An ER Doctor Reflects On Hurricane Katrina, 20 Years Later

Dr. Erica Fisher was working at Charity Hospital when it flooded, trapping her and 1,600 other people inside during Hurricane Katrina.

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

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• 0:45Ira Flatow?

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• 1:04Flora Lichtman?

  Hey, I'm Flora Lichtman, and you're listening to Science Friday. Today on the show, we are looking back at one of the most devastating disasters in modern US history: Hurricane Katrina. Twenty years ago today, it made landfall in Louisiana, and the levees designed to protect the city failed. Huge swaths of the city flooded. People were trapped in their homes, at their jobs, and in hospitals. Around 1,600 people were inside Charity Hospital, the city's only public hospital, as it flooded. One of the doctors there was Erica Fisher, a New Orleans local who was born in Charity. And when Katrina made landfall, she was a resident working in the emergency room.

• 1:48Flora Lichtman?

  As the city flooded, she and her colleagues fought for days to keep their patients alive. Dr. Fisher is now an emergency medicine physician at the University Medical Center in New Orleans. She's here to reflect on Hurricane Katrina and the vulnerability of our healthcare systems in the face of disasters. Dr. Fisher, welcome to Science Friday.

• 2:08Speaker 03

  Thank you so much for having me.

• 2:10Flora Lichtman?

  You know, before we really get into it, what is this anniversary like for you?

• 2:14Speaker 03

  So, this anniversary, it brings back so many painful memories about, you know, what the city went through during Hurricane Katrina. Um, it also brings back memories of, you know, me being stuck at a hospital and unable to communicate with my family who were, who were also still in the city. So it's so emotional for me to reflect on everything that happened during Hurricane Katrina.

• 2:43Flora Lichtman?

  Well, I appreciate you coming on the show to reflect with us today.

• 2:47Speaker 03

  Sure.

• 2:48Flora Lichtman?

  Katrina made landfall August 29th, 2005. How did the day unfold?

• 2:53Speaker 03

  Okay, so I was asked to be on the activation team, um, which is the team that usually respond and stay in the city during natural disasters. So, you know, I had to report to the hospital the Sunday prior to Hurricane Katrina because Hurricane Katrina made landfall that Monday. So I remember the Saturday before the hurricane came, I was at my mom's house. Um, so she was packing, you know, she was getting ready to evacuate the city with my brother. And the mood was like really, really sad because she was like, she was really hurt that she had to leave me here in the city, you know, to weather out the storm. And we were almost in tears.

• 3:38Speaker 03

  Um, I reported to work, um, as usual, started my shift that night as usual. It's just the atmosphere was very gloomy. Um, this was before the storm made landfall to the city.

• 3:51Flora Lichtman?

  When did the flooding start?

• 3:53Speaker 03

  Okay, so Hurricane Katrina made landfall that Monday. The rains were really, really heavy and the winds were extremely strong. But then after that, the rain stopped, you know, it, it stopped raining. And when it stopped raining, the flooding was only ankle deep at the time. So I reported to work that Monday night and we were all like really happy because we thought that, okay, we'll be home the next day. Um, we didn't see the true disaster that the hurricane caused at the time.

• 4:28Flora Lichtman?

  Right, because there was this delay, right, as the levees fell and then the water rose.

• 4:33Speaker 03

  Right, right. And then all of a sudden, the water started rising around the hospital. And, um, we didn't know why because we had no real form of communication um, at the time because all of our cell phones were not working. The water just started rising and the hospital started flooding. Um, the basement started flooding first, of course. And, um, you know, we didn't know how far up the water was gonna rise. So the decision was made, um, at the time for us to evacuate the first floor, which is where the emergency room was located.

• 5:07Flora Lichtman?

  That must have been so frightening.

• 5:10Speaker 03

  It was. It was so frightening because, again, we didn't know what was going on in the city at the time. And, um, to evacuate the first floor took a lot of teamwork because we had to transport hospital beds, medical supplies, and every single one of our patients to the second floor auditorium. So it was very, very frightening. But, um, with teamwork, we made it happen.

• 5:36Flora Lichtman?

  Was there power, water? What services did you have?

