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As a volunteer doctor, I had to figure out how to reassure them.&quot;,&quot;section&quot;:&quot;News Desk&quot;,&quot;url&quot;:&quot;https://www.newyorker.com/news/news-desk/treating-patients-at-houstons-largest-emergency-shelter-as-hurricane-harvey-rages&quot;,&quot;image&quot;:{&quot;@type&quot;:&quot;ImageObject&quot;,&quot;contentUrl&quot;:&quot;https://www.newyorker.com/news/news-desk/treating-patients-at-houstons-largest-emergency-shelter-as-hurricane-harvey-rages&quot;,&quot;url&quot;:&quot;https://media.newyorker.com/photos/59a5b4f746a4563cb22baf0c/4:3/w_960,c_limit/Nuila-Harvey.jpg&quot;}}"/><link rel="amphtml" href="https://www.newyorker.com/news/news-desk/treating-patients-at-houstons-largest-emergency-shelter-as-hurricane-harvey-rages/amp"/><meta name="copyright" content="Copyright (c) Condé Nast 2018"/><meta name="description" content="Ricardo Nuila on working as a volunteer doctor among evacuees from Hurricane Harvey, in Houston’s George R. 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class="SiteHeader__title___aZr3Q" data-reactid="82"></p></div></div><section class="PageContainer__pageContent___1xERg PageContainer__article___136yK" data-reactid="83"><!-- react-empty: 84 --><article class="Layout__layoutContainer___2gtig" data-reactid="85"><header data-reactid="86"><div class="ArticleHeader__articleHeader___1G7-9  ArticleHeader__default___1GpE3" data-reactid="87"><div class="ArticleHeader__headerRow___nDCwd" data-reactid="88"><div class="ArticleHeader__rubricAndIssue___1YUtt" data-reactid="89"><div class="ArticleHeader__rubric___3YLRT" data-reactid="90"><a class="Link__link___3dWao Rubric__rubric___3hrQE  " href="/news/news-desk" title="News Desk" data-reactid="91"><!-- react-text: 92 -->News Desk<!-- /react-text --></a></div></div><h1 class="ArticleHeader__hed___GPB7e" data-reactid="93">Treating Patients at Houston’s Largest Emergency Shelter, as Hurricane Harvey Rages</h1><!-- react-text: 94 --><!-- /react-text --><div class="ArticleHeader__metaInfo___1aBON" data-reactid="95"><div class="ArticleContributors__byline___3-luq" data-reactid="96"><div class="ArticleContributors__contributorWrapper___1CrIJ" data-reactid="97"><div class="Byline__articleHeader___13Q7D  " data-reactid="98"><p class="Byline__by___37lv8" data-reactid="99"><!-- react-text: 100 -->By <!-- /react-text --><a class="Link__link___3dWao  " title="Ricardo Nuila" rel="author" href="/contributors/ricardo-nuila" data-reactid="101"><!-- react-text: 102 -->Ricardo Nuila<!-- /react-text --></a></p><p class="ArticleTimestamp__timestamp___1klks " data-reactid="103">August 29, 2017</p></div></div></div><ul class="ArticleSocial__socialShare___2Skji ArticleSocial__header___1huCC" data-reactid="104"><li data-track-type="socialShare" data-track-location="default" data-source="facebook" class="SocialShareItem__icon___3QQZ0 SocialShareItem__facebook___15Vks " data-reactid="105"><a class="Link__link___3dWao  " 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media="(min-width: 1280px)" srcset="https://media.newyorker.com/photos/59a5b4f746a4563cb22baf0c/master/w_649,c_limit/Nuila-Harvey.jpg, https://media.newyorker.com/photos/59a5b4f746a4563cb22baf0c/master/w_1298,c_limit/Nuila-Harvey.jpg 2x" data-reactid="133"/><source media="(min-width: 1024px)" srcset="https://media.newyorker.com/photos/59a5b4f746a4563cb22baf0c/master/w_813,c_limit/Nuila-Harvey.jpg, https://media.newyorker.com/photos/59a5b4f746a4563cb22baf0c/master/w_1626,c_limit/Nuila-Harvey.jpg 2x" data-reactid="134"/><source media="(min-width: 768px)" srcset="https://media.newyorker.com/photos/59a5b4f746a4563cb22baf0c/master/w_727,c_limit/Nuila-Harvey.jpg, https://media.newyorker.com/photos/59a5b4f746a4563cb22baf0c/master/w_1454,c_limit/Nuila-Harvey.jpg 2x" data-reactid="135"/><source srcset="https://media.newyorker.com/photos/59a5b4f746a4563cb22baf0c/master/w_727,c_limit/Nuila-Harvey.jpg, 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data-reactid="143"><p data-reactid="144"><!