, but the roads were jammed with
evacuees and it took ve hours to travel a distance that normally took one hour. As
a result, hundreds of EMS people were left in New Orleans, and many of them
pitched in to help. Several came to the Dome with us.
As an interesting aside, my wife and I had just sold our vacation condo in the
French Quarter. Wed spent most of that week packing up our belongings to take
back to our home in Lafayette, where Acadian is headquartered. I recruited some of
our guys who were in town for the conference to help us move. We had everything
loaded up and were able to get out of town just minutes before the evacuation or-
der came in and the trafc started to back up.
The storm hit on Monday morning as expected. Back in Lafayette it wasnt too bad,
and after the storm had passed, things appeared to be calm and under control. But
by mid-morning in New Orleans the lower 9th Ward levee breach poured 6-8 feet
of water in that neighborhood. By mid-afternoon, the 17th Street Canal breach
ooded 20% of the city. Severely damaged communication systems limited infor-
mation to the outside world. It wasn't until late Monday night and during the early
hours of Tuesday morning that our dispatch center began getting scattered reports
about the extent of the ooding and devastation. Now, 80% of the city was
ooded. We immediately jumped into high gear.
The rst order of business for Acadian was to begin mobilizing ight medics to y
our helicopters to New Orleans to assess the situation at the hospitals. We also
needed to relieve the staff that had been at the Domes rst aid station since Sun-
day. I assembled a group and we traveled by helicopter from Lafayette to New Or-
leans. We could not believe what we saw on the ground as we ew over...the city
was an enormous lake. Nobody expected the levees to break (except the engineers
and experts whod predicted it years earlier, but thats another story). Because there
was no power, communications were crippled, so nobody knew what the condi-
tions were from one location to another. The landlines were all down. Few cell
phones worked because the towers that hadnt blown down were operating on
generators. Those generators eventually ooded too. Luckily we had satellite
phones and were able to acquire some radios and other communications equip-
ment over the next several days.
After we arrived at the Superdome, the population of refugees starting growing.
Thousands of people were arriving, wading through chest-high water to get to the
only shelter they could nd. Our little rst aid station provided the only medical
care available to the public at that point, and we quickly realized that this would
not be enough. The Dome is an enormous place, but thankfully, we had two or
9
three Gators, which are like golf carts that function as mini-ambulances. We
drove them around the Dome picking up the sick and injured and taking them back
to our rst aid station.
We were inundated with requests for help inside and around the Dome. Sometimes
we left the rst aid station by foot or in the Gator to assess and triage people: in the
football stands, hallways, on the eld, outside, or wherever we were needed.
Mothers arrived with their babies, sons with their mothers, wives with their hus-
bands - most with worsening chronic medical conditions like diabetes and heart
disease, and others with mild traumatic injuries from the rough conditions wading
through the ood waters. The demand for medical care soon outweighed our abil-
ity to supply it. Conditions in the Dome were rapidly deteriorating.
We didnt yet know that one of FEMAs Disaster Medical Assistance Teams (DMAT)
had arrived and set up a treatment station at the New Orleans Arena. The Arena is a
smaller building next to the Superdome where the NBAs New Orleans Hornets
play (see the site map at the back of this book). The two arenas are connected by a
raised walkway. News of the ooding and the increasing number of refugees was
spreading, and rescue teams were beginning to arrive from all over the country.
We sort of stumbled upon the DMAT people. When we realized they were there we
collaborated to create a system for transporting serious patients to their station,
which was better equipped to deal with critical medical issues. Soon the DMAT
area lled up with patients, and there was no place to keep them and no way to
evacuate them. There were not yet helicopters and only limited military assistance.
I called our dispatch on the satellite phone and asked them to send our six helicop-
ters to the Dome so we could move patients to hospitals, but all our helicopters
were busy in other parts of the city. A few minutes later I got a call back saying that
some medically-equipped helicopters owned by Petroleum Helicopters Incorpo-
rated (PHI), which primarily serves offshore oil rigs, had arrived at the Dome to
help out. Because communications were so bad and the Superdome was so big,
nobody knew that these PHI helicopters had landed, and their nurses and medics
didnt know where to nd us. I made my way over to the Superdome helipad and
there they were, waiting for instructions.
Finally I had an idea where everybody was: our rst aid station was inside the
Dome, the DMAT area was in the Arena, and the PHI helicopters were at the heli-
pad. It was time to start connecting the dots. We had some portable radios...the
guys on the Gators had one and the rst aid station had one, so I positioned one of
my staff at the DMAT area with a radio, and positioned myself at the helipad to be-
gin directing trafc.
10
The Gators buzzed around the Dome picking up people and bringing them to our
rst aid station. The critical patients were transported along the elevated walkway to
the DMAT area. After they were treated at DMAT, theyd be put back into the Gators
and driven over to the helipad. From there they were own to a makeshift hospital
at Louisiana State Universitys basketball arena (the Pete Maravich arena nicknamed
the P-Mac) in Baton Rouge.
This system worked, but only for a short while. The ight from the Superdome to
the P-Mac was a 90-minute round trip ight, but we soon ran short of helicopters
because the number of patients was increasing by the minute. We couldnt be
without our helicopters for that long. Earlier in the day, Acadian leaders dispatched
30 extra ambulances to a staging area that wed set up at the Interstate 10 overpass
at Causeway Boulevard in Metairie. It was only a six-minute helicopter ight from
the Dome to I-10/Causeway and outside the oodwaters with a direct drive to Ba-
ton Rouge. The overpass was in a cloverleaf conguration, and it turned out that
each of the cloverleaves could serve as a helipad. It was a brilliant solution. The
helicopters could take people from the Superdome to this new site and be back in
six minutes to pick up another load.
When we set up on the I-10, thousands of people started showing up. Word was
out that we were there, and people started coming from everywhere, wading
through the water in search of dry ground, medical care, food, water, shelter...any
relief they could nd. Rescue helicopters began dropping people off there. Soon
the I-10 cloverleaf was a mess.
Back at the Dome, military trucks started arriving with intensive care unit vent pa-
tients whod been evacuated from hospitals. These are patients who cannot breathe
on their own and rely on electrically powered ventilators to move air in and out of
their lungs. Without a ventilator, they die immediately. When someone like this is
rescued, they have to be bagged, which means that a manual breathing apparatus
is used. It looks something like a bellows with a tube that blows air into the pa-
tients lungs. The bellows, or bag, has to be squeezed by hand to keep the air ow-
ing. These ventilator-dependent patients became a priority over the Superdome pa-
tients, and put in the front of the line for helicopter evacuation.
We later heard many stories about hospital staff members who took turns for hours
on end bagging ventilator patients after the electricity went out. Many hospital em-
ployees chose to stay at their hospitals rather than go home to ride out the storm,
because a hospital is a usually safe place to be in an emergency. Some of these
employees even brought their families, so there were plenty of helping hands when
it became necessary to bag patients. Even the teen children of the staff members
were enlisted to help with this task of bagging the patients. Because many of
11
these patients were terminally ill, some people disagreed with the decision to bag
them, believing it would be more effective to use the manpower elsewhere.
At the Dome there had been reports of rapes and murders, and wed heard that
snipers were shooting at anybody in uniform. A fog of war set in as the National
Guard MP's warned us that the generators would soon ood and the lights would
go out, and the criminal element would take advantage of the dark to attack us and
steal our medical supplies. The MP's advised us to remove our command vests,
hide our stethoscopes and try to blend into the population so we wouldnt be tar-
geted.
We formulated an escape plan in case of rioting which instilled an enemy out
there mindset that stirred my staff into a panic. There were tens of thousands of
people in the Dome, many of them were sick and dying. There was no electricity,
no plumbing, limited water and food. People were urinating and defecating wher-
ever they could. Between the smell of human waste, sweat and death, and increas-
ing fear, it was unbearable to be inside.

By Wednesday there were military and Coast Guard helicopters, plus our eet, the
civilian helicopters and Hueys, and Blackhawks as far as the eye could see. Ambu-
lances came from different companies around the county. All we did, day and
night, was move patients out of New Orleans as fast we could. FEMA established a
eld hospital at the New Orleans airport, and by Thursday we were able to y peo-
ple directly to the airport, where they would be sent to various hospitals around the
region.
We moved our rst aid station outside with an MP escort. The DMAT people were
still in the Arena, which was more secure, but there were now thousands of sick
and injured patients needing help, and they were getting sicker all the time. People
ed their homes without bringing their prescribed medications, and if they did
bring their medications, the pills got soaked as the people walked through the wa-
ter. There were un-medicated psychiatric patients, dialysis patients, diabetics, eld-
erly people having strokes and heart attacks, sick children, women giving birth and
people dying from dehydration. It was a nightmare. By Thursday, with rumors of
crime escalating, we decided to vacate the premises and move our entire operation
to the eld hospital on the I-10 cloverleaf.
There were so many people being transported that wed long since abandoned the
protocol of setting up medical charts and collecting personal information about the
patients. We were loading people into helicopters and ying them out so fast there
just wasnt time to keep track of them. Family members didnt know where their
loved ones were being taken, and neither did we. People were transported to hospi-
tals and shelters all over the Southeast with without records, but there was nothing
12
we could do about it. At this point, nothing mattered more than getting those folks
out of the Dome to safety.
Below Ive included a timeline of events relevant to our story. Naturally, this is not
an exhaustive list of what happened, but will provide some big picture context to
the stories that follow.
Hurricane Katrina Timeline
Friday, Aug. 26, 2005:
Louisiana Governor Kathleen Blanco declares State of Emergency
Saturday, August 27, 2005:
New Orleans Mayor Ray Nagin declares State of Emergency. Orders volun-
tary evacuation where residents in low-lying areas encouraged to evacuate
Sunday, August 28, 2005:
Hurricane Katrina becomes a Category 5 storm with 160 mph winds
Superdome opens as a shelter of last resort
Acadian personnel are deployed to the Superdome to help triage special
needs patients and staff the rst aid station
Nagin announces that buses will pick people up throughout the city and
take them to the Superdome
Nagin orders mandatory evacuation of the city
Superdome now has 10,000 people inside and 150 National Guardsmen
stationed inside (most are unarmed)
National Weather Service predicts levees may be overtopped
Monday, August 29, 2005:
At 6:10 a.m. Hurricane Katrina becomes a Category 4 storm with 145 mph
winds and makes landfall
Lower 9th Ward levee is breached with reports of 6-8 feet of ooding
17th Street levee is breach with reports that 20% of the city is ooded
People continue to arrive at the Superdome despite its being damaged in
the storm
Phone and email out of New Orleans is limited due to ooding, and many
believe New Orleans has dodged a bullet
Tuesday, August 30, 2005:
Floodwaters have risen overnight and the city is 80% ooded
Acadian deploys 50 ambulances to the Interstate-10/Causeway Boulevard
intersection and establishes helicopter landing zones and medical triage cen-
ter. Helicopters arrive here with rescued victims.
13
Acadian deploys 7 of its air ambulance helicopters to evacuate the most
critical patients from New Orleans hospitals. Other air medical transport
companies send helicopters to assist in the evacuations. As requested by state
administrators, Acadians dispatch center begins coordinating and deploying
all civilian air medical resources in the affected areas
Dr. Judice and Acadian medics y to the Superdome to support and re-
place existing Acadian personnel
Air evacuation of ill and injured patients at the Superdome begins
FEMA activates the National Response Plan to fully mobilize federal gov-
ernment resources
Reports suggest looting is widespread
Wednesday, August 31, 2005:
Massive air evacuation of ill and injured from the Superdome continues.
Population taking refuge in the Superdome now thought to be over 25,000
Air evacuation continues at Tulane Hospital & Baptist Hospital as well as
Touro Hospital and Childrens hospital
Acadian dispatches liaison to Belle Chasse Naval base to assist in air asset
coordination
Twenty-seven (27) civilian and 12 military helicopters assisting in evacua-
tion of medical patients in the city
Thursday, September 1, 2005:
Acadian staff is evacuated from the Superdome due to security concerns
Touro Hospital administrator phones saying he and patients slept on the
roof waiting for help. Acadian sends helicopters
Most of Tulane Hospital evacuated but still working on Charity
Memorial Hospital & University Hospital air evacuation continues
Marc Creswell set up night landing zone at Childrens Hospital
Received call from Meadowcrest in Gretna that there were 120 people still
left in the hospital
Triage center moved from 1-10 and Causeway to Airport
Friday, September 2, 2005:
Evacuations of patients from hospitals completed around 1:00 p.m.
Acadian staff enlists three 18-wheelers to complete evacuation of 48 pa-
tients plus staff at Charity Hospital
Acadian provides ambulance support to FEMAs Urban Search & Rescue
operation in New Orleans East. Help evacuate forgotten nursing home pa-
tients
Fifteen airlines begin ying refugees out to various cities around the U.S.
Buses arrive at the Superdome to evacuate refugees
14
I now respectfully turn the story over to the dedicated EMS personnel. Together, we
will tell you in the following pages and in our own words, exactly what we experi-
enced during the Katrina rescue and recovery.
15
By Air, Land, & Sea
On Saturday, August 27th 2005, two days before Katrina made landfall, New Or-
leans Mayor Ray Nagin declared a state of emergency and suggested voluntary
evacuation. The next day, as the storm turned toward his city, evacuation became
mandatory. By Sunday afternoon Acadian Ambulance was swamped with calls from
hospitals and nursing homes requesting evacuations for their patients. Outbound
trafc from New Orleans was bumper-to-bumper, substantially lengthening trip
times and tying up ambulances in standstill trafc. Additionally, as the storm drew
near, the boxy ambulances became unsafe to drive in the high winds. Later, the ris-
ing oodwaters made ambulance transport impractical, if not impossible.
The lower areas of New Orleans ooded rst, including the Lower 9th Ward and
Saint Bernard Parish. Volunteers, along with local police and re department rescue
teams combed the landscape in boats, but air rescue got off to a slow start because
military and FEMA helicopters did not arrive on the scene until three days after the
storm. The Coast Guard and helicopters picked up the slack from private compa-
nies. Acadians small eet worked nonstop, and there were a few National Guard
helicopters ying patients from the Superdome to hospitals in nearby areas. But it
wasnt until Wednesday that Coast Guard and National Guard arrived in full force.
After that, air-trafc was so thick it was precarious to y over the city.
Phone calls in and out of New Orleans (504 area code) and Baton Rouge (225
area code) were challenging because of ooding (New Orleans) or the phone net-
work being overwhelmed (Baton Rouge). More open lines of communication in
and out of Lafayette (337 area code) made Acadians dispatch center a hotline for
desperate victims of the storm and their concerned family members across the U.S.
**
Mike Burney, Dispatch Manager
On Sunday morning, the day before the storm, we got word that Orleans Parish and
St. Bernard were going to issue mandatory evacuations. We had maybe 30 units
ready to move patients from nursing homes and hospitals, but once we got those
patients on board, the streets were gridlocked because there was so much evacua-
tion trafc heading out of town. Shelters were opening up in Alexandria, and the
trip there normally took four hours, but now it was closer to eight hours, so a lot of
our units were just sitting in trafc. They were trying to get patients as far away from
New Orleans as they could.
By Sunday afternoon we had more calls than we could actually handle - many from
residences with special needs patients who were handicapped or requiring special
16
assistance and equipment. Even on Saturday we had residential evacuations calling
in, and we were inundated with requests. We struggled to get as many people out
as possible, but we had to put facilities, hospitals and nursing homes ahead of the
residential calls. We tried to utilize what we resources we had, and put as many
people in each unit as we could. At 8 a.m. Sunday morning the Superdome was
opened up as a shelter, so instead of taking patients out of town, we started taking
them to the Superdome, which initially helped out tremendously. A lot of patients
weren't happy about being taken there, but they had no choice at this point. It was
the Superdome or nothing.
After a while we started losing more units, because so many were transporting pa-
tients long distances to hospitals in central Louisiana. That was about an 8-hour
round trip, so that put most of our ambulances out of commission. By 4 p.m. the
decision was made to cease ambulance operations and get our personnel and
equipment out, because the storm would soon be bearing down on us. In 50 mile
per hour winds, ambulances are unsafe because they are box-type modules that
can topple over.
By 6 p.m. we had pretty much shut down. Some of our ambulance crews were po-
sitioned at hospitals, emergency operations centers (EOC), and hospitals to ride out
the storm. And some were at the Superdome, where we had a rst aid station set
up.
Monday morning the hurricane came through, and the next day, Tuesday, we
started hearing about ooding in St. Bernard Parish. I think that's when we realized
that they were in trouble. We knew that the levee in St. Bernard broke during the
hurricane and there was massive ooding, and we were very concerned about
nursing homes that refused evacuation. We were getting reports from paramedic
Janie Fuller, who was at the EOC in St. Bernard, that the ooding was pretty bad. At
one point she advised us that a Greyhound bus had been parked outside and she
could only see the top of the bus because the water had come up so much.
Tuesday morning we resumed operations under what seemed like normal circum-
stances, and we were preparing to bring patients back into the city. But now the
city was ooded and ground transport out was going to be a problem. Dispatch su-
pervisor Mike Sonnier had determined that none of the helipads at the hospitals
were functional for various reasons, and we even heard that one of the helipads
had been blown off the top of the building, so air transport would also be a chal-
lenge. Mike instructed personnel at Tulane Hospital to cut down the light posts on
the top level of the parking garage so we could use it as a helipad.
From that point on we started getting hundreds of calls from hospitals with every
imaginable crisis on their hands. There was no electricity (some were operating on
17
generator power), and there were NICU babies and ventilator patients coming from
every hospital, while the water was continuing to rise. I remember one hospital
calling to say that they were out of oxygen, out of power and the generator was not
working.
On Tuesday we started ying the NICU babies out, and also the vent patients from
Tulane, and we told the other hospitals that we'd asked the state to provide us with
boats so we could go to the outlying hospitals, pick up patients and bring them to
our improvised helipad at Tulane. We worked on that for the next two days.
Mike's idea to cut down those light posts was genius. He is a former Air Med medic
and he knew that if he could get those poles down we could use that as a landing
zone. That is basically how we evacuated the hospitals. University and Charity hos-
pitals were sending patients by boat to Tulane and getting them up to the third oor
of the parking garage so we could airlift them out.
FEMA called us on Tuesday to ask that we take over management of the civilian air
rescue helicopters. In other words, if another agency such as Miami Flight offered
to help out with their helicopters, FEMA wanted us to coordinate with all of those.
So we started doing that. We would assign them a mission and they would take
care of it and then call back to ask for their next mission. It was going pretty well at
that point.
Flight paramedic Marc Creswell was coordinating that at Tulane, and at one point a
FEMA representative came up to him and said, "OK, we have it now, and well take
over." So we turned it over to them, ceased our operation there and moved Marc to
another location. We were dismayed to hear later that after we left, things kind of
shut down in terms of a continuous ow of patients.
We'd been also taking patients to the airport, where they were scheduled to get on
C-130s and y off to various locations. But the babies, being NICU babies, ew
straight to Lafayette Womens & Childrens Hospital, and some to Baton Rouge. That
went well when we were doing it by ourselves, but when FEMA came in, there was
another slowdown, according to some of the hospitals. It just wasnt moving fast
enough.
By Thursday morning, day four, we were still trying to get patients out of hospitals,
but we had to also start evacuating our own personnel from the Superdome be-
cause it was no longer safe for them to be there. I got a call from one of the guys at
the Dome, and I heard the urgency in his voice. He said, "Come get us out of here
because it isn't safe." We had Air Med 1, 2 and 6 at our home base in Lafayette, so
we sent them to move our people from the Superdome to a eld hospital we'd set
up on Interstate 10 at the Causeway off ramp.
18
**
Jay Boudreaux, Paramedic Dispatcher
We made a couple of unsuccessful attempts to get to the Superdome by ambulance
to drop off supplies on Tuesday, but the water had risen and was continuing to rise.
As we were driving through the city people on every corner agged us down. I had
a patient to transport, and we had to gure out if there was an open hospital any-
where, which was a challenge in itself because there was no radio communication.
We took a stab in the dark and went to West Jefferson, and they were open.
Patients were being evacuated by boat and being brought in by helicopter and
emergency vehicles. They did have some ambulances transporting to the triage area
at the I-10, but the majority were coming by military aircraft. The on ramp there at
the I-10 and Causeway is a cloverleaf, so they were landing on the cloverleaves,
and the ambulances were frantically unloading the helicopters one right after an-
other.
Tuesday night paramedics, Henry Rivet, Todd LaPorte and I tried to get back to the
Dome with medical supplies. We drove a rental truck that was much higher than an
ambulance and could drive through the water. We got within three blocks, but then
we couldnt get any closer, because if the truck stalled then we would be forced to
sleep there, and that wasnt a good thing. So Henry and Todd decided to put the
supplies, including hamburgers cooked at the Gretna station, in an ice chest and
oat them over to the Superdome. I waited in the truck, and that was the longest 40
minutes of my life, sitting in the middle of ooded Tulane Avenue in the dark with
no idea of what was going on in the city or when Todd and Henry would come
back.
Thursday morning, I went out to I-10 and Causeway, but then Erroll called and
asked me to go to the Superdome to coordinate with the military to evacuate pa-
tients. One of the Air Med helicopters ew me in. So I went to the heliport to coor-
dinate with the military. Those guys take care of their business really well, but they
werent getting adequate information about where their helicopters were needed.
Those guys evacuated a lot of people eventually, but early on they werent doing
much because they just didnt have the information. Working with the military was
interesting, and they did a really, really efcient job once we were all on the same
page.
On Thursday, along with the hospital evacuations, we evacuated 130 medical pa-
tients from the Arena, and when I got back there Friday morning, I heard 200 more
had come in during the night, as overow from the Dome.
19
One of the big challenges was that the hospitals in the downtown area dont have
heliports. Normally when we transport to those hospitals, we land at the downtown
heliport and take an ambulance the last four or ve blocks, but this wasnt possible
because of the water. At one point we ended up converting the top oor of the
parking garage at Tulane hospital into a landing zone by tearing down the light
poles. From there we were able to get patients from Charity Hospital, University
Hospital and the VA to the top oor of the Tulane parking garage and y them out
from there.
**
Marc Creswell, Flight Paramedic
Prior to the storm we got a request from Renaissance, a nursing facility in St. Ber-
nard Parish, to evacuate their patients. We ew eight or nine people to Yazoo City,
MS, and left there when the winds got to about 40 miles per hour, and it was a risky
maneuver trying to get out of there in those winds. We dropped the aircraft off in
Alexandria to secure it for the night, and a xed-wing aircraft brought me back
home to Lafayette.
Tuesday morning we found out about the ooding and everything went crazy.
That's the day that we ended up pulling down the light poles at the top level of a
parking garage at Tulane to make a landing zone. This helped us get their critical
patients out quickly, using mostly Acadian aircraft, and it wasnt until much later
that we got any help from outside agencies. We kept on ying and ew quite a bit
of the night and I bedded down there at Tulane.
We went to Childrens Hospital the next day, and then to Memorial Hospital to
evacuate more people. We were taking patients in droves, with no destination hos-
pitals assigned, no charts, no reports we were just grabbing people and taking off
with them.
By Thursday morning we nally had some military help, and we worked our teams
to death, made double time everywhere. I ran those nurses and doctors into the
ground, but we managed to get people out fairly quickly. We must have turned over
5060 patients, just bringing them all over the place.
I was called to go to a hospital called St. Johns, which was a long-term acute care
facility, and it was a really desperate situation. They were ooded and had been out
of power for a while, and there were nothing but women there. There was only one
guy a security guard with no medical knowledge, and he had a handgun for secu-
rity. They had 27 patients and 11 or 12 deaths, and the bodies were stacked on the
rst oor.
20
Later on I was summoned to Meadowcrest, which is a hospital toward the eastern
part of Orleans Parish. They had just started evacuating people and were desper-
ately looking for someone to lead them out of there. We found out how many they
had, where they were going and what they needed, but we didnt have a landing
zone there.
This was one of those times when we had to improvise, so we found a parking lot
across the street that had a bunch of trees in it, and I managed to nd a tree saw.
Cody Schuff, a couple of other guys and I worked together to cut all those trees
down -- probably a dozen of them -- in about 30 minutes. We were wearing our-
selves using a handsaw, and after about 20 minutes, a guy from a utility truck
comes by with a chain saw and offers it. He said, Ive been watching yall struggle
with that hand saw, and thought you might need this." He got there as we were cut-
ting the last tree, and we had to wonder why he stood there watching us for so long
before coming over with his chain saw. Anyway, we cleared the whole place out
and made a night landing zone area.
We lit the place up like a Broadway show, and things really started picking up. PHI
was dropping four helicopters on us about every 40 minutes. Blackhawks, Hueys,
you name it. Every known aircraft was in and out of there till about 11:00, until it
got too foggy. After the fog came in, we started trucking those people out of Mead-
owcrest. We had six heavily armed guys from the Jefferson Parish Sheriffs Depart-
ment for security, and a dozen ambulances.
The staff at Meadowcrest had emptied out their freezers because there was no elec-
tricity, so they took all the meat out and put it on ice. So here we were working like
mad, and suddenly the hospital staff gives us all this meat: pork chops, tenderloins,
chicken and sausage and what not. There was a guy named Captain Mike from La-
fayette who rigged up a barbecue and started cooking for us, and he brought his
own brand of seasoning. If you ever hear of Captain Mikes seasonings from Lafay-
ette, go buy it, because it is the best. I swear I ate so much barbecue I thought I was
going to turn into a Texan.
I found a bed in the Meadowcrest emergency room and slept there. Woke up the
next morning to the smell of barbecue, so I engorged again. The name of the game
in New Orleans during this whole time seemed to be that if you see it, you need it,
you take it. You dont take a whole lot, just what you need, eat as much as you can
when you can, drink as much as you can when you can, because you dont know
when you will get any more.
After that we moved on to evacuate patients from the Superdome and take them to
the triage station at the I-10, and this was probably the worst scene I saw the whole
time. It was ve days post-hurricane, and people were in really bad shape. The
21
people that were going to die had died. The people that will die, were dying. The
smell was just unbelievable. People crying out for help, and there were a lot of
people that were psychiatric cases. It was unbelievable. You always see this kind of
stuff on TV, so you dont really think that something like this could happen in your
own world.
We got all those patients moving and this is the biggest thing FEMA is so bu-
reaucratic! You got to get names, got to get this and that, and these patients are dy-
ing right dead in front of you, but FEMA wants all these little things. We didn't have
time for all this bureaucracy.
I came back home because we ceased air operations during the day, and I got a
good shower and slept in my bed. Did not sleep really well because I was still
spun up, and woke up real early the next morning and went straight to the commu-
nications center, packed a bag and went back out to the airport and did it all over
again. Stayed there most of the day and turned over patients real rapidly. Dr. Ri-
cardo Martinez had lots of connections and he was great, and even if he did not
have many connections, he was very well motivated.
You know, my military roots come to play here. I kind of call it like a forward air
controller. I just kind of got on scene and gured what we had, where they were
going, how much resources we needed, and how long we were going to be there.
We just went rooftop to rooftop to rooftop for eight or nine days.
**
Dr. Ross Judice, Medical Director
At one point while I was at the Superdome helipad coordinating the evacuation of
patients from the Arena, some military trucks showed up with orders to bring the
vent-dependent patients from the VA Hospital being bagged over to the Dome to
have them own out from there. Because they were most critical, we temporarily
halted the evacuation of the DMAT patients. The PHI helicopters took the rst four
patients, one at a time (they only are congured to carry one patient), and we had
no way to evac the last two because the pilots had maxed out their hours and
couldnt y anymore.
I remembered that Id seen some National Guard Blackhawks ying in and out with
supplies earlier, so I went over to where they were stationed and asked them to y
these last two patients out. The guy said, in a snotty way, Yeah, weve been watch-
ing you y them out on those PHI helicopters. I was shocked that hed just been
sitting there watching us move the patients one at a time when those Blackhawks
could have taken them all in two trips. I didnt want them to know how angry I felt,
22
because I really needed them to y these bagged patients out, so I asked him nicely
and he agreed, but he complained the whole way.
That was Tuesday night. Later on it got quiet in terms of ights, and I went into the
Dome to be a doctor again, thankful to be doing what I know best instead of direct-
ing evacuation operations from the helipad, which is what Id been doing for the
last 12 hours.
Wednesday morning, to our great relief, a zillion helicopters showed up, all types,
civilians, military, Coast Guard, and National Guard. It was probably the largest air
medical evacuation ever within U.S. borders. Thats when things started getting
really chaotic, because more people were getting sicker and sicker in the
Dome...people without their meds, babies being born, dehydration, strokes, you
name it. Wed load people onto a Blackhawk, it would lift off, and the a civilian
helicopter would land, wed load it up, it would lift off, then a Coast Guard
helicopter....it went on and on like this for hours, all day Wednesday into the early
evening.
Wed shove people into those helicopters so fast that our communication system
just fell apart, there was no taking names, no paperwork, nothing, just throwing
people into helicopters and getting them out of there. There just wasnt time. I re-
member writing down the names of the rst three patients on the PHI helicopters,
but after that, there was no way. There just wasnt time.
I had one guy whod had a stroke in the Dome, and he had a large extended family
with him. I put him on a helicopter, which has no room for extra people. The family
ipped out because they couldnt go with him, and I had to call the MP's to push
them away. We couldn't even tell them where their daddy was going. Most of these
patients were being dropped off at the I-10 cloverleaf to be put into ambulances
and taken to various locations, but we had no idea where those locations might be.
And plans changed all the time. Even if they went to a particular hospital, theyd
often be transferred, so families were always being separated, and this happened to
hundreds, maybe thousands of families.
**
Remi Judice, Nurse Anesthetist
On Wednesday at the Superdome, helicopters would come in groups. In a 45-
minute span you might get 10 or 15 helicopters landing. Then at other times, wed
have long dead periods where we wouldnt see a helicopter for 30 minutes. If we
werent careful we could have a whole bunch of sick people in our staging area
near the helipad in the middle of a hot summer day, and have to treat them when
we didnt have many supplies and no way to evacuate them. I was frustrated when
23
there were no helicopters coming in, and walk over to the heliport and say, Do
you know if any helicopters are coming? And the guy would say, We have 2 get-
ting ready to land. Get your patients ready." And Id say, When? And hed say In
the next 15 minutes. Get em down here."
So wed get em down there but the helicopters wouldnt land for another hour. So
wed have sick people just sitting there waiting in the hot sun with one little tent
over them. Then nally a helicopter would come, but would only take certain pa-
tients. They'd say, We want eight people that can walk. Well, those arent the
sickest people, the sickest people are the ones that can't walk...they're on the
stretchers, and at some point there were National Guard and civilian helicopters
that wouldnt take any stretcher patients.
Somewhere between 3 and 10 p.m. there were helicopters coming in, and we
couldnt ll them fast enough. They were anxious to land and leave, for one reason
probably fuel, and another reason they probably had other missions to do. There
were obviously two different agendas for the helicopters...one was to evacuate pa-
tients and the other was to transport supplies. I was just involved with the evacua-
tions.
At one point I called the DMAT area to bring out some patients for evacuation, and
we were able to evacuate everybody. It was a race against time to get patients from
DMAT to the helicopters. The DMAT person would tell me he had two walking
wounded and one stretcher, and I'd say, I dont care what they are, I want as many
people as you can send. And he would say, I found two more stretcher patients,
and were sending you six walking wounded. And I'd say, Send em all. I wanted
to make sure no helicopter was left unlled. We were putting people into helicop-
ters as fast as we could, not writing down their names or knowing where they were
going. After a while it slowed down to a crawl, and eventually in the late evening
around 9 p.m. there were no more helicopters ying and we just took care of pa-
tients in the dark.
24
Life and Death on the Interstate: The I-10 and Cause-
way Cloverleaf
With most of the city ooded, there were very few safe, accessible places to set up
medical treatment stations. However, parts of the interstate freeway system in New
Orleans are elevated above ground level, and since the freeways were empty and
abandoned, a section of Interstate 10 at the Causeway Boulevard off ramp turned
out to be an ideal location for a triage area. We set up this station on Tuesday. On
Thursday, when we had to leave the Superdome because of safety issues, the I-10
became our center of operations. The on and off ramps were in a cloverleaf con-
guration, so the helicopters could land on each of the four leaves.
There were an astounding number of patients. Helicopters, ambulances and boats
were constantly unloading evacuees. There was insufcient security or transport to
handle the mass of people, estimated to number around 5,000. Although the triage
station was for sick or injured people, the general population sought refuge there as
well. A barricade separated the triage station from traumatized people whod been
displaced for three days or more, and were without food, water, and shelter or toilet
facilities. As elsewhere in the city, there was fear everywhere.
A triage station is where medics determine the patients needs, and then prioritize
them according to which ones need help rst. In triage, medics use a system called
tagging in which patients are identied by different colored tags:
BLACK - This person cannot be saved given the available resources and re-
quires only support and pain medication until death occurs
RED - Immediate life threatening injuries that must be treated at once
YELLOW - Non-life threatening injuries that are a lower priority than red
tags
GREEN - Minor injuries, also known as walking wounded
The walking wounded initially were sent away and not treated so that the severely
limited resources could be used for the red or yellow tags. If a patient was judged
unable to survive they were black-tagged. Turning away the injured was a reality
check, especially for those who were trained throughout their careers to respond
with immediate care.
All were wounded or emotionally traumatized in some way, including our own
medics, who had never experienced a mass casualty event like this one.
25
**
Jeff Thibodaux, Paramedic
I can tell you that spending 16-18 hours at I-10 and Causeway evacuating people
coming in on Hueys & Blackhawks and Chinooks and the Coast Guard was a sight
to be seen.
We got there Tuesday at probably about 2 p.m. and left Wednesday morning about
9 a.m. It was just a mass of people coming in from all over New Orleans. People
had been picked up off of roofs and cut out of attics. As soon as they came off of
the helicopters they would hug us and say, God bless you, because they were so
happy to be safe on dry ground. Wed escort them toward the I-10 where we had a
triage center set up. If they had a medical problem we would run them through tri-
age, and if not, wed put them in general population across the median and just
wait for school busses to evacuate them.