• 5:40Speaker 03

  We had no power and we had no water. Um, it just so happened the generators of the hospital were located in the basement. And of course, the basement flooded first. So we had no power. Um, some kind of way, um, we were able to get power just only to that auditorium room that we were in, um, taking care of our patients. Um, that was the only space that we had power.

• 6:11Flora Lichtman?

  You said earlier that you also weren't able to be in touch with your family. Did you have family still in the city?

• 6:18Speaker 03

  I did. The majority of my family was still here in the city. Um, and I'm from New Orleans. I grew up in the Lower Nightwall area of the city, which was the most devastated part of the city. And I still have family in the Lower Nightwall. And my dad was still here in the city. And I had no way of communicating with them to see how they were.

• 6:44Flora Lichtman?

  So you're in the middle of this crisis in the hospital, where I'm sure your adrenaline is pumping and meanwhile, you're thinking about your family.

• 6:52Speaker 03

  Yes.

• 6:53Flora Lichtman?

  What was kind of keeping you going?

• 6:56Speaker 03

  I don't know. I guess the hope that my family would make it out alive. Because, um, while I was working, I also got word that The levees breached and the Lower Nightwall was flooding, right? Um, they were finding dead bodies everywhere. Um, the resident that stayed there didn't realize that I was from the Lower Nightwall and that my family was still here in the city. So when I got word that my area was devastated, was flooded, dead bodies everywhere, I truly broke down. That's when I really broke down.

• 7:34Flora Lichtman?

  Hmm, did they make it through safely?

• 7:37Speaker 03

  Yes, thank God, thank God they did. Um, my dad sought rescue at a local church around his house, where he had to, um, wade through the water, um, to, um, to get to this church where he was eventually evacuated from the church. Um, I, my cousins, because the lower interstate had flooded so, so badly, they ended up on top of the interstate for several days before they were rescued, um, out of the city. So, yes.

• 8:09Flora Lichtman?

  Wow, I'm glad they made it.

• 8:12Speaker 03

  Yes.

• 8:12Flora Lichtman?

  There safely.

• 8:13Speaker 03

  Yes.

• 8:15Flora Lichtman?

  How long were you and the patients trapped in this hospital without power and water?

• 8:21Speaker 03

  We were there for six days.

• 8:24Flora Lichtman?

  Wow, and was there a plan in place for what to do if there's flooding and no power and no water? Or were you all sort of playing it by ear and, and improvising?

• 8:35Speaker 03

  Not that I'm aware of. There was no plan in place. Um, I believe we were all just playing it by ear because when the hospital started flooding, the decision was made to evacuate the emergency department first floor. So I don't think that was planned. I think that was at the spur of the moment type decision.

• 8:55Flora Lichtman?

  What happened to Charity Hospital after it was evacuated?

• 9:00Speaker 03

  After we left, we were evacuated from, um, Charity Hospital, um.

• 9:06Speaker 03

  Charity Hospital was deserted. Upstairs was damaged because some of the windows burst during a storm. And as again, the basement flooded. It was never reopened after the storm, no.

• 9:19Flora Lichtman?

  How did losing that hospital impact the residents of New Orleans?

• 9:24Speaker 03

  It significantly impacted everyone. Because Charity was the safety net of the residents of New Orleans that did not have health insurance. The low-income residents, they didn't have any access to good quality medical care. Hurricane Katrina damaged Charity Hospital. You know, Charity was that hospital of the South that everyone talked about. So, we lost, we lost something big. We lost Charity.

• 9:55Flora Lichtman?

  You know, I think people don't always think about how hospitals and healthcare might be made vulnerable by natural disasters. You know, I think of a hospital as the safe place that you take people after the disaster has happened or during it, right? But not the casualty of the disaster itself.

• 10:14Speaker 03

  Right.

• 10:15Flora Lichtman?

  Do you have thoughts on that, or can you reflect on that?

• 10:17Speaker 03

  When Charity started flooding and we had to evacuate the emergency room, first floor to the auditorium, it just didn't feel the same. You know, we were the safety net for the city. And now, we couldn't let anybody in. We couldn't take in any more patients because we had no place to put them nor take care of them. The emergency department is everything to the city. So, when there was no emergency room to take care of people that were still here after Hurricane Katrina, it was just devastating to me.

• 10:56Flora Lichtman?

  I mean, what could have or should have been done differently, do you think?

