DETROIT – When Hurricanes Irma and Maria devastated Puerto Rico last fall, Henry Ford Hospital emergency medicine physicians Howard Klausner, M.D., and Steven Rockoff, D.O., were among the thousands of U.S. medical personnel deployed to the island during the recovery effort to help provide care and treatment to the sick and injured.
Drs. Klausner and Rockoff are members of Michigan’s Disaster Medical Assistance Team, a group of highly skilled volunteer medical providers and support personnel who are deployed to presidentially-declared disasters. In this capacity, they serve as temporary employees of the federal government, which provides them security protection and food and housing.
Both physicians served two-week deployments – Dr. Klausner in November and Dr. Rockoff in late September to early October.
Dr. Klausner worked at a makeshift field hospital in San Juan, near where the U.S. Naval hospital ship USNS Comfort was docked. Dr. Rockoff was stationed at Hospital De La Concepcion in San German, one of the few hospitals operating on back-up generator at the time, to assist the hospital staff where needed.
“The experience was like no other,” Dr. Rockoff says of his first DMAT deployment, which he joined after Hurricane Sandy. “You felt like you were really helping people.”
Dr. Klausner, whose previous deployments include 9/11 in New York and Hurricane Katrina in New Orleans, says the Puerto Rico assignment was particular gratifying, the destruction and human toll notwithstanding.
“The people we saw were very appreciative and gracious for what we were doing,” he says.
The devastation that Irma and Maria left behind was a challenge even for seasoned veterans like Klausner and Rockoff, who collectively have 28 years of emergency medicine expertise with Henry Ford. While neither had time or were permitted to tour the island, they saw images of crumbled buildings, downed power lines, cell towers bent like horseshoes, flooded roadways and obliterated homes – the same images shown daily on TV and online in the United States and worldwide.
The 12-hour workdays were long and demanding. At the field hospital, the care provided was similar to what primary care and family medicine physicians do: asthma flare-ups, renewing medications, diabetes insulin checkups, and COPD and pneumonia evaluations. In situations of critical illness or injury, patients were triaged and stabilized and then either transported to the nearby USNS Comfort, which staffed several specialty physicians and a dentist, or a local hospital that was accepting patients. The team worked with a local Walgreens to get medicine for patients.
Patients were desperate for care, often lining up at 2 a.m., six hours before the field hospital opened. “People sat and waited,” Dr. Klausner. “Many of them said, ‘this is much better than other places on the island.’”
At Hospital De La Concepcion, as many as 200 patients were seen daily – for minor illness or injury to multiple fractures, heart attack and trauma. Some patients arrived by private car. Many of the hospital staff stayed for “days on end,” Dr. Rockoff says.
“I didn’t know what to expect,” he says of the experience. “IV fluids and medications were limited or scarce, you did the best you could. At the end of the day, medicine is medicine. You kind of adapt to the situation.”
Their medical teams relied on local medical students to serve as translators during interactions with patients and to provide guidance on understanding Puerto Rico’s hospital system, which comprises both private and public hospitals. Paper records were used for documenting patient interactions.
“I heard more thank-yous from patients than I’ve ever heard,” Dr. Rockoff says. “You’re not used to hearing that.”