Needless to say it was a scene...people coming without shoes, without shirts, ba-
bies with no diapers. It was unbelievable.
**
Gifford Saravia, Paramedic
The day I went back to the Superdome they told us our medics had left because it
wasnt safe to operate there anymore. We were redirected to Causeway and I-10,
and our rst impression as we ew over was that it was a litter-strewn nightmare.
There was a big old glob of people on one side of the road and the triage area on
the other side. When we landed, there was trash all over the place. It was raining.
The medics were working in the rain.
**
Dee Dee Sewell, Paramedic
At the I-10 and Causeway triage station, I saw patients lying on cots and on the
ground and on the street. Some people were able to get on the buses, but then
there were the others, just rows and rows of people laying out on the ground, old
people, sick people, bare pale wrinkled skin on the hot concrete pavement no
cover sheets, no pillows, just old, sick people laying about on the roadway. I saw
people in shock, people sleeping out in the open in the middle of the day, just as
far as you could see. I saw people holding babies with no diapers, and they had no
bottles to feed the babies with. They hadnt had bottles since the storm and the ba-
bies were weak and listless. The women sat fanning the babies with anything they
could nd to use and the sweat was dripping down their own faces.
26
When I got to the triage station, it was chaos. The medics and volunteers were run-
ning around asking, What do you want me to do, what do you want me to do?
and the people in charge were being pulled in a million different directions. There
was a whole line of ambulances waiting to take people to safety and a bunch of
buses to take the wheelchair patients, but those vehicles were sitting there because
nobody had given them any orders. One of the doctors was very frustrated and
when I asked him what was the holdup he told me, The patients have been tri-
aged, but nobody seems to have the authority to put them on buses and send them
on their way. I asked, Where would they go? And he said, They'll go to the air-
port where a eld hospitals been set up. Theyll get some care and be evacuated
out. I asked if he was sure about that and he said he was, so since nobody else was
around to make the decision, I just hollered, load em up!
The ambulances were from all over the place, they were not just our ambulances,
and they were so happy to nally be doing something. Id go up and say, put these
two on this ambulance, put these two, take these two, line up all those wheel-
chairs, get them over there on that bus, etc., and it worked really well. In a fairly
short time we had that place cleared out so that the next group could come in. And
they did they just kept coming and coming and it seemed that as fast as we
moved some out there were twenty more to take their place.
There was a doctor from Tulane who was sitting with an elderly lady. I didnt know
he was a doctor at the time; I thought he was a family member and it was obvious
that he was one of the evacuees too. She couldnt really speak, she was just so de-
hydrated, and the doctor stayed right with her. He called me over to her cot and
asked Is there anything you can do? She needs to get out of here. Shes dying. I
told him Shes on the next ambulance, shes next. I got a crew and we were able
to get her out and he thanked me and gave me a big hug. I asked if that was his
wife and he told me, No, Im a doctor. I knew she was dying and I didnt want her
to die alone; nobody should have to die alone.
**
Steven Hamilton, Paramedic
Triage was not as easily done as one might expect in this type of situation. As
paramedics were used to treating a problem immediately. If someone is complain-
ing of weakness, we put him or her in an ambulance, start an IV, and take it from
there. That was the mindset I had when I rst started triaging the people who were
walking up to us. But then I had to take a step back and realize these people are
walking up to me - these are green patients, and theyll be OK on their own for a
while. I need to send them on their way so I can take care of the more critical peo-
ple. And thats what we did, managing these patients according to Acadian triage
protocols.
27
I did that for about four or ve hours, maybe a little longer. You know, people com-
ing off the helicopters were thanking us for what we were doing. They were so
grateful, even though theyd lost everything. And for the most part, a lot of them
were in good spirits, while others were not. I had one lady trying to get back on a
helicopter to go back to her house to get her meds. You could just tell from that
point that these people were just lost. Their minds were gone.
**
Gary Miller, Distribution Supervisor
We went to the Causeway to bring the medics some food and supplies, and once
we were there, we assisted the medics with their patients. Of course the medics tri-
aged the injured and ill. There were rows and rows of people along the interstate
underneath that overpass waiting to get out of there. There were so many who
needed help, and they were just spread out all over the place. Some we thought
were sleeping, but actually they were probably dead.
**
Richard Pellerin, Paramedic
Wednesday, probably around 11 in the morning, I made it out to the triage station
at the Causeway and I-10 where there were 750 to 1,000 refugees, but its really
hard to estimate. There were probably four helicopters landing at a time, dropping
off additional evacuees.
Acadian had ambulances there, as did other transport services. We were loading
patients into the ambulances, one stretcher patient and as many as 5 or 6 ambula-
tory patients. Wed squeeze them in there, as many as we could to maximize our
space.
People were coming in by ambulance that had been pulled out of the water, and
we were getting boats as well, so the number of refugees was just mounting and
mounting and it got to the point where we were less efcient because there were so
many people.

Communication was an incredible problem at the Causeway and I-10. One of the
biggest problems we had was our medics not staying with their ambulances, and
we did not have radios to contact them. So I was constantly grabbing ambulances
and putting them in line and sticking medics in each ambulance to transport pa-
tients out. I had no idea who was going where or which medics were with which
ambulances.
28
I tried to keep families together if I could, and I had to convince people that only
one family member could accompany a patient. There were a few instances where
a mother and father and 2 kids were all they had, so I made exceptions for them. As
far as personal belongings, we did our best to keep everything together realizing
that what they carried with them was everything they owned in the world.
**
Jay Pierret, VP Business Development
As we approached the city it was drizzling, and as we ew over, we could see how
empty the city was. Then we approached the I-10 and Causeway.
We could see all thousands of people waiting in line. The ambulances were lined
up, along with military trucks, ambulances, backhoes and all types of heavy
equipment scattered all over the place. We got in and obviously there was no clear
organization to it, there was a line of people that were wet and getting rained on,
so I tried to help them as much as possible, trying to clean up the place, move the
trash out the way, etc. But then we got word that we were going to move to the
New Orleans airport; so we had to pull out all of our ambulances and coordinate
from there. We did it as discreetly as possible so we wouldnt freak people out and
make them think we were abandoning them.
**
Jay Boudreaux, Paramedic Dispatcher
Wednesday morning I went out to I-10 and Causeway, and worked there all day. I
helped with communications. That was the day it began to get out of control. There
wasnt enough security, and several times I called Terry back in Lafayette on the ra-
dio and asked him to try to get either more security or more buses to get people out
of there, because it was getting pretty scary. Id guess at one time that there were
5,000 people waiting on rides.
We had no portable toilets, and no food or water. At times we had surplus water
that had been dropped off by military aircraft, but it had been baking in the sun for
several hours, so it was warm...actually, hot.
It seemed that initially that the triage area was working well, and at certain points
the military aircraft would be slow to return with patients, but those guys got to be
pretty efcient and there were always enough ambulances. But to me, there should
have been more buses to get people out because we had 5,000 people whod been
without food or water for three days.
29
Helicopters would come and go. They would land from the north and depart to-
ward the south. They got into a trafc ow pattern and landed, dropped their pas-
sengers and took off. There was no trafc control at all, but most of the aircraft was
military and they were communicating amongst themselves.
**
Mark Fryou, Paramedic
We drove our ambulance on the elevated interstate highway to an on ramp down-
town to try to help evacuate some ventilator dependent patients. They were report-
edly being evacuated by boat from one of the hospitals. While waiting for the boat
to arrive, a truck pulled up with about 4 men in it. They hollered at us to come and
get a body out of the back of their pickup truck. We told him we had no place to
bring a dead body. We said that we were waiting for sick patients to arrive and that
we couldnt risk transporting the body while leaving the patients without an ambu-
lance. Three guys and one woman got out of the truck and they put the body on a
piece of plywood, covered the body with a sheet and put him on the ground. They
sat next to the body.
We agged down a state trooper and explained the dilemma of the body on the
ground. As it turned out, the lady sitting next to the covered body was the deceased
mans wife. The trooper made a couple of calls on the radio and began to leave. He
said that the coroners ofce advised him to leave the body there. Now obviously
this is the thing to do in that type of situation, but its quite different realizing that
this woman not only lost her husband, but now she doesnt have the vaguest idea
how to deal with the body. Under the circumstances, theres really nothing more
that we could have done without wasting a bunch of resources. It was very sad.
A female approached us with her leg wrapped up. She was beaten up because she
didnt get off a pay phone fast enough. Since she didnt have any life threatening
injuries, we advised her to catch a military vehicle and go to the Superdome ve
blocks away.
Later we made our way to the triage at I-10 and Causeway. They had a large num-
ber of evacuees on the left side of the triage area awaiting bus transportation, and
even though this was only mid-afternoon on Tuesday, the atmosphere was chaos,
and you could feel the tension in the air.
We loaded up with three patients, one in the front of the ambulance, one walking
wounded in the back and a ventilator-dependent patient from the VA that had been
taken to the Superdome by National Guard truck and then own over to the
Causeway for ambulance transport.
30
I gave him some Versed because this guy was bucking the tube and we transported
him to the P-Mac in Baton Rouge only to nd out that once we got there, he was
black tagged by the physician there.
At the P-Mac, there was a patient own in by military helicopter who was intubated
and had gunshot wounds, and they black-tagged him also. So recognizing (but not
necessarily agreeing with those decisions), we realized this was a waste of our re-
sources as well as the helicopters resources by ying in all these patients who were
ultimately being black tagged.
31
The Children
Human values dictate that the most vulnerable in any population must also be the
most protected. Parents and nurses entrusted their precious babies to our care even
though we were strangers. Placed in makeshift water boxes instead of incubators,
sick babies were own out of the devastation to hospital destinations unknown.
Pregnant mothers delivered their newborns at the Superdome and Arena. Medics
fashioned baby bottles with rubber gloves for desperate mothers. Baby formula
and diapers were own into the city along with medical supplies and personnel.
Through it all our medics displayed so much love and caring toward the children.
**
Marc Creswell, Flight Paramedic
They called me to go in to Children's Hospital to clear out a landing zone. We got
that set up and met with the director of nursing, who was under the assumption that
we were going to do this nice and pretty like we always do, taking our time and
carefully putting one baby into each helicopter. I told her that this is a third world
country now and we have to move in high order, and we have to do it now. She
thought we were going to put one baby per isolette per helicopter, but we wound
up packing 46 babies in Kentwood water boxes, wrapping them up and shoving
them in to the helicopters. Talk about improvising! I managed to nd several Ken-
twood water boxes that were meant to hold two one-gallon jugs of water. We
knocked out the middle portion, shoved a bunch of blankets into it and we put the
kids in there.
Meanwhile, the New Orleans airport quit taking patients because they were full.
They lled that makeshift eld hospital with so many patients that they were putting
people on the baggage carousel, and they just couldnt take any more. This was
Wednesday. So because we couldnt bring patients, we went to New Orleans Chil-
drens and picked up those kids and brought them to places where we knew we
could bring them. I think we got 16 or so out. We organized an effort with Miami
Childrens Hospital and Arkansas Childrens, which both had helicopters. We just
threw a bunch of helicopters at them real quick and got all of them out of there in
just a couple of hours.
32
**
Tony Cramer, Flight Paramedic
Our initial purpose was to get a lot of babies out of there. We landed at Tulane and
all we could see was the level of the water rising. Tulane had a huge generator, and
people were saying, As soon as the water gets above the trailer, were going to lose
that generator and lose all power.
The thing that got me the most was the parents asking if they could come along
with us, with their babies. Of course, we had no way to move these parents; there
just isnt room in the helicopters. These poor people had to leave their brand new
babies, but they understood and said, Whatever happens, just save our baby." We
nally got the babies ready to go in the isolettes, but when we got to the elevator, it
no longer worked. So we had to get a bunch of people and start packing these iso-
lettes -- which are 6 feet long and weigh 300 lb. -- up three ights of stairs to get to
the helipad. You cant imagine how difcult that was. But we managed to do it and
we loaded them up and got the babies to Womens Hospital. The support group
there was fantastic.
It was required eventually to abandon the isolettes. We ended up with two nurses
on board, each holding a baby, and 3 and 4 other babies on stretchers.
**
Clay Henry, Vice-President of Dispatch
I believe it was either Wednesday or Thursday night after the storm, we had an
Acadian helicopter lift off with a team and a critically ill child. They landed at the
refueling site only to nd that the fuel tanker had been pulled out of there without
notice.

So the helicopter was grounded, and the team was extremely upset. They even got
on the phone and yelled at us, thinking somehow it was our fault. So after some re-
assuring that we were doing everything we could to help them, we dispatched a
ground ambulance, which took about 20 minutes to get to them. It was all we
could do, because all our other helicopters were either too far away or had patients
on board.
The baby ended up going into cardiac arrest on the side of the road at the weigh
station. The ambulance got there, loaded up and began transport towards Baton
Rouge. The team on the ambulance evidently resuscitated the baby. I dont know
the patients outcome, but it was supposedly pretty grim. There was probably about
a 30-40 minute delay of not being in the air because of lack of fuel.

