DJP Update 12-1-2005 An Opinion from the Editor of the New Orleans 
Times-Picayune newspaper published in Washington Post; Lagniappe
Sent to DJP megalist

ITEM ONE: An Opinion from the editor of the New Orleans Times-
Picayune newspaper published in Washington Post

ITEM TWO: New Orleans Hospitals

ITEM THREE: Lagniappe

ITEM ONE: An Opinion from the Editor of the New Orleans Times- Picayune newspaper published in Washington Post

Do Not Forsake Us

By Jim Amoss
Washington Post Editorial
Sunday, November 27, 2005; Page B07

President Bush flew into New Orleans shortly after Hurricane Katrina devastated the city. His staff had to fire up giant generators to bathe St. Louis Cathedral and Jackson Square in floodlights, as a backdrop for his promise that he would "do what it takes" to rebuild New Orleans.

"There is no way to imagine America without New Orleans," he said, "and this great city will rise again."

Then the lights went out, and the president left. Vast swaths of the city have been in darkness ever since.

It would be unprecedented and indefensible for the federal government to leave an American city to fend for itself in recovery. But when we 
talk of the federal government's role in rebuilding New Orleans, it's important to understand its direct culpability in the destruction.

At the site of the worst urban disaster in American history, we are a city obsessed. Rebuilding New Orleans is our breakfast-table conversation, our lunchtime chatter, our pillow talk. But while we talk, we also wait. For a settlement on our homeowner insurance 
policy, for our children's schools to reopen, for a sign that our neighbors will come back.

Above all we are waiting for Congress and the federal government to decide that New Orleans deserves strong levees -- stronger than the 
sorry system, designed and built by the Army Corps of Engineers, that collapsed, wrecking our neighborhoods. We want word from Washington that a great American city will not be left to die.

As our newspaper has documented in recent weeks, the miles of federally built concrete floodwalls that were meant to keep Lake 
Pontchartrain from flooding the city through its drainage canals during a hurricane appear to have been poorly designed and improperly 
constructed. The floodwall system is a federal project, designed by the Corps and built under Corps specifications. Evidence suggests 
that metal sheet piles didn't go deep enough into the ground and that the walls were built on peaty soil that did not provide adequate anchorage. One engineering professor from Louisiana State University called in to investigate the failures said it was the kind of engineering shortfall he'd expect his first-year students to be able to identify.

When several of the federally built floodwall panels gave way on the morning of Katrina, after the worst winds had passed, the storm-
swollen lake cascaded into the city. It was a man-made disaster, a federal engineering failure with multibillion-dollar consequences.

Today, when we New Orleanians travel around the country, we are comforted by a tremendous outpouring of sympathy from ordinary 
Americans. Many have given generously to charities for Katrina victims. We also hear people talk about how things must be getting 
back to normal.

Nothing could be farther from the truth. New Orleans has become two cities -- an enclave of survivors clustered along the Mississippi 
River's crescent and a vast and sprawling shadow city where the water stood, devoid of power and people.

The ancient heart -- the French Quarter and Uptown -- is throbbing with commerce and signs of life from the hardiest returnees. But cross Freret Street, and you enter a dim realm. The neighborhoods that extend from there to the lake are comatose. At night, I drive through darkened and abandoned streets, past acres of housing that marinated in polluted floodwater for weeks, past blocks where I know 
people died, unable to escape the storm, past the homes of poor, middle-class and affluent New Orleanians -- all devastated alike.

When daylight returns, many of those dead blocks come alive with visiting homeowners dragging their soggy belongings to the sidewalk, 
stopping sometimes to hug and to cry, then going back to work. Our street scene is an endless row of ruined refrigerators, moldy sheetrock, debris and garbage bags.

The vastness of this destruction is almost impossible to fathom. A steady stream of members of Congress have toured the devastation at 
ground level, and they all have the same impression that a stunned Sen. Lincoln Chafee of Rhode Island came away with last week: "You 
have to see it."

Our city and state understand that it is incumbent upon them to come up with a plan, sensible and well thought out, for the rebirth of New 
Orleans. The problem is so vast that it is difficult to harness, and the first steps have been halting. But we're working on it.

When we're ready, we will be expecting, not unreasonably, a commitment from our government to fund a well-designed system of 
substantial levees, floodgates and other barriers extending into the Gulf of Mexico; a system that will protect us not only from a 
Category 3 hurricane like Katrina but from the strongest storm, a Category 5. Such a system would already have been built if anyone had 
taken into account the billions of dollars the government's failure to protect New Orleans is costing us now.

Can America, having witnessed the loss of well over 1,000 lives to Katrina, not rouse itself? Despite its problems, New Orleans remains 
one of our greatest cities, beloved of this country and the world. We are at the fulcrum of one-third of the nation's oil and gas and 40 
percent of its seafood. We gave birth to much of this country's indigenous culture, and we continue to nourish it. What does it say 
about our civilization if this unique American metropolis is left to die?