-- react-text: 145 -->Evacuees at the George R. Brown Convention Center, in Houston, await shelter from Hurricane Harvey.<!-- /react-text --></p></div></span><small class="ImageCaption__credit___rg3mC " data-reactid="146">Photograph by Brendan Smialowski / AFP / Getty</small></figcaption></figure></div></div></div><div id="articleBody" data-template="two-column" class="ArticleBody__articleBody___1GSGP" data-reactid="147"><div data-reactid="148"><div data-reactid="149"><div class="SectionBreak__sectionBreak___1ppA7" data-reactid="150"></div><div class="SectionBreak__sectionBreak___1ppA7" data-reactid="151"><p data-reactid="152"><!-- react-text: 153 -->Here <!-- /react-text --><span data-page="page_1" data-reactid="154"></span><!-- react-text: 155 -->in Houston, a patient shivering in August is never a good sign. On
Monday, as <!-- /react-text --><a href="https://www.newyorker.com/news/news-desk/hurricane-harvey-and-public-and-private-disaster-in-houston" class="ArticleBody__link___1FS03" data-reactid="156"><!-- react-text: 157 -->Hurricane
Harvey<!-- /react-text --></a><!-- react-text: 158 --> brought its third day of catastrophic rain to southeastern Texas, a
steady procession of refugees sloshed into the George R. Brown
Convention Center, the city’s largest emergency shelter. They were cold
and wet. Many couldn’t stop shaking. I had been scheduled to work a
shift at Ben Taub Hospital, where I am an internist, but flooding there
had forced a partial shutdown, so I spent the afternoon volunteering for
the Red Cross instead, treating patients in one of the convention
center’s large halls. In the rush to evacuate—on foot, <!-- /react-text --><a href="http://www.newyorker.com/news/news-desk/houston-a-makeshift-navy-struggles-to-respond-to-hurricane-harvey" class="ArticleBody__link___1FS03" data-reactid="159"><!-- react-text: 160 -->by boat<!-- /react-text --></a><!-- react-text: 161 -->, in
rescue helicopters—some people had left behind seizure medication,
asthma inhalers, insulin. Dialysis patients didn’t know how to get to
their treatment centers, if the centers were even still open. One woman
said that her cardiologist had told her that if she didn’t take her
blood thinner every day, she might have a heart attack. Was her life in
danger?<!-- /react-text --></p><p data-reactid="162"><!-- react-text: 163 -->As is often the case in the early stages of a disaster, demand quickly
outstripped supply. Only a few doctors had made it to the convention
center, which was already nearing its five-thousand-person capacity, and
the makeshift pharmacy could dispense only over-the-counter medicines
such as ibuprofen and children’s Tylenol. No antibiotics, and certainly
no blood thinners, were available—how could they be, with <!-- /react-text --><a href="http://www.newyorker.com/news/news-desk/listening-to-houstons-desperate-cries-for-help-after-harvey" class="ArticleBody__link___1FS03" data-reactid="164"><!-- react-text: 165 -->the roads so inundated<!-- /react-text --></a><!-- react-text: 166 -->, and in such a short time? One patient I saw had spent a full
day in the rising waters. The triage team had measured her temperature
at ninety-three degrees Fahrenheit, qualifying her as hypothermic. My
first instinct was to heat her with a device called a Bair Hugger, an
inflatable warming blanket commonly used in hospitals. When I asked one
of the E.M.T.s whether he might have one, he responded as generously as
he could. “We’re hoping to get more towels,” he said.<!-- /react-text --></p><p data-reactid="167"><!-- react-text: 168 -->I remember, early in my career, finding the word “reassure” listed as a
possible response on many multiple-choice tests, including for my
medical license, and feeling put off by it. To my novice ears,
“reassure” sounded like “do nothing.” But, over the years, I’ve learned
that understanding why a patient might be scared and targeting that fear
with your words can serve as a powerful remedy. We didn’t have much in
the way of equipment or medications at the convention center, but we
could reassure those who were more wet and frightened than sick. My