33
The next day I asked Erroll for an explanation and he said that somebody with
FEMA had pulled the fuel tanker out of there, thinking it wasnt going to be needed.
It was clearly a mistake on their part, and according to Erroll, it was put back some
time the next day. Our helicopter ended up being grounded the rest of the night
because we couldnt get fuel. So that particular shift ended up being out of service
for eight or nine hours on the night we were taking the infants out of the hospital.
**
Jay Pierret, VP Business Development
At I-10, Acadian paramedic Robert Clement was holding these two little girls that
had been abandoned; actually they were part of a group of seven children who'd
been left on a rooftop. He was quite attached to these girls. He said that people
from the crowd were offering to take the babies, but he wasnt giving them up. He
was very protective and showed how much caring the medics have for children. He
was making sure that these kids went through the proper channels and werent just
handed over to strangers. He was holding two of them and eventually gave one to
another medic, but the girl was quite attached to him. I had some candy so I gave
some candy to her and some of the other kids.
**
Gifford Saravia, Paramedic
After the evacuation of the medics from the Superdome we were redirected out to
Causeway and I-10, and it was raining. The rst thing I noticed when I walked up
was that there were several medics just holding babies, mostly toddlers. There were
seven of them, so I asked one of the medics, Rob Clement, What are yall doing?
He said that a Blackhawk had landed and all of these babies came out, but there
were no adults with them. Nobody knew their names, where they were from or
who they belonged to, so they had the media photograph them to post on some
type of internet bulletin board to try to get them paired back up with their parents.
Greg Mullen informed me today that he heard the parents were actually in San An-
tonio, had located the babies through that bulletin board, and babies were own
out to San Antonio to meet them. Theyve all since been reunited. This one was a
happy ending to a possible disastrous story.
**
Kimberly Lewis, Paramedic
We transported little kids that were separated from their families. Getting these
women off the helicopters with their children was so sad, not knowing where the
rest of their family was, and having just one bag of clothes and one bottle and some
34
diapers, it was sad. There were a lot of children like this, especially at the Cause-
way. It was really confusing. Everyone was separated from their families and we
were just putting them on the buses telling them, Youre going to meet up with
them, dont worry, and it broke my heart because I didnt know if that was true.
Im not a mother yet, but I can only imagine what it would be like to lose your kids
and have all of your belongings gone in one day. These little kids, you know, they
didn't know what was going on, and it was really hard to see them. Of all the
things I saw, that made me really want to cry. But Id do it all over again in a heart-
beat.
**
Steven Hamilton, Paramedic
About 10 p.m. Tuesday night, Brendan had us head over to Oschner Hospital to
transport six patients to Baton Rouge. These were infants coming out of the NICU.
Two of them were in isolettes and one was intubated, so they needed to be moni-
tored. Justin Abshire and I got in one unit and headed to Oschner. Brant Duple-
chain and a nurse practitioner from Baton Rouge Womens and Childrens loaded
into another unit also headed to Oschners. Once we got there we noticed that the
hospitals didnt have any electricity and were on back-up generators. The nurses
were in good spirits though. They were wearing shorts and t-shirts trying to stay
cool, but were frantically taking care of these infants and newborns.
**
Remi Judice, Nurse Anesthetist
Around, Id say 6 p.m. on Wednesday, we were told that the staging area was full
and there werent any helicopters coming back to the Superdome. The DMAT team
called and said they had a 5-day old that was sick and severely dehydrated and
needed immediate evacuation. It just so happened that some privately owned heli-
copters were coming in, and when they landed, I told the pilot that we had a 5-day
old that needed immediate evacuation. He said he wouldnt transport that baby un-
less we had a neonatal specialist on the helicopter. I guaranteed that we had a
paramedic trained to do that, and I said I would go along too, since Im a nurse
anesthetist, but he still said, No, I want a neonatal specialist." He was very em-
phatic, so I went and found one (or what the pilot thought was one), which was
really an anesthesiologist named Scott Gammel. After speaking with Scott upon my
return the next day, Scott told me that he had the baby own in to Womens and
Children's Hospital in Lafayette and that the baby was doing ne.
I was told that outside the Superdome some of the looters overturned a boat with a
very young baby less than a week old in it, and the only thing that came back up
35
after they ipped the boat back up was the baby. The medical teams revived it, and
we heard that the looters ended up shooting two civilians, but didnt shoot at the
medical personnel.
The baby was brought into the Arena and they needed to get it evacuated and
wanted to send a physician along. But the physician on duty didnt want to leave
the staging area, so he set up an impromptu 100% oxygenator and we got an 02
meter, an oxygen tank, a cup and a piece of tubing. We put the cup over the in-
fants face and rigged the tubing to ow oxygen into the cup so the baby could
breathe 100% oxygen.
Then the FEMA doctor asked to borrow my stethoscope. I looked at his name, and
asked if he was going to be making a round trip, and he said yes, hed be back later
on tonight. So I gave him my $125 cardiology stethoscope to take along with him,
which I felt was a good investment in the health of the baby. He took the baby to
the helicopter and I never saw him -- or my stethoscope -- again.
**
Dr. Chris Najberg, Emergency Medicine Resident
Sometime around 9 p.m. on Wednesday at the Superdome there were ve women
in active labor. They all came in almost at the same time.
At that time there were also two very sick infants, both under 6 months old, one of
whom had pneumonia and was and very lethargic and had sunken membranes. At
the time, one of the pregnant ladies -- about 8 months -- had a history of placenta
previa, according to the documented diagnosis, but she also appeared to be in ac-
tive labor, which presented a serious problem, as she would have required a C-
section and almost certainly would have died. Dr. David Bryant was able to arrest
the labor by giving magnesium and 3 liters of normal saline. We had to get this pa-
tient out as the highest priority, as she might not survive the delivery. So Dr. Chuck
Burnell and I were able to arrange a transfer using a Blackhawk helicopter within
about 20 minutes. I went with the patient myself and took some basic supplies,
should the worst case scenario happen. However, thankfully it did not, and I was
able to get her to Baton Rouge where we dropped her off at Womens Hospital.
**
Dee Dee Sewell, Paramedic
The buses came back to pick up more patients, so we went down the row of people
that were lying on the ground to get them into the buses and evacuated out of
there. We found two women with six children, but only two of the children were
theirs, and they said, We cant go. They were desperate. I said, You need to go,
36
and they said, Were waiting for more people, for the family, and I said, You
cant wait, the buses are here, you need to go. And they said, But you dont un-
derstand, these are not our children. They just gave them to us when we evacuated
the Dome and they said dont get separated from these children. We dont know
who they are, theyre not ours. And they wouldnt leave.
It was getting hotter and hotter outside and the babies were tired. The next thing I
knew I saw those children at the triage station, and the women had nally just left
them there. They couldnt take them and they couldnt do anything with them, so
they left them at triage. We made a cardboard box as a bed for a little one that
looked to be about ve months old. I looked around in the rubble and I found a lit-
tle bag that someone had left with two baby bottles in it. We washed those out as
best we could and fed the babies. Then we gave the babies to some volunteers that
were there to help feed them and take care of them.
Last night when we were coming back from New Orleans, we were just drained, I
mean we were exhausted. We were talking about how emotionally draining it had
been and the effect it would have on the people for years to come, and then we got
paged on the pager. This was a miracle, because our phones hardly ever worked.
Between us all we had six phones and it was a constant scramble to see who could
nd a signal, but for the past two hours wed had no phone capability at all. So
here we are, leaving New Orleans, nally and the pagers worked. It was an urgent
page to me from Keith Simon, in PR. He said that hed heard from Maria Placer
with Channel 10 in Lafayette that a mother had been found here in Lafayette who
had been separated from her 10 month-old baby back in New Orleans. They
wanted to know if wed be willing to go back and get the baby. Well, we couldnt
turn around fast enough, I mean literally, we were in trafc bumper-to-bumper, but
we made a u-turn right then and there and went back to get that baby. We had a
little trouble nding the neighborhood, but with dispatchs assistance, we got there.
The neighborhood had hundreds of houses with missing roofs, missing windows
and trees down in the yards, but thankfully, the streets were clear and we could get
through.
We found the little house and there were four people outside with this little child
named Destiny. Her grandfather was sitting in a wheelchair and was looking
very erce and worried as they handed over their baby granddaughter to a group of
total strangers. We told them that we would take very good care of Destiny and
would keep her safe and bring her back to her mama in Lafayette.
And so we did, and she was absolutely adorable. She had great big eyes and just
the cutest little smile and for some reason she seemed to just take right to me. I
think I can speak for us all when I say it was a huge, huge honor to us for that fam-
ily to trust us and let us be a part of taking this child to her mother.
37
Dianne teased me because it was my grandsons rst birthday and I was really miss-
ing him and wishing I could be there to celebrate his birthday. She said I was over-
due for a dose of baby holding, and she was right. I held that angel all the way
home. When we got to Lafayette we found out that the mother did not know we
were bringing her child back. When we came in she was so excited! As it turned
out, she was in the hospital at the time of the storm -- in labor having her second
child -- and Destiny was with the grandmother in New Orleans. Then somebody
brought in this absolutely beautiful newborn baby...Destinys new little sister! Eve-
rybody hugged and cried, and it was just a perfect ending to a really horrible past
ve or six days.
38
The Elders
It is impossible to look through these stories and decide which group of survivors
has the most horrifying stories. In the case of the elderly, it is particularly heart-
breaking, because many of the nursing home residents had already been separated
from their families and were living out their last days alone. Many sick elderly res-
cued alive from the ooding were alone and confused, and were rushed to safety
by well-meaning rescuers. Without their medications or their caretakers, they relied
on our medics for comfort and care.
**
Jay Pierret, VP Business Development
Friday, while on a Search & Rescue operation in New Orleans East, two men
walked up and asked us for water. We gave them some water, but we didnt have
any MREs at this time, so we couldnt give them anything to eat. They said, Hey,
were okay, were doing ne, but you really need to go to this nursing home cause
theres old people out there and theyre dying. He said we needed to get over there
and take care of them. They told us it was just down Chef Menteur Highway about
3 or 4 blocks.
I transferred that information to the FEMA people via the yellow radios they'd
handed out to us. There was a lot of radio chatter about it and eventually the search
and rescue teams were deployed. They found a Catholic nursing home with a nun
running it, and she was still there trying to help people. The medics that came back
from that mission said that she deserved a medal because of how she had it organ-
ized and how many people she saved. I believe somewhere between 15 and 20
people were already dead; we evacuated 57.
The medics did a fantastic job of getting those people out. The search and rescue
guys were unbelievable. They grabbed the patients and brought them down the
stairs, because all the patients that were alive were on the second oor, so they had
to be carried down the stairs. Initially they started putting them in ambulances two
and three at a time, bringing them to the staging area or the triage area and having
the doctors work on them. Then Dr. Judice in the FEMA operations center called in
the helicopters to transport them out. It started working extremely well once it got
started.

I was providing support for everyone, providing ice and water and keeping track of
the people going in and out so we didnt lose track of any of our personnel. So even
though I'm not medical, I feel like I contributed a lot, and I'm thankful that the guys
39
who came up to me asking for water gave me the information about the nursing
home. I feel honored that I played a part in that rescue.
**
Gifford Saravia, Paramedic
Soon we discovered that they had a nursing home with approximately 70 patients
still inside. There were many already dead, but the rest were still in relatively good
condition, so the staff there started bringing patients to our triage area. Some of
them were stable enough to be moved to the landing zone in a eld across the
street from the nursing home. That day I think we managed to take out 57 patients.
It gave us a great sense of satisfaction, something concrete that we actually were
able to accomplish that day.
**
Levan Doucet, Paramedic
We were setting up an evacuation site at the intersection of Chef Menteur and I-10
in New Orleans East, where we were going to receive patients coming in by boat,
triage them and send them on Blackhawks out to various locations. While we were
setting up the staging area, a couple of men walked up to and said there was a
nursing home three-quarters mile from our site that still had some residents in
there. FEMA personnel and a couple of armed guards went to this site and con-
rmed, yes, there were patients that needed to be evacuated, and they were pretty
critical.
Initially we transported the patients by ground to the staging area, but then the
Blackhawk pilot (I think they were National Guard) said that if we could move one
of the vehicles in the parking lot he could land right there, which would eliminate
having to stop at the staging area. So a bunch of guys on the scene physically lifted
the car and pushed it out of the way. The Blackhawks landed right there, only about
50 feet from the nursing home.
There were a number of patients and it was very hot, and we helped the FEMA guys
as much as we could; they were busting their butts. You know, considering every-
thing going on, I was very impressed with the way everybody performed. I wish I
knew the names of the two ladies that were taking care of these people because
they did a great job. I met some heroes that day. They had been there for a week
and had set up a mini-hospital inside the nursing home and a morgue as well.
I met a 99 year-old woman that we took out of there and I asked her, Maam, have
you ever own before? and she said, No, sir, and Im not afraid," so it was beauti-
40
ful. That was her rst helicopter ride ever...99 years old. She was just as with it as
you and I are today.
But not all of them did as well as she did. They were in a whole range of conditions
from very poor to very good. Most of them were in very good spirits, and I attribute
that to the caring and positive attitudes of the nursing home staff. But a lot of them
were exhausted and dehydrated, and some died before they could be loaded onto
the helicopters. I heard that 14 people died before the rescuers showed up.

I stayed till the end, I think around 5 or 5:30. We had people from Miami-Dade
County Search and Rescue, we had people from College Station (Texas) Search and
Rescue, we had another couple of guys from Illinois and Im not certain who they
were with, and everyone just worked together and it went very well.
**
Dr. Ross Judice, Medical Director
During the New Orleans East operation on Friday, Gifford would lead our ambu-
lance teams deployed with the US&R teams and I would stay in the US&R Com-
mand Center in Kenner. When the onsite team found the nursing home, I got on
the phone and talked with John in Acadians dispatch center and said that it was
time to send the rst helicopters to the landing zone. John tells me that Dr. Antoine
Keller was calling to nd out if we could help locate his wifes grandmother. She
was in a nursing home and the family was very worried. Unbelievably and to his
great shock, I sent word to him that we were evacuating that very nursing home to
the New Orleans airport, but also that there were some fatalities. Acadian ew him
to the airport that day where he found his wifes grandmother alive and well. Chill-
ing.
**
David Trahan, Telecommunications Analyst
Tuesday morning, right after the hurricane, we were to bring supplies to the Gretna
station, evaluate the situation there and recover computers and other equipment.
That was our primary mission.
We also went to the Superdome to deliver food and supplies, and of course we had
to go through countless obstacles. We were going down Poydras and a National
Guard guy stopped us and asked us to take nine elderly people with oxygen tanks
to the Superdome. We told him we were in a supply truck that wasn't equipped to
transport patients (we took the supply truck because it was tall enough to drive
through the water). So he said he was going to "commandeer our asset." He had a
white van with these people in it. He ordered us out of our truck, but a moment
41
later a National Guard truck came by and the driver said he could transport those
people. Their truck was so high it took a six-foot ladder to get into it, so we helped
these nine elderly patients one at a time up the ladder. The rst man I helped was
about 80 years old and totally blind, but we slowly got him over to the ladder and
had to physically help him up each rung.
**
Dee Dee Sewell, Paramedic
There was an old man getting on an evacuation bus, and he started crying because
he had wet himself and was ashamed to be on the bus with everybody. We told
him not to worry about it because there were many other people there who were
the same way, and he didnt smell any worse than anybody else. He told me that for
three days he had sat in his wheelchair and nobody took him to the bathroom. That
poor man. The thing was there were no bathrooms close by and the people were
so desperate to get on the busses that they didnt dare leave their spot - even to go
to the bathroom. They were hot and exhausted and they wanted to get off of this
pavement place that had been their home for the past several days. The bus was
their only way out of this misery.
**
Remi Judice, Nurse Anesthetist
In the Superdome when we nally got helicopters going back and forth, Dr. An-
toine Keller recognized that there were 25 nursing home patients in wheelchairs
sitting there with no medical care. He wanted to evacuate them, but it was too late,
because the helicopters had stopped ying for the night. So we had these 25 nurs-
ing home patients just sitting there.
We decided to send them back to the DMAT area and at that same time there was a
young lady with the military who said she might be able to get them out by bus. It
was 11 oclock at night, half of the patients were slumped over in their wheelchairs,
and I told the caregivers to bring them back to the DMAT side, and if they wanted
to evacuate by ground, they could do that from there.
**
Kerry Hargrave, Basic EMT
Tuesday morning we arrived at I-10 and Causeway and found 800-900 evacuees
standing in line. Some triage was going on. We immediately started picking people
up, and I had a chance to speak to one of the ladies who rode in the front with me.
She was 94, and told me that she'd woken up this morning and gone to the
restroom, but when she put her feet on the oor, she was up to her ankles in water.
42
She said, Can you believe that? My husband and me came here in 1930 to look at
this house, and we were told it was in one of the highest spots in New Orleans. So
we bought it.
She and her husband had never spent a night apart in 55 years of marriage. But
now she didn't know where hed been transported. I told her I'd get her name and
social security number for FEMA and they'd help her nd him.

She went back to the story saying by the time her and her husband were able to get
up into the attic, the water was almost over their heads. They had the clothes on
their backs, and had grabbed their medicines, but dropped them on the way up to
the attic. But water was coming into the attic at that point, so her husband cut a
hole in the roof, and once they got out, the water was even with the top of the roof.
So much for being in one of the highest spots in New Orleans.
**
Liz Mrak, Paramedic
I was in the Superdome Tuesday and Wednesday. One of the things that kind of
stood out was a daughter, aunt and mother that asked me for help. The aunt was in
her 80s and dehydrated. This was at the time when we were moving our rst aid
station from the inside to the outside of the Superdome. I put her on a cot, but then
got distracted with other tasks because we were so busy moving patients and
equipment out of the building.
A while later the daughter found me and said Maam, how come yall left my aunt
inside? I said, What? Is she still in there? I couldn't believe she was still there,
and so was her 83 year-old sister. At this time things were getting rowdy inside the
Dome; they were looting the vending machines next to our rst aid station. So I
grabbed an MP and said that I needed to go back inside and get two more patients
out. He got four more MPs and they surrounded me, along with some more Na-
tional Guard people, to help me get these ladies out of there. The ladies eventually
got sent over to DMAT where they got hydrated, and when we were sitting on the
ight line ready to come home, I got to see them get on the helicopter, and that felt
great.
**
Dr. Ross Judice, Medical Director
There were Alzheimers patients wandering all over the Superdome. They had no
idea where they were or who they were. They had no identication, and didn't
have their medications. It was heartbreaking. All we could do was try to calm them
43
down, talk to them, hold their hands and nd ways to distract them until we could
y them out of there.
I went out into the stadium stands because of a request for help that came to the
rst aid station. While I was checking an elderly ladys vital signs I asked the elderly
man sitting next to her how he was doing. I take chemo for lung cancer. Where
am I going to get my next chemo? I said, Lets get you out of here rst and worry
about chemo tomorrow. Assuming the two were married, and trying to change the
subject, I asked how long theyd been married. The lady said that they didnt know
each other and that her husband drowned in the ood. My heart sank.
When people in the stands would see you were a medical person, they would yell
at you from the next stadium section over, Come over here to check out another
sick person. One confused elderly man got his foot stuck under the stadium chair in
the row in front of him. His feet were huge, and he wouldnt follow our directions.
Paramedic Dave Babin and I spent 20 minutes trying to get that mammoth foot un-
stuck. The crowd was giving us advice all along the way. I kept thinking, Is this a
crazy situation or what? We nally got that foot unstuck and we sat in the bleacher
chair, looked at each other, and started laughing at the weirdness of it all.
44
Rescuers in the Storm
Katrina changed her path and headed northward, making landfall in Louisiana on
Monday morning. The high winds ripped trees from the ground and peeled roofs off
buildings. Nobody expected the levees to break, and as the water rose, witnesses
watched helplessly as entire neighborhoods were swept away.
Optimistic, heroic, dedicated...these words only begin to describe the character
and the integrity of those who worked in the rescue effort during Katrinas after-
math. With many of their own homes washed away and their own loved ones lost,
these amazing people persevered in their professional capacities and exceeded ex-
pectations of humanity and humility. Roles were lled, needs were met, duty was
done and hope was fostered.
Responders slept with one eye open when the environment became unsafe in the
Superdome, but still they stayed and worked until the military insisted that they re-
locate for security reasons. Later, some individuals criticized the medics for aban-
doning their post, but these medics had stayed the course and worked 24/7 when
nobody else was willing to risk it. Many of them wanted to stay even after the mili-
tary insisted they leave for their own safety.

Round-the-clock shifts took their toll on medics and responders. Workers compiled,
gathered and distributed long lists of supplies. People made incredible efforts to de-
liver resources to places that were in great need but almost impossible to access.
The numbers of those in need were far greater than any single ambulance company
could capacity to handle.
The best and the worst of human nature surfaced in the waters of Katrina. Supplies
were scavenged. Private companies volunteered their resources. Boats were com-
mandeered. And shots were red...
**
Janie Fuller, Paramedic
Saturdays meeting at the EMS expo, as Im sure you can imagine, had a very de-
pressed tone, knowing that we were probably going to get a Cat 5 straight at us. Af-
ter that day, all the days kind of blended together. At some point, after the water
rose in Chalmette, we ended up with 12 feet of water in the building we were stay-
ing in, which was the government complex. I was able to stand on the second oor
atrium and look down to the rst oor, into 12 feet of water, with snakes crawling
around and garbage oating everywhere.
45
Looking out of the windows of the building, all you could see was water. I remem-
ber as the water rst started to rise, watching the vehicles, rst it didnt look so bad,
but then when it started covering the roofs, it was terrifying. As the water continued
to rise, we watched it get to a point that we couldnt see the AC units on the roofs
of the buildings anymore. It was kind of like watching a Hollywood movie; the spe-
cial effects were unbelievable.
Sometime during that evening, we got a call about a female that had a hysterec-
tomy within the past week and her blood pressure was dropping. Being the only
medic in St. Bernard at the time, I got one of the councilmen, Joey DeFatta, to
commandeer an airboat for me. We went upstairs and talked to Larry and Junior,
Larry being the guy in charge of the OEP
3
and Junior being Junior Rodriguez, the
parish president. I told them the situation and got the OK to go down and do what I
could for her, knowing that we couldnt get her out. There was just no way. Ground
transportation at this point was zero.
**
Billy Vincent, Paramedic
To see the Gretna Station after the hurricane was a sight to behold. The whole front
side of the station was blown out. The back wall of the mechanic shop was gone.
The big roll-up door was blown into the station. Parts of the inside of the station
had gotten wet, because part of the roof was peeled back. It looked like a war
zone. I stayed there through Tuesday evening and was relieved by Conley who
came back to start cooking and feeding the crews.
**
Jeff Thibodeaux, Paramedic
I was sent to Thibodaux Monday where we pretty much rode the storm out that
night at Thibodaux Regional Hospital with the other three crews, and I tell you
what, when you see 8090 mph gusts, it is pretty horrendous. We knew it was get-
ting pretty bad because they sealed off the ER with 4x8 sheets of plywood and we
pretty much stayed inside.

As you know, when the wind gets above a certain amount we have to stop running
the ambulances. So we stood by and saw a couple of people come in from the
storm. One was 37 weeks pregnant and I delivered her baby. The other one had a
heart attack; the family had done CPR and drove her in from Chackbay.
46
3
Ofce of Emergency Preparedness
**
Danny Garretti, Paramedic
The hurricane hit late Sunday night, early Monday morning. They had moved us out
of our station in Ocean Springs
4
to the Ocean Springs Middle School, which is
about three miles from the beach. That was scary, truly scary. They had a motor
home in the parking lot and it was shoved about ten feet out of the parking space.
Trees were being launched about four feet off the ground and looked like they were
ying at 100 miles an hour.
At night nobody got enough rest. You might get two hours sleep in 24 hours. I mean
it was kickin. I went six days straight like this. Oh my gosh, I was loopy. On the
sixth day I didnt know how I was surviving.

Shana Green was my partner. She made things pretty good. She was there the
whole time with me except for the rst 12 hours. We managed to entertain each
other and laugh when things were bad. I tell you what, it truly hit home with the
sights we saw.
I saw lots of body bags. We interfaced a lot with the Fairfax
5
Search and Rescue
guys and they were telling us what they were doing. It was truly humbling. The little
body bags which represented a little body that really gets to you. But that is one
of those things. I guess if its your time, its your time.
**
Jay Authement, Paramedic
In St. Bernard on Saturday and Sunday before the storm, we evacuated people from
a couple of nursing homes. After that I went home, got the family together wife,
kids, and mother-in-law packed them up and sent them to Memphis, TN. I
planned to come back to work Sunday night. So I called my supervisor and he said,
Jay, operations are cancelled. Dont come to work; take care of your family.
The family was ready to go to Memphis, so I said, Yall go on, Im going to stay
with the house and try to save what I can, guring it wasnt going to be that rough.
My fathers house right next to me withstood Hurricane Betsy, so my father said hes
going to stay in his house too, no matter what. Hes about 70 years old, but he gets
around good. So the two of us decided to stay in our houses, next door to each
other.
47
4
Ocean Springs, MS
5
Fairfax County, VA
We tied the boats up, and when the hurricane passed with the winds sometimes up
to 150 miles an hour, we were outside in a little foyer where we could watch the
trees blowing down, and we'd say There goes that one, there goes this one. Every
now and then wed see a tree go down and then a roof ying off.
When the rain was done, the wind done with, and the eye passed, the second part
of the hurricane came, and the wind was stronger. But again, there was never any
fear. It didn't seem all that bad. Even at 150 mile per hour winds, seeing things
blow around, the house didnt, never once, shake or anything; same for my fathers
house. The rain was minimal. We had maybe a half-inch of rain on the ground. So I
thought, well this isnt bad at all. Roong tiles were gone, but those are easy to re-
place. The house was very secure with no water inside, so we were doing good.
My father sat at the kitchen table in my house and I went outside after the hurricane
passed, and that's when I noticed water was coming in, like running over a bathtub.
And I hollered at my father because I remember my grandmother once saying
something about a storm surge, and I told my father that one of the levees must
have broke, and we need to get out of here.
I was running to our big atboat, which was on a trailer, and I jumped in the boat
and cut all the ropes. I got my father into the boat; we were already in 3 feet of wa-
ter. For some reason the boat, even though it was untied, created suction and
wouldnt come off the trailer. So I had to swim underneath it and released the suc-
tion. So now the boat was oating and we were secure. This all occurred in maybe
a 15 or 20-minute span. And as for our personal belongings, we took nothing.
None. Everything was in those houses.
The last day, think it was Wednesday, I went through the house again, walking
through the water and all, and I looked at everything and thought everything in
here can be replaced, and wondered what can't be replaced. On the wall there
were some pictures that managed to stay dry. Whatever pictures were dry, I took
out the frames and put in a suitcase. In the attic I had some videotapes, maybe two
or three, but the majority of the ones with the baby were gone. The ones in the attic
that I could save I put in a suitcase. Thats the only thing I came out with - a suitcase
of pictures.
**
Julie Barousse, Paramedic
A nurse came and asked if I needed any help and I told her, No, I'm just nishing.
Everything is ne." She told me that her house was destroyed but she was staying at
her mothers down the road and they had power, water, electricity, hot water and
48
food, so if we needed anything, to come down to her mother's place. I said,
Maam, the Baptist church is feeding us, but do you have any chocolate? She
said, No, but I can make you some chocolate milk.
I told her, Dont be shocked if I come knocking on your door later asking for some
chocolate milk." Well, when I went to the Baptist Assembly Hall for dinner that
night, this nurse had dropped off a bag for me a huge Walmart shopping bag full
of chocolate candy bars. I mean, there was probably 50 or 75 candy bars in that
bag with my name on it and a little note that if I needed anything to contact her at
this address and phone number.