What New Orleans needs is no extravagance. Our city must help itself in rebuilding its neighborhoods and reforming its institutions. What 
is lacking is political will in Washington and the determination to bring our engineering know-how to bear upon the problem. Without a 
substantial levee system, homeowners won't muster the confidence to rebuild, and businesses will not see fit to invest.

President Bush was still smarting from the embarrassing federal response to Katrina when he stood in the heart of our city and made 
his promise to rebuild. It would be a greater embarrassment to an entire nation if that promise went unfulfilled.

The writer is editor of the New Orleans Times-Picayune.
--------------------

ITEM TWO: New Orleans Hospitals

Comments of my surgical partner Jim Brown, MD on a Reuters article below.  (DJP comment: It is very depressing when one thinks of a 
future in Medicine in New Orleans East where we had our surgical practice.)

(Jim Brown MD's comments)
More talk!!! Everything has been said at least 3 times already. But I still do not see any significant action concerning health care. There 
is not a single permanent hospital bed between Touro and Slidell; yet, whenever someone mentions that, a dozen excuses pop out of the mouths of political, medical and social leaders why  a hospital could not function in this environment. Hospitals function at the front lines of wars, in the deserts of Iraq, the jungles of Africa, Haiti and other places. Why not New Orleans East? Corporate America wants patients and an almost guaranteed return on their capital before investing in health care in this area. That can't happen now. However, I believe that a modest facility attending to basic medical needs could survive and profit, especially with some relief from the legal  and bureaucratic 
onslaughts that bedevil medicine today. The big question is,"Who will step up to the plate?" Corporate America ? Local community action? 
Local private enterprise? Federal government?


New Orleans hospitals face shortages - Yahoo! News
NEW ORLEANS (Reuters) - New Orleans lost its hospitals to Katrina's flood waters, and now risks losing its doctors and nurses to slow 
recovery -- leaving a big missing piece in the puzzle of putting the city back together.

The tens of thousands of residents who fled the city three months ago have dispersed to temporary homes across the country. Along with 
rebuilt homes, schools and other public services, adequate health care is needed to attract them back to the city.
"We are asking them to either risk their life and their health by moving back to an area where they are not going to have health care, 
or to leave New Orleans for good," Dr. Kiersta Kurtz-Burke, a rehabilitation physician at Charity Hospital, said at a public 
meeting on the future of New Orleans' health and social services.  Just one acute care adult facility, Touro Infirmary, is operating 
within Orleans Parish boundaries and it cannot find the nurses and other support staff it needs to get back to pre-Katrina capacity of 
260-270 beds.

Flood-damaged Charity and University hospitals were deemed unsalvageable. Charity was the only free hospital in New Orleans, one 
of the poorest cities in America and where some 20 percent of residents had no health insurance.
"Our message is that New Orleans is a city that has been ravaged --  the infrastructure has been ravaged and the health care system has 
been ravaged," Touro Infirmary Chief Executive Leslie Hirsch said at a job fair the hospital held this month to try to tempt nurses to 
join its staff.

"There is a national nursing shortage anyway, even without the devastation of this storm, and now, with the storm, the devastation 
just exacerbates what was an already significant challenge."  Private doctors have lost patients who have stayed away from the city 
which has only one public school open, tens of thousands of damaged homes and few operating public facilities. Doctors who worked at 
Charity worry that their patients, many of whom earn just too much to qualify for government aid, won't be able to afford to come back to 
New Orleans.

"Most of us would like to work in Charity Hospital, we would like to be able to have a presence in New Orleans," Kurtz-Burke said. "You 
have a very motivated group of people, most of them currently without pay -- we can't do that indefinitely -- and you will lose a huge 
number of very dedicated people."

Mark McGinnis, chief financial officer at the not-for-profit West Jefferson Medical Center, on the other side of the Mississippi River, 
said recruiters were already looking for New Orleans doctors.  "Nobody knows how fast the population is going to come back, and we 
are going to start losing physicians because they don't have a practice or a patient base any more," he said.

"The vultures are out recruiting our physicians from all over the country to come to their communities."
New Orleans had a wide range of hospitals before Katrina struck, including teaching hospitals, two trauma centers and treatment for 
the uninsured at Charity. Hospitals are not permitted to reopen without costly recertification.

"When we talk about rebuilding, we want to talk about rebuilding it better and doing it right," said Bill Rouselle, who chaired the 
meeting on New Orleans health services.

"We were at the bottom of most statistics, and we do not want to recreate the same thing that did not work before."


ITEM THREE: Lagniappe
Repair of home slow; have to coordinate many different repair experts.  Beginning to like this small trailer parked in driveway.  
Using a handheld XM Delphi to capture satellite signals for news and music and piping it though speaker system in trailer.  Really enjoyed 
having three of our grandkids stay in trailer with us Thanksgiving night.  Tabasco, our wonderful dog, follows Robin like a shadow.

Stay well.
DJP

Donald J. Palmisano, MD, JD
DJP@intrepidresources.com
Donald.Palmisano@ama-assn.org
www.intrepidresources.com
312-560-0180 cell