experiences at Ben Taub, a safety-net hospital that specializes in the
care of <!-- /react-text --><a href="https://www.newyorker.com/news/news-desk/poor-and-uninsured-in-texas" class="ArticleBody__link___1FS03" data-reactid="169"><!-- react-text: 170 -->poor and uninsured people<!-- /react-text --></a><!-- react-text: 171 -->,
helped me in this regard. I could tell the woman who was nervous about
her blood thinners that some of my patients had gone without the drugs
for a month or more. I could tell the diabetics that staying well
hydrated was one of the best ways to keep their high blood sugar in
check, because I had seen so many patients who didn’t have money for
insulin. The extreme circumstances, I said, made their missing a dose or
two O.K.<!-- /react-text --></p><p data-reactid="172"><!-- react-text: 173 -->As more evacuees arrived, so did more doctors and nurses and
pharmacists—not such a surprise, since medicine is to Houston what
finance is to lower Manhattan. The Texas Medical
Center is the largest medical district in the world, home to such
renowned institutions as the M. D. Anderson Cancer Center and Texas
Children’s Hospital. Before I knew it, a refrigerator stocked with
insulin had been installed by the large partition that separated the
medical area from a jumbo TV. (Crimson bands of rain swept across the
Doppler radar, again and again.) Someone organized a row of chairs for
patients whose blood sugar was too high for hydration alone; they
received I.V. fluids and a rescuing shot of insulin. At one point, a box
full of sandwiches arrived, and I asked an E.M.T. whether I could give
one to my hypothermic patient, since eating revs up one’s metabolism.
“We’re all sharing here,” he said.<!-- /react-text --></p><p data-reactid="174"><!-- react-text: 175 -->Many of the patients I saw had been fuelled by the same sentiment. One
group of young men had spent thirty-six hours straight ferrying their
East Houston neighbors to dry land. So exhausted was one from the wading
and the lifting and the weight of wet clothes that he started to shake
like he was having a seizure. He held a blanket over his shoulders as he
showed me photos on his smartphone of the rescues he had performed. “We
were helping cancer patients,” he said. Not long afterward, a towering
box of thick new beach towels arrived, a wonderful sight. I asked my
hypothermic patient to wrap her feet in one and to hug herself with
another. After her temperature climbed back to normal, she walked out of
the medical area, giving me a thumbs-up. On the way, she passed a cancer
patient who had been on the cusp of starting treatment when Hurricane
Harvey arrived. He seemed angry, frightened. “I want to focus on your
pain,” I said, in my best attempt to reassure.<!-- /react-text --></p></div></div></div></div><footer class="ArticleFooter__footer___3-wlJ" data-reactid="176"><!-- react-empty: 177 --><div class="ArticleContributors__bio___3XQjk" data-reactid="178"><div class="ArticleContributors__contributorWrapper___1CrIJ" data-reactid="179"><ul class="ArticleContributors__contributorBios___3_jrJ ArticleContributors__noAvatar___26vfu" data-reactid="180"><li data-reactid="181"><p class="ArticleContributors__contributorBioText___3m1QB" data-reactid="182">Ricardo Nuila is an attending physician at the Harris Health System, in Texas, and teaches medical humanities at the University of Houston Honors College.</p><a class="Link__link___3dWao ArticleContributors__contributorBioLink___3ifgZ " href="/contributors/ricardo-nuila" data-reactid="183"><!-- react-text: 184 -->Read more »<!