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  • Matthew Minson, MD

Hell and High Water


Ten years ago today I was in a predeployment mode and staged in Northwestern Louisiana with TXTF-1 USAR. I sat with my colleagues Stan Hempstead, Richard Bradley, Dennis Gross, Byron Wells and a few others watching the television coverage as the lines outside the Superdome grew in anticipation of a category 5 hurricane’s impact. It was a big storm for sure, but we had been through the well-practiced enterprise of post landfall entry, search and rescue before.

Two days later the well practiced enterprise was anything but.

Outfitted in reinforced gear- steel toed and shanked boots- and carrying heavy rescuing materials, we carried on a sustained and complicated water campaign. In appropriated watercraft and using highway overpasses as a boat launch we were dressed essentially as human anchors. Not much else was going any better. Communications were non-existent, misinformation was rampant, perception was surreal and yet the mission was clear. Over the course of our time there, everyone on the team suffered something: heat stress, dehydration, injury-both body and mind- still all the while we just kept pushing forward toward those people that were still out there.

We needed to get to those people trapped by the contaminated water and we needed to get them the hell out of there. While it may have been one of the biggest search and rescue efforts in this country’s history, it was also a novel and complex mixture of political, social, and popular catastrophe punctuated by acts of heroism. My colleagues and I didn’t have a voice in any of those characteristically “important” decisions. We weren’t consulted on the strategic implications, the plan of attack, or the resourcing. Frankly we weren’t really aware of what they were. We only had the reflexes- the muscle memory if you will- of the responder. Someone was in trouble, and we had the skills and ability for addressing that. To not go would have been unconscionable.

For years we had all trained and studied. We had responded to our state’s and nation’s disasters resulting from bad weather, storms, natural and human threat, aerospace tragedies, even terrorism. With Katrina, however, we were faced with a test of extraordinary degree; thousands of people trapped in privation, civil unrest and in those earliest hours and days, not much to fall back on but what we had in our heads and on our backs.

There has been a lot written and a lot of talk about Katrina. Prior to now, I have avoided indulging my memory. In many ways it was self protecting, in many ways it was all still just a little too raw. The good thing about time is that the lesser aspects of recollection have sort of evaporated-like the floodwaters themselves- and I am left with, I hope, the important things. I’m left with the human things, the stories and- while this may sound a little odd- I’m also left with a sense of pride.

I remember the Katrina response as two distinct responses. The first included the days before landfall through the first couple of weeks. The second was the phase thereafter. The first was what most people envision when they think of Katrina. They remember the footage of a porous levee and an inundated American city, the images of looting, and the people of New Orleans, that were able, wading through water that was alternatively polluted by petrochemicals and sewage. I recall those same things, but more personally, I remember certain faces. I remember an old woman that I treated on a concrete outcropping in the water before riding in with her to the airfield so I could keep her IV protected. I remember mass triage on the Wisner Blvd elevation and prioritizing the ones with guns off first. There are hundreds those memories that crowd in when I start to think about them, but one in particular always comes to mind.

I recall a young man named Marcus who I first encountered on a rescue air boat. We started talking and he told me he had worked for the city. I told him about my affection for New Orleans, how I had almost done my residency there. I liked him and that made it even more disturbing when he hesitated to board a staged helicopter for a flight to the airport. He said he couldn’t leave without knowing if his father was still in a house and walked back into the water. At that moment we were told of a building where a large number of women and children were trapped. We had to go and wouldn’t be back until the next morning.

Maybe it was the fact that humanity has a way of coming through in a crisis with a sort of accelerated familiarity, but whatever it was, there was something unique about that quick connection between Marcus and me. Maybe it was just the fraternity of terrible circumstance, but he knew I cared what happened to him, that I was invested in him. We looked around. A pair of old shoes was sitting on a concrete pillar that supported the guardrail on the overpass that had become an island in the poisonous sea. We made a deal. He would leave a note with the words, I made it out, Matt” in the shoes and I would stop worrying about him.

Our team moved on to the new rescue area and when the darkness made continued efforts too dangerous because of the submerged automobiles and other hazards, we pulled back. That night I tried to sleep under a tractor trailer and picked up an am radio station that was functioning as a bulletin board connecting people who had lost track of relatives. I thought about Marcus out there. Eventually fatigue took over and I slept. The next day as we drove back to the over pass, I wondered what I’d do if that note wasn’t there. It wasn’t like I could divert efforts from all those other entrapped people to hunt for one person. At first I didn’t want to look. I couldn’t be sure but as I walked along the overpass it looked like the shoes weren’t there. I moved closer with a sense that this was just going to be another entry in the stream of misery and woe, when providence cut me a break. There, two pillars farther down were the shoes. I walked over and looked in.

“I made it out, Matt.”

I don’t think I can adequately describe the relief I felt in that moment.

There would be a lot of other scenes and images that would stay with me through these ten years- some good, most others bad- but they are a part of me now like the scar on my left wrist, and the limited deafness I have from a Coast Guard Jayhawk’s rotor after my hearing protection blew off as I cabled up with an elderly woman needing medical care.

My job, the job of any USAR doctor, was to protect the men and women on the team so they could save others. During the first two weeks of Katrina I worried about broken gas pipes effervescing the water and finding an ignition source to erupt in flame, or downed powerlines, or just drowning. During the next two weeks as the levees were blocked and the water was pumped out, the flooded houses gave off toxic breakdown products and my concern was not so much about the immediate threat, but the long term health effects of those things we couldn't identify as easily. Altogether we spent twenty-one days in the field only to pull back to Texas as another storm, Rita, was forming and heading for our homes.

But that’s a whole other story, as my grandmother used to say.

As I said, much has been written and broadcast about the numerous failures, including in the formal publication of The Federal Response to Hurricane Katrina, Lessons Learned. Two groups were called out for not failing, the US Coast Guard and the Search and Rescue teams. My recollection of the bigger issue was limited by the austerity of our situation as responders and the magnitude of our task. There were a lot of failures, for sure, but I honestly think that the actions of the men and women with whom I served in New Orleans constituted our finest hour. And with as many as I witnessed over the years, that is really saying something.


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