Welcome back to Weathering the Storms for 2012! The hurricane season got a jump start with Tropical Storm Alberto suddenly churning up off the coast of South Carolina over the weekend. It looks like it will skirt the coast up past North Carolina and head out to sea. I imagine the surfers at Cape Hatteras and the rest of the Outer Banks are getting ready for some big days. Alberto is a good reminder that there are no hard and fast rules in the emergency prep business.

A change in leadership occurred at the National Hurricane Center, with Rick Knabb taking over as Director. Dr. Knabb is most recently known for his work at The Weather Channel. This is actually a return to both South Florida and the NHC as he grew up in Coral Springs and previously worked at the NHC for eight years. I have been follower of his on Twitter @TWCDrKnabb, and his tweets were always timely and practical. Welcome home, Dr. Knabb.

This is the 20th anniversary of Hurricane Andrew. We will talk more about that as the season progresses closer to August 24th. This year we have already heard that we are in for a relatively slow season, with ten named storms. In Andrews year, there were only six named storms, but that one, wow.

The Baptist Health family suffered a tremendous loss with the passing of Mr. Wendell Beard. Mr. Beard provided visionary board leadership to Baptist Health South Florida, as well as Homestead Hospital and West Kendall Baptist Hospital. Many of us had the privilege of knowing Mr. Beard, and we can attest that he was a tireless supporter of the people who work at Baptist Health. Some people can never be replaced. He was one of those. Please readhis obituary in The Miami Herald.

For Mr. Beard:
Wish that I was on ole Rocky Top
Down in the Tennessee Hills.
Ain’t no smoggy smoke on Rocky Top,
Ain’t no telephone bills

- Felice and Beaudloux Bryant

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Just a few weeks ago, we had the worst storm of the year in South Florida. It is ironic and I suppose a commentary on human nature that there was no worry, no panic, no mad rush to Home Depot or Publix and no one was calling out sick. No nada nothing (as we say here in Miami). I didnt even write a blog leading up to it. Why? The only reason I can think of it that we didnt give it a name. If we had called it Tropical Storm Oprah, there would have been wall to wall news coverage with all of the above.

A few things did happen that we had to contend with, mostly minor. It did rain a bunch, 10 inches in 48 hours, 30 mph winds, seven foot waves at the beach, rip tides and flash floods. We sprang a couple of leaks at Homestead Hospital and West Kendall Baptist Hospital. There was some concern about flooded streets making it difficult for staff to arrive or depart. The Transport Center staff starting making arrangements to move people back and forth, just in case, but it wasnt necessary in the end.

Still, it was pretty much business as usual all over South Florida and the Keys, with all kinds of events going on as scheduled, the Columbus Day Regatta happened, the Miami Broward Carnival went on (just a little wet), and all of the stores and restaurants were open. The lack of concern was kind of refreshing, and all was dealt with in the normal course of things that go on when you live in the sub-tropics.

What brings this to mind is that far out in the Gulf is something now called Hurricane Rina. We are looking at it as it is something of an anomaly this late in the season. Now that it has a name though, it has come to everyones attention, and we are already seeing the signs. A little worry here and there, questions about work and what will we do. The NewsPlex is cranking up with regular reports. But.this pretty unlikely, probable non-event is still five days away from even being a consideration.

And here I am, just like all the rest, writing about it because it has a ..!

Just call my name and Ill be there in a hurry
On that you can depend and never worry

Aint No Mountain High Enough — Diana Ross

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The situation for us here in Miami and the Keys, and all of South Florida, has continued to improve. We now expect Hurricane Irene to brush by us off-shore, with the most likely effects being similar to the typical strong thunderstorms we normally experience this time of year.

Baptist Health will maintain normal operations as we expect no disruption related to Hurricane Irene. It is likely that we will see some heavy rain from feeder bands on Thursday and Friday, so take that into consideration as you travel to and from work.

