I sat at the ACEP headquarters attending an EMS board review course as the Texas Emergency Medical Taskforce (EMTF) was springing into action to respond to what would become one of the worst natural disasters in U.S. history. I am the medical director of EMTF 1, which encompasses the Texas Panhandle, including Amarillo and Lubbock, where I am the EMS medical director, and I call Amarillo home. It wasn’t much of a surprise when the text and email requesting my deployment to the Texas coast came through.

By then, Hurricane Harvey had hit, and the damage was done. I knew only what I could gather from the news as I made arrangements for shift coverage, canceled a Las Vegas trip for me and my wife, and gathered a backpack full of stuff to live for five days in who knows where (see Figure 1).

Figure 1: Dr. Troutman’s supplies for his five-day deployment to the Texas coast.

Figure 2: A mobile medical unit parked in a private airport in Ingleside.

Figure 3: Interior of a mobile medical unit.

My air travel to San Antonio was uneventful and I pointed a rental car towards Corpus Christi, Texas. We were around 60 hours after landfall. Houston was now being battered with rain, and reports of flooding were coming over the radio and Facebook. Our mobile medical unit (MMU), a fancy term for a rather large expandable tent with dozens of ED beds (see Figure 2), was being setup up at a commandeered (I didn’t know you could really do that) private airport in Ingleside, which was right outside of Aransas Pass and along the primary road in and out of the areas worst hit by the eye of Harvey.

I finally arrived at our site, where it was overcast, with steady 30-plus-mile-per-hour winds and a rather ominous appearing sky. Toppled and smashed multi-million dollar jets were scattered around us; their hangars had blown away. Some hangars were still intact, and we broke into them when we needed things. Flat ambulance tire? Tools? We found an air compressor and all the tools we needed. Nobody stole anything, but the concept of commandeering something was new to me. I am sure whoever owned those things would not mind. We were doing good things.

The next few days become a blur. Patients—upwards of 80 to 90 a day—visited our MMU (see Figure 3). We had three physicians, dozens of nurses, paramedics, and other support staff who did everything from making sure we had supplies to see patients, to making sure generators were full of fuel. The complaints were typical for any emergency department: heavy on wounds, medication refills, and chest pain in those who were not used to working so hard. The difference was the story. I have always enjoyed hearing patients’ stories, and those in the path of Harvey had stories to tell.

Figure 4: One proud grandfather who visited the mobile medical unit kept this hat with him during evacuation.

Figure 5: Another patient weathered the storm with his dog, Shirley.

Figure 6: A third patient evacuated with his family, but lost everything but the shirt on his back.

One grandfather in a hat (see Figure 4): “I wear it everywhere. My daughter gave it to me 11 years ago when she had her daughter. We got lucky: We left, came back, nothing out of place. The neighbor’s house is gone. Strange how that happens. I really just need a tetanus shot. I have cuts everywhere.”

Meet Shirley (see Figure 5) and her owner: “I’ve had her four months, and she was two months old when I got her. She is full of piss and vinegar. She took the storm better than I did. We didn’t have much, but we still have each other. I ran out of my medications. Can you do a refill? I have the empty bottles….”

And a man who evacuated and returned to destruction (see Figure 6): “They said it was going to be a cat 1, so we just left. I wanted to get my girls to safety, and my mom … she’s dying. She wanted to die at home. When they said it was going to be a cat 3, I wanted to go back and board the windows, but my wife wouldn’t let me. Her room is destroyed, the rest of the house is a wreck. She’s stuck in Austin now. This shirt is about all I have. My friends called me Stewie.”

I took a brief break and ventured into some of the areas hit hardest by the eyewall. Like most, I’ve seen thousands of pictures of natural destruction, but nothing equates to seeing this in real life. I love to see the humor people can express when they have lost so much (see Figures 7 and 8).

Figure 7: Handmade sign from one of the hardest hit areas.

Figure 8: Handmade sign from one of the hardest hit areas.

Figure 9: Broken telephone pole.

The number of broken telephone poles was astounding (see Figures 9 and 10), but even more amazing were the hundreds of lineworker crews with buckets, drills, and rigs working on restoring power to this area. They came from all over the country. I have a new appreciation for the way their trade pulls together in a disaster.

Some have asked about our living conditions. It wasn’t the Marriott, but it’s closer than you would think. We were in large tents with thousands of square footage and air-conditioning to the point of being too cold. We had MREs, but as the community around us stabilized and more people lent a hand, our unit became a popular place for food donation and for responders to come and eat (see Figure 11). We had no fewer than three to five dinner offerings each night and plenty of lunch and breakfast. I felt bad, having so much food at our disposal, and hoped nobody within 100 miles of us was hungry. I started feeding most of my patients, and they appreciated it. Most of them hadn’t had much of a hot meal for days. The sleeping cots, with a foam topper, were surprisingly comfortable. We received access to a community center not far away with hot showers and clean bathrooms. We lived better than most within 20 miles of us.

Figure 11: A food station fed physicians and patients.

We sent most of the patients we treated home (or what was left of it). Some were sent to the nearest open hospital, which was more than 45 miles away. The industry that really came together during the storm was the area’s independent freestanding emergency centers (FECs). One such facility was just five miles from us, and it had CT, X-ray, and lab up and running with its backup power. We sent them patients needing resources but not admission. Back in Rockport, another FEC was up and running and taking care of dozens of patients in the middle of the disaster zone.

As I reflect, we had it too good. We had one another and our families, with life as usual back at home. For the people of the coastal bend of Texas, their stuff was gone, their homes destroyed, and their lives turned upside down. But Texas is strong, and the Astros just won the World Series. The future is bright for Texas!

Dr. Troutman is the President-Elect of the Texas College of Emergency Physicians. He is the CEO and co-founder of a FEC called ER Now in Amarillo and Wichita Falls, Texas. He is the EMS medical director for UMC EMS, Lubbock Fire Rescue, Amarillo Medical Service, Amarillo Fire Department, and Vernon Fire Department.