• 11:01Speaker 03

  First of all, I think there should have been a clear plan on what to do just in case something this magnitude of a disaster would happen. Because as we know, New Orleans is prone to flood. You know, we get hurricanes, New Orleans floods sometimes.

• 11:22Flora Lichtman?

  Have hospitals in New Orleans learned from this experience? Are things done differently now in terms of preparation for flooding or extreme weather?

• 11:31Speaker 03

  I believe so. Um, I think we have more disaster drills now um, in the event of any type of natural disaster, whether it's flooding or any type of warfare. You know, I think the design of University Medical Center also had um, that in mind. You know, the emergency room is not on the first floor anymore. Just in case there is another type of flooding of the city, it is on high ground now. And I'm sure the generators are not located in the basement anymore.

• 12:09Flora Lichtman?

  I was gonna ask.

• 12:13Flora Lichtman?

  On this 20th anniversary, Dr. Fisher, what do you want people to know or think about?

• 12:19Speaker 03

  Um, see.

• 12:22Speaker 03

  So Hurricane Katrina displaced a lot of residents of the city. It also displaced several of my family members. So I truly miss all of the crawfish balls that we used to have, all the family gatherings that we used to have prior to them evacuating and starting new lives. So I really, I truly miss the sense of community that I once had prior to Katrina.

• 12:50Flora Lichtman?

  Hmm, you know, I think when people think about natural disasters and climate change, we don't always think about this part of it. You know, not only the healthcare piece that we've been talking about, but how it changes the fabric of our lives, how it changes our communities.

• 13:07Speaker 03

  Right, right, because it changed my community a lot.

• 13:11Flora Lichtman?

  Dr. Fisher, thank you so much for speaking with us today.

• 13:14Speaker 03

  Thank you so much for having me.

• 13:16Flora Lichtman?

  Dr. Erica Fisher is an emergency medicine physician at the University Medical Center in New Orleans.

• 13:25Flora Lichtman?

  Coming up after the break, science writer Maggie Kurth is here to round up other science news from the week.

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• 16:10Flora Lichtman?

  Joining me now to discuss some of the other notable science news from the week is science writer and editor Maggie Kurth. Welcome back to Science Friday, Maggie.

• 16:19Speaker 05

  Hi, thanks for having me.

• 16:21Flora Lichtman?

  Okay, we have been talking about Katrina, specifically its impact on healthcare in New Orleans. But what about climate change? 20 years on, what have we learned from the storm? Has anything changed?

• 16:35Speaker 05

  Yeah, I mean, yes and no. It's been, like you say, 20 years since Katrina pushed storm surge through New Orleans levee system. It flooded 80% of the city. It killed more than 700 people in just New Orleans alone. And that event has really shaped the way Americans think about climate disasters and how they happen. You know, you're talking about rising risk, inadequate defenses, and then those social consequences of how police, media, and neighboring communities ended up vilifying survivors. And then the government and nonprofits failed those same people when they tried to rebuild their lives. There's been change, but it's not all been good.

• 17:19Flora Lichtman?

  Hmm. What about sea level rise? What have we learned about that?

• 17:23Speaker 05

  Well, there's a couple of sobering studies out this month that suggest that climate risk and infrastructure failure parts of this equation are still a problem for New Orleans. So first off, researchers at Tulane compared 30 years of satellite data to climate models, and they found that sea rise projections that were made originally back in the mid 1990s have turned out to be remarkably accurate. In 1996, the IPCC models were projecting about eight centimeters of sea level rise over the next 30 years. Satellites were directly measuring the height of the ocean in that same time period and found a nine-centimeter rise.

• 18:03Flora Lichtman?

  Wow.

• 18:03Speaker 05

  Yeah, it's a really big deal for climate science because those early models were pretty crude compared to what we have today. And there was just a lot less known in particular about how important ice melt in Antarctica and Greenland would turn out to be. So today, these satellites show that sea level rise is accelerating, and the models find a low-confidence possibility that catastrophic ice sheet collapse could really inundate low-lying cities.

• 18:31Flora Lichtman?

  Hmm. What about the levees? I mean, their failure was such a huge part of the Katrina disaster. Are walls and levees a sustainable strategy?