I almost cried. I almost cried, because here she is, lost everything, and she went
out of her way, probably drove to Walmart without hardly any gas in her gas tank,
to get me some chocolate. It was awesome. Makes me want to cry just talking
about it.
**
Paul Fuselier, Paramedic
Something thats going to stick with me for as long as I live is the fact that we had
employees who lost everything; I mean, literally, no homes. Their families were safe
because they'd evacuated them. There were these guys who had been working
three four some of them ve days straight in horrible conditions. Wed ask
them, Hey, man, take a break, you want us to relieve you? and theyd say, "Where
am I going to go? I have no place to go. My family is safe. I am better off right
here. He was around friends and he was being productive, so I guess it was the
better place to be. That was difcult because, you know, I had a place to go home
to when my job was done there. I had a roof over my head and these guys didnt.
So to see them stick it out and still want to work and help was just amazing to me.
**
Gifford Saravia, Paramedic
That day in the Superdome rst aid station we continued to treat patients as they
came in. We were doing stuff that was appropriate, yet under normal circumstances
we would have had some orders and some guidance. Basically we were just im-
provising the best we could on our own. This continued until about 2:30 a.m. and
then David Lacombe and I climbed up into one of the ambulances -- in the front
and passenger seats -- and we got some shut-eye. But I woke up about every hour
or so looking around, because you never knew what to expect. There was a strong
military presence at that time, but we still didnt have total security.
49
**
Dee Dee Sewell, Paramedic
I ew out to I-10 and Causeway to evacuate and triage. When we got there, there
were people as far as you could see in every direction, behind the barricade - just a
sea of people as far as you could see, and they all needed to get on buses and get
out. When I was coming back to Lafayette later that night, I threw up off and on all
the way home. This little story is sort of funny I guess although it wasnt at the time.
I hadnt eaten all day, even though there was food there; I had no time to eat or
drink. Whenever I'd nally get a bottle of water, I would start to drink it and some-
one would yell, We need help over here, and I'd put it down and go run to help.
So before you knew it, I'd been there all day without eating or drinking and I had
developed a killer headache. I had been working since the hurricane doing
CISM
6
, and I didnt have my blood pressure medicine with me. So I told the triage
doc that I had a headache, and he said, Oh, Ill x you up, and gave me two pills
and I said, What is that? and he said, Thats two Tylenol.
So, a little while later, Im sitting there for a minute in a chair (we nally had a little
bit of a break) and I was talking to one of our medics from New Iberia. I noticed I
was beginning to feel really strange. My head was woozy and my arms felt like
lead. I was lightheaded and everything was spinning, and I was frightened and
alarmed because Im thinking Im having a stroke on the
Causeway in the middle of a hurricane disaster. This is terrible!
Then I thought: Wait a minute, Im not having a stroke, and what did that doctor
give me anyway? I went over and looked at the bottle and it was Hydrocodone.
and it was 7.5 milligrams and he had given me two of them. Well, I weigh about
105 pounds, and I took it on an empty stomach so that was not good but it ex-
plained a lot. I almost passed out. They made me lie down for about 20 minutes,
and then I got up. I was okay except that I threw up every 10 minutes. I would be
running around taking care of patients and then I would run over to the trashcan
and puke. Im sure that wasnt very reassuring to the patients, but looking back, it
was kind of funny.
On the way home that night we brought back a doctor who had been trapped in
one of the hospitals for days since the disaster began and she was just beside her-
self about all she'd been through. Im not going to say she was hysterical, but she
was very stressed and shocked, and very emotional. They had no water, no electric-
ity, and they hadnt been able to communicate, which was the case at several of the
hospitals. She told me that the rst night they had patients dying because there was
50
6
Critical incident stress management (CISM) is a peer support system used to help medics manage the
extraordinary stress from witnessing life and death situations.
no dialysis, no medicine for them, and to watch her patients die was just so wrong.
She said shed go outside near the emergency department for a smoke break and
hear people in the neighborhood crying out. There were old people and young
people, and little children, and booming fathers voices saying, Help me! Help
me! And little kids' voices crying for their mommies.
She imitated the big booming fathers voices, My children are drowning! Were
drowning! Were in the attic! We cant get out! Somebody, please, I cant hold on
anymore. Please, somebody help me! And the next night she said there were fewer
voices and fewer lights about half as many and then the next night there were
even fewer and her voice broke as she said this last part. She told me she has
worked as an emergency room doctor for many years and shes seen people die,
but shes never had to listen to people die like that. We rode together in the dark in
the back of the ambulance for awhile and the silence was deafening as we thought
about this and I think both our hearts were breaking for these poor, poor people.
We have been going from station to station assessing our medics who have lost eve-
rything- their homes, their family members - everything. Weve been going to see
them for support and for CISM, and well be going back to do more of that later.
These medics and rescue crews are working so hard because its all they know to
do right now. They are working in some very stressful situations where they are
afraid for their lives, because they go into homes where they cant transport the pa-
tient, but they still need to respond and take care of them. And I've heard that peo-
ple are shooting at the rescuers now. Ive heard stories where the medics will start
an IV and have to just instruct the family on how to stop it when it is nished be-
cause the patient cant go to the hospital. Only the absolutely most critical patients
can go to the hospital, and this goes against everything weve ever been taught. Our
philosophy at Acadian Ambulance is that if a person is sick, they need to go to the
hospital and its our responsibility to help them understand how important it is to
get medical treatment. Weve never had to turn people away or tell them that we
can't take them. This was an unbearable situation for us. The decision to not take a
sick patient is unbearable.
**
Tammy Gaudet, Paramedic
I am working out of Covington
7
East right now and I would like to say thank you to
all of the re department, especially those in Folsom that allowed our crews to
come over there. They made space for us, fed us, gave us water and we greatly ap-
preciate everything they did do for us.
51
7
Covington, LA
All the medics have worked major overtime, trying to keep the trucks running so
we can evacuate patients and checking out homes for people in addition to caring
for patients. We have a crew right now thats going out trying to nd someones
family member because no one has heard from them since the storm. Not having
any communication with dispatch or our family members the rst few days was
hard, but weve all managed to keep good spirits and stay positive through all of
this.
Care Ambulance Service out of California, they came down and helped us a lot.
Theyve given us trucks and split up their crews to work with us. And with the Fol-
som Fire Department we all had foodwe barbecued the minute the rain stopped.
The guys got out there and started cutting trees down. They cleared Highway 25
and 40 by that night. We were very well taken care of and could not have asked for
a better or safer shelter.
**
Kimberly Lewis, Paramedic
Friday and Saturday night we went back out to Slidell. It was like a tornado hit it, it
wasnt a hurricane, and it was a tornado. All the streetlights had been picked up
like toothpicks. So it was real bad out there. They had no power and everything was
just ripped to pieces.
There were 150 remen at one re station all helping out there. They had been do-
ing search and rescue for three days and hadnt been home in six days. These guys
were from everywhere...Texas, Arkansas, everywhere. They were going into houses
and nding people, seeing if they were alive or not, and they were doing search
and rescue through three feet of sludge. It was bad.
It ended up that me and several other girls helped out by cooking for these guys
one day. I couldnt cook fast enough. I mean, its not in our job description, but
these guys needed to eat. So for four hours we were in a kitchen like 1950s
women, cooking for the men me and two girls from dispatch and two other med-
ics from New Orleans. One of those girls lost her house, and had nowhere to go
back to, so she just wanted to work to keep her mind off it. These guys, my heart
was with them. They were working harder than we were. I thought we were work-
ing our butts off at the Causeway, but they were working really hard.
**
Jason Hawkshead, Paramedic
From the minute I walked into the Superdome I started sweating and eventually we
all stank. The place was so foul it was indescribable. I have smelled it one more
52
time since then, the day after I came back from the Superdome, when my wife and
I went to see how our house fared, and everywhere we passed where there had
been a dead bodies sitting around for a week. It was the same smell, and I'll never
forget it.
I learned a lot that night in the Superdome and saw the worst in a lot of people, and
it bothered me a lot at rst. But Ive just come to understand that some people out
there are like that. I saw the best in a lot of people as well. I know my skills have
gotten better, my condence level in what I can do has gotten better, and how I can
recognize emergency situations from non-emergency situations has denitely in-
creased just from the 15 hours that I spent in the Arena that night.
I remember looking over at one of the nurses and he didn't look well. He was an
ER nurse from a big hospital in San Diego. I told him that he needed to sit down
and let me start an IV on him. He realized I was right because he had not urinated
all day and have not eaten in two days. It just took somebody to actually recognize
the need.
**
Jeff Hennessy, Paramedic
I came down from Chicago after getting a notice asking for volunteers to help with
disaster relief. This is my ninth year in EMS. Originally, when we came down here
we only had a one-way ticket. We got a letter from the governor giving us special
permission for the ight to come in to the New Orleans airport, the rst commercial
plane to land here since the storm. So we got to land because we were a humani-
tarian ight. But that was a one-way ticket, and our supervisors will make the ar-
rangements to get us home.
There really is no way to describe it. It's beyond any comprehension. You cant
even imagine the things that Ive seen. I ew over the city - just seeing the devasta-
tion was incredible. The rst thing that came to mind was this is a war zone. It was
chaos at the airport. People were coming in any way they could. I saw airport bag-
gage carts being used to carry three or four stretchers at a time, taking them out to
planes to be evacuated. And all the people coming in after being out in the heat
for days without medicine, food, water...its daunting.
Today is the rst chance Ive had to drive through the city, because until yesterday
the farthest we had gone was the airport. Seeing how many people were coming
through the airport gave me an idea of what must be going on in the rest of the city.
I had to drive through the city and see it rst handbuildings torn to shreds, cars
overturned, trees ripped out of the ground; I mean, massive huge trees, just ripped
out of the ground, you can see the roots in the air.
53
It's hard to imagine the force behind the hurricane that came through here. And to
think that people actually stayed in their homes and lived through it is unbeliev-
able. And there are still people in the city needing to be rescued. I can't believe
some of the stories I've been hearing.
Ive put in some long hours and I'm not even tired. I just want to keep working and
keep coming back and doing more. Ive put in two 24-hour days already. I mean
you come back even though youre tired because you know that these people need
help. I started yesterday at 7 in the morning and I got off at 1 a.m. and I still got up
at 6 this morning to do it all over again. You may be tired, you may not be sleeping
under the most comfortable situation, and you may be sleeping on the oor in
somebody's ofce. But at least Ive got showers and Ive got food. Ive got clean
clothing to put on every day. Ive got a job.
Ive never been involved in a situation like this before, but just from small-scale
events in my experience, I know that its a lot of work and that people would be
suffering a lot. So when they put out the call for volunteers, I jumped at the chance.
My company is working overtime. Theyve got extra hours to process, getting peo-
ple up to the level of training that they need, bringing in people who normally work
in the ofce and putting them on to the street people who normally are inside
handling paperwork are now out in the eld doing the work. We sent down 50
people and brought down 20 ambulances, all loaded with supplies to be dropped
off in the area.

Can we afford to stay? I mean we still have our own obligations at home, to take
care of our families and show up at our jobs. I check in every day, cell phone cov-
erage isnt everywhere, but I check in when I can at home and let them know
whats going on. You cant tell em everything because words cant describe it. And
that was the difference between being at home on Monday, Tuesday. Wednesday
watching it on TV and then Thursday being here in the middle of it, it was so sur-
real; actually seeing it happen.
**
Neal Hargrave, Materials Manager
On Friday morning I received a call to meet with President David Pierce. At the
time he requested, per Dr. Ross Judice, that we supply 100 ambulance stretchers as
soon as possible. It seemed like a pretty major feat to get done considering these
devices are not stocked in inventory, but built-to-order.
54
I immediately got on the phone and contacted our representative, Kris Way in
Kalamazoo Michigan with Stryker Medical Corporation. He said they would do
everything possible to help us get that accomplished; he just didnt know how
many he could get done and how quickly they could get them to us.
Within about 30 minutes, I received a call back from him and he told me that be-
tween what they could manufacture in one day and those orders that were ready to
be shipped to other customers, he had come up with a total of 64 Stryker stretchers
that could be airlifted out of Michigan and into the New Orleans area.
By 7 a.m. the next morning we had 64 stretchers being unloaded at the air charter
services hangar. You know how we got those stretchers delivered? We received a
call from World Jet who offered to y in anything we needed at no cost so they ew
in the stretchers from Kalamazoo Michigan at no charge. We loaded the stretchers,
and by that afternoon they were on a 48-foot trailer headed to the group manning a
hospital in the P-Mac.
Another story Id like to share has to do with the New Orleans Fire Department
(NOFD) and the Department of Health in New Orleans (NOHD). Dr. Judice re-
ceived a call from someone with the NOFD explaining the situation that his or her
employees were in. There were no supplies, no equipment. They had been wearing
the same uniforms for ve days and were in desperate need of some help and sup-
plies.
Dr. Judice put together the list of what they needed and contacted me at 8:30 that
night. One of the primary needs was to get some uniforms that the NOFD employ-
ees could change into. We made some calls to different people and ended up with
donation of 500 pairs of coveralls from ACE Uniforms in New Iberia, who had ar-
ranged to get them from the manufacturer. Those uniforms, had we purchased
them, would have cost $15,000. That manufacturer came to the aid of the NOFD
and provided them free of charge.
We were also able get many other items that we are not accustomed to purchasing
on a regular basis, such as chainsaws, jacksthings that were not part of our nor-
mal operations. We put together several palettes of these types of supplies and sent
them to the Lafayette airport and got them out to New Orleans as soon as possible.
They were there in less than 24 hours. The word I got back was that the commander
there was seen to have tears rolling down his face from the fact that Acadian ambu-
lance cared enough to help them out.
I also would like to acknowledge some other donations:
3M Corporation donated electrodes
55
Easter Pennsylvania Ambulance Service brought full ambulance of supplies
with them
Microex donated gloves
Southwest Medical Center donated a full 18-wheeler load of bottled water
Ferno, Washington30 cots
Id like to acknowledge the work of my Materials Management team. Ive always
felt like I had an outstanding team, and this event reafrmed that belief. This group
worked tirelessly for 15 or more hours per day. I never heard a complaint, never
any issues at all, and so I feel really proud of the work our group did. We can cer-
tainly feel like this group played a major role in saving lives, although we werent
on the front lines, we did what was necessary to get the job done, to get the prod-
ucts and materials out to the people in the eld.
Id like to acknowledge Gary Miller. As I mentioned before, my entire team played a
great role in getting supplies out to the eld, but Gary needs to be recognized for
his work in New Orleans. He made an effort to bring supplies and equipment out
to the Superdome on several occasions - sometimes putting his life in danger. He
waded through water waist deep to get to the Superdome with supplies and equip-
ment, at one point even feeling threatened by hoodlums, but luckily there was a
military policeman on hand who was able to disrupt what was about to happen.
We apparently had some looters trying to get their hands on whatever they could,
and Gary was right in the middle of it.
**
Remi Judice, Nurse Anesthetist
I called Robin Judice on Tuesday evening and asked how Ross was doing and if he
needed any help. She said things were under control and I let her know that I
would come help out if I were needed. During the night she must have spoken with
Ross, because she called me around 5 in the morning and asked if I could round up
some people to come down and help with the medical treatment and medical
transport.
She put me in touch with Acadian VP John Zuschlag, and I asked John what he
needed and how many people he needed, and then I started calling people that I
thought might be interested in coming or might be available to come.
The rst person I called was Antoine Keller. Hes a cardiothoracic surgeon with
Cardiovascular Institute of the South and he said immediately that he would come.
The next person I called was Scott Gammel, who works for LA Pain Management as
an anesthesiologist and pain manager. He had to rearrange his schedule but made
56
it work. I thought of other people to call, but I was unable to nd anyone who was
available. I wanted to ll up the helicopter.
I wanted to be as much help as I could, so I called my brother, Ronnie Judice, who
lives next door, and asked him if he wanted to come and he said yes. We told him
what to pack, maybe an overnight bag with some stuff and I packed my own stuff,
plus the bag that I bring to work with stuff like atropine, epinephrine, syringes, my
stethoscope, etc. I brought Ibuprofen from my home, Tylenol, baby Motrin, any-
thing I thought kids might need, because I gured thered be a lot of kids there.
I got all that ready and Ronnie and I met Antoine and Scott at Lafayette Regional
Airport at 7:30. We waited for a supply truck that John Zuschlag was sending from
Acadian full of supplies for us to take along with us. There were two helicopters
available, but they couldnt take all four of us with the supplies, so we divided up.
Scott & Ronnie left on the rst helicopter, probably 20 minutes before we did. An-
toine and I spent that time looking through the supplies to gure out what was most
important to bring, because everything couldnt t on the one helicopter with us.
We took IV tubing, IV bags, IV geljust rst-responder kinds of things, and we left
the rest to come on the next helicopter.
When we realized there were only small IVs and the possibility that you could use
central line catheters for some of the patients, we called several hospitals looking
for donations. I called Southwest
8
, Antoine
9
called Lourdes
10
and we also called
Dr. Mike Jennings who works for LA Pain Management to coordinate trying to get
some more supplies sent down to New Orleans via Acadians helicopters.
I also called my wife, Lisa Judice, at University Medical Center
11
, and she scav-
enged through the hospital for supplies, being its a public owned hospital. She
went around and asked all the nursing managers what supplies they could let her
have and she also got about $200 in nancial donations from some of the nurses to
buy supplies at CVS Pharmacy or Wal-Mart.
57
8
Regional Medical Center of Acadiana in Lafayette, LA
9
Cardiovascular surgeon, Dr. Antoine Keller
10
Our Lady of Lourdes Regional Medical Center in Lafayette, LA
11
University Medical Center in Lafayette, LA
**
David Maddox, Paramedic
I think this is a reality check for everybody to be thankful for what weve got. Im
thankful and have been blessed. My mom lost her house, but there is so much that
we take for granted. I think that is the message for us all. In our daily grind of
struggling with whats not perfect, we should stop and recognize how fortunate we
really are. We have shelter, a job, and a friend; there are so many that lost family,
homes, jobs and everything they own. We need to be thankful for what we can nd
to be thankful for.
Stephanie tried to send me home three times, and each time I told her, By all
means, No." My family is ne, they are being taken care of and I was needed here.
On the fth day, some guy from Lafayette made me go home. They took my sup-
plies, they took my unit and kicked me in the ass and told me, Go home." Its a
blessing in disguise really; I got a lot done at home too. I got a generator set up. But
I wanted to be out there helping people. Thats where I felt the most useful.
58
Sick, Disabled
In our part of the country hurricanes are a way of life, and at Acadian Ambulance
we have decades of experience evacuating people who are too sick to walk, drive,
travel or survive without medical care. Evacuations are commonplace when big
storms are headed to our shores. We are often called upon to move ill and disabled
people from homes and hospitals.
Most hurricane evacuations are voluntary, but in Katrina a mandatory evacuation
order was issued. The prospect of moving all those patients was daunting. We as-
sumed -- as everybody else did -- that after the storm passed, things would return to
normal and we could return people to their homes and hospital beds within a day
or two.
We had no idea that the levees would break and the city would ood. We had no
idea that 30,000 people would take shelter in the Superdome and that conditions
there would deteriorate so rapidly. All we cared about was getting the sick and in-
jured to safe place where they could be treated. But there were tens of thousands
of them, and our resources were stretched to the limit.
Even our most experienced medics had never seen anything like it... nursing home
residents drowning in their beds, dead bodies piled up in hospital corridors, thou-
sands upon thousands of sick people -- diabetics, stroke victims, amputees, men-
tally ill people, newborn babies, pregnant women -- all struggling to survive, many
of them without their medications or supplies. For the sick and disabled population,
Katrina was a nightmare beyond imagination.
**
Paul Fuselier, Paramedic
You know, Ive been doing this work for 24 years and have been through hurri-
canes, tornadoes, all kinds of disasters, you name it. But this was one experience
that I have never in my 24 years imagined. I had to do things that I thought I would
never do.

As medics, we have a slogan: Everyday we save lives. That is what we strive to do
every day in our normal work. We have a patient or two or three on a typical day,
and we do everything we can for them.
But we were placed in a situation in the Superdome where there were just too
many people that needed help. We triaged people; we placed them in categories,
and unfortunately, there were many in the category of we cannot help you. They
59
were simply not going to make it, and we knew it. When we triage, we tag patients
with different colors according to their status. And it goes from anything that is real
acute to minor, and theres a category for imminent death.
The color code of that category is black. We "black tag" those patients. You can't
imagine how difcult it is to place a breathing patient in that category. I had never
done that before in 24 years. Thats just something that we dont do in a normal op-
eration.
There was somewhere between 20,000 - 30,000 people in the Superdome. They
came to our rst aid station and wed triage them there, and if we could do some-
thing for them, we would move them over to the Arena across the road where they
had set up a makeshift DMAT hospital.
I dont know how many hundreds and hundreds of people we saw. We were inun-
dated. It was chaos. We had medics and doctors and nurses from all over the coun-
try, a lot of them from the EMS conference that just happened to have been taking
place in New Orleans the previous weekend. Some of those people stayed through
the storm and beyond to help out.
The hardest part of triage is to black tag a person who's staring right at you, alive
and aware. You get to a point where death is inevitable and you have to make a
choice between that person and another person you can save. You only have so
much time, so much manpower, and so much medication. Those are the faces that
stare back at you.
**
Dr. Ross Judice, Medical Director
We saw patients of all sorts. We had patients who were having heart attacks,
strokes, seizures and an autistic teenager who had soiled himself. We transported
elderly patients who were confused and didnt know where they were. We saw
psychiatric patients, Parkinson patients, patients who were roaming around the Su-
perdome who didnt know where they were, infants, a tremendous number of pa-
tients who had lacerations on their feet and legs from walking through the oodwa-
ters. I cleaned up a wound of a diabetic woman whose son tried to get her to a lo-
cal hospital, carrying her on his back while walking through water up to his neck.
At the hospital they were turned away, so they had to sleep in the ooded area until
they were able to walk to the Dome.
60
**
Gifford Saravia, Paramedic
Within ten minutes of me arriving at the rst aid station at the Superdome a man
approached us and said that they had a diabetic who they couldnt wake up, and
he pointed us the direction of where he was. We grabbed a bag and took off. It
took us about 10-15 minutes to nally nd this man, and sure enough, his CBG
was 29. We started an IV and gave him D50 and woke him up, and we told his
neighbors to give him some crackers. Then we left. Thats basically how the treat-
ment was there. I dont even know the guys name. You just sort of did what you
could and moved on because you couldnt walk 50 feet without somebody asking
you for assistance. There were people lying all over in the halls and aisles. Some
were asleep, some kind of milling about, some just sitting there staring off into
space. Some were probably dead.
**
Billy Vincent, Paramedic
After the Superdome roof was peeled off by the hurricane, it was literally a thunder-
storm raining inside the Dome. You couldnt see from one side to the other for the
amount of rain that was falling inside. It was a sight that was just crazy.