We will continue to monitor the situation. Thanks to everyone for their expressions of dedication and availability to care for our patients no matter what the weather. It is deeply appreciated

In the meantime, we had a Baptist Health team go down to Haiti late last week to perform surgical (58 cases!) and medical work for the many still in dire post earthquake circumstances. On this trip were Michele Ryder, Tony Gonzalez, Magdalie Gedeon, Aylin Vidal, Lois Wise-Kist Iccledan Acclien, Priscilla Bailey, Michael Canning, Valerie Davis, Antoine Dessources, Roselaure Gousse, Socrates Haydar, Ivannia Hernandez, Bret Kendon, Kris Kist, Pierre Limosin, Tameeka Loussaint, Salvador Marin, Martha Pearson, Francisco Perez, Yeni Rauda, Luc Richards, Mabel Rodriguez, Farah Saint-Louis, Samuel Saturn, Ytimea Sony, Nancy Thelusma, Jorge Valdes, Ken Willis and Calvin Babcock. As the storm began to approach Haiti we were concerned about them finishing their work in time to get out of there. Fortunately that worked out. We did, however, have to evacuate one of our surgeons who fell ill while doing surgery there. I want to recognize Elmer Loaiza, supervisor of transport for the Baptist Health Transfer Center, for expeditiously getting our sick doc out of there in a hurry (ably assisted by David Aragon) Your expertise in patient transport logistics is unequaled. By the way, the hidden jewel TTC moves 2,000 patients a month to make sure that our patients are in the right bed, at the right facility, with the right staff, and the right equipment.

Due to storm, we also had to postpone a trip to The Bahamas that is an annual effort to assist several orphanages there. Each year the staff of South Miami Hospital donates clothing, school supplies and other needed items. On this trip are Nancy Pobiones, Rooney Brodie, Christine Stiltner-Angulo, and Karen Vassell from West Kendall Baptist Hospital. Rest assured, as soon as we get clearance from the Bahamians, they will be there.

One more thing, Baptist Health was named one of the Best Places to Work by Modern Healthcare Magazine(again) this week. These people named above, and the things they do, are a big part of why we are just that.

Irene goodnight, Irene goodnight
Goodnight Irene, Goodnight Irene
I’ll see you in my dreams

Goodnight Irene — Leadbelly

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The following is our first update to the 14,000 members of the Baptist Health family:

We are monitoring the progress of Hurricane Irene closely. Although the forecast track has slightly improved for us, Irene is expected to grow into a Category 3 storm. This is a powerful storm capable of significant disruption. Even as the news improves, remember with every storm there is a margin of error, so we need to pay close attention.

Baptist Health CEOs and leaders have been in communication regarding early preparations. At this stage, we will function in a business-as-usual manner. If you have any immediate questions or concerns, speak to your supervisor or manager using your normal chain of command.

We will continue to keep you informed as the situation becomes more certain.

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It is critical that a hospital remain a hospital during a crisis. A real hospital, not a warehouse, or a school gymnasium, or any other vacant space that converts to a general shelter. For better or worse, people see the hospital as a general community resource. We tacitly encourage this thinking, after all, think of the many things we provide to the community. We have educational programs on campus, we host AA meetings, we hold health fairs, we are often a gathering place for community events. It is a deep seated feeling. Perhaps it goes back to the time in history when hospitals did function as refuges of last resort, not really a place to be healed or to have a life saving intervention, but a place to be made as comfortable as possible during your last days and hours.

It is very difficult to then to roll up the welcome mat, and tell people that a hospital is not a shelter. The community must understand, it is the only place you can go for emergency and acute medical care. That mission must be preserved. Yes, there are exceptions and I have made them myself. In the eye of one particularly bad storm, we heard banging on the Emergency Room doors, and when we opened them we saw a dozen Guatemalan migrant workers looking very bedraggled. It had to be bad out there, as these folks were a tough, stoic bunch. Of course, we let them in.

Still.when you are battening down the hatches the last thing you need is a bunch of able bodied citizens, milling around the hospital, consuming all of the food in the cafeteria (you will need that later), sitting around the lobby, and generally getting the way of the provision of acute patient care. As much as it may go against the grain of being a community, non-profit, faith-based, caring healthcare organization, you have to do this one important thingshow them the door and make sure they leave.

Even better, as a savvy reader of this blog, dont let them inside in the first place. Develop security measures as part of your hurricane plan that begin a lock down well in advance. We are piloting a system called FastPass in several of our hospitals, that creates a security checkpoint and quick identification process that allows us to identify each visitor. We will use it to raise the security level in advance of the storm to limit access of the general public. Even more importantly, and even before you get to the FastPass checkpoint, you can control and limit vehicular access to your campus. If you do not, you may find yourself housing a sizable collection of big boys toys.