• 18:43Speaker 05

  Unfortunately, it's looking like they aren't. That's this other story that has the more immediate risk for New Orleans. The Times-Picayune recently had a story reporting that the city's $15 billion hurricane walls are actually sinking faster than the sea level is rising.

• 18:59Flora Lichtman?

  Oh, wow.

• 19:00Speaker 05

  And yeah, in some parts of town, they're sinking at a rate of 28 millimeters a year, which doesn't sound like much, but you combine that with stronger hurricanes, higher sea levels, and it could really mean the difference between a bad storm and a deadly disaster.

• 19:18Flora Lichtman?

  In other climate news, there's a story out this week about heat waves and their health effects?

• 19:23Speaker 05

  Yeah, so there's a large, long-term study out of Taiwan that found that heat waves can age your body as much as smoking and drinking can. And this study is focusing on the ways that heat stresses your body and causes changes to your organs that are similar to what happens as you age. So it's the kind of thing that can make you more susceptible to dementia, heart disease, cancer, diabetes, things like that. This study followed more than 24,000 people between 2008 and 2022. And during that time, the researchers took samples and they ran tests on these participants, measuring things like inflammation, liver and kidney function and blood pressure.

• 20:05Speaker 05

  There are about 30 heat waves that happened in Taiwan in those years, but people had different levels of exposure depending on factors like whether they lived in rural areas or worked outside. And the more heat wave exposure, the more the participants' medical results showed signs of aging.

• 20:24Flora Lichtman?

  How much faster were they aging in relation to their exposure to heat?

• 20:29Speaker 05

  Not a huge increase. You know, we're talking about less than a quarter of a year added to your biological clock for every 1.3 degrees Celsius extra that you're exposed to. But again, this is a rate of aging that's on par with things like regular smoking or drinking that we already take seriously as threats.

• 20:51Flora Lichtman?

  It's been a chaotic week in DC health circles. Several leading scientists have been forced out or resigning at the CDC. And at the same time, at the FDA, there's new guidance on COVID vaccines. What all is going on?

• 21:06Speaker 05

  Yeah, so Robert Kennedy Jr. has announced new guidelines limiting who's approved for COVID-19 vaccines. You know, previously, we're going on kind of the emergency situation approval from when the pandemic was at its height, and he basically canceled that. So it's going to be harder to get vaccinated if you're under 65 and healthy.

• 21:29Flora Lichtman?

  In what way?

• 21:30Speaker 05

  Well, for example, people who want a COVID vaccine this year are going to have to consult with their doctor first, most likely, instead of going directly to a pharmacy, like you've been able to do in the past. And it's not clear what impact the decision by the FDA will have on things like whether your insurance covers your vaccine. And access could really end up depending a lot on the particulars of your doctor and what they choose to stock and what they choose to prescribe.

• 21:58Flora Lichtman?

  Do you need, will you need a prescription to get the vaccine?

• 22:03Speaker 05

  Basically, what's going on is that it's becoming off-label use for anybody under 65 and healthy. And off-label use is legal, but it kind of ends up making things more complicated. So doctors are allowed to keep saying people can get a vaccine, prescribing a vaccine to everyone. But some might not want to because there's liabilities around off-label use. And because the guidelines are getting issued later than they normally do in the year, it's not clear whether insurance is going to cover it yet.

• 22:37Flora Lichtman?

  So does that mean that if you have a condition that puts you at higher risk, you can get a vaccine just as easily as you could before if you were under 65?

• 22:46Speaker 05

  It sounds like that is the case, yes. But what counts as high risk seems to be a little bit complicated. The FDA had a limited number of things that they were sort of listing as increased risk. But the CDC is supposed to have its own list that's not out yet. And that kind of adds to some of the confusion and chaos that's happening. And at the same time, you're seeing things like, you know, different health agencies are signaling different policy. Medical societies like the American Academy of Pediatrics are issuing their own guidelines that are different from the FDA. And there's a research group at the University

• 23:27Speaker 05

  of Minnesota who put out its own evidence report for fall vaccines that is also different from the FDA. So there's just a lot of confusion about who is going to get listened to when it comes down to what doctors and pharmacies and insurance can and will do.

• 23:44Flora Lichtman?

  Yeah, it is so confusing for Americans to have to sort through.

• 23:48Speaker 05

  It's incredibly confusing.