After it was all over, the sun came out and the humidity level and temperature in-
creased dramatically inside the Dome. Asthma patients started coming out of the
woodwork. We were treating an enormous amount of asthma patients that had lost
their meds because they were not able to get their inhalers when they were trying
to escape from the hurricane. We became extremely low on medication. I think we
were down to maybe one or two more treatments before we were going to be
completely out of medication and not able to treat them.
I went to talk with the DHH
12
guy and one of the doctors for the military, Dr. Foster
Cordish. By this time some ambulance services from northern Louisiana including
Shreveport Fire and Rescue showed up. We were able to get with those guys and
pull a bunch of meds they were not using off of their ambulance. We also pulled
every spare oxygen cylinder off of every Acadian ambulance. And we also pulled
one main oxygen cylinder off of one of the ambulances to administer the medica-
tion to these asthma patients. Those supplies lasted us for a short while about a
half or three-quarters of a day.
Sometime on Monday we were being inundated with diabetic patients that had lost
their medications in the panic to evacuate, and their blood sugars were extremely
61
12
Louisianas Department of Health & Hospitals
high. Some of them were not even registering on our glucometer. We did not have
any insulin and no medical order to give insulin. Dr. Cordish managed to nd a
box of insulin about fteen vials, and gave it to me with a sliding scale order to
administer it. I cant even imagine how many diabetics we treated in the time we
were there from Monday through Wednesday with that sliding scale and insulin.
His orders and the ability to have that supply of insulin truly saved many lives.
**
Remi Judice, Nurse Anesthetist
One memorable patient was an alcohol abuser who had to be sedated. She was se-
dated when she came to the staging area, and I thought maybe she was comatose
for some other reason, but she was actually an alcoholic with withdrawals, so the
DMAT docs sedated her with Versed and she was very sedated. She started waking
up and got belligerent. I tried to give her every opportunity to leave the staging
area; she could have been evacuated, but she wasnt thinking clearly and she
ended up leaving, sort of AMA
13
from the staging area. She pulled out her IV and
went back into the general population.
Later that evening they called for an evacuation for someone who was intubated
and needed to be bagged. I didnt see the patient; I just knew it was a priority. An
intubated patient is critical in my opinion, so we transported that patient directly
from the DMAT to the helicopter and bypassed the staging area.
The person who bagged the patient, Sergio, was a physician from LSU Medical
Center in New Orleans. Sergio bagged that patient to Baton Rouge and it was dark
by the time the helicopter returnedwith the same patient onboard! The patient
was going wild and they werent able to make it to Baton Rouge, so they brought
the patient back to the Superdome. I didnt know who it was; I thought it was
somebody that maybe they'd found on the highway or somebody they had rescued
from drowning. Come to nd out it was this same alcoholic woman that had
woken up from her sedation and ended up pulling the ET tube
14
out in the staging
area and ending up going round trip half way to Baton Rouge and came back be-
cause she was so out of control and used all that fuel and manpower and was never
evacuated.
I dont even know what happened to that lady, but it really put things in perspective
that you cant control what these people were doing before the hurricane. She was
62
13
Against Medical Advice (AMA) is when a patient refuses the medical providers advice & proceeds on
their own course.
14
Endotracheal (ET) tube is placed down the patients wind pipe so that the nurse or medic can blow air
into the lungs.
probably drunk on the street before it happened and just kept getting drunk and
never had to worry about going into DTs
15
but when she comes into our world and
we have to take care of her and have compassion for her, we have to treat her like
shes sick and do the best that we can for her, it's a different story. I decided to tri-
age her out because I didnt have the manpower, just myself, to take care of her and
the other 10 people that were in the staging area, so I pulled her IV and told her to
leave. We just had to make decisions like that.
There was one lady that was blind. I remember having to walk her to the helicopter.
She couldnt see, but she was very calm and it seemed out of place for her to be so
calm, if you can imagine walking under a Blackhawk helicopter with the roaring of
the blades above you and the wind and not being able to see. And she just walked
as steady as she could, following my arm. We loaded her up on the helicopter and
she took off. Never knew where she was goingto Houston, Baton Rouge, maybe.
There was just so much despair in the patients that came through the staging area,
mostly the older people who were just resigned to the reality of the storm. They
probably sat on their porches just two days before, waiting for the levee to break
and having to be inconvenienced by this water and probably never expected to be
brought to the Superdome.
**
Richard Pellerin, Paramedic
There were times that we probably put six mothers with six brand new babies and
one nurse in the back of an ambulance. We transported a mother with a one-day
old baby that she named Katrina. We also had grossly obese patients on the ground
for several hours until we were able to get them out of there, maybe 400 lb. pa-
tients. I remember seeing cerebral palsy patients on ventilators, and they became a
priority because the batteries were going dead on the vents. I know we had women
that were in active labor that we were shipping out to the airport. We had patients
from Lindy Boggs Hospital
16
that were extended hospital stays; some were two or
three days post open heart surgery, and they were out there in the elements ghting
for their lives. I remember a gentleman that had been bed bound in the hospital for
6 weeks, and he was taken from that environment and thrown into the environment
as an evacuee. I cant imagine what thats like, being in such poor physical condi-
tion.
63
15
Delerium tremens (DTs) are symptoms of alcohol or drug withdrawal - tremors, agitation, confusion,
etc.
16
Lindy Boggs Hospital, a mid-city New Orleans hospital, was in the ooded area.
The Animals
The plight of pets in a disaster is heartbreaking beyond words. When the evacuation
order was issued, thousands upon thousands of people tried to take their pets
along, only to be told that they couldnt carry them onto the buses, helicopters or
military trucks. Many people simply let their pets go, hoping theyd survive on the
streets, while others clung desperately to their animals, refusing to evacuate without
them. Still others, having no idea how bad the storm would be, secured their pets in
their homes and yards, thinking they were safe, only to discover that their beloved
pets were now directly in harms way. By some reports, as many as 250,000 pets
were stranded in the oodwaters in what became the largest animal rescue opera-
tion in history.
**
Jay Authement, Paramedic
When the water started rising, my three big dogs were in the utility room in the
house and the little one was in the front of the house. My daddys house was right
next door to mine, and his dog was inside. The water at this time was about 4 or 5
feet high inside the houses, and I was outside with my daddy getting into our boat.
My daddy was crying, I need my dog, I need my dog." So I said, Well, alright, Ill
get the dog.
I tried to open the back door, but it had suction from the water and I couldnt open
it. I busted a window and went in, swam through the house and got the dog,
brought him out and threw him in the boat. The water was still rising, but it wasnt
that bad, so I decided to go into my house and get my dogs too. I swam in through
the house and found the little dog oating on a mattress in my sons room. The
house, everything in there we can replace, but the dogs, thats the one thing I have.
So I went through the house one by one grabbing all the dogs and throwing them in
the boat.
My daddy and me slept in the boat that night with ve dogs. We found a place out
of the rain on top of my neighbors car in his carport. We put the boat right on top
of the car, thats how high the water was. We slept there for the night with the ani-
mals. I remember looking back into the house and seeing the cockatiel was up to
his tail in water, so I had to hang him up high in the house so water wouldnt get to
him, and then when I got back outside, I noticed that one of the dogs was missing
from the boat, so I had to go swim around looking for him.
By then it was getting rough with the animals in the boat. They were trying to jump
in the water, I dont know, nerves whatever, I kept having to jump in and get them
64
and put them back in the boat, plus I kept going back in and out of house to get
what food I could nd. Id go to my fathers house, swim through there to get little
cans of Spaghettios, and then I'd go into my house, swimming around looking for
food.
By the next night it was like, OK these dogs in the boat are going to kill us if they
keep jumping out. The water was receding but very, very slowly and there was now
only about a foot of water in the houses. So, I gured the big dogs wouldnt drown
if I put them back in the house; they could jump up on the beds to stay dry, so I re-
leased them into the house, threw them whatever food was in the refrigerator, took
off the storm boards so they could have some light and broke some windows so
they could have some air. And I left them. I kept the little puppy and my daddys
dog with us. The big dogs, I had to turn away from them, cause I knew I couldnt
save them.
We also had a horse. On the rst day when the water stared rising, I put him in a
shed that was elevated about two feet off the ground on cinderblocks. After the wa-
ter got to be four or ve feet, I thought the horse would probably drown, but it
turned out he was high enough up that he survived. I swam out to the shed and
found him caught up in a lot of mesh, so I cut him loose. His legs were in the water
but the rest of him was above it.
We spent some time going around the neighborhood in our boat rescuing as many
people as we could. We took people over to St. Bernard High School, which was
an ofcial evacuation site. But the police there said that people couldnt bring their
pets in, so people went up the stairwells to the roof and left their pets out on the
roof in the hot sun, and the animals were dying left and right. From there, every-
body got evacuated to the high school stadium, but some people wouldnt leave
their pets. One woman had a dog hidden in her dufe bag. The sheriffs came in and
said, If you dont get out now, youre on your own. They put people in big trucks,
and some of them got put on a barge going somewhere else, I dont know where.
But those people all left their pets out on that rooftop.
Eventually my daddy and I ended up at the stadium. Before going over there, I went
back to the house and undid the door so if the big dogs wanted to run they could
run. We kept the two small dogs with us, but from the stadium we were going to be
evacuated by bus, and the police said no pets. So I had to leave the two little dogs
there. There were people going through and systematically putting animals out of
their misery. There was this policeman who went back to his house and got about
300 bullets so he could go back to the stadium and shoot the animals, including
the puppy and my daddys dog. The ones back at the house, I dont see how theres
any way possible they could have lived.
65
**
Dr. Ross Judice, Medical Director
During the Friday 8 am brieng at the airport, Theodore Monnette, the apparent
head of FEMA operations at the airport, described the process by which the public
and the medical patients would be evacuated. The meeting was attended by repre-
sentatives from TSA (Transportations Safety Administration), the airport, U.S. Air
Force, and others. There was a discussion about pets and Mr. Monnette said that all
the animals would be transported with the people because we could not afford to
upset the people by separating them from their pets.
But the military people wanted people with animals to be separated and moved to
the commercial airlines so as to not have animals on the military aircraft. I spoke
up for the rst time at this meeting and said, Having been in the Superdome for 36
hours trying to evacuate people on military aircraft and watching the pilots quibble
about which patients theyd take and which patients they wouldnt, I think that hav-
ing pets on their aircraft is very small thing. Mr. Monnette replied, OK, well then
thats settled. In other words he made the nal decision to override the militarys
stupid request to put people with pets only on commercial aircraft.
66
Superdome
Katrina hit on a Monday morning, but it wasnt until Friday that the land evacuation
of the non-medical patients started. By the time the military and FEMA showed up
at the Superdome to start moving people out, there were about 20,000 refugees
stranded in intense heat with no plumbing, electricity, food or water in dangerous,
lthy conditions.
When the mandatory evacuation was ordered, all but the poorest, least self-
sufcient people were able to get out of town. The upper and middle classes
evacuated, but everybody else went to the Superdome, which was set up as a
"shelter of last resort. Once a mandatory evacuation is ordered, the city and state
agencies are no longer obliged to care for!those!who stay behind. The agencies!are
relieved of ofcial responsibility and disclaimers are issued.
!
But the Superdome people stayed behind because they didn't have the resources to
leave. Evacuation isn't cheap. You need to have someplace to go, a car to take you
there, and money for gas. If you don't have friends or family to stay with, you have
to stay in a motel. For someone who earns minimum wage,!$40 a night for a motel
is way!out of reach.
Conditions inside the Superdome were deplorable beyond description. People were
sick and dying everywhere, and during the rst couple of days, the only help they
had was a small rst aid station manned by Acadian and a second medical area in
the adjacent Arena, which had been set up by a FEMA Disaster Medical Assistance
Team (DMAT) that ew in from New Mexico.
These medics worked tirelessly to treat and evacuate hundreds upon hundreds of
sick and injured refugees, though evacuation was slow and inefcient with only a
few civilian helicopters and Acadians small eet covering the effort until the military
arrived.
**
Billy Vincent, Paramedic
On Sunday, a day before the storm, I was assigned to the Superdome to help get
our rst aid station up and running, because the Dome had been designated as a
shelter. I left from the Gretna Station in the new supply van.
(Acadian manager and nurse) Ray Bias showed me around the Superdome, showed
me where our rst aid station was and where triage was going to be set up down-
67
stairs. We had everything up and running early, before people were led into the
Dome. I was assigned to triage.
About nightfall we started receiving trucks from different areas. Some of them were
from nursing homes; some were from other places. I dont have a clue as to how
many patients we saw...there were thousands. The ones that stand out in my mind
are the ones that we couldnt help because we didnt have the ability or the man-
power to take care of them. This was the rst time that I ever had to put black tags
on people who might have had a chance to survive. I will remember those peoples
faces for the rest of my life, knowing that in a normal situation, when there were
places to send people to get help, those people would have lived. Its just some-
thing you train for, but not something that you ever think you really are going to do.
I did not mention previously about some of the great help we had. On Wednesday,
four or ve medics from Ohio and a physicians assistant helped us at the rst aid
station. It was a blessing to have them there; they were stranded in town because of
the EMS Expo, and they just came down and helped us out. It was unbelievable to
have their hands and their help, because if they had not been there, we would have
sunk, because we didnt have the manpower to take care of all those people.

The days all get blurred together because I didnt get much sleep. Another memory
that stands out was the day they needed some paramedics to y on a Blackhawk
with some patients who had to be intubated and sent over to I-10 and the Cause-
way. So David Lacombe and I got on the Blackhawk to y these patients out. There
were two of them, and one weighed about 400 pounds. Both were intubated and
bagged.
**
Gifford Saravia, Paramedic
Tuesday morning at the Academy
17
we were notied that our assistance would be
needed. I had anticipated this and brought some clothes with me to work. Liz Mrak
and I volunteered to travel out to the Dome. We got on a helicopter along with
Ross Judice and we arrived there around 1:00 p.m.

The rst thing we noticed in there was the stench. Can you imagine 30,000 people
piled up in a building with no ventilation, in high temperatures, with non-
functioning restrooms? It was dark; about every tenth light was on, which was from
an emergency generator, the only source of power in the building.

68
17
The National EMS Academy (NEMSA) is the educational division of Acadian Ambulance. NEMSA edu-
cates EMTs and paramedics.
You know what happens in a hot, humid part of the country like this when you turn
off an air conditioning unit and the humidity comes up and the oors start to
sweat? In the Superdome it was like that, but a thousand times worse, and the
sweating oors turned into mud on the walkways. We had to be careful of how we
walked because it was slippery and treacherous, not to mention that people were
laying all over the place either sleeping, sitting up or just kind of staring off into
space. We realized later that some of them were dead.
After a while you dont smell the smell anymore, because once youre in it and
breathing it, you become immune to it. The rst aid station was an 8 x 10 room
with a stretcher in it, and equipment and supplies were piled up against the walls.
They had police barricades all down the hallway, but it was too chaotic to contain.
Essentially it was a free-for-all. The people were leaning against the barricades and
the medics would try to give them supplies. The medics would ask, What do you
need? What is your condition? People were walking up with anything ranging from
a scratch on a nger to someone literally drowning in pulmonary edema.

David Lacombe told me, We need to have a clear point of entry, set up a triage
area and a treatment area. We cant have medics going back and forth to the fence
because it undermines the order we need to create.
It took us a while to get everybody to buy into it, but once everybody did, things
started to go a lot smoother. We had an ER nurse there from the Houma area, so we
set her up as the triage nurse the rst point-of-entry person. Everybody who was
trying to lean over the fence was directed to her. Then we set up another treatment
area for minor bandages and stuff. The second area we set up was for people who
might need a nebulizer treatment or an IV or some further assessment, and we had
four cots for that.
And nally, in the rst aid station we eventually had a bed in there for the most
critical patients. Thats the area I gravitated toward. It was kind of odd because there
was no physician present. Dr. Judice was organizing the air evacuation at the time.
We were all nurses and paramedics, but it was like in an emergency room, running
critical patients and doing what we knew how to do. But we had no one there to
give us orders or conrm anything. It was surreal.
We had some Gators for transporting equipment and people, and initially the med-
ics would receive word of somebody needing assistance and would jump in a Ga-
tor and go retrieve that person. But as the numbers of people in the Dome in-
creased, this was no longer feasible.
Liz Mrak was manning the rst aid station inside the Dome. Every now and then
shed call out over the radio that she had a critical patient who needed to be
69
brought to the DMAT area, so wed get a Gator routed over there to pick them up.
At some point during the morning, the stench became unbearable, and that's when
the security threats started surface. The National Guard thought it would be better
to move the rst aid station out of the Dome onto the plaza level terrace where the
air was a bit cleaner and it didn't smell so bad. They completed that move and we
started seeing patients out on the terrace.
I asked a lot of patients how they got there and where they were during the storm,
and theyd tell me their stories. A lot of them waded through the water, some for
several miles, to get to the Dome, and on the way they had seen bodies oating
around. I havent yet heard what the estimated body count will be, but Im assum-
ing it would probably be safe to say around three thousand. It would not surprise
me.

A few hours later the military advised us that our position there was not defensible,
so we were advised to move across the bridge which adjoined the Superdome to
the Arena, and thats what we started doing tearing down everything and merging
with DMAT team. At that point some of our relief started to show up. I got home
about 11 p.m. on Wednesday...some 34 hours after arriving.
The next day they told us that our medics had evacuated the Superdome because it
was no longer safe for us to operate there. We were then redirected out to Cause-
way and I-10.
**
Dr. Ross Judice, Medical Director
Our reach extended halfway around the Superdome, because when we would hear
about somebody needing help on the far end of the Dome, we would always en-
counter someone along the way who was in critical condition, so wed stop and as-
sess him or her. The Gator was extremely difcult to navigate around the Super-
dome because there were so many people sleeping in the aisles, and we didnt
want to run over anybodys legs. Obviously we didnt want to hurt people, but we
were also concerned that such an incident could elicit a riot.
Throughout the evening there were rumors being passed to us by the military that
the generators were very close to going out. They told us that once it got dark in
there, we would be in a very unsafe situation, so we developed a two-part contin-
gency plan. Part A was to try to make it out to Gate C where some of our ambu-
lances were. Part B was a stairway behind the rst aid station that went all the way
down to the loading dock where the military was receiving shipments of food, wa-
ter, and supplies. Fortunately, the lights continued to be on the whole time.
70
My assessment of the Superdome was that conditions were going to deteriorate
very quickly. There were thousands of elderly people sitting in the stands, thousands
of people coming to the rst aid station with injuries and illnesses, thousands of
people who did not have their medications (or their meds had been soaked in the
ood waters), and the living conditions were sub-human. I knew we had to get all
of the medical patients out of there as quickly as possible.
When I got to the rst aid area the crews there looked weary. I asked if they were
planning on working shifts and they just kind of shrugged. I called a meeting of the
entire group and told them that we were going to work four-hour shifts still thinking
that this would all be over soon. First shift was 10 2 and second shift from 26.
We instructed them to put those times on the white board and that everybody had
to sign up for one shift. I asked the folks who had signed up for the 10-2 shift to
continue to work and the other staff needed to go get some rest.
At that point I began to work with this rst shift, seeing patients throughout the rst
aid area and going out on calls with the Gator to assess and to transport patients.
At one point I went out on foot alone, because someone had asked me to check on
an elderly lady who had lost her husband in the oods, and also an elderly man
behind her who had asbestos-related cancer. But once I set out on foot through the
crowds, I was stopped over and over again by people pleading for help. I tried to
see as many people as I could, if they required transport I would radio in to the
guys manning the Gators. Theyd drive around, bring the spine board and transport
the patient to the rst aid station. Those who appeared to be critical were trans-
ported to the DMAT area.
Everybody in the Superdome was weary and traumatized. Some were very nice and
appreciative, but there were also roaming groups of young men who in my opinion
appeared threatening (though they never threatened us). I took a low-key, head
down, eyes to the oor approach in the situations where it looked like people were
fairly agitated so as not to iname the situation any further. Some people were very
helpful; they would come to the rst aid station and ask us to go see about some-
one, and we would dispatch one of our staff to go assess the situation and call for a
transport if necessary. We were called to the security area down in the basement to
assess a rather large gentleman who was having a seizure. He was probably 300+
pounds. We were nally able to get him transitioned over to the Gator and trans-
ported up to the rst aid station, then on the DMAT area. There were many obese
people there, and it was quite a challenge to transport them.
The population of patients was growing all the time because the conditions were
making people sick, and our ability to air evacuate them out had to be very aggres-
sive to keep up with the deteriorating health conditions inside the Superdome. At
71
this point I was aware that we were in a very, very serious crisis and that we were
desperate to get these patients out.
The room we used within the Superdome was breached on one occasion when
somebody from the public came in and began shining a light around, and we felt
that our belongings were not secure. So we locked our personal belongings inside
the ambulances.
On Wednesday I met with a Colonel named Pam (cant remember last name) of the
Louisiana National Guard medical unit that taking care of the special needs pa-
tients. She told me that she wanted to try to evacuate the special needs patients
(there were approximately 600 of them). She said that she had a plan and she
wanted my help. I replied that I would do anything to help her out.
She wanted to basically load all the special needs patients into our ambulances and
wheelchair vans that were parked at the Superdome and transport them halfway
around the Superdome on the elevated walkway to the Poydras exit, where they
would be ofoaded onto army trucks and transported out of the area, presumably
to waiting buses. There were security issues to consider because we would be
transporting through areas accessible to the public, and people were starting to go
a little bit crazy. This was an OK plan, but we didnt have much fuel in our ambu-
lances and our staff was tied up elsewhere so they couldnt drive the ambulances.
Pam said she could get some fuel, and that her army staff would drive the ambu-
lances.
We turned over the keys to two or three ambulances and two or three wheelchair
vans to her drivers. They had a loading crew get the patients onto the ambulances
and vans, and a transport crew that drove patients around the Dome from point a to
point b in a circular fashion. They would load them, drop them, come back, load
them, drop them, and come back. It was actually quite an efcient system.
Not long after that, I received a call from our dispatch center requesting that I be
evacuated by air. I assumed that they meant just me alone, and I refused to go. They
then claried that they wanted to evacuate the entire Acadian team that arrived on
Tuesday, which at that time was only six of us; the recently arrived teams werent
evacuated until the following day. Some of us had been there for 30-something
hours, and once I heard this, I agreed, because all of us were completely ex-
hausted.
72
**
Paul Fuselier, Paramedic
We had newborns to 92 year-olds coming in. It was from one extreme to the other.
Ive been to the Superdome before, to football games and different things, and I re-
member the sights, the sounds, even the smells, like the smell of popcorn. But now
my memory of the Superdome is totally different. Its just gloom and despair.
I am proud of our people, Dr. Ross Judice and the other doctors who came in, those
guys from Cincinnati, the Acadian people who were there. Some of them came in
before the storm and rode the storm out in the Dome. Everybody worked hard and
you didnt hear anybody ask for relief or anything. We had to force some people to
go home.

We had people who were conned and trapped because of the ood, and there
was so much difculty getting them out; the National Guard trucks had to get them
out through the water or y them out. We were trying to get them out by helicop-
ters as quickly as possible, but there were just not enough hands. We had a small
rst aid room with one stretcher and a few chairs for people to sit on. This rst aid
room was designed for one or two people at a time, not a hundred. And we had
some other stretchers that the National Guard provided, so we could lay people
down on them outside of our room. Sometimes if we were lucky we had ten re-
sponders in there medics and nurses and whatever. And other times we only had
ve people, and the line of people waiting for help seemed endless. It really taxed
our people who had already been pushed to the limit.
**
Kimberly Lewis, Paramedic
On Thursday I was assisting with transporting the patients from the Superdome to
the Causeway, and from there theyd get in the ambulances and go to the P-Mac on
the LSU campus in Baton Rouge. All the helicopters were going back and forth be-
tween the Causeway and the Superdome. Wed load em and go, load em and go.
All day Tuesday we received patients at the Superdome and then we'd send them
out to Causeway. On Tuesday I think I was there for 20 hours.
**
Steven Hamilton, Paramedic
I ew by helicopter into the Superdome with ten other medics.
Toby Bergeron, who told me that I didnt know what I had gotten myself into, met
me. Apparently there had been two murders about an hour before we arrived there.
73
Toby showed us around, told us what we were to do, where we should go and
where we shouldnt go, all due to our safety. After getting a debrieng from him, I
was assigned to work landing helicopters. We put patients on the helicopters to
transport them out to hospitals or staging areas around the city or state. I quickly
realized that this was a tough task because not all the helicopters that landed actu-
ally wanted to take patients because some were delivering supplies and personnel
only.
About midnight on Wednesday, the military shut down the ight operations. No
helicopters were coming back until the next morning. I visited with one of the
commanders to nd out what time we were going to start the next morning and
could never get a straight answer from him. He was telling me between 7:30
8:00, maybe even later. So I realized that these guys really didnt have the game go-
ing on at that time. I got pretty upset.

