HOUSTON – The triage line inside the Astrodome (search) hasn't changed much since the buses began arriving from New Orleans two nights ago. It's long with tired, ailing refugees, some in wheelchairs, some on crutches, some critical, some not, but every one of them waiting on a doctor.
This is the Astrodome, not the Superdome. It's smells a lot less here. It's cooler, and less chaotic. Still, it's a basin of folks with so many ills, where everyone lines up to be treated. And it's no short line.
Mary Cavnar Johnson, M.D., private practitioner turned Red Cross volunteer, is quick and kind. Whenever she glances over a patient's shoulder, though, the line doesn't get any shorter.
In four hours, she's treated 50 people. (At her practice, Johnson sees no more than 30 in a routine, eight-hour day.)
All around her, where baseballs and footballs once flew over green turf, volunteers in Red-Cross vests, nurses and doctors are taking pulses, feeling foreheads, flipping through a 51-page list of generic medications, scribbling prescriptions as fast as they are able.
Beverly Williams, 43, hands her a worn slip of paper. Williams has high blood pressure. She lost her medications in New Orleans, her house, and her three kids. That was three days ago. She keeps twitching in her chair. Johnson doesn't like the twitching.
"Your BP is real high, Beverly." The doctor pumps up the blood-pressure cuff on her patient's arm. "You getting headaches?" Pump, pump. "What meds were you taking?"
Williams shakes her head. The dark pouches under her eyes twitch. She's trying, but recollecting isn't easy when you've been addressless, foodless and bedless for much of 72 hours.
Johnson nods to the EMTs. Gently, she says, "Beverly? Here's your prescription. These folks are going to take you to a hospital. Then a pharmacy. Tomorrow, we'll do another BP check. OK?"
Grimacing, the woman hoists herself from the chair. Turning to go, she murmurs, "Y'all be blessed."
Next is Yuri Clark, 17, student. Two days earlier, she was up to her chin in New Orleans murk. ("It felt like walking in dirty vegetable soup.") Now, she's got a welt on her left thigh as big as her palm. It hurts. So does her head.
Something bit her, the doctor says.
A snake, perhaps.
Then comes Barth Phillips, 48, who has pneumonia and pleurisy, inflammation of the lung linings. After him is Betty Guidry, 54, diabetic with no insulin. Unfortunately, the Dome's makeshift pharmacy just ran out, too.
Johnson calls out: "When's the insulin coming?"
"WHEN'S THE INSULIN COMING?"
Answers take time. There are, give or take, roughly 50 doctors, paramedics and nurses on hand to treat the Dome's 11,375 new residents. So, Johnson puts on a happy face, then puts Guidry on a transport to a nearby hospital.
This day, triage got some new equipment: tables. The tables are arranged in a line. On one side slump patients, on the opposite, their saviors. Dr. Evan Melrose, 36, of Texas Medical Center, is one.
"Overwhelmed?" he asks. "No. Not yet."
Melrose is one of the Big 10 — doctors who can prescribe medicine. They're taking dicey patients first: the ready-to-stop hearts, the congested lungs — anybody who is "on deck" for a stroke.
His pen is fast at work for Annie O'Neal, 62, who has heart disease. O'Neal fled New Orleans with the clothes she wears, a purse and five Walgreens bottles. "I grabbed my meds," she says, "then my money."
Above a missing person announcement, above one gentleman's sandpapery rendition of "Amazing Grace," Melrose shouts instructions to O'Neal. A volunteer rushes up, holds out a palm of tablets. Apparently, a sick woman was going to swallow them, not knowing what they were.
"Anybody know what these are?"
"I don't read palms," Melrose jokes, and points to a garbage bin.
That produces a smile from the next patient, Shirley Oliver, 50, formerly a cook at the Superdome. Oliver's blood pressure is off the chart, perhaps because rescuers plucked her and her daughter, son, and four granddaughters off a rooftop, then left them on an overpass.
Describing her odyssey, her face clouds, her shoulders quake, and the tears start. "My mother was in a hospital when the storm hit. They evacuated her. But I don't know where she is."
Melrose mops his brow, lowers his gaze.
Later, he says: "You try to focus on the task at hand, you know? But when you see what's in their eyes ... well, I've found myself pushing back tears."
Another volunteer to the triage unit is Mary Clair Haver, 37, native of Lafayette, La., obstetrician. Many young, pregnant women are coming off the buses, ready for delivery.
Earlier, two doctors and four nurses raced up the stadium ramps and frantically searched the fourth-level bathrooms for a woman in labor. Then a pregnant 17-year-old approached Haver, panicked because she hadn't felt the baby move all day.
Haver sighs. "We don't have fetal monitors here. We don't have the basics. All I could was feel her. And I didn't feel the baby kick."
Just then, Kyrisha Miner, 27, wobbles over. Her ankles are swollen, her blood pressure is up. "How many babies are in there?" Haver jokes.
"One — I hope!"
Her baby is due on Sept. 7. But Haver says they need to induce the birth right away.
"Today?" Miner gasps.
When the woman is gone with a list of instructions, Haver says, "It too dangerous. I'm taking no chances. Not with her."
Then she's back to the triage table, for a heart patient. A long day is about to get longer.
"As long as they need me here."