-- /react-text --></a></li></ul></div></div><ul class="Tags__tags___1WDCj" data-reactid="185"><span 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",["inline-embed",{"type":"analytics","meta":"%7B%22type%22%3A%22analytics%22%2C%22url%22%3A%221%22%2C%22width%22%3A%22%22%2C%22height%22%3A%22%22%2C%22caption%22%3A%22%22%7D","ref":""}],"in Houston, a patient shivering in August is never a good sign. On\nMonday, as ",["a",{"href":"https://www.newyorker.com/news/news-desk/hurricane-harvey-and-public-and-private-disaster-in-houston"},"Hurricane\nHarvey"]," brought its third day of catastrophic rain to southeastern Texas, a\nsteady procession of refugees sloshed into the George R. Brown\nConvention Center, the city’s largest emergency shelter. They were cold\nand wet. Many couldn’t stop shaking. I had been scheduled to work a\nshift at Ben Taub Hospital, where I am an internist, but flooding there\nhad forced a partial shutdown, so I spent the afternoon volunteering for\nthe Red Cross instead, treating patients in one of the convention\ncenter’s large halls. In the rush to evacuate—on foot, ",["a",{"href":"http://www.newyorker.com/news/news-desk/houston-a-makeshift-navy-struggles-to-respond-to-hurricane-harvey"},"by boat"],", in\nrescue helicopters—some people had left behind seizure medication,\nasthma inhalers, insulin. Dialysis patients didn’t know how to get to\ntheir treatment centers, if the centers were even still open. One woman\nsaid that her cardiologist had told her that if she didn’t take her\nblood thinner every day, she might have a heart attack. Was her life in\ndanger?"],["p","As is often the case in the early stages of a disaster, demand quickly\noutstripped supply. Only a few doctors had made it to the convention\ncenter, which was already nearing its five-thousand-person capacity, and\nthe makeshift pharmacy could dispense only over-the-counter medicines\nsuch as ibuprofen and children’s Tylenol. No antibiotics, and certainly\nno blood thinners, were available—how could they be, with ",["a",{"href":"http://www.newyorker.com/news/news-desk/listening-to-houstons-desperate-cries-for-help-after-harvey"},"the roads so inundated"],", and in such a short time? One patient I saw had spent a full\nday in the rising waters. The triage team had measured her temperature\nat ninety-three degrees Fahrenheit, qualifying her as hypothermic. My\nfirst instinct was to heat her with a device called a Bair Hugger, an\ninflatable warming blanket commonly used in hospitals. When I asked one\nof the E.M.T.s whether he might have one, he responded as generously as\nhe could. “We’re hoping to get more towels,” he said."],["p","I remember, early in my career, finding the word “reassure” listed as a\npossible response on many multiple-choice tests, including for my\nmedical license, and feeling put off by it. To my novice ears,\n“reassure” sounded like “do nothing.” But, over the years, I’ve learned\nthat understanding why a patient might be scared and targeting that fear\nwith your words can serve as a powerful remedy. We didn’t have much in\nthe way of equipment or medications at the convention center, but we\ncould reassure those who were more wet and frightened than sick. My\nexperiences at Ben Taub, a safety-net hospital that specializes in the\ncare of ",["a",{"href":"https://www.newyorker.com/news/news-desk/poor-and-uninsured-in-texas"},"poor and uninsured people"],",\nhelped me in this regard. I could tell the woman who was nervous about\nher blood thinners that some of my patients had gone without the drugs\nfor a month or more. I could tell the diabetics that staying well\nhydrated was one of the best ways to keep their high blood sugar in\ncheck, because I had seen so many patients who didn’t have money for\ninsulin. The extreme circumstances, I said, made their missing a dose or\ntwo O.K."],["p","As more evacuees arrived, so did more doctors and nurses and\npharmacists—not such a surprise, since medicine is to Houston what\nfinance is to lower Manhattan. The Texas Medical\nCenter is the largest medical district in the world, home to such\nrenowned institutions as the M. D. Anderson Cancer Center and Texas\nChildren’s Hospital. Before I knew it, a refrigerator stocked with\ninsulin had been installed by the large partition that separated the\nmedical area from a jumbo TV. (Crimson bands of rain swept across the\nDoppler radar, again and again.) Someone organized a row of chairs for\npatients whose blood sugar was too high for hydration alone; they\nreceived I.V. fluids and a rescuing shot of insulin. At one point, a box\nfull of sandwiches arrived, and I asked an E.M.T. whether I could give\none to my hypothermic patient, since eating revs up one’s metabolism.