Most of us have very large and very expensive parking structures that house thousands of cars. Little did we know that these garages shine like a beacon to owners of valuable things on wheels! We once had a gridlock traffic jam of boats on trailers, jet skis on trailers, and collectors cars that would put the Barrett-Jackson auction to shame. Almost anything that would fit through the entrance was in there. I am talking about a 1963 Red Corvette split window coupe, a 1966 Shelby Cobra, two Ferraris, a glow in the dark green Lamborghini (bienvenido a Miami), and a couple of mid seventies Cadillac convertibles that looked brand new. Even half a dozen flats boats, the specialty boat of choice for sneaking up on bonefish.

But the real big numbers come from people who simply want to have their regular car high and dry and out of the way of falling limbs and flying debris. What does this have to do with patient care? Nothing! Unless these cars were driven by hospital staff coming to work.all together nowshow them the door!!! Controlling your environment, your campus, your resources and importantly the patient care workspace is key to protecting the core mission of every hospital, providing acute and emergent patient care. Those people you turn away will appreciate it later, when their hospital is there for them.

What has happened down here is the winds have changed
Clouds roll in from the north and it started to rain
Rained real hard and rained for a real long time
Six feet of water on the streets of Evangeline

Randy Newman – Louisiana 1927

Originally posted on June 2009

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It appears that Emily did not survive her trip over Hispaniola and has been downgraded. We can expect at worst some rain and heavy surf over the next several days from remnants of the storm. There is a very slight chance of it reforming, but by the time it does it is likely to be past Miami, and in any event will turn out to the Atlantic where it will do no harm.

Thanks to all for paying attention to the circumstance and reacting appropriately. Maintaining calm, even with a minor event such as this, is critical to keeping operations normal in the interest of patient safety.

Oh they call it Stormy Monday
But Tuesday, Tuesdays just as bad

Stormy Monday, B.B. King

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Its too soon to tell much as far as potential impact on South Florida, or anywhere on the East Coast for that matter. I think that it will be late Thursday before we have a reasonably clear picture. One more immediate concern is the status of Haiti. It is currently in the path, and heavy rains are projected. The problem is that there are still more than a million people there living in tents or other temporary housing. We will continue to monitor that particular situation in the meantime. Our surgical teams, led by Calvin Babcock and Michele Ryder, are scheduled to return to Haiti on a surgical trip in about two weeks, scheduled long before this storm. As far as formal preparations go here locally, we are only just beginning to heighten awareness of the storms path. More to come.

We have a summer intern from the College of Charleston who is a follower of WTS and wanted the opportunity to write a guest blog. So we let him take a stab at it. Enjoy.

Doggler Radar

To anyone who is a music enthusiast, it is easy to understand how I am feeling at the moment. Have you ever listened to some of your favorite artists songs, only to be disappointed by a subpar guest appearance? On one hand this experience could glorify your preferred musician, and on the other you could despise the featured artist for the desecration of a beautiful song. I sure do hope our blog entries flow together in harmony similar to Martha Reeves and the Vandellas, rather than Mick Jagger and David Bowie. (See YouTube link)

Has anyone ever wondered what would happen if we didnt have the Doppler radar system? How would we possibly predict a storm coming without our beloved technology?! Now lets go deeper, what we do with no T.V. or computer quickly see what the forecast for the day, week, or month? Before you start to panic, there is a method that has been used to predict these storms since, well, the beginning of time.

Growing up, Hurricanes signified many chaotic things, but there always seemed to be excitement among all the kids in school, especially for the possibility that we might have one or two days off of classes. We all remember the 2005 hurricane season, as it was the most active Atlantic hurricane season recorded in history. Hurricanes Katrina, Rita, and Wilma all made landfall in Florida at one point during their paths of destruction. All schools were closed for extended periods of time during these hurricanes, especially Wilma, where we had weeks of power outages from the torrential wind and rain. I remember being particularly bored at the house, while my parents were preparing thoroughly for each storm, after their past experiences. During this down time, I was spending a lot of time with our dog, Star, a 4-year-old Belgian Sheppard.

As each storm approached, I would be outside with Star, just because I wanted to always have a mental image of what everything looked like before the storm hit. At the age of 14, the chaotic natures of hurricanes was fascinating, and I was up for any kind of adventure. As I would sit outside with Star waiting for each storm to come in, the dogs demeanor would noticeably change. I am not talking about 10 minutes before the storm either, as the winds and rains approaching would frighten any dog; but days before the hurricanes approach. I think back in amazement, as on three different occasions she became anxious, attentive, and unwavering while she never left my side. It took me years to understand that Star was telling me that there was a large storm coming, and preparations needed to be made.