• 23:50Flora Lichtman?

  Yeah. Okay, let's move back in time. Other health news. There's a story about ancient mucus.

• 23:57Speaker 05

  Yeah, so this is kind of interesting. There's a study tracking the origins of a variant of MUC19, which is a gene that controls type, thickness, and location of mucus production.

• 24:10Flora Lichtman?

  This is a good Halloween costume.

• 24:11Speaker 05

  I know, right? It's my MUC19 costume. So this variant today is really common among people living in the Andes Mountains in South America. And it turns out, though, that this gene variant got to humans through interbreeding that happened between Denisovans, Neanderthals, and us. The assumption is that it would have had to get to humans at some point between, you know, twenty thousand years ago or so in order to reach South America. And they found the exact same variant in Neanderthal skulls from Siberia that were about fifty thousand years old. They've also found it in Denisovans. So it is just this really interesting thing where you can sort of trace back that this

• 24:56Speaker 05

  probably originated in Denisovans, but it got passed around through several different human relatives before it got to us.

• 25:06Flora Lichtman?

  Following the snot trail through time. I love it.

• 25:09Speaker 05

  Yeah, exactly.

• 25:10Flora Lichtman?

  Does everybody have this gene, or do only some people have this gene?

• 25:15Speaker 05

  This particular variant of a gene is pretty specific to people in South America. There's, the gene exists all over, but this variant is a little bit more specific. And the fact that it's common in South America but nowhere else now suggests that the people who took it with them to that continent, it got some kind of protective benefit from it that you didn't get from, for the people that stayed back in Asia.

• 25:41Flora Lichtman?

  Hmm. If you have the variant of this gene, is your mucus different?

• 25:46Speaker 05

  The study that I read did not say anything about how it necessarily made your mucus different, unfortunately. I was looking for that.

• 25:54Flora Lichtman?

  Standing by for that.

• 25:55Speaker 05

  Yeah.

• 25:56Flora Lichtman?

  Information researchers. Okay, finally, something a bit more hopeful. News about a dwarf planet formerly known as an asteroid, but now a dwarf planet, Ceres.

• 26:07Speaker 05

  Yeah, so Ceres is the largest object in our solar system's asteroid belt. It's not big enough to be a planet. It's about a third of the width of Earth's moon. It's just this cold rock today. And back in the late teens, NASA's Dawn spacecraft found salt deposits on the surface that had been left behind from a time long, long ago when water had bubbled up from underground on this thing. And so there's a new study out now that is building on that work. So today, Ceres's water is only existing underground. It's these briny ice deposits.

• 26:46Speaker 05

  But the researchers ran computer simulations to try to understand what it might have been like billions of years ago. And 2.4 to 4 billion years ago, there was probably enough radioactive decay happening inside Ceres's core to generate heat, drive hydrothermal vents that brought the water up to the surface, and most importantly, create these kind of salty, wet mineral deposit soup places that life can potentially form. You know, something similar to what you find at hydrothermal vents on Earth's seafloor today.

• 27:26Flora Lichtman?

  So they found the conditions where life might arise. Do they have any other evidence that anything lived there?

• 27:33Speaker 05

  No. So yeah, they found evidence that those conditions could have existed, but no one knows whether life did take hold right now. Just that it's possible that Ceres could have had those right ingredients for life at one point. But this is interesting because it does add evidence that some of these other smaller now cold moons that you find around places like Saturn or Uranus could have had the same history.

• 28:00Flora Lichtman?

  Thank you, Maggie.

• 28:01Speaker 05

  Yeah, thank you.

• 28:03Flora Lichtman?

  Maggie Kurth, science writer and editor, based in Minneapolis.

• 28:10Flora Lichtman?

  Thanks for listening. Don't forget to rate and review us wherever you listen. It really does help us get the word out and get the show in front of new listeners.

• 28:20Flora Lichtman?

  Today's episode was produced by Rasha Aridi and Charles Bergquist. But a lot of folks helped make this show happen every single week, including

• 28:29Ira Flatow?

  John Dankoski.

• 28:31Speaker 06

  Danielle Johnson. Beth Ramey. Jackie Hirschfeld.

• 28:35Flora Lichtman?

  I'm Flora Lichtman. Thanks for listening.