The New Orleans Flooding Disaster

By Richard P. Holm MD

Some say that the measure of a society is how it learns from its mistakes.

What did we learn from the flooding of Hurricane Katrina, which affected New Orleans and a wide swath of southeastern Louisiana in late August of 2005?  Eighty percent of New Orleans was flooded in up to 15 feet of very dirty water. 

From the 1940s through the ‘60s the city waterways were closed, levees were built, and the land dropped by eight feet with drying and compaction of previous swampland. We knew already by the 1990’s that about 50% of New Orleans was below sea level.  After Hurricane Georges (ZHY-ORZH) in September 1998 engineers called the poor condition of levees a catastrophe ready to happen, and yet they were still unprepared when Katrina hit.


After Katrina for many weeks southeast Louisiana lost most forms of communication with downed towers and lines, although text messaging was left, as it requires little signal power.


Most area hospitals were flooded and lost electricity while looters and drug seekers attacked in boats. One hospital indicated that many people died due to lack of supplies and simply the overwhelming need to provide care without enough help.

Civil disobedience also involved extensive looting and even sniper fire, while one third of the New Orleans Police Department had deserted the city in the days before the storm.  Major health problems that followed in the hours and days after the flooding mostly involved not having a safe water supply. 

Be prepared is the lesson.  Structures for flood prevention should be in top shape; a chain of command for rescuers and maintenance of law and order should be ready; a failsafe method of communicating to include text messaging needs to be available; and effective evacuation plans should be available.  Each family should store a safe water supply, non-perishable food, and a portable crank radio and flashlight.  Finally we should all learn to text message.


Our local, state, and national society can and should learn from past mistakes.

Impossible To Fix

By Shawn Vuong

Medicine demands perfection. Nobody wants their loved one to die of something that could have been caught earlier on a blood test or CT scan.

So, a lady with a headache comes into the ER. The ER doctor knows that this headache is probably a tension headache or a migraine headache. The ER doctor also knows that the odds of this lady having a brain tumor are low, very low. Although every other ER doctor in the state would order a CT scan for every headache case that comes to the ER (due to the fact that they are scared of litigation brought against them, not because they think every headache warrants a CT), this ER doctor decides it is close to the end of his shift and he doesn't want to waste time ordering the CT scan this lady probably doesn't even need. So, he sends her home with some migraine medication.

Well, thanks to Murphy's Law this lady ends up permanently injured due to a malignant brain tumor. So because of this devastating turn of events, the family files a malpractice claim against the ER doctor.

Thanks to the teachings of a very wise law professor with significant expertise in tort law, I know what's coming next.

The doctor will be asked if it is the 'Standard of Care' to order a CT scan for a headache patient. Although medical literature may say that it is not the best practice to order a CT for every headache patient, and although every other ER doctor in the nation is ordering CT scans for fear of medical malpractice litigation, it IS considered the 'Standard of Care' just because every other ER physician is doing it. Right or wrong. Thus, this ER doctor will likely lose this malpractice case.

How do we as a profession change this? Obviously, a group of ER doctors cannot just follow the medical literature and stop ordering CT scans for every headache. This will just increase the chance that they will be successfully sued in a malpractice case. So, in reality, no ER doctor will stop ordering unnecessary scans. The more the 'Standard of Care' deviates from what the medical literature considers the best medical practices, the more of a disservice physicians are providing to patients. Yet, the legal climate prevents the doctors from changing the way they practice from the 'Standard of Care' due to fear of litigation.

This sounds impossible to fix.

-- Please note that this article is not trying to say ER doctors should not order CT scans for headaches. I have no idea if you should or not, I am not a licensed physician. This hypothetical scenario was merely thought up to help illustrate the problem with defensive medicine.

Tom Daschle for Health and Human Services Advisor

By Shawn Vuong

Well its pretty much official, our own Tom Daschle will be the secretary of HHS.  What does this mean for doctors and patients in South Dakota?  What does this mean for doctors and patients nationwide?  

Some don't believe Daschle is the right man for the job.  They may be worried about his past voting history, his history of partisan politics, or even his wife's job as a lobbyist that may play in conflicts of interests.  Others think he's perfect.  Either way you look at it, he's going to be a key component of the healthcare reform that America is about to see.  

To get a good idea of what's in store for us, I plan on reading "Critical: What We Can Do About The Health-Care Crisis" by Daschle.  The book came out Feb 2008, and I think its going to be the outline of what's to come.