After Katrina: Picking up the pieces

Five weeks after the floodwaters of Hurricane Katrina left his office in ruins, New Orleans internist David Myers was stooped down in the parking lot, rummaging through debris that used to be his medical practice.

Waiting room chairs, lab coats, wads of insulation, Viagra samples, business cards, chunks of drywall, ink pens-a work crew had gutted his office and deposited its contents in several jumbled heaps outside. The shaven-headed doctor looked solemn. "The hope of finding anything worth saving is pretty much ridiculous," said Myers, dressed in green scrubs as if he were preparing to perform surgery.

Then he flashed a smile. "Oh, good," said Myers, brandishing a sheath of documents. "My incorporation papers. They have my tax ID number."

There were other reasons to smile. Myers spotted a stack of cards and notes from patients. Though the ink had run, the sentiments were clear: "Thank you for all your help and patience over the years."

As Myers tucked away these keepsakes, a patient pulled up in a white truck. He was a burly contractor who had interrupted his booming hurricane restoration work to check up on Myers and show him the results of a CT scan.

"Man, these are good," said Myers, his face lighting up. "Say, do you want to see me next week?"

It wasn't a normal day at the office, but for Myers, it held the promise of better days to come. He's one of a nearly 6,000 physicians in Louisiana and Mississippi who were displaced by Hurricane Katrina, according to a study by researchers at the University of North Carolina at Chapel Hill (it didn't include Alabama, also battered by the storm).

Besides wreaking havoc with physicians' homes and offices, Katrina unleashed a flood of uncertainty about the future. After all, the disaster dispersed hundreds of thousands of doctors' patients across the country. Will enough of them return to the devastated areas to sustain a reconstructed medical practice? And if so, will these patients be able to afford medical care in a Gulf Coast economy that will take years to recover? A practice also depends on hospitals for inpatient care, yet it's not clear how many of the institutions shuttered by Katrina will reopen, or when.

Doctors like Myers are proceeding into the future one trash heap at a time. Slowly but surely, many of them are planting signs in their old neighborhoods announcing that they're open for business again. Others have moved west, north, and east, starting over in cities and towns a safer distance from America's Hurricane Alley. For all of them, there's no getting back to normal-at least the old normal.

"We're not sure what will happen, but we're staying"

Katrina slammed into the Gulf Coast on Monday, Aug. 29. The day before, Myers' wife, Stephanie, and their three children left their home in the Mid-City neighborhood of New Orleans, just blocks from his office, and evacuated to Baton Rouge. Myers planned to hunker down at Lindy Boggs Medical Center back in the Big Easy, but the storm's strength and his wife's admonition-"If you die, we're in bad shape"-changed his mind, and he joined his family the next day. On the way, he stopped by the office, grabbed his medical license and various certifications, and backed up billing data on a CD. "I should have taken more," he says. "I didn't think we'd have the water we had."