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Stranded Hospital's Other Crisis 'Patients' New Orleans Team Fought in Flood to Save Stem cells That Might Later Save The Ill
SUDEEP REDDY
The Dallas Morning News
26 November 2005
With the last of the patients evacuating, Janet Krane had one final task before she could leave the flooded Memorial Medical Center in uptown New Orleans.
She scurried through dark, sweltering hallways to a lab, where a pair of freezers preserved more than 200 sets of stem cells that could someday save the lives of the hospital's cancer patients.
Reading through manuals with a flashlight in her mouth, she screwed hoses from giant liquid nitrogen canisters onto the cylindrical units.
"We knew that we had to take care of the cells," said Ms. Krane, director of the New Orleans Cancer Institute in the Memorial complex. "We thought of them just as patients."
The next morning, three days after the waters rose, the hospital was completely empty. Its employees wouldn't know for weeks whether their efforts to save the cells had succeeded.
Memorial, owned by Dallas-based Tenet Healthcare Corp., has become a symbol of the desperate conditions that hospitals faced in the aftermath of Hurricane Katrina.
Though Memorial doctors and nurses faced trying conditions to evacuate patients, dozens died inside the facility after the storm hit the Gulf Coast on Aug 29.
Other hospitals also lost patients - and valuable research programs - that had taken years to build.
The Louisiana attorney general's office is investigating the deaths at hospitals and nursing homes in the New Orleans area during and after Katrina.
To Ms. Krane and the rest of the hospital staff, the stem cells in the freezers represented a critical opportunity after the disaster to save more lives.
Before Katrina hit, the New Orleans Cancer Institute was one of just two facilities in the city that offered super-specialized care for patients with leukemia and myeloma, both forms of blood cancer.
Patients set to undergo chemotherapy would first have their stem cells collected and stored in small bags inside the cryogenic freezers. The cells are stored for up to a decade, in case the patient needs an infusion to regenerate blood cells.
Hospital administrator Dave Goodson was the first to return to Memorial a week after the evacuation, arriving via helicopter because the facility was still surrounded by water.
Assessing the facilities, he checked on the cells in the cancer center.
A backup generator, which was running when Ms. Krane last visited the cells, had maintained the freezers at minus 184 degrees Fahrenheit and regulated the flow of liquid nitrogen into the freezers.
Generators off
But the generators had since shut down, leaving no computers to monitor the equipment and only the natural flow of nitrogen to cool the stem cells.
The two 4-foot cylindrical freezers were still vaporized, with frost on their lids. "But the tanks were beginning to run low," said Mr. Goodson, Memorial's director of support services.
He returned with a pair of engineers from a nearby Tenet hospital, NorthShore Regional Medical Center.
With Ms. Krane and two others on the phone, Mr. Goodson used a plastic tea pitcher from an employee break room to ladle liquid nitrogen from an unused freezer into the two working freezers.
The room was pitch black, except for flashlights. Mr. Goodson wore a long glove to keep his arm from freezing. And he dipped slowly, 20 times over the next half hour, to replenish the freezers.
"I was cautious not to hit anything," he said.
The engineers hooked up new tanks that could maintain the freezers for 10 days.
"We again held our breath to make sure, within the seven- to 10-day period, we could get back to supplying and servicing those machines," Mr. Goodson said.
Within a week, a supplier made its way through government checkpoints in New Orleans for the first of several deliveries of the 800-pound liquid nitrogen tanks.
The improvised process and a loss of electricity again in late October cast doubt on their success. "We thought we had lost the stem cells." Ms. Krane said.
Samples were sent to an outside lab for testing.
The tests found that the cells remained viable.
'Life and death'
Noreen Duhon, who received a stem cell transplant at the hospital more than two years earlier, had learned of the cryogenic freezers during her treatment.
Her cells were stored in the freezer even though her twin sister also provided cells for the transplant.
"I thought about those tanks when I was evacuated, and I thought about those people that were in there waiting for transplants," said Ms. Duhon, who was first diagnosed with multiple myeloma 11 years ago.
"This is a life and death situation," she said. "Having been through the process, I thought 'my God, what's going to happen if they can't be preserved?'"
Dr. Todd Roberts, the medical director of the transplant program, said the cancer center had between 100 and 200 patients who were in various stages of treatment when Katrina struck.
They were sent to hospitals across the country, and Memorial's staff has only made contact with about half of them since the evacuation.
A handful of patients may need the stem cells soon for transplants. The rest of the cells will also be stored in case they're needed down the road.
"If someone has a long period of five or six years where they maintain their remission but they relapse, then these stem cells are potentially viable for them," Dr. Roberts said.
Memorial's program, the largest in the state with 31 transplants last year, has been halted along with the one operated by Tulane. The hospital's future is still being determined, though Tenet has pledged to rebuild its medical network in the area.
Dr. Roberts credits Tenet and the Memorial staff for saving the stem cells despite the numerous barriers.
"There has never been a situation like this," Dr. Roberts said. "We really were shooting in the dark and hoping for the best. It so happens that it turned out perfectly."
E-mail sreddy@dallasnews.com
CHART(S): SAVING STEM CELLS IN THE NEW ORLEANS' MEMORIAL MEDICAL CENTER; PHOTO(S): 1. BRAD LOPER/Staff Photographer) Hurricane Katrina flooded the area around Memorial Medical Center (at top) with most of the rest of the city. 2-4. (Tenet Healthcare Corp.) Dave Goodson works in the dark to refill freezers with liquid nitrogen to preserve the stem cells of cancer patients.
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