\n“We’re all sharing here,” he said."],["p","Many of the patients I saw had been fuelled by the same sentiment. One\ngroup of young men had spent thirty-six hours straight ferrying their\nEast Houston neighbors to dry land. So exhausted was one from the wading\nand the lifting and the weight of wet clothes that he started to shake\nlike he was having a seizure. He held a blanket over his shoulders as he\nshowed me photos on his smartphone of the rescues he had performed. “We\nwere helping cancer patients,” he said. Not long afterward, a towering\nbox of thick new beach towels arrived, a wonderful sight. I asked my\nhypothermic patient to wrap her feet in one and to hug herself with\nanother. After her temperature climbed back to normal, she walked out of\nthe medical area, giving me a thumbs-up. On the way, she passed a cancer\npatient who had been on the cusp of starting treatment when Hurricane\nHarvey arrived. He seemed angry, frightened. “I want to focus on your\npain,” I said, in my best attempt to reassure."]]],"canonicalUrl":"https://www.newyorker.com/news/news-desk/treating-patients-at-houstons-largest-emergency-shelter-as-hurricane-harvey-rages","categories":{"sections":[{"id":"5904126172dadf5d0a508800","modelName":"category","collection":"categories","contributors":{},"hierarchy":[{"id":"5904126172dadf5d0a508800","modelName":"category","collection":"categories","contributors":{},"hierarchy":[],"name":"News","parent":[],"photos":{},"root":[],"slug":"news"},{"id":"5902ab3b07071543e751a992","modelName":"category","collection":"categories","contributors":{},"hierarchy":[],"name":"Sections","parent":[],"photos":{},"root":[],"slug":"sections"}],"name":"News","parent":[{"id":"5902ab3b07071543e751a992","modelName":"category","collection":"categories","contributors":{},"hierarchy":[{"id":"5902ab3b07071543e751a992","modelName":"category","collection":"categories","contributors":{},"hierarchy":[],"name":"Sections","parent":[],"photos":{},"root":[],"slug":"sections"}],"name":"Sections","parent":[],"photos":{},"root":{"id":"5902ab3b07071543e751a992","modelName":"category","collection":"categories","contributors":{},"hierarchy":[],"name":"Sections","parent":[],"photos":{},"root":[],"slug":"sections"},"slug":"sections"}],"photos":{},"root":{"id":"5902ab3b07071543e751a992","modelName":"category","collection":"categories","contributors":{},"hierarchy":[{"id":"5902ab3b07071543e751a992","modelName":"category","collection":"categories","contributors":{},"hierarchy":[],"name":"Sections","parent":[],"photos":{},"root":[],"slug":"sections"}],"name":"Sections","parent":[],"photos":{},"root":{"id":"5902ab3b07071543e751a992","modelName":"category","collection":"categories","contributors":{},"hierarchy":[],"name":"Sections","parent":[],"photos":{},"root":[],"slug":"sections"},"slug":"sections"},"slug":"news","children":[{"id":"590a02541c7a8e33fb390be1","modelName":"category","collection":"categories","contributors":{},"hierarchy":[{"id":"590a02541c7a8e33fb390be1","modelName":"category","collection":"categories","contributors":{},"hierarchy":[],"name":"News 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Harvey","url":"/tag/hurricane-harvey"},{"name":"Houston","url":"/tag/houston"},{"name":"Texas","url":"/tag/texas"},{"name":"Health Care","url":"/tag/health-care"}],"contentType":"article","contributors":[{"name":"Ricardo Nuila","type":"author","title":"Ricardo Nuila is an attending physician at the Harris Health System, in Texas, and teaches medical humanities at the University of Houston Honors College.","email":"","bio":null,"social":[{"network":"Twitter","handle":"riconuila"}],"url":"/contributors/ricardo-nuila","image":null}],"dek":"","displayMostPopular":true,"formatting":{},"hed":"Treating Patients at Houston’s Largest Emergency Shelter, as Hurricane Harvey 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