Once that shut down I went to the treatment area and started helping the DMAT
team. These guys were so helpful, so friendly, and it was good to be around them.
**
Remi Judice, Nurse Anesthetist
When we got to the Superdome on Wednesday there were eight or nine helicopters
that we could see, maybe three or four on the helipad and maybe ve ying around
as we ew in. Ross introduced us to some of the medics whod been there for a
while, and they looked quite tired. Dr. Scott Gammel took over the rst aid station
and I took Dr. Antoine Keller and we went down to the heliport where Ross was di-
recting trafc. We asked him what he needed, and he suggested that we set up a
staging area near the helipad. This was between the Arena where the DMAT people
were housing the sickest patients, and the helipad. We tried to hold 10-20 some-
times 30 or 40 patients at a time, depending on how acute they were, so there
wouldnt be much distance to cover to get them onto a helicopter to evacuate.
We were adjacent to the National Guards satellite communication, so we had
clear paths back and forth to all the medical facilities, with security provided by the
Guard. There was no big military presence at that time, only National Guard.
We tried to keep, in our triage station/staging area, maybe 5 stretcher patients if we
could, and 20 walking wounded, so we would always have an immediate supply of
patients for the helicopters when they came. When the helicopters touched down,
we would hand communicate with the person at the helipad to gure out how
many patients he wanted, because we didnt want to bring patients more patients
up to the helicopter than they could take, and then have to bring them back to the
staging area again. That would be a big waste of manpower.
74
We also had Gator vehicles to transport people from the Arena to our staging area,
but we only had them for short times because they were usually busy elsewhere, so
when the helicopters did land, we needed the Gators to transport the stretcher pa-
tients.
The helicopters would drop off supplies on one side of the Superdome but would
only pick up evacuees on the other side, so we never knew until the helicopter
landed on our side how many and what kind of patients they were available to
take, whether they were stretcher patients or walking patients. So my brother Roch
and some Air Force communications ofcers were trying to make it possible for us
to communicate with the helicopter pilots coming in.
Around 4 oclock I started carrying two walkie-talkies, one for Acadian and one for
DMAT, and so it was quite interesting trying to differentiate who was asking for
what on which walkie-talkie. I felt like somebody on the oor of the New York
Stock Exchange. I was actually bargaining with the people on both walkie-talkies,
making deals about how many people would go here or there, negotiating.

So for the rest of the day thats what I did. I communicated between the DMAT side
and the helipad, and at times there were no helicopters coming in, so we would
just take care of patients, keep them out of the sun, keeping track of their IVs, tak-
ing them to the bathrooms...well, there were no bathrooms, so wed take them out-
side to a place where they could relieve themselves (there were no toilets for civil-
ians to use). We decided to make all the males urinate in the used water containers
so we could keep it as sanitary as possible, although the little that we did didnt
make much of a difference. Sanitation was impossible. The women were upset be-
cause I could bring the men to urinate, but I really couldnt bring the women until I
found a female to escort them.
**
Gary Miller, Distribution Supervisor
There was this older man wading in the waist-deep water coming out of the Super-
dome. He walked past me and said that he couldnt take it in there anymore and he
didnt know where he was going, but he just had to get out of there. You know, he
was just shaking his head and waded off in the water. Who knows what ever hap-
pened to him.
75
**
Dr. Chris Najberg, Emergency Medicine Resident
I personally saw some of the worst damage I ever witnessed. It was absolutely in-
credible. You never knew what you were going to see next.
I arrived at the Superdome to nd the crowd in an extremely agitated state, and the
level of fear was increasing all the time. The National Guard was there, and most of
them were carrying weapons. They were saying that evacuation of medical per-
sonnel was beginning because they expected the worse to happen at any given
second.
The crowd was restless, milling around in the stiing heat and stench, occasionally
throwing an object, shouting or getting into shoving matches. Judging by the condi-
tions in there, I dont blame them for being angry. They had been living for four
days in some of the worst living conditions I have ever seen. Sometimes the feces
on the ground was six inches deep, and people were sitting in the bleachers with
dead family members propped up in the seats next to them. I personally saw this,
and my heart goes out to those people.
At one point I was helping to transport a female patient around the Dome in one of
those big army trucks that was high enough off the ground to get through the water.
She weighed 700 pounds, and we werent able to y her out because of weight
limits on civilian helicopters. The military helicopters could have taken her, but
they were unavailable at the time, so we drove back into the Dome with her. For
the moment, all we could do was leave her in the truck while we tried to gure out
the best way to get her to a hospital in Baton Rouge.
I made my way back to the rst aid station and told Dr. Bryant that the Acadian op-
eration was pulling out due to great danger. I saw him off on one of the helicopters,
and then went back to the truck and got into it with my patient, who had now been
waiting in the back of the truck for nearly 12 hours in the extreme heat. We began
to make our way through the city, passing groups of 500 or 1000 refugees at a time
on the streets.
At one point we passed a group that had several members waving frantically to me,
and by all appearances from 20 feet away I could see that there was a man with
this group who appeared not to be breathing and possibly dead. I could not stop to
help them due to my patient in the back, who was now breathing 50 times a min-
ute, and my only medical supplies were an oxygen tank, a mask and a pair of
gloves. There was nothing I could do for the man, so we just drove on, but we were
pursued by 3050 people screaming and throwing bottles and rocks, because they
believed we were abandoning a sick patient.
76
We made our way out of the city, passed barricades manned by police and citizens
with weapons, I assume they were trying to contain the disorder. I saw several res,
and it was a very chaotic scene. I had never imagined anything like this. It was
something out of an apocalyptic movie.
It took about four hours to get to Baton Rouge, and along the way my patient began
to have altered mental status and developed mucus plugs in her trachea. I was able
to get an Acadian Ambulance to intercept me at I-10 and the Sorrento exit, and
they were tremendous help in giving me a portable suction unit to relieve the mu-
cus clot, some oxygen and a BVM
18
, as my tank was nearly empty. I was able to
bag her until she regained consciousness.
We stopped at Mercy Hospital and obtained a few more supplies at the door, as the
patient was too heavy to be unloaded. At that time I chose to continue my transport
with the patient to Baton Rouge, since she was now stabilized. We made it to Earl
K. Long hospital without further incident.
It was now about 4:00 p.m. and I had not slept since 6:00 a.m. the previous day. I
went home, took a long shower and slept for 14 hours.
The next day I was able to get back into New Orleans with the help of David
Pierce, president of Acadian Ambulance, and I met with Ross Judice to discuss fu-
ture plans. I spoke with several New Orleans Fire Department. personnel and they
described what they had been doing. In my opinion, their actions were heroic.
They had not had relief in a week and they were continuing to do search and res-
cue, even though many of them had minor injuries.
I just want to add that I cant emphasize how grateful I am to Acadian for providing
me with this opportunity, and I have to say that they have gone above and beyond
the call of duty. I did not know that they had this many ambulances, but I think I
probably saw all of them in New Orleans, over 100 at least. I am thoroughly im-
pressed and very grateful.
**
Todd LaPorte, Paramedic
Everything was going well until about 2 a.m. on Thursday when our security --
which was actually military MP's that were guarding the ramp between the Super-
dome and the Arena -- told us to move the rst aid station our of the Dome and to
inside the Arena. The guards were securing the area so that people couldnt just ar-
77
18
Bag valve mask (BVM) is a bellows-type bag used to push air into the patients lungs.
bitrarily come in looking for medical help, there were also people coming to us
seeking a way out, because they could see Blackhawks ying in and out evacuating
people.
All of a sudden we started seeing MPs running toward the main part of Dome. We
found out later that one of the military guys inside the Dome had been shot, and
that pretty much did away with our security. People started leaving the Dome
just walking out on their own towards the Arena, or wherever who knows where
they were going. We had gotten a report that there was a sniper out on one of the
bridges next to the Arena that had shot a couple of people on the ground, so that
was the biggest concern, because we had no security left.
Once daylight broke, we got the word out that we needed to get out of there and
some helicopters were sent to pick us up. But by that time the area reserved for
military and medical personnel had become inundated with people from the
Dome, and there was a huge throng between the helicopters and us. We had to
push through a few thousand people to get to our helicopters. It was obvious to the
people that we were leaving, and they wanted to get on the helicopters with us,
which was, of course, impossible. Once we got out of there and got back to the
Causeway and I-10, things got much better.
Medical supplies were a big issue. Everything was pretty much depleted as far as
medicine; there were no more diapers for babies, no medicines, nothing. Every-
thing was running out. Dr. Chuck Burnell, an ER doctor in Lafayette, was working
up there with the DMAT team, and he knew that I was the guy handling communi-
cations, such as they were. He had a contact at VA Hospital that could get the
medication we needed, so he asked us to nd some boats or big trucks that could
go through the water over to the VA to pick up the meds. We were able to get a
couple of boats from Wildlife & Fisheries, and we also commandeered a National
Guard dump truck that was high enough off the ground to go through the water. We
were able to go to the VA and stock up with all the medications they neededfor
the rest of the night at least.
We saw every kind of case out there. I know that several babies were delivered in
the Arena that night. There were a lot of dialysis patients who were, of course, a
high priority, because without dialysis theyre going to go into shock. Those were
the most critical needs that I saw, but otherwise it was just people who were really
worn out and their medical conditions were worsening because of the heat, the
stress, the exhaustion, and the lth. The whole situation was a nightmare.
To be blunt about it, the Superdome was basically one big toilet. Im assuming
people kept using the bathrooms even though the toilets were long since overow-
ing and there was no water. When you walked in the hallways it was obvious peo-
78
ple were doing whatever they had to do wherever they could do it. It was the most
disgusting thing you could imagine, and it was unbearable to be inside that build-
ing. If we could have gotten stuff done sooner, if we could have gotten people out
quicker, a lot of the trauma could have been avoided.
79
Crime
All of America -- in fact, all of the world -- saw the TV news images of young men
stumbling around drunk, people looting and other negative depictions of the
people in New Orleans and the Superdome. America passed judgment, or in some
cases, just pretended that these folks didn't exist, except when one of them shot a
gun or stole some tennis shoes, and then it was all over the evening news.
But the bad guys probably represented less than ve percent of the entire group
at the Superdome. The rest of the people were average, law-abiding, working class
citizens. They're the people who worked as maids and janitors, drove the trash
trucks and washed the dishes in the kitchens of New Orleans' nest restaurants. Yes,
a few of them were drug addicts and alcoholics who were detoxifying in that hellish
environment, and some might have been criminals or gang members, but they still
deserved to be rescued. The whole group simply represented a typical cross section
of poor urban life. If anybody was committing acts of violence it was the people
who would be doing that anyway in their normal lives, so why would they be ex-
pected to behave differently in a disaster?
From Monday until Friday these people! were stuck in the Superdome, struggling
and raging and dying, and nobody!was in charge. The police!werent there, the Red
Cross!wasn't there, but the National Guard was present and so were medics. Out in
the oodwaters, reghters braved the ood to rescue people despite losing their
homes, braved the oodwaters to rescue people. The human effort was tremen-
dous, but the local government was crippled by the storm, and there was very little
order. The people of New Orleans had to!govern themselves, which was not some-
thing they had the skills to do.
In the Superdome, the fog of war made it hard to decipher fact from ction.
Word of murders and rapes came from various sources, including the National
Guard and other ofcials. Reports of snipers in the downtown area hung in the
air for days. What was denitely true was this: the fear was palpable and real to the
medical personnel and rescuers.
**
Marc Creswell, Flight Paramedic
We got back to Touro hospital and the staff was preparing to commandeer some
buses. I went with two New Orleans cops to get these buses, which were parked
near the Walmart. Apparently a bunch of looters had gotten into Walmart, and po-
lice were swarmed all over the place. The buses were waiting for us, and it was
scary, because apparently there had just been a reght between the police and the
80
Walmart looters. There were about 100 New Orleans cops surrounding several
square blocks, and they had blocked off everything.
We managed to get the buses and I rode in the rst bus with one of the New Or-
leans policeman, who was armed with a shotgun. He gave the bus driver the order
that if anyone got in front of us or tried to stop us -- which could be an ambush or
something like that -- he should do what he had to do to evade the person. But if
evasion wasnt possible, just run them over. The driver understood that and we took
off driving really fast.
The cops had been ghting hoodlums all over the city now for at least 36 hours,
and they hadn't eaten and were hungry and thirsty. At one point we spotted a guy
coming out of a convenience store with a shopping basket full of food and Gator-
ade, allegedly a looter, and the cops took him down at gunpoint and took his food.
We nally get back to Touro, and got those folks out, and eventually we were there
by ourselves. Security detail had left, and it was just me and two other guys. At one
point we noticed that two guys were trying to crawl up the side of the parking
tower trying to get into the hospital, probably looking for drugs, so we started
throwing tuna sh cans and empty water bottles at them, trying to get them off the
tower. Then we got our helicopters and got out of there, because it was just too
hostile.
**
David Trahan, Telecommunications Analyst
Leaving the Superdome one day, I had to drive through a crowd of about 15 people
standing in water. One little girl started to move out of the way, but her mother
grabbed the child and actually put her in the path of my truck. I guess she wanted
us to stop and help, or give her a ride, but it just wasn't possible. We couldnt drive
around the child because the road wasnt wide enough. So I slowly drove to the left
as much as I could, and the child nally did move out of the way. It was a strange
attitude that was prevalent every once in a while, but people were desperate.
After getting back to the Gretna ofce, we heard that there was gunre on our lot
and some looting going on in the neighborhood. They had stolen our generator
right from under us and one of the deputies ran out and red his machine gun and
dispersed the crowd. At this point we were ready to come back home to Lafayette,
and a law ofcer came over and asked us if we had guns because he was con-
cerned about our safety. He wasnt there to help escort us; he was just telling us
that we needed protection. We didnt have any guns or anything like that, and we
had to go through an area where people were starting to gather before we could get
up to Highway 90.
81
Before we left we were under strict orders that under no circumstances were we to
give up the truck. We were told to run over anybody that may want to stop us, and
if there was a crowd, to plow through the crowd. Whatever happens, do not give
up the vehicle. It was martial law.
Well, I told them I wasn't sure we could do that, and luckily we didnt have to. We
had one situation where we had to stop, but the crowd did not try to take our vehi-
cle. During this whole period we did witness a lot of looting. We saw people steal-
ing post ofce trucks and things like that.
We made it back to Lafayette and spent the next day reorganizing the communica-
tion center. The next morning, Im thinking this was Friday, it was decided to move
out of Gretna because things were not safe there. We left in the middle of the night
with a couple of armed guards with machine guns, and when we got to the Gretna
station, it was total darkness, and these guys were running around with ashlights
on the ends of their machine guns clearing out the building and the parking lot. At
one point a car came around very slowly, and the guys with machine guns were
screaming and yelling, and we hid while they ran around in the dark securing the
area and waiting for something to happen. But the guys in the car just scanned their
headlights around the parking lot and left. So nothing happened there, but it was a
tense moment.
**
Randall Trahan, Paramedic
The rst days I spent doing evacuations from nursing homes. The second day,
Wednesday, I ended up getting yanked by Coast Guard helicopter to the Lakefront
Arena on the campus of the University of New Orleans. I was basically the only
medic out there, but there was also a doctor, a pharmacist and a nurse with up-
wards of 1,200 people needing medical attention. From 9 am until about 4 p.m.
about 5,000 evacuees found their way to us.
There were numerous babies, kids, old people and sick people, and there was no
food and no water until some of them ended up stealing from a Safeway and bring-
ing food down there to the shelter. Instead of giving it out, a lot of these individuals
were selling it to the other refugees.
This place became a shelter due to the fact that it was the closest spot on high
ground, and FEMA, the Red Cross and other authorities didn't know people were
congregating in this location. People were coming out of the water from the boats,
and there were truckloads of people just driving on in. But no one knew we were
there. There were no supplies and no food dropped there. There was no military
82
presence and no police presence, and violence was erupting at night. The doctors
and nurses were getting scared. I made my way out of there after about seven hours
and notied someone that there was a big problem over there.
**
Voice mail received September 1st @ 9:34 AM
Keith, I have an emergency at Tulane Hospital. Theyre shooting! Their medical
personnel are inside the building. I need to get a helicopter to the roof of Tulane
Hospital. Michael _______ and medical people are being shot at and I need to get a
helicopter to get them out of there. My name is Carol _____. I am calling from New
Jersey. My son, Michael ________ has called with an emergency call for the medi-
cal personnel. Please call me back immediately
**
Billy Vincent, Paramedic
On Wednesday, it was me and a paramedic named Stephanie on the ight line try-
ing to catch a ight. The majority of the group had already been own out. Dr. Ju-
dice had gone downstairs to check on the rst aid station and get a bite to eat when
a person with a gun started shooting down at the Superdome from the parking ga-
rage across the way. We took cover underneath the second story of the parking ga-
rage where the military had set up their bunks. The military ew a Blackhawk heli-
copter over to the parking garage and dropped off some military personnel. Later
they came back and let us know that there was nothing to worry about; they had
taken care of the problem. They didnt get specic on what taking care of the
problem meant.
**
Steven Hamilton, Paramedic
One patient at the Superdome was a soldier who was shot in the right thigh. It ap-
peared to maybe be an accidental discharge of his weapon. One of the doctors in
the Arena who took care of the patient was a surgeon. He told me if it was probably
another half inch to the right or left this patient would not have lived; he would
have bled out right there and there would have been nothing we could have done.
About 7:00 the next morning, Thursday, Todd LaPorte contacted dispatch and ad-
vised them that it wasnt very safe at the Superdome. We had some hostile people
coming over to the Arena from the Superdome. We got multiple reports that they
were trying to set res, and these reports came from several people and military.
Dispatched advised that it would be unsafe for us to be there, and within an hour
83
all 11 of us were evacuated out of the Superdome and back to the Causeway & I-
10.
**
Jason Hawkshead, Paramedic
We left on a helicopter from Lafayette going into New Orleans and arrived at ap-
proximately 9 p.m. Coming into the city, the only thing that was visible was police
cars with lights everywhere like little ants going in between all the streets. When
approaching the Superdome we went in a circling pattern because they wouldnt
clear us for landing because it was not safe. We were advised in advance that it was
unsanitary and not exactly the safest place in the world, but we all volunteered to
go into there anyway.

They nally allowed us to land and told us that there had already been multiple
murders in the Superdome that night and that the citizens were restless and hostile
towards our presence. I did not see any police there at all. I saw mainly just Na-
tional Guard, FEMA, and us. We were to operate above our license level, and we
were told that if we felt comfortable doing it, these people needed us, and to go
ahead and do it.

The situation was dire when we arrived. I remember there were at least 30 people
in need of medical attention and at least half were in serious need, such as hypo-
glycemia, severe chest pains, severe shortness of breath and four women about to
give birth.

For the rst time in 9 years working as an EMT-basic, I saw three births that night.
Whatever illness or problems people were presenting with, pretty much everybody
got a nerve pill or a shot of Valium just to help them calm down because it was
very, very frantic in there.

At some point during the night there was an MP who got shot through the leg with
his own MP5, so a doctor, a paramedic and I worked on him. I believe thats when
the severe hostilities in the Arena and in the Superdome really kicked off, because
he was one of our own and he had been shot, and that put everybody in a panic.
He was put in a helicopter on his way to further treatment, and that made people
mad because there were people dying and they didnt understand why he got to go
out rst. So that incensed the crowd dramatically.

Also that night we were told that we could no longer go outside of the Dome be-
cause there was a sniper shooting at us. Apparently the sniper was trying to hit any-
thing in a uniform. He shot four people under the mezzanine in between the Su-
perdome and the Arena, but this may have been just a rumor.
84
The supervisors on the ground made a decision at daybreak to get us out of there
because it had become totally unsafe. It was no sooner than 4 or 5 minutes after
they made that call that our people were leaving on the helicopters. Im thankful for
the opportunity to go and experience that, yet it scared the crap out of all of us.
**
Kimberly Lewis, Paramedic
We were on the I-10 and Causeway on Thursday. The crowd started getting real
restless and it was a bad situation and I was on a helicopter back to the Superdome
to get our guys out of there because it was getting bad there too. On the way, when
we were off-loading and getting back up in the air, there was some people about 2
miles out from the Superdome -- I dont know if they had been looting or what --
but they had guns and I think they were trying to get our attention, not to get res-
cued, but just to get our attention, and they started shooting at the helicopter.
We had critical patients on there with us. One of them needed surgery, a vent pa-
tient that was critical, and the whole helicopter was full. So when that started hap-
pening, we all started freaking out. We had the National Guard with us and they
said, Theyre just trying to get our attention; they dont know better. But just the
fact that they were shooting in the vicinity was very scary.
**
Gary Miller, Distribution Supervisor
We headed back to Gretna after dropping off food at the 1-10 & Causeway triage
area and helping there for a while. Once we got back we were told that a genera-
tor was stolen. They were also trying to steal three trucks a block away from our
post. One of the deputies stationed by us shot in the air to scare them off, but that
didnt work, so they shot with an M16
19
and that stopped them from getting the
third truck, but they did get away with the rst two.
Near the Superdome we actually saw people taking U.S. Mail trucks there were
15 or more people in the back, one driving, and one on the side, just going down
the road like it was nothing. After passing them, we noticed a cop had another
mail truck pulled over with the same number of people inside it. When the cop no-
ticed these other stolen trucks coming down the road, he got in the middle of the
road and pointed his shotgun at them and made them pull over. It was stuff you'd
never think you'd see. It was like a movie. It will stick with me for a long time the
sights, the sounds.
85
19
The M16 is an automatic rie used by the U.S. Military and law enforcement.
A cop walked up to me and asked if I had a weapon. I told him, No, and I asked
him why. He said, Because yall need to be protected. These people are at the
point where they will do anything to get what they want.
And I noticed it was getting a little crazy as we made our food runs. In fact, during
the last food run I asked for a police escort because I felt that we were in danger if
we went out there again without protection. After one run, we opened up the truck
and immediately two big guys came around the corner, but when they noticed the
cop behind us, they backed up and just said that they thought we might need help
unloading the truck. I know that was not their intention at all, and without that es-
cort, things would have turned out a lot different. We saw looting everywhere. I
mean, it was, you know, you just couldnt believe it to see it. They werent in a
rush to get away; they would just casually walk away like it was nothing. It was a
pretty wild experience that I hope I never see again.
86
St. Bernard
St. Bernard Parish was one of the hardest hit areas of New Orleans, and even now,
ve years later, residents are still trying to make sense of what happened there. Ac-
cording to a description on Wikipedia, The storm damaged virtually every struc-
ture in the parish. The eye of Katrina passed over the eastern portion of the parish,
pushing a 25-foot storm surge that destroyed the parish levees. Almost the entire
parish was ooded, with most areas left with between 5 and 12! feet of standing
water...For more than two months after the storm, much of the parish remained
without proper services, including electricity, water, and sewage.
Some of the Acadian responders lived in St. Bernard, and while frantically trying to
save themselves and their pets (see Jay Authements account in the Animals chap-
ter), also worked tirelessly to rescue friends and neighbors.
**
Jay Authement, Paramedic
We were going back and forth trying to help people out, driving our atboat, going
to different houses. We pulled out 20 or 30 people. Alex had a chain saw, so we
were able to cut through roofs and get people out of their attics. Wed listen for the
sound of people hollerin and wed know which house to go to. Theyd start hol-
lerin when they heard the boats coming, theyd start banging on the roof, and wed
go cut their roof open and bring them through the hole. If you didnt hear nobody
hollerin, you didnt need to go to the house.
People were going to houses looking for bodies, going into attics. We went through
every house, and while we were in these houses wed take what food we could.
The police told us, go to every house, and dont steal anything but food. You want
food; take whatever food you can nd. So we did.
On Thursday, when I got with Alex, we had the two dogs with us, my dogs were al-
ready turned loose in the house, and because of the surge we had speckled trout
and redsh in our house.
A the sheriffs ofce said, Were going to have a dump truck come down St. Ber-
nard Highway to get yall. I had a pirogue, so we used it carry people out to St.
Bernard Highway where they could get on the dump truck. Duke Collins was there,
a policeman, so I went up to him and said, Duke, its time for me to get out. I got
to go. Get me some transportation out.
87
He brought me to Poydras where they had a barge. They put maybe 200 people on
this barge, and everybody was dehydrated because of the heat. One of them was
hypoglycemic and the only thing I could do was to nd him some sugar. It was a
miracle that we found any food or water at all.

There were no IVs or anything that the dehydrated people needed. And the people
were turning red, and then there was this guy all pale and ashen, and he was so
sick, but the most we could do at the time was give people water, what little there
was to go around.
The boat came all the way up to Algiers Point, and when we got there, they had
three buses that were taking some people and the rest of us had to wait for two
hours. Eventually 14 buses arrived and they were loading people up, but nobody
knew where they were going.
My dad, we got him out the day before. My father actually stayed in the parish be-
cause they brought him to the Port Ship Service in Arabie, where they set up a tem-
porary center for the elderly, so he had to stay there. Dad doesnt know which way
is up right now, because hes all lost, and I didnt know where theyd taken him.
I ended up getting on a bus and we headed out, but I didnt know where we were
going. Of the 14 buses, most had no restrooms; so we had to stop in Baton Rouge
to use the bathroom. I went up to the front of the bus, and started talking to the
driver. He said, What you going to do after Houston? I said, What do you mean,
Houston? He says, Well, were going to Houston. I was shocked. Houston? Im
not going to Houston. He says, Oh yes Everybody on this bus is going to Hous-
ton.
By that time, the police started coming into each one of the buses with their shot-
guns, not letting anybody out.
Well, I was fast enough to get out before theyd come in, and I said, I am not going
to Houston. Im getting off this bus right here in Baton Rouge. So I started walking,
and when the police told me to stop, I didnt stop. The people on the bus started
getting rowdy because they wanted off too, so the police just started arresting them.
While they were busy arresting people, I was able to sneak away.