There is no explanation I have for the connection between the canine species and the weather. Maybe they can sense the barometric pressure dropping more quickly than other animals, maybe they can feel the vibrations of the storm, and maybe they can smell a storm from miles away. All I know is those days before the hurricane there were no T.V. stations that gave me 100% assurance that there was a storm on its way, Star did. After all, for all you dog owners and lovers, these animals that you cared and nurtured for so many years care about you too and serve as your guardians. They will protect you if someone invades your house and if you are injured, so is it so hard to believe they would also protect you from an approaching storm? That is for you to decide, but when the time comes this hurricane season remember, nature knows nature best. Trust your loyal companions.

Cyrus the Summer Intern

Free, like a river raging
Strong as the wind Im facing.
Chasing dreams and racing father time.

Born Free, Kid Rock

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I dont remember Jeff Sims. He was one of hundreds of people who came through Homestead, on their own dime, with the simple impulse to help. Remarkably, he sent us the email below reflecting on his experiences. I think you will enjoy reading it.

My name is Jeffrey Sims. 19 years ago next month, Hurricane Andrew made landfall devastating Homestead and the local hospital.

In the aftermath there was a sever shortage of nurses and emergency personnel. At the time, I was living and working in Louisville, Kentucky and like many others was compelled to help out in any way we could.

I grabbed a delta flight from Louisville and flew to Miami whileI waited for several of my friends to drive their ambulances down from Indiana. For the next 2 weeks, we worked day and night. Days were spent working in the emergency room and nights out in the field transferring patients from emergency calls. The days were long and hot starting at 630 a.m. and ending at 3 a.m. But it was a growing experience i would not have missed for the world.

I still remember the air conditioned army tents we slept in out back of the emergency room and the glorious comforts of those damn army cots. I have always been a rather large man play football for many years in my youth, but when I laid on those cots I looked like a full size marshmallow on top of a thumb tack. Not a visual one wants to see or experience I assure you.

The reason i am writing is, I was wondering what the hospital looked like now. I have never been back to homestead but i did hear that the city has grown greatly. I didnt know if anyone had any pictures of the hospital now and of the transformation of it over the last 19 years. When i was there it was not a very big hospital but it sure had some real nice people who we worked along side of for many days. If it is not asking too much, I sure would like to see what has happened over the years to it.

I have had to retire from floor nursing since i became ill in 2008. I look back over my 28 years as a nurse relishing the many experiences and was just wondering how that little place with the big hearts turned out after all. Thank you….Jeff Sims, San Antonio, Texas

P.S. Jeff, we built a new hospital just a few miles away and the old hospital is now being converted into a Magnet school for health careers, a wonderful use for it. The new hospital is a state of the art showplace, but we cant help but miss the old one, you are right, it had heart.

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We have Tropical Storm Bret kicking up waves all along the East Coast, good for the surfers and not a worry for anyone else.

In case you havent seen it, here are the names for this years storms: Arlene, Lee, Bret, Maria, Cindy, Nate, Don, Ophelia, Emily, Philippe, Franklin, Rina, Gert, Sean, Harvey, Tammy, Irene, Vince, Jose, Whitney, and Katia. NOAA also provides a pronunciation guide for each name. For Lee, its LEE, for Bret, its BRET, and for Gert its GERT. Seriously.

The last Hurricane name I can remember having a difficult time pronouncing was Hurricane Georges. Everyone pronounced it differently ( and still does!). I recall this particular storm because it caused the beginning of a long lasting relationship between the country of St. Kitts and Nevis and Baptist Health. In the aftermath of this hurricane, St. Kitts and Nevis suffered nearly $500 million dollars in damages to this small country of two islands. We had earlier met the then new Prime Minister Denzil Douglas, through the work of our Caribbean representative Kathleen Tuitt. He was a physician by training and so we had much in common with him. After hearing of the damage, we put together a team of 25 doctors and nurses to go down to assist with the recovery. They worked incredibly hard, augmenting a clinic, the small hospital, and going out into the countryside to see what needed to be done. Our physician leader was Joanne Mahoney, M.D., who continues to this day as one of the outstanding doctors at Mariners Hospital in the Florida Keys. Today the Honorary Consul for St. Kitts and Nevis in Miami is our own President Brian Keeley and our relationship remains strong to this day.

“We can be heroes
Just for one day
We can be us
Just for one day”
– Heroes by David Bowie

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