Courtney Donovan M.D. I can’t say that I feel great about the

Courtney Donovan

M.D.

I can’t say that I feel great about the state of disaster planning here at the hospital. I know we keep talking about doing something, but it never seems to get any further than talk. I mean, no offense, but I think this is the third time since the derailment that someone has tried to talk to me about lessons learned. There’s a point where just that repetition makes it clear that no lessons have been learned.

But just to be a good sport: The big lesson from the derailment is that our staff is intelligent, resourceful, energetic, and flexible. That’s the good news. Stuck with a horrific situation and a disaster plan that I’d describe as “aspirational,” we got through a very rough event. It was more painful than it needed to be, since we had to improvise most of it and improvisation is never the most efficient way to do things. But we provided real help to people and I think we kept the loss of life admirably low.

But god. There was no structure, no thought to anything. I tried to get the nurses to perform some triage, but they were too busy reacting to the latest mini-crisis to pop up in front of them. I don’t blame them, of course! I tried to give some orders, but then like the nurses I was always pulled in to sit with the next patient, and someone else would come out and countermand whatever I’d said, and it just went on like that all night.

On a personal level, I know I pushed myself too hard that night. I mean, with good reason, but still. I was exhausted and loopy after 14 hours or so, and it’s just luck that I didn’t make any serious medical errors. I’m not the only one who put it all out there. I know most of the medical staff were in bad shape towards the end, too. I guess that’s always going to be a risk, but I think we could have planned our operations a little better. If we’d been more thoughtful about what we were doing, maybe we wouldn’t have needed to grind ourselves down so far.

You know what else? I’ve never felt good about our long-term check-ins afterwards. People who had recurring problems related to the derailment came in, but neither we at the hospital or anybody in public health did enough to check in with people on an ongoing basis in the months after the disaster. Even when we were having those water contamination issues! People forget about that–the derailment disaster really continued for months afterwards as the cleanup went on.

I hope you’re serious about taking this information and turning it into something useful. For god’s sake, please don’t just write it all down and keep it on your laptop this time.