I got into the LSU main campus in Baton Rouge and I found a phone and called the
1-800 number to Acadian Ambulance switchboard. Amy answered, and she said,
Jay? I said, Yeah Amy." She said, Stay on the line, hang on. So she put me
through to Linda. Oh my God, Linda was screaming and hollering by that point.
She was in such a panic not knowing if I was living or dead.
88
Im going to move back to St. Bernard. We will rebuild. Insurance is going to pay
for some of it. Theyre going to have to bulldoze everything down, but were going
to do it. Were already buying stuff.
**
Marc Creswell, Flight Paramedic
In St. Bernard, some ofce buildings that belonged to the oil reneries were being
used as a shelter, and we tried to bring some relief to the people who had been
working there for ve or six days. Theyd been eating box lunches for days and we
really wanted to help them out, so we organized and called a few people -- includ-
ing my dad who is one of the most resourceful guys Ive every known -- and asked
him to nd us some food. We had a barbecue pit, and sure enough, my dad got a
bunch of meat donated, and one of our Acadian vice presidents got some food do-
nated from Outback Steakhouse. Somehow the St. Bernard parish president was
able to round up some prison trustees to come and cook for us, and for many peo-
ple working there, it was their rst hot meal in six days. You could tell instantly that
their morale boosted. We also got them some satellite phones and some other ne-
cessities.
Oh yeah, and we got them some national media attention, which was really impor-
tant.
Fox News was there but they werent really paying any attention to what was going
on in St. Bernard and the other neglected parishes. I told the news guys, If you
want to pay $5.00 a gallon for gas, then go ahead and ignore this story. But if you
want the reneries to get started up again and having those gas prices drop, you
better do a story about whats happening here. Those little parishes werent getting
enough news coverage, so consequently they werent getting enough help. We
needed heavy equipment, mobile kitchens, volunteers and general labor, but no-
body knew we were there. Fox nally did a story and let me to talk about this on
the air for 2-3 minutes. And after that, the phone didnt stop ringing.
89
Organizing Chaos
This chapter follows Dr. Ross Judice during the rst week after the storm passed
from the chaos of the Superdome to the triage area at Causeway & I-10, from the
confusion at the New Orleans Airport to the FEMA search and rescue operations at
the New Orleans Saints training facility. Two state public hospitals, Big Charity
and University Hospital, along with Tulane Hospital and Veterans Administration
Medical Center are located downtown near the Superdome.
Being thrown into the chaos of the Superdome was like being transported from
quiet suburbia into inner city Bangladesh. While Acadians presence at the Super-
dome was very small in comparison to the throngs of people and National Guard
presence, we had a large impact on triaging, caring for, and evacuating patients.
At other locations on different days, Acadian led when needed and we supported
when appropriate. At the I-10 & Causeway triage area, Acadian medics worked tire-
lessly to triage, treat, and evacuate hundreds if not thousands. At the airport and in
search and rescue operations we provided support to other agencies.
**
Superdome, Tuesday & Wednesday
After I arrived at the Superdome Tuesday, Ray Bias
20
took me into the loading dock
area where there was trailer that was being occupied by some of the state Depart-
ment of Health and Hospitals (DHH) staff and Dr. Fred Cerise, Secretary of DHH.
Ray and I sat down and tried to get a sense of what was happening as they briefed
me. There was very poor quality radio communication with the downtown public
hospitals in and out of that location. They were trying to evacuate some ventilator
patients from University Hospital by boat and wanted to transport them to the Clai-
borne off-ramp at the Poydras exit. They were trying to send some ambulances to
that location and the ambulances were having a very difcult time nding their way
because of the ooding and the confusing spaghetti-like elevated highways. The
command center was having a difcult time communicating exactly where they
should go was it the on ramp or the off ramp?
Dr. Cerise asked if we could re-deploy all of our ambulances (some 50 or so) that
were at the Causeway and I-10 to that location. I got on the phone and talked with
David Pierce
21
. We agreed that this was not a good idea since the State personnel
90
20
Ray Bias is a nurse and manager for Acadian. Based in New Orleans, Ray played a key role in getting
Acadians Superdome operation organized.
21
Acadian President David Pierce was located in the Lafayette dispatch center.
did not have good radio communications. I didt have much condence in the
States plan. We should not risk abandoning a triage area at Causeway that was
working to move to a questionable staging area location with a no command struc-
ture and no meaningful communications. David and I agreed that the ambulances
would stay at the I-10 and Causeway, and that we would move ambulances once a
downtown staging area was formed.
Dr. Cerise and his group called into a teleconference with Gov. Kathleen Blanco,
state health ofcer Dr. Jimmy Guidry, state EMS director Nancy Bourgeois, and state
trauma president Les Johnson. The information provided by DHHs Superdome
group to the governor was sketchy. The communication shortcomings affected their
ability to survey the situation at the downtown State hospitals. At this point, there
was no over-arching plan for all of the patients, both public and private, other than
moving ventilator-dependent patients to the ramp at Poydras Street.
At this point all of the four downtown hospitals were lled with patients, staff, and
family members. None had evacuated before the storm. All four hospitals had in-
tensive care unit (ICU) patients - Tulane had critical babies. The state was denitely
focused on the state hospitals. It was evident that there was no sense of the worsen-
ing medical situation inside the Superdome.
After the brieng with the governor, Dr. Cerise, Ray, and I found New Orleans EMS
Director Dr. Jullette Saussy and assessed the situation. FEMA's Disaster Medical As-
sistance Team (DMAT) - a FEMA team of doctors, nurses, and medics from New
Mexico - were setting up in the Arena and already had serious medical patients.
These patients needed urgent air medical evacuation. I called our Erroll Babi-
neaux
22
and requested air evacuation of these patients. He informed me that there
were two Petroleum Helicopters, Inc. (PHI) medical helicopters on the helipad.
They had been there for two hours and nobody had given them any patients or any
orders. The Dome was a big place and the right and left hands werent coordinated
or communicating.
I decided to take charge of the air evacuation situation, so I sent Ray Bias with a
portable radio communication to the DMAT area in the arena. Our medics in the
rst aid station and around the Superdome had radios. Some of us had satellite
phones. We set up transport teams to move patients on demand. We borrowed
some command vests from the National Guard Chemical Response Team. We set
up a helipad/landing zone in the Dome parking lot because the National Guard
was using the regular helipad and wouldn't let us use it too. We started moving the
most critical patients out of the Superdome and Arena. This would be the beginning
of a massive air medical evacuation effort.
91
22
Erroll is Vice President of Acadians Air Operations.
A PHI representative, Terry, and I organized multiple helicopter trips between the
Superdome and Baton Rouge a 90 minute round trip. The patients needing
transport out were exceeding our ability to get them out. I decided to send the heli-
copters to the Causeway and I-10 where I knew we had 50 ambulances. This was a
15 minute round trip ight. They could transport the patients by ambulance the rest
of the way to Baton Rouge. The short hop ights were much more time efcient
and moved so many more patients out.
All day the PHI air medical teams performed amazing work. At some point around
dusk, seventeen ventilator patients from the VA Hospital arrived in big army trucks.
We transferred them to helicopters with the help of some military guys, because the
patients were very heavy. We had no spine board and they were on inatable mat-
tresses making them difcult to carry and maneuver. Those patients were being
bagged, and some doctors and nurses accompanied them from the VA hospital. We
loaded these patients on the helicopters as they arrived and evacuated them out to
Causeway and 1-10.
Terry told me that his people were running out of fuel and the pilots were running
out of ight time hours. We knew we would have to discontinue ights very soon,
so we tried to get as many people out as we could. As soon as ights stopped, an-
other big truck arrived with two more ventilator patients, one of them weighing 500
pounds. Since there were no more helicopters, I instructed them to transport the
patients to the DMAT area. The DMAT people felt they could not handle these pa-
tients, so I requested some assistance from a Colonel Keeling at the military post
nearby. He authorized a few more trips on the Blackhawks for the critical patients
who were still coming into the DMAT area, one I believe with a gunshot wound.
Flight operations shut down during the night on Tuesday. I treated patients inside
the Dome all night and on Wednesday morning I went to the landing zone at 4:30
a.m. to wait for helicopters. I had every condence that the world knew what was
happening here and that any minute now wed have plenty of helicopters. No heli-
copters came.
Alarmed, I went down to the DHH command post in the basement of the Super-
dome to see if they had a plan for air evacuation. When I arrived there, everyone
was sleeping. I made a couple of phone calls on their satellite phone. Then I went
on to the National Guard command center at the landing zone. All those people
were sleeping as well, and lights were out. I could not believe that in this desperate
situation that required a 24/7 operation, everybody was sleeping. Nevertheless, I
trusted that the aircraft would come at rst light. I lay down at the landing zone,
unsuccessfully tried to get a few minutes of sleep, and waited for the helicopters to
arrive so I could begin moving patients from the DMAT area as quickly possible.
92
First light came and went on Wednesday, and by 8 a.m. the rst helicopter nally
arrivedbut it was not militaryit was Acadian bringing in relief staff. To my sur-
prise, among the group that arrived on the helicopters were three of my brothers.
Remi is a nurse. Roch is a communications engineer with expertise in satellite
communications. Ronnie was a National Guard medic. With them were medics
and doctors carrying medical supplies and equipment.
I got on the phone to Acadian CEO Richard Zuschlag and pleaded for as many
helicopters as possible. After some monumental efforts on Richards part, the mili-
tary helicopters - Coast Guard and National Guard Blackhawks - nally began y-
ing in at around 9 a.m. and never stopped until the evening.
In the beginning the military was real persnickety. They'd insist on taking exactly
two stretcher patients and three walking patients, but we had one litter patient and
eight walking patients, and they would refuse them! By the middle of the day on
Wednesday we were just shoving people in wherever we could and ignoring the
militarys rules.
I set up a tent near the landing zone to stage patients needing emergent evacuation.
The patient ow was like this: our medics triaged requests for help among the tens
of thousands of people inside and around the Superdome. Most were treated and
released, while some were brought to the rst aid station for IVs, breathing treat-
ments, oxygen, monitoring, or wound cleaning. The most critical patients were
taken to the Arena on a gator or stretcher where the DMAT doctors and nurses
treated and triaged to see who was evacuated next. These patients were transported
down to the landing zone staging tent, and prepared for the next available helicop-
ter ight out. Most were own to I-10 and Causeway and transferred to ambulances
for the hour long ride to Baton Rouge. Some were own directly to the eld hospi-
tal on LSUs campus.
At approximately 4:45 p.m. Wednesday I received a radio call from a colleagues
who said that a FEMA representative wanted me to attend a command meeting. I
rushed over there, and when I entered, there were many people, mostly military,
and what looked like some high ranking ofcers from the National Guard and the
Army, plus Mayor Ray Nagin and his entourage, and many others that I assumed to
be junior ofcers of some kind. General Russell Honore was present, having just
landed minutes earlier. The meeting centered on trying to gure out how school
systems in nearby cities could be closed and their school buses sent to New Or-
leans to transport people of the Superdome. Seemed like a good idea.
But nobody seemed to know whether it was Gov. Blanco or Secretary Cecil Picard
who had jurisdiction over school buses, and this held things up for a long time. In
93
my opinion, the Governor should have been called immediately and told about the
school bus plan. She could have authorized it right then instead of wasting time ar-
guing about who was in charge of school buses. The nal task delegated in that
meeting was that someone would check with the governor about the buses.
Again, in my opinion the situation was way too desperate in the Superdome and
this should have been an urgent decision. The buses nally arrived two days later.
General Honore asked, Why cant we walk these patients out of the Dome?
An ofcer from the National Guard or Army (I think) reported that they had a plan
to walk people out of the Dome, and another ofcer said that it could be easily
done. Mayor Nagin was fairly outspoken about trying to create a sense of urgency
about getting people out of there, and questioned why we were developing a new
plan and what happened to the plan from yesterday? I personally did not know yes-
terdays plan, but it appeared to me that these changing scenarios irritated Mayor
Nagin.
They addressed me only one time during the meeting, to ask me how many patients
we had evacuated from the Superdome and how many more were left. My re-
sponse was that I had no idea, because wed evacuated them so fast that we hadnt
kept count. I also informed them that every minute that passes creates new patients
because of the terrible conditions. The healthy people were getting sick, the sick
people were getting sicker, and the sickest people were dying in there.
After the meeting Gen. Honore and Mayor Nagin met separately and I was standing
with that group. I suggested to Gen. Honore that we should make immediate plans
to walk the able-bodied people out. That comment seemed to register, but I re-
ceived no acknowledgement from him or from anyone else. I might have been the
only person in the meeting with rst hand knowledge of what the medical condi-
tions were like inside the Superdome. I wish that I would have spoken more
authoritatively about the urgency of getting people out of those conditions, espe-
cially the healthier folks who could have walked out, and alleviated the crowded
conditions. I was also going on some thirty hours without sleep and that may have
affected my ability to make an impression. I was exhausted and more than a little
loopy.
After the meeting, Mayor Nagin and his entourage walked past my group of medics
just outside the Superdome exit. I thought it would be appropriate for him to say
hello to my staff who had been working tirelessly on behalf of the citizens of
New Orleans. Frankly, we were all exhausted and in need of an attaboy. I ap-
proach the Mayor, made an introduction and my simple request. He was downright
rude, responding angrily, I aint got time for that. At that moment, I lost all respect
for the man. He couldnt spare ve minutes!
94
**
Causeway & I-10, Thursday
On Thursday I ew from Lafayette over to the intersection of I-10 and Causeway.
Our crews had set up triage there on Tuesday. The plan was for my team of seven to
get off the helicopter and for seven weary medics board the helicopter for home.
Upon landing, a desperate group of around fteen people made a dash to get on
the helicopter. I stopped the group to assess the situation and found out they were
some doctors and nurses who had been stranded in ooded hospitals for days and
were recently evacuated to the Causeway. I had to decide who got to leave on the
helicopter and who did not.
After a quick assessment about who had been working the longest, I put seven
Acadian medics on the helicopter. I met with the doctors and nurses and apolo-
gized and told them that we would try to get them out as soon as we could, but
that we needed to transport our own staff. We later put them on ambulances head-
ing to Baton Rouge.
By Wednesday there had been rumors of murders and rapes in the Superdome, and
the whole thing appeared to be completely insane, so we evacuated our people out
on Thursday. I came home Wednesday night, got about 6 hours sleep, and Thursday
morning I went back to the Causeway and I-10.
Acadian safety manager George Ellis briefed me. Austin/Travis County County
(Texas) EMS was on scene and they had replaced our weary medics in the triage
area. There were essentially four groups at that location: the State Police, Acadian
(who had now taken a secondary role to the Austin group), and the Louisiana De-
partment of Health and Hospitals staff. I introduced myself to Gordon Burg, inci-
dent commander from Austin, and explained who I was and what I was doing
there. I was awed by the professionalism and resources of his group. They had a
state-of-the-art communications trailer with satellite links and internet access.
Gordon and I agreed that we should move the triage component to the New Or-
leans Airport. It was not efcient to y people in to the Causeway by helicopter and
then shuttle them by ambulance a few miles over to the airport. It made more
sense to y people directly to the airport where they would be evacuated out of the
area.
I thought the best way for us to move the triage team to the airport was using a two-
phase plan. First the Acadian staff would move over to the airport and establishing
a triage area. Then we would instruct the helicopters to y directly to the airport,
freeing up the Austin group to pack up and re-deploy to the airport. Gordon as-
signed a medic named David to accompany me to do some recon and planning at
95
the airport before we moved over there. Jumping in the supervisor sprint vehicle,
David and I led a convoy of Acadian medics in ambulances to the airport.
**
New Orleans Airport, Thursday
We stopped at the entrance to the airport where the Texas National Guard and se-
curity were controlling trafc into the airport. Those folks informed me that the Na-
tional Guard was trying to nd out who was in charge so that they could set up
their own staging area. I was transported by an airport security ofcial up to the
terminal area where I attempted to nd out who was in charge at the airport.
Meanwhile, David from Austin was charged with assessing the triage needs in the
airport. The ambulances drove up to the terminals top level departure area.
Inside the airport I noted there were public strewn all over the terminal. One eld-
erly lady sat in the terminal with an MRE in her hands. As I passed by her, she
asked if I could open it because her arthritis was bad.
A DMAT team was set up in the downstairs Delta terminal, and another DMAT
team set up upstairs. There was confusion by DMAT personnel about who was in
charge of the entire medical or airport operation. We trotted downstairs to the
DMAT area on the lower level to see what they knew about ights coming into the
airport. I briefed them on the situation at Causeway & I-10. This DMAT team re-
ported that ights were already incoming and that they were very well equipped to
triage those patients coming in by air. By consensus we agreed that Austin/Travis
County and Acadian would deploy on the top level to better organize the triage
coming by ambulance.
As far as I could tell, no people were being evacuated out of the airport. My im-
pression was that the airport was beginning to look like what Id already seen at the
Superdome: people coming in, piling up and no one moving out.
We had approximately 10-15 ambulances and a lot of staff awaiting directions.
This, combined with the 10-15 ambulances that we brought from the Causeway
meant that we now had between 20-30 ambulances at the airport. It had been my
assumption that some patients would be own in by helicopter and some would be
bused in, and they would all be quickly evacuated out of the airport to whatever
hospitals and facilities we could nd. When I discovered no patients leaving by
ground, and other ambulances from other services also staged there, I decided to
send half the ambulances home and keep the remaining half at the airport. It was a
waste of equipment and manpower for Acadian to have 30 ambulances just sitting
there with exhausted crew members.
96
I gathered all the medics in the Departure area near where the ambulances were
parked, and told them that I was releasing half of the medics to go home. Some
were relieved. Some refused to go. And some asked me, Where are we supposed
to go if the hurricane destroyed our homes? I felt a huge lump ll my throat,
paused to collect myself, and suggested that they go to the homes of family or
friends where they could get some sleep and gure out the rest tomorrow. If you
need anything at all, get with Dee Dee and shell make arrangements. Dee Dee
Sewell, our employee liaison and critical incident stress manager, was there -
thankfully. The heaviness of the medics as victims hit me like a ton of bricks for the
rst time since the mess started.
David from Austin came over to talk with me. He suggested I deploy a recently ar-
rived Oregon DMAT team to set up the triage since that was their specialty. David
suggested that the Austin group would be more useful in a forward eld location,
and would redeploy with a search & rescue team. I informed David that I had no
authority over FEMA teams. He suggested that they were willing and ready to listen
to anybody who looked like they were in charge. In Davids opinion, he thought
that I carried myself in a way that showed I was in charge and that they would work
with me.
With some authority, I walked into the DMAT command post on the upper level of
the terminal and said I was in charge of the triage site over at the Causeway and
wanted speak to their team leader. I essentially asked the head of the Oregon
DMAT team to deploy and organize a triage function on the upper level where am-
bulances were bringing patients. I was somewhat shocked that people listened to
me, but it is clear they were looking for some sort of leadership and I lled that
void.
A few minutes later Dr. John Jui and his staff with the Oregon DMAT team came
over to our ambulance staging area to get more information about their orders and
their deployment. I told him that I really had no formal authority but the upper
level triage area was the greatest need at the moment. He agreed. I told him I was
on my way to the FEMA Urban Search and Rescue (US&R) operation center over at
the New Orleans Saints training facility and that I would be in touch. We ex-
changed contact information.
97
**
New Orleans Saint Practice Facility - Thursday & Friday
Roger Brammell
23
approached and said that he had been at the FEMA operations
center over at the Saints Training Facility. Don Shawver, US&R security chief, was
requesting that we stage over there and assist.
I took the sprint truck
24
with Gifford Saravia, Jay Pierret, and three of the freshest
ambulance crews and drove to the New Orleans Saints practice facility. Don wel-
comed us and gave us instructions about where to park our ambulances, where the
food was, where we could sleep, and where the operation center was. After getting
some food, I went into the operation center. Dr. Michael Olinger briefed Gifford
and me about the next days operation. They were planning to stage over in New
Orleans East at the exit just over the high rise on I-10 near Chef Menteur Highway.
Search and rescue teams would deploy along Chef Menteur Highway. They would
go into the ood waters of New Orleans East to rescue individuals and bring them
out.
Our ambulances were needed to transport any medical patients that were pulled
out over to a collection site. There they would be triaged by a medical team headed
by Dr. Ken Miller, US&R physician in charge of medical sector. From there the
medical patient would be own to the airport while all ambulatory people would
be driven out by bus or truck.
The FEMA people told me that they were not able to access air medical transport
for whatever reason. It didnt make sense to me because as federal emergency
personnel it seemed to me that they should be able to access military helicopters
and even requisition civilian aircraft. I told them that I could provide some air sup-
port through our dispatch center and through Acadians connections with the gov-
ernor. In sum, my assigned responsibilities included organizing Acadians transport-
ing patients to the collections area, where our people would also establish a land-
ing zone. In addition, I was to use Acadians connections to obtain aircraft, pref-
erably military aircraft. Gifford would lead our ambulance team deployed with the
US&R teams and I would stay in the US&R Command Center in Kenner.
Captain Richard Smith with the New Orleans Fire Department sat with me for a
while. He was under the impression that Acadian was going to inoculate all of the
re department staff for tetanus and hepatitis A. I told him that I was not aware of
that, but I would do whatever I could to try to help him and his team. He told me
98
23
Roger Brammell is an Acadian paramedic.
24
A sprint truck is a supervisor SUV equipped with lights and sirens.
that the reghter personnel were a moving target - some of them were supporting
Search & Rescue and others were going to be deployed to the Little Sisters of the
Poor Hospital in Gretna. One of Captain Smiths crew members sat down and told
me about the non-stop tireless efforts of the New Orleans reghters and what they
had done to during and after the storm. He became tearful as he described wading
through the ood waters to save families in distress. He and his colleagues went
days without sleep. Only later did he tell me that he lost his house in the ood. I
was impressed with his seless sense of duty.
That night I attempted to sleep in the practice eld where many of the medical
people were sleeping. I lay down on the articial grass but couldn't sleep because
of worries about this whole mess. Since I couldn't sleep anyway, I got up to see
what was going on in the command center and was surprised to nd nobody there.
I became increasingly frustrated, because I believed this should have been a 24/7
operation and there should have been people working day and night.
I didnt understand why there was a brieng session scheduled for the next morning
at 6 a.m. Why not schedule at 3 or 4 a.m. so people could be deployed rst thing
in the morning? They could have gotten into their helicopters and boats at rst light,
but instead, people didnt get deployed until 8:30 a.m., and boats werent in the
water until somewhere around 10 a.m. It was all so methodical and casual without
the sense of urgency that Acadian demonstrated in its efforts.
At the 6 a.m. planning meeting they tallied up all the resources neededtrucks,
MREs, medical staff teams, etc. There was a need for ve ambulances and a Black-
hawk to be ready in case there were medical patients who needed to be evacuated.
I was assigned the task of taking care of the ambulances and the Blackhawks.
After the morning brieng at about 7:30 a.m., I told US&R planning chief Dan
Hudson that it was very important that we assess the situation over at the airport
and made sure that they knew that the US&R was going into New Orleans East. The
airport rescue workers and DMAT teams needed to be prepared to receive more pa-
tients and more evacuees. The estimates from the brieng was that the mornings
operation would bring some 3,000 new people to the airport. To my surprise there
was no communication between US&R team at the Saint training facility and
DMAT teams at the airport, even though they were separated by only a few miles.
It appeared that they were operating in silos.
Mark C. N. Libby, the emergency coordinator for Region 1 in New England for the
U.S. Department of Homeland Security National Disaster Medical System, and I
drove to the airport. We would locate and brief the leadership about the search and
rescue operation. To my surprise the population at the airport had increased from
the day before. In my fantasy world I assumed that perhaps someone at the airport
99
would have taken charge and started evacuating all of these patients in preparation
for todays inux of patients and general population.
There were people all over the place and, like the day before, it reminded me of the
Superdome. I had grave concerns that if people werent moved out, there could be
potential security issues and a huge bottleneck because Fridays operations were
sure to bring thousands more people to the airport.
During the 8 a.m. brieng at the airport, Theodore Monnette, the apparent head of
FEMA operations at the airport, described the process by which the public and the
medical patients would be evacuated. The meeting was attended by representatives
from TSA (Transportations Safety Administration), the airport, U.S. Air Force, and
others. Mr. Monnette appeared to be very calm and in charge and he engendered
condence in me. He explained that local law enforcement was going to move the
public through the area to board the planes and that federal guard security was go-
ing to be supporting them.
After the meeting Mr. Libby introduced me to Mr. Monnette and we all talked with
the gentleman in charge of the medical part of this operation. We explained that
we were part of the search and rescue operation and that we would be transporting
patients to his location.
Returning the Saints training facility, I spent the entire day in the operation center
with members of the US&R command team. It was clear to me that this was a very
professional group. They knew what they were doing and the search and rescue
teams were very professional and they knew what they were doing. This was later
conrmed by the Acadian staff that deployed out with the search and rescue teams.
All were impressed with their operation.
At some point a commander called out for the rst helicopter. I got on the phone
with John Zuschlag at Acadian and told him it was time to send the rst helicopters
in. He said he would call me back in 5 minutes. When he called back he said that
the military had changed its plans and the search and rescue operation was no
longer a priority. Instead, the National Guard helicopters were being used to drop
sandbags into the levee breaches.
I told John that this was not an option. We'd just received word of a nursing home
with 50-60 patients that needed those helicopters. Again he said he would call me
back in 5 minutes. When he called back this time he said that the military was
adamant that they would not send a helicopter.
I would not accept no for an answer. Again, he said he'd call back in 5 minutes.
100
When he called me back this time he told me that he had a Chinook and two
Blackhawks on the way. I felt very good at that point that we were able to help with
this operation. It took persistence, begging and arm-twisting to get them to give us
some helicopters. Thanks to John and others for getting those helicopters.
Erroll later told me that he had been in touch with Chief Warrant Ofcer Charles
Tracy with the Louisiana Air National Guard. Through the efforts of Tracy, Colonels
Keeling and Jenson at the Superdome, they were able to provide the Chinook and
Blackhawks. The Chinook landed very close to the nursing home and was used to
evacuate about 50 nursing home patients.
Looking back, it's amazing that FEMA allowed us into their operations without be-
ing "federalized." They did it because Acadian was still able to inuence the air op-
erations. In other words, what FEMA couldn't do, Acadian could do. We could
work with the civilian helicopter companies and the National Guard to get Chi-
nooks and Blackhawks, but for some reason, FEMA could not.
**
Lafayette & New Orleans, Saturday & Sunday
We began to work on getting supplies to the New Orleans EMS Service and Fire
Department so they could continue their heroic work. While some medications
were for patient care, most of the medications on the following list were for the
medics and remen because they left their homes during the ooding without their
medications. The supply list tells their story:
Gatorade, Diet Coke, Coke, dental oss, citronella candles, regular candles, tetanus shots, Cipro eye
drops, triple antibiotics, Bactrim DS, Benadryl, Lipitor, Diovan, Allegra, Lotrimin, tolnaftate, Cortis-
porin, Vicodin, Cardizem SR, Zyrtec, Morphine, Epinephrine 1:10,000, Atropine, Albuterol, D50,
Lidocaine, DEET bug spray, saline, lactated ringers, IV set ups, gloves of all sizes, HEPA masks, Hu-
mulin, Novalog, regular insulin, syringes, Cosopt, potassium chloride, Silvadine, cardboard splints,
bolt cutters, T-bars to change tires, whore red" nail polish, BDUs
25
, cargo pants and shirts or jump-
suits in the quantity of 500 broken down into specic sizes, female underwear broken down into
specic sizes and quantities, male underwear broken down into specic sizes and quantities, ve to
ten chainsaws, plus two-cycle oil, ten decks of cards, socks, sheets, towels, laundry detergent,
bleach, boots
We ew the supplies in two aircraft over to the Belle Chasse Air Station. With the
help of Navy personnel, we loaded all those supplies from the hangar into two am-
bulances and drove to the Little Sisters of the Poor Hospital. We found Ron Pelas,
New Orleans EMS supervisor who appeared exhausted. He helped us gure out
where in the facility the supplies need to go. Dr. Chris Najberg ew over with us.
101
25
Battle dress uniforms (BDU)
He had helped at the Superdome earlier in the week. We turned everything over to
him since he was staying to to help. We ew home.
Later that day, my initial contact, New Orleans EMS supervisor Jacob Oberman,
phoned me to express his deepest appreciation. He said that when he saw the de-
livery it brought tears to his eyes. Medical Director Dr. Jullette Saussy also phoned
in and expressed her gratitude for the delivery. One of the items that we delivered
was a box of hand, face and lip lotions that Martha Day from Teche Pharmacy gra-
ciously put together in a box. Dr. Saussy told me when she received the box, It
made me feel human again. She lost most everything in the storm, and along with
her staff, worked heroically on behalf of the city.
Sunday, I was notied that one of my paramedics was reporting severe headaches,
neck pain, sensitivity to light, nausea and vomiting that was fairly acute onset. He
had recently been in the oodwaters and exposed to the muck of the ood. We
sent an ambulance to pick him up and take him to the hospital, where the supervi-
sor stood by his side as he was being worked up. All of his tests were negative, and
he was discharged home. This was a very tenuous time. There was no way to know
whether there was an infectious or toxic cause to his complaints. We did not know
if we were facing large scale health problems.
We organized a team to provide hepatitis A inoculations and prophylactic antibiot-
ics for all of our employees and rst responders who had been in the ood waters.
With no real precedent, we made up a prophylactic protocol that made sense to us.
We were able to procure medications from Abbeville General Hospital, Lafayette
General Medical Center, Womens & Childrens Hospital, Medical Center of
Southwest Louisiana, Iberia General Medical Center, St. Francis Cabrini, Huey P.
Long, Opelousas General, Tom Day at Teche Pharmacy and Tina Stefanski at the
Ofce of Public Health.
We put together an announcement to all employees about the immunization effort
and developed an immunization alert provided information to the employees tak-
ing these vaccines and antibiotics. It was a great effort by the Acadian education
and quality team that pulled this together. They had to literally stuff Cipro or Leva-
quin into little packets, print labels, print instructions and coordinate all those logis-
tics to make sure that we were prepared to get this much medicine out to our staff.
102
Difcult Communications
The expectation is that when we call for help, help will come; that when a message
is sent someone will be there to receive it. Arguably the most effective communica-
tions model is the simplest one a direct line of communication between a sender
and a receiver. In the wake of Katrina, communication broke down and not much
was reliable. The radio towers around New Orleans were down, civilian and mili-
tary communication frequencies were not compatible, functioning communications
devices were scarce, and there were no guarantees that there was anyone at the
other end that even had the resources to help. Acadian personnel did what they
were trained to do when they could, improvised when they couldnt, and assumed
authority when needed to do so.

