Musings of a physician after Katrina.(GUEST EDITORIAL)

My entire career, except for 2 years in the U.S. Army, has been centered in New Orleans--at Tulane Medical School, the U.S. Veterans Affairs Medical Center, and on the faculty of Louisiana State University. Although the city has weathered many storms, nothing prepared us for the destruction of Hurricane Katrina.

In addition to the massive physical toll the hurricane has taken on the Gulf Coast, it has also displaced patients, medical education, and clinical research.

At LSU, I supervised cardiology in two large clinics at Charity Hospital in New Orleans. The patients there were among the poorest people in the city, and you probably saw them in the news coverage after the storm. These patients, who were always so grateful for the care they received, have lost not only their homes, but their connection to their health care system.

And many of the private practice patients are gone as well. We simply have no idea where most of them are at this point.

The conditions in the aftermath of the storm have been especially hard on patients with heart failure, hypertension, and other cardiovascular diseases. Some are without their medications and many are unable to follow their diets.

The situation has also displaced medical students, fellows, and house staff from the two major universities in the area--LSU and Tulane University. In many cases, medical students are taking classes on other campuses or at different universities. However, the situation is more complex for fellows and house staff, who are required to do a certain volume of cardiovascular procedures to attain certification.

Another casualty is the research that was ongoing at the two universities. Storm damage and flooding will have a tremendous impact on basic medical research. Materials stored for genetic testing as part of a clinical trial are likely destroyed. All of the basic medical research infrastructure will have to be rebuilt. Records may be lost, experimental animals in vivariums may be gone, and delicate equipment may be damaged.