Purgatory

        I lay mulling over the horrors I had seen over the last few days.  I did not understand why Charity Hospital had not been properly evacuated in a timely manner.  There were helicopter pads atop the building.  Rescue could have begun within hours of the storm if the authorities meant to rescue the stranded sick.  I felt haunted as my mind revisited my day’s efforts of attending elderly poor people  laying on thin military stretchers spread upon the airport concrete floors because of bureaucratic negligence and poor planning for rescuing the city's indigent. Frustration weighed heavily on me; Why couldn't  officials to do the right thing? 
            I did part of my  residency training at Charity Hospital so it was not hard to imagine how frightening it must have been when the electrical power went out in the emergency room and the patient rooms.  The building structure retained many of the architectural features from the eighteenth century.  The stairwells were narrow and lighting in the passageways was dim and sparsely placed providing an eerie glow that filtered through the stairways. The space in the stairwell was not wide enough for a standard hospital gurney to be used in transporting patients from floor to floor.  When the elevators were not working, a non-ambulatory patient would have to be transported between floors on a collapsible stretcher or in the arms of a burly hospital worker.  The first Charity hospital of New Orleans was built in 1739; it was destroyed in a hurricane forty years later.  It was rebuilt in 1779, but was again destroyed in 1810 by fire.  A third Charity Hospital was opened in1815. Charity hospital was run by nuns for the first hundred and fifty years.  The hospital received a massive renovation in 1938 after being adopted as part of the Tulane Medical Center and state medical school training facility.  The current building had eighteen floors encased in an art deco façade and bolstered by large columns and ornate architectural elements. The top four floors were once the mandatory boarding quarters for medical residents and consisted of small dormitory-like bedrooms. The next two floors housed the administrative offices. There was a mechanical operations floor below the administrative offices.  Then there were the mental health areas that span three floors.  Below that there were three floors of operating rooms and recovery areas.  In adjacent wings were intensive care units. Hospitalized patients occupied the next five floors. The second and third floors housed the medical school staff and medical graduate studies offices.   The first floor had the emergency entrance, trauma rooms and the fast-track emergency area.
                I spoke to a few of the nurses who were trapped in Charity hospital for four days after the hurricane and they told me horror stories.  Medical dispensing carts could not be opened after the power failed because they were controlled by computers and medical staff on hand, having no codes to open the keypad protected pharmacy, could not readily access needed medications.  After the first day without rescue, the medical staff used force to open the medical carts on the wards. When supplies on the carts were exhausted, they raided the emergency rooms for supplies and eventually broke into the pharmacy to get medication. Physicians who were scheduled to be at the hospital did not come, without them, nurses did not have written orders specifying the medical plan needed to care for the patients. When patients learned that doctors were not coming in to make hospital rounds and the nurses could not get medication, those who could walk left the hospital and went to the stadium, which had been identified by the mayor as a place to wait out the storm. Patients who could not ambulate feared that they would die an agonizing death and begged the nurses to give them a final dose of medication to stop their suffering. There was wailing and crying, lots of coughing and wheezing.  Nurses described feeling helpless and trapped. They were left to comfort patients as best as they could. There was no running water so maintaining hygiene became a problem and cross-contamination became a real threat. There was rumor that some of the nurses mixed a cocktail and passed it around to be used to relieve dying patients of their burdens of waiting for a slow death.
                After tossing and turning for more than an hour, I kicked off the covers and walked slowly towards a tent setup for showering.  I never felt completely safe inside the cramped space.  I stepped into the plastic stall and turned on the hot water. Today I was going to Charity Hospital to work with the sweep team who were looking for bodies in the towering hospital building. I did not look forward to this detail, but it gave me a change from routine and I felt that I had to do something as penance for leaving the city before the storm.  I got dressed quickly; putting on the heavy boots supplied by the National Guard then the white jumpsuit worn when working with hazardous material and went out to the waiting jeep.  The reported number of dead in Louisiana was more than one thousand.  Some believed that the count was low; they talked about bodies in the Bayou being meals for alligators and other swamp creatures.  It would be difficult to account for these losses.  Perhaps a complete count of the losses would not be known for years.

I looked down at my feet as the jeep drove through the city.  I could not bear to look at the uprooted trees and broken signs littering the streets.  I just wanted to get to the hospital and get to work. I had to do good for somebody else to restore myself. I felt compelled to help restore dignity to the unfortunates who did not survive the disaster.  The recovery team was told to mark the site where a body was found using a bright orange plastic flag, supplied to them as they boarded the jeep, and to spray paint the floor or a visible surface with orange reflective paint that was issued with the flashlight- equipped helmet, the white biohazard jumpsuit and boots. The jeep pulled up on the emergency vehicle  ramp at Charity Hospital. I watched everyone go inside the towering building before I got off the jeep. Once inside the building, I moved away from the group of young men with long guns and headed towards the surgical intensive care ward. The place smelled like a swamp- stagnant water and rotting vegetation. All of the furniture was swept to one side and piled upon itself. I struggled to move my feet in the thick mud on the floors everywhere. Each step released a suctioning noise as if the floor was trying to pull me into its essence.
  I found the stairway and started up; my foot slipped, I reached out grabbing for the wall, but the wall had no strength. My hand passed through the water-soaked plasterboard which had the texture of  marshmallow. My shoulder sunk into the softened wall and I fell  downward through a shaft then finally hit a hard surface landing flat on my back. I lay  in the dark gasping, surrounded by six inches of pooled water. I coughed to clear the dirty water that I inhaled on impact. I sat up. The fall had bruised my back and legs, but nothing seemed to be broken,  so I struggled to my feet. I found myself in a well or a vault. I sloshed water around my ankles  as I stumbled around the small enclosed space, searching for a way out. Waving my arms around wildly, I felt the cold roughness of a brick wall. I traced my fingertips along the cold  stone hoping to feel a door jam or window casing. About six inches over my head, I touched old splintery wood suggestive of  a door or some kind of an entryway. I   began jumping as high as I could and stricking against the aged door.
 ”Hello can anybody hear me?", I shouted as  I repeatedly leapt up and struck the wooden structure. My fingers and palms hurt as they became bloodied and pricked with splinters.    My jumpsuit was drenched and water had gotten into my boots. I was soaked to the bone.  Exhausted, disgusted,tearful, I stood shivering in the total darkness, cold and  frightened.  None of the people who rode with me on the jeep seemed aware of me.  I couldn't remember if there had been a roll call. No one had asked me my name.   Would anyone find me before I peristed in this purgatory?