And it wasnt just Acadian - a neighboring parish sheriff in New Iberia who had just
received a big new mobile command center for such disasters showed up at our of-
ce to help us re-establish communications. By Tuesday afternoon, he had his fty
foot tower up near New Orleans, his generator running and had reconnected Aca-
dians system through a programmable channel to reestablish communications with
Acadians radio tower over in Houma, Louisiana. We didnt have all the bells and
whistles, but at least we had basic VHF communications.
**
Paul Fuselier, Paramedic
We had some communication problems. I think that was universal across the
board. First of all, all your radio towers and everything were gone. Sometimes you
had cellular communications; sometimes you didnt. It was hit or miss. We had sat-
ellite phones, but again, it was hit or miss. Inside the Superdome, communication
was extremely limited. We did have some portable radios and we were able to talk
with each other around the Dome. If one of us was in one area of the Dome and
needed help, the portable radio communication helped out. But our biggest prob-
lem was communicating with dispatchers and people outside New Orleans. It
taught us that no matter how much we think our communications are in line, there
is always something better we could be doing.
There's one thing we have practiced that Im proud of. I call it going back to the
old school, to the old days where you didnt have all the fancy equipment. A lot of
times we were doing local dispatching, which means we were dispatching our-
selves. We have had radio towers go down before, and when that happens, the su-
pervisor gets in his Sprint truck and goes up to the highest point that he can get to,
and elds phone calls. When the towers are down we can go from unit-to-unit, but
103
we cant get from dispatcher-to-unit. And that's what we were doing during Katrina
dispatching unit-to-unit and trying to get crews where they needed to be.
When things happen youve got to go back to your basics.
**
Billy Vincent, Paramedic
I was in the Superdome before Dr. Judice arrived with more medics, supplies, satel-
lite phones, and some radios. The time we were without those radios made life ex-
tremely hard. It was nearly impossible to coordinate between our rst aid station
and the special needs site at the other end of the Dome, which was manned by Na-
tional Guard doctors, nurses, and medics.
Whenever a patient came into our rst aid station and needed treatment that we
could not provide, we would have to coordinate with the special needs site to get
that patient moved over there (until the DMAT team arrived). But we had no com-
munication, so we had to use people as runners. We'd send a runner over there to
see if they could handle that particular patient, and if not, then how long before
they could receive that patient. So the runner would come back and let us know,
yes we can bring the patient, or no its going to be another hour. It was like the old
Pony Express. People running back and forth delivering messages.
**
David Trahan, Telecommunications Analyst
I was leading the pack of six trucks, and I was the rst truck into New Orleans.
Naturally, after a hurricane, you can imagine what we had to go through to get
there maneuver around downed poles, downed trees, low-lying wires, etc. When
we got to the other side of the Mississippi River bridge, there was no way to get
onto West Bank Expressway, and there were specic directions to go up the wrong
way on the trafc circle. I wasnt sure exactly what to do, so I pulled over into a
gas station with all my trucks behind me and lo-and-behold up comes the National
Guard and FEMA behind us. I didnt realize that we had been leading the way for
them. They apparently had no clue how to get to the other end.
When we got over to Acadians Gretna ofce, the rst thing I found out was that we
had no phone service. So I established phone service to the New Iberia Sheriff's
Command unit. We were asked to go back down to the large triage area at the I-10/
Causeway cloverleaf, where we brought satellite phones.
For the next few days, my job was to keep the telecommunications up and running.
We were the only people with communications to the outside. The executive ofcer
104
of the air base visited our command post and he was very impressed. For the next
couple of days his people came in and used our phones until he got his satellite up,
and even then we had a better setup than they did. We were told that we had a bet-
ter command post than the naval air base or the army or FEMA.
We had Internet because of a satellite connection that CapRock provided, and a
couple of guys from the naval air came over to use our connection. We provided
them with the coordinates of particular houses that they knew people were in, so
they could do these drop-ins and rescue people from these houses.
**
Remi Judice, Nurse Anesthetist
Someone that was in control of what they called FEMAs CA6-COM gave me a ra-
dio. He said it was a Homeland Security walkie-talkie. It was yellow and it had
Property of FEMA or maybe it was U.S. Government on it, and he made me
sign a piece of paper saying I had that radio. He told me that if I misplaced the ra-
dio or kept it, the FBI would come nd me wanting to know what I had done with
the radio. But I didnt pay that much attention to any of that, loose cannon that I
am, and I said, Okay. I signed my name, and communicated with him almost the
whole night with that radio. When it was time for me to rotate out of there, I
thought the helicopter might leave me, so I left the radio with someone named
Surfer who worked for Acadian and told him that the guy at CA6 said if I lost this
radio the FBI would come after me.
**
Dr. Ross Judice, Medical Director
I was asked if I could y to the Superdome to assess the situation and relieve Ray
Bias. We went down there with some equipment and 30 or so portable satellite
phones.
When we arrived at the Superdome the military wouldn't let us shut down the heli-
copter. Ray was nowhere near the helipad, and the military was rushing us. It was
very chaotic, and long story short, many of the satellite phones didn't get to where
they were assigned. Because of the chaos of the Superdome situation, carefully laid
communication plans to get the satellite phones to the appropriate people fell
apart. This is the mantra of any disaster...despite careful plans expect hiccups in
the execution.
Thursday at the airport and FEMA Search and Rescue operation center, I was in
contact with our dispatch center via the satellite phones. Communications were
still difcult, and I couldnt always get a line out on the satellite phone. My cell
105
phone was not very usable, except in the middle of the night when there were
fewer calls being placed from all over the country and the world. I was issued a
FEMA radio and I also had our Acadian portable radio. But the Acadian radio did
not work all the time.
106
Reections
It is said that hindsight is 20/20 vision, and certainly when it came to Katrina, dis-
cussions about what should have happened and how things should have been con-
tinue to this day. Most of those discussions are political in nature, and most of
America has heard them all by now. What we havent heard are the reections of
the medics and rescuers, which cover a wide spectrum of emotions, beliefs and
socio-political views. Here, after having some time to restore their bodies and souls,
our medics look at their experiences in retrospect.
**
Paul Fuselier, Paramedic
Had the ooding not been involved, the procedures probably would have run fairly
well. But then all of a sudden 80% of the city is ooded, and that really changed
things. I think we were prepared for what a hurricane does, but we were not pre-
pared for what a hurricane can do when all of the sudden water is everywhere. Its
a different ballgame. I think that the oodwater caught us all by surprise. And once
that came in, every plan went out the book. Suddenly everybody was trying to g-
ure out what to do.
Its really hard to prepare for every scenario. And that is why we keep training. We
practice these things, tabletop drills, and full-scale drills. That is why we keep prac-
ticing because you never know what will happen.
There is a lesson to be learned, but not just for New Orleans. Dont ever stop train-
ing. When you do train, use different scenarios. A lot of emphasis has been put on
terrorist attacks. But dont forget about oods and the tornadoes and the other
things. Train for plane crashes, for it all. You never know you never know.
**
Remi Judice, Nurse Anesthetist
On Friday, according to Ross and others, there were helicopters as far as they eye
could see, like a swarm of bees, but this was ve days after the storm, and this
should have happened three days earlier. In retrospect, there was a lack of re-
sponse, lack of communication at all levels, and according to the National Guard,
their resources should have been used differently. In my opinion and there should
have been more military involvement, because the hurricane was on Monday, and
two days later I was there and there were very sick people that were not being mo-
bilized out.
107
Thats what I really recognized that whole time I was trying to get people on those
helicopters, I should not have had to wait to see how many patients I could send
off. I should have been able to send them all.
**
Marc Creswell, Flight Paramedic
The scope of this disaster is just too big to comprehend. The hospitals didnt gure
on being ooded. Now we know that we need things like larger generators, gen-
erators above the ood zone, pre-set plans to evacuate by buses, and back-up
medical supplies. There are not enough resources in ten states to evacuate every
one of those hospitals in two days.
We could have turned over the patients much more quickly if there had been a bet-
ter plan for a large disaster. DHH came to help us after we struggled alone out there
for two days, and we nally got patients to Terrebonne and to Laplace and other
places. But prior to that we were ying them to Alexandria, Shreveport and Mon-
roe. When you only have ten helicopters and you take one out of service for four
hours to make a long trip like that, you cripple the operations. The military nally
came in with those transports and they started a treatment center at the New Or-
leans airport, and that allowed us to turn around real quick, but it bottlenecked. So
the helicopters were sitting there for an hour trying to unload their cargo!
St. Bernard Parish, that little hospital, its a long-term acute care for patients that are
pretty sick and theyre going to be for a long time and they need a lot of resources.
They called us on Thursday when we were halfway nished with Touro Inrmary.
So we commandeered a vehicle and went down there to nd a bunch of patients
with no way to get them out and no helipad. I dont know what happened to them.
I dont know how they got out. I recall them saying that several patients had died,
and they kept the bodies on the rst oor of the building. I dont know how many
died there but theres going to be other hospitals that will have a bunch of dead
people. I dont know how the rest of those people got out.
I know there needs to be plans for elevated helipads at every hospital with a census
of more of 100 patients. There needs to be a plan where you can run at least half
the hospital off of emergency power for a week. There should be provisions -- food
and medicine -- in the hospitals to sustain them for a week. DHH needs to establish
a team to organize that effort and secure places for those who present themselves at
a hospital after a disaster. DHH is powerful enough to be able to tell hospitals 50,
100, 200 miles away, "Get your hospital ready we'll be there in two hours."
This kind of thing is really taxing on medics and rescuers. I was on those rooftops,
and it was 95 degrees. We were sweating for 15-18 hours a day. So many things go
108
through your mind. You have trouble getting to sleep. You wonder if you did the
right thing, and that lasts a long time. But I do know that we did everything for the
right reasons. We did it because it was right. I have no regrets.
**
Dr. Ross Judice, Medical Director
Its easy to play Monday morning quarterback in situations like this. I can tell you
the most glaring problems I observed rst hand.
Lesson 1: Leadership and communications are the priority.
There was no observable unied leadership structure (incident command) at the
Superdome or airport during those rst few days. The local leaders appeared to be
overwhelmed, in many cases victims themselves, and lacked a communication in-
frastructure. Louisiana ofcials onsite lacked immediately accessible resources and
reliable communications. At the Superdome, the National Guard and FEMA
seemed unwilling to engage the rest of us in any meaningful way. Because the Na-
tional Guard wouldnt give us any fuel for our Gators to transport, I had one of my
medics steal some of the fuel when the National Guard wasnt watching. On an-
other occasion, I bartered with a National Guard ofcer for some fuel in return for
the use of our ambulances. At one point a clueless FEMA ofcial forced us to use
FEMA radios despite having our own radios. Also, there is a common misconcep-
tion that satellite phones will solve all communications problems during a disaster
where the landline and cellular phones are down. Satellites have limits on their
bandwidth and have the reliability of cell phones during a disaster. What I wit-
nessed was this: no leadership, no coordination, no communication.
At times I felt that the Superdome and airport lacked what I call the crazy
muthaf***** in charge who was the assertive, identiable leader willing to corral
the morass into an organized unit - that is, until General Honore arrived. Thank
God for him.
Under FEMAs own National Incident Management System (NIMS) protocols which
all disaster and emergency services should use, a unied command system sets the
criteria for leadership, communication, and resource and information management.
While we train and utilize NIMS protocols and procedures for local emergencies
like train derailments and bird u, we were not prepared for a multi-jurisdiction,
regional disaster hampered by massive infrastructural disruptions. During the rst
week of any large scale disaster of this type, the local resources are devastated, and
the federal resources take time to mobilize and organize.
109
Lesson 2: Government operates in silos and by the rules. Private citizens and
companies reinvented the rules.
While the men and women of the DMAT and Search & Rescue teams were incredi-
ble, the different FEMA teams operated in silos during that rst week. I saw this at
the Superdome, the airport, and the FEMA US&R operations center in Kenner. Lo-
cated less than 10 miles from the airport, the op center in Kenner did not commu-
nicate and coordinate with the FEMA DMAT teams at the airport. FEMA individuals
seemed determined to exert their authority without having a sense of what was go-
ing on.
During the Friday search & rescue operation in New Orleans East, we found out
that Louisiana Wildlife and Fisheries were conducting a search and rescue opera-
tion in the same area duplicating US&Rs efforts. FEMA was surprised to hear
that.
FEMA couldnt gain access to state National Guard helicopters for rescue efforts. In
other words, there did not appear to be state and federal coordination of efforts.
While the individuals working within government performed heroically, the bu-
reaucracy stied timely innovation and problems solving.
The military helicopters were so rule-bound that they operated inefciently by leav-
ing patients on the ground who needed to be immediately airlifted. Only by ignor-
ing their rules were we able to evacuate as many patients as we did. We werent
the only ones ignoring their rules. Doctors and nurses were turned away because
they werent federalized (i.e., credentialed by FEMA to work in a disaster area),
but that didnt stop them. They found someone in need and helped them. Boaters
from around the region snuck past road blocks to access the ood waters, and
saved thousands stranded in their homes without food or potable water.
During a search and rescue deployment out to eastern New Orleans, the mile long
convoy of trucks, trailers, boats and ambulances got a little lost. The rst vehicle
turned down a street that was clearly going nowhere. Every single vehicle behind
them followed suit, except for the ambulances at the tail end of the convoy. They
recognized that the only way out was for the convoy to wind its way back out to
this same intersection, so they stopped and waited. A few minutes later, out came
the lead vehicle with the rest of the convoy in tow. The ambulances jumped back
on the back end of the convoy.
While this is an example of a simple mistake, the lesson looms large in the context
of Hurricane Katrina. By following the rules so strictly, the well-meaning and highly
qualied government or government-sponsored personnel often took unhelpful
turns, while private companies utilized their resources much more efciently.
110
Innovation provided in real time saved the day. Acadian vice president Bill Vidaco-
vich talked drivers of three large 18-wheelers into driving through the ood water
to state-owned Charity Hospital. He and the Charity staff loaded 48 patients up in
the back of those trucks and drove out of there. Somewhere, a state ofcial was
formulating a plan on how to evacuate those people who had been stranded for
days. Bill didnt need to form a committee develop the plan. Those desperate pa-
tients didnt have time for feasibility study. They needed innovative action, and they
needed it immediately.
Lesson 3: The truth is hard to nd during a disaster.
Strictly dened, the fog of war is a term used to describe the level of ambiguity in
situational awareness experienced by participants in military operations. The term is
appropriate in the context of Hurricane Katrina. Lack of reliable information, the
inability to communicate, and the fear and excitement of the event cast a cloud of
ambiguity over the entire operation. At the Superdome, rumors of violence one
minute were validated with actual violence the next. Exhausted minds tried to wrap
themselves around the unreality of it all.
At one point, rumors led Acadians CEO in Lafayette to contact my wife, Robin, and
told her that I had a mental breakdown and was sedated and returning from New
Orleans in the back of an ambulance. Rumors of roving evacuees ransacking com-
munities around Louisiana were common. Rumors of four feet of water on Bourbon
Street turned out to be false the French Quarter was spared from any ooding.
These and so many other rumors were so far away from the truth but entirely be-
lievable in this most unbelievable of circumstances. In retrospect, there were many,
many cases of unjustied panic over various rumors.
Then there was the truth a truth that was horrifying. People were suffering and
dying, families were torn apart, and helpless children in the middle of it all. Sepa-
rating fact from ction is vital in disasters. We all remember the lessons learned in
elementary school the teacher made us play the game called Gossip. A story is
whispered to the kid on one side of the class, and that kid whispers to the next kid,
and so on. By the time the message is relayed at the other end of the class, the story
has completely changed.
This is not unlike what happened during Hurricane Katrina by well-meaning peo-
ple. One night I called Robin to tell her I was all right. She had been sending out
email reports of my activities to friends and families. Later we would discover that
these emails were forwarded again and again. She began getting phone calls from
around the country for information and offers to provide aid and resources. Among
the callers were a U.S. Senator, a CEO of a major airline, a military ofcial from
NORAD, and journalists from major U.S. newspapers. The CEO of Dollar General
called her to say he had truckloads of water coming into New Orleansand
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wanted to know where to send them! She primarily served as a trafc cop by con-
necting callers with the right people through Acadians evolving network.
Suddenly a storm of journalists called to nd out about the massive number of
deaths at the New Orleans airport. A journalist published this about the airport:
Ross Judice of Acadian Ambulance Services sent out an urgent plea for help at
dawn Friday, when he said a meager staff was trying to care for more than 2,000
sick and injured patients, and eight to 10 patients an hour were dying. It was re-
printed in newspapers across the country. While I told Robin at dawn on Friday that
the airport appeared overwhelmed, the rest was a result of playing the game Gos-
sip - I think. Somehow the truth got stretched to the point of distortion.
In disasters, this distortion is the rule. Be aware of that and act based on the best
information available.
Lesson 4: Medics cant throttle themselves. They know only one speed full speed.
There is not a better group of human beings than emergency medical services per-
sonnel - EMTs and paramedics. They love people, they love duty, and they love ex-
citement. Most of all they love action. Hurricane Katrina provided all of this, and
the medics responded admirably by throwing themselves completely into the fray
without any concern for themselves. Many worked for days on end without rest,
and complained when they were asked to go home for a break.
When I arrived at the Superdome on Tuesday, the medics who had been there since
Sunday morning were manning the rst aid station, caring around the clock for the
thousands that arrived at the shelter of last resort. When I asked about rotating
shifts, they looked at me like I was from Mars. They did not want to leave their
posts. I would repeatedly see this dedication to duty over the next several weeks as
Katrina, and later Hurricane Rita, would provide these medics and miracle workers
with human suffering in need of care. The medics cared for patients hour after hour,
day after day, and month after month over the course of two hurricanes and be-
yond.
The last lesson is this: while medics are heroically caring for those in distress,
somebody needs to be caring for the medics.
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Epilogue
This book describes a narrow slice of the Katrina story. As this book was being
compiled and edited, many acts of courage and heroism from rescuers came to
light. These stories are worth telling. Perhaps some other author will begin the tell-
ing where this one left off. After all, these are narratives in the context of an un-
precedented historical event. It is my hope that this book inspires the telling, and
serves as a reminder that human suffering can only be mitigate by human compas-
sion and seless service.
I regret that it took me so long to tell these stories. Its been 5 1/2 years since
Hurricane Katrina. I suppose life happens. I will say that I felt a duty to complete
this project - a duty to those in EMS that serve heroically every day. I hope this
book honors each of them and honors the EMS profession.
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