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The Catalyst

Children protected at all costs

By Fred Tecklenburg, MD
Pediatric Critical Care

Hurricane-force winds uprooted oak trees and scattered limbs and debris blocking Ashley Avenue. Below left, water from the storm surge caused massive flooding and reached more than five feet around MUSC’s Horseshoe at Ashley Avenue. Photo by James H. Nicholson, Pathology & Lab Medicine

It’s hard to believe Hurricane Hugo was 25 years ago. I have several vivid memories that I think I’ll take to my grave.

As the storm intensified, my colleagues and I had a bird’s eye view from the Pediatric Intensive Care Unit of bluish arcs emanating from exploding transformers over peninsular Charleston followed by entire sections of the city going black. The Ashley Avenue side of our relatively new Children’s Hospital felt the first blast of the storm. Patients were moved to the hallways — some beds with two or three children in them.

There were leaks everywhere on our top floor, with saturated floors and some broken windows, but the winds calmed down as the eye approached and it seemed that our patients — and the building — were reasonably safe.  

Dr. Charles Darby, then–chairman of Pediatrics, and I went down to the loading dock area on Sabin Street during the eye and were awestruck by the clear view of stars overhead and the eerie sensation of barometric changes and the rapidity of a storm surge creeping up and then covering the street.  

I went back to the PICU, which is on the top west floor of the building, to wait for the notorious “back end” of the storm. Within minutes we could hear a howling wind seemingly beating the side of the building with each new band. A nurse called me into a patient room in the far southwest corner of the unit because she thought the room was moving. Sure enough the corner was literally shifting with ceiling panels twisting and the windows making a sick groan. We quickly disconnected the ventilator and lines, bagged the patient and pushed the bed out of the room. Literally, as we closed the doors, the windows burst open in the room like an explosion.  

We had eight patients in the 10–bed unit — most of whom were on ventilators with all the usual support lines.

Hospital staff exhibited readiness throughout the hurricane and afterwards caring for patients and prioritizing their safety.  photo provided

As we stood in the main area which housed seven of the beds, trying to decide where to move our rescued patient, the decision was made for us. Windows started breaking open and the whole unit felt like one large, wet wind tunnel. One crib with a ventilated patient was pushed across the unit before staff captured it. We called a mayday over the emergency radio system, and within a minute or two there must have been 40 or 50 nurses, physicians and maintenance staff moving all the patients into the hallway.  At some point in this process, Al, the bioengineering support man for the unit, a pediatric resident and I ended up on the leeward side of a piece of partially unsecured plywood that had been placed over a crucial window. In truth I don’t remember how we ended up in this predicament — but we were all holding it in place as all the patients were being evacuated. Finally, we looked at each other and said “on the count of three” as we let go. The plywood went flying, and so did Al, across the room on the wet floor. Anyway, everyone – including us plywood supporters –made it out safely.

Only one patient – the one who took a sail on his crib – suffered some morbidity: he required a blood transfusion for blood lost from a disconnected arterial line.  

If this wasn’t enough excitement, once in the hallway we lost all generator power.  We literally bagged our patients by flashlight for hours until we relocated them to parts of the adult hospital that had generator power.  

Many of us stayed in the hospital a couple days straight.  The most remarkable thing to me through the whole experience was the solidarity and commitment of all the MUSC community.  Everybody — the nurses, house staff, maintenance staff, faculty — pitched in and got through it.

To cap it all off personally, I got food poisoning on the third day post–Hugo and was fluid–resuscitated on the unit manager’s floor with four liters of saline. To add insult to injury, I never was able to move back into my house post–storm. I gained a keen appreciation for the little things in life and at work because of that storm.

December 11, 2014



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