A soft-spoken older man thanked me for giving him back his life last week while I was working at our makeshift shelter eye clinic in downtown Houston. What had I done that was so life-changing? I gave him a pair of hyperopic glasses. His were washed away along with his house in the 19 trillion gallons of rain dumped on Texas by Hurricane Harvey. This gentleman, who had evacuated just days before, told me about the struggles he had with walking and reading medication bottles since losing his spectacles. In that instant, I was reminded of what a special privilege it is to practice ophthalmology.
Hurricane Harvey made landfall in southeastern Texas on August 25th, causing catastrophic inland flooding. Most have seen the images of Harvey’s destruction in the media. But it’s a different feeling to see it firsthand, affecting familiar faces and landmarks. The main road I take to work every day morphed into a waist-deep river. Many of my friends watched in distress as water levels rose hourly from their front yards to their porches and ultimately into their homes. Everything in the region came to a standstill—including many of our health care operations. In hindsight, I think it’s fair to say that I naively underestimated how greatly the ophthalmology community would be impacted.
There are 345 practicing ophthalmologists in Houston; this does not include neighboring cities also affected by Harvey. The Texas Medical Center (TMC), the largest medical center in the world, was largely shut down for 6 days. It’s easy to forget what a high-volume specialty we are until times like these. At Baylor College of Medicine, ophthalmology accounts for 12.5% of all outpatient visits. In our faculty practice alone, 1538 ophthalmology visits and 67 eye surgeries were cancelled; this number doubles when accounting for our affiliated VA and Ben Taub public hospitals. And these figures apply to my own institution only; the total number of ophthalmology patients affected in Texas is presently unknown, but undoubtedly staggering.
Perhaps the greatest lesson I learned from my first hurricane experience was the importance of preparedness. Because the TMC had an advanced flood protection system in place as a consequence of Tropical Storm Allison in 2001, the damage caused by Harvey was less than what might have been. Detailed plans delineating medical care provision were established as soon as Harvey’s threat was forecasted. “Ride-out” teams—those designated to remain in-house if entry into/exit from hospitals becomes impossible—were formed. Because of these teams, many patients—including one with endophthalmitis and another with an open globe—were able to receive timely, vision-salvaging care.
It has been truly inspiring to see the community come together in the face of disaster. Within the ophthalmology bubble specifically, I have witnessed countless examples. Ophthalmologists unaffected by the storm opened their doors to fellow ophthalmologists who needed a space to work until their offices were restored. Most of us ran virtual practices while we were trapped inside our homes, using our cell phones to call and text our most critical patients. Last week, I received an email from a retina specialist in Arizona generously offering to temporarily train our retina fellows if needed. He was an ophthalmology resident at Tulane when Hurricane Katrina struck. Baylor and the University of Texas–Houston had absorbed his residency program while New Orleans recovered, and he wanted to give back. Collaborative efforts amongst local institutions and organizations resulted in the inception of an operational volunteer-run eye clinic at the NRG and George R. Brown Convention Centers, which have sheltered more than 15 000 displaced citizens. People there can undergo a refraction and complete eye examination; thanks to generous donations, they can even receive prescription glasses ground on-site and medication eye drops that have been lost in floodwaters.
Recovery will be long and challenging. We are in the process of rescheduling nearly 2000 ophthalmology appointments. We have to outsource our bevacizumab injections at the county hospital because the basement-level compounding pharmacy flooded. While tedious, these things do not compare to the devastation experienced by those who lost everything. Over the past 2 weeks, I have seen the strength, self-reliance, and resilience of the Texas people with my own eyes. I have seen the kindness of strangers who emerged to aid in relief efforts. I have seen neighbors help neighbors rebuild their businesses, homes, and lives. The tragedy of Hurricane Harvey has allowed me to once again realize the impact we have not just as ophthalmologists, but as human beings. One thing I will never forget about my hyperopic patient is the moment I placed his new glasses on his face. He smiled and said, “I see things so much more clearly now.” I feel the same way, sir.