After Superstorm Sandy, a Community Cries Out for Its Hospital

Building a new hospital in Long Beach -- as FEMA intended when it allocated $154 million for that purpose -- will lead the country as a venue for new modalities of care for survivors of catastrophes.
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The second deadliest hurricane in U.S. history, Hurricane Sandy killed 33 people in eight countries and caused $68 billion in damages. The National Oceanic and Atmospheric Administration's ranked its "destruction potential" as 5.8 out of 6.

As I have written about here, one of the casualties was my home in Long Beach, New York. (It was rebuilt and sold.) Of greater significance was the loss of Long Beach Hospital, which had served this barrier island since 1922. Evacuated in the days before Hurricane Sandy made landfall on Oct. 29, 2012, Long Beach Hospital never reopened. Financial mismanagement was the reason given; however, FEMA allocated $154 million for a new hospital to be built in Long Beach. New York State Department of Health allocated the funds to South Nassau Communities Hospital about five miles away. South Nassau is not building a new hospital in Long Beach.

As a psychotherapist who specializes in acute stress, trauma, and PTSD, I lead two free support groups in Long Beach where people continue to struggle with the emotional aftershocks of a natural catastrophe.

Should you be thinking, "Support groups? Aren't you over it by now?" events like 9/11 and Hurricane Katrina have shown us that it takes three to five years for the psyche to metabolize the loss of safety that catastrophe destroys. Less tangible but longer-lasting than property damage, loss of safety generates a host of anxiety-related symptoms, from flashbacks to phobias to hyper-vigilance. (In the interest of full disclosure, I check my emergency go-bag twice a week. It's a classic case of hyper-vigilance in action.)

Among the most sizable aftershocks rippling across the island is the loss of the Long Beach hospital.

Geography necessitates that the community have a full-service hospital. Located on a barrier island on the south shore of Long Island, the City of Long Beach, N.Y. is the 24th most densely populated community in the U.S. Its year-round population of 33,275 residents swells to more than 50,000 during the summer. Stretching about 3.5 miles from east to west, this narrow barrier island faces the Atlantic Ocean to the south and to the north, the Reynolds Channel which is part of the Intracoastal Waterway System. Three drawbridges connect Long Beach Barrier Island to the south shore of Long Island (called "the mainland" by locals).

According to the Berger Commission, a non-partisan panel of experts appointed by former Governor Pataki and the New York State legislature to assess community health needs in the 21st century, the City of Long Beach is supposed to have its own hospital. The Berger Report states:

The closest hospital to Long Beach is South Nassau Communities Hospital, which is located 5 miles to the north ... while this distance does not appear to be a barrier to alternate access, all three drawbridges are frequently up during summer, snarling traffic and blocking emergency access ... Geographic isolation and dependence on these drawbridges ... mandates that the hospital provide the community with appropriate access to emergency services and acute care.

The present lack of consistently speedy EMS transport to South Nassau is dangerous to patients who are close to death. Residents are worried about their safety in the event that they need to call 911. The elephant in the room that no one is addressing publicly is the DOA question. If your ambulance is stuck in traffic or forced to wait for a drawbridge, how does that increase your risk of dying on your way to South Nassau?

There are no official DOA statistics... yet. But do we really need 911 fatality statistics as a wake-up call? If so, how many people need to die in an ambulance on their way to South Nassau Communities Hospital before the New York State Department of Health and South Nassau decide to do the right thing?

Father Chris King, pastor of St. James Episcopal Church, recently addressed a public forum on this issue held in Long Beach City Hall. "I know that I speak for my congregation when I say the I'm not convinced that the scheme proposed by South Nassau Communities Hospital is a sufficient -- much less the best -- solution for providing non-ambulatory health care to our city. South Nassau can't meet patient demand now," he said. Merely visiting someone there can mean waiting in a long line just to get a parking place. What's it going to be like five, 10, 20 years from now?"

On Oct. 29, 2012, when Hurricane Sandy hit, Father King was rounding out his fifth year as pastor of St. James. In those five years, he said that only two parishioners died. "In the year after Sandy, we had to bury five. Admittedly, they were frail and just didn't have the strength to push through that terrible year," he said, adding that "a major contributing factor was that they couldn't handle the many stresses involved in traveling back and forth from Long Beach to hospitals in other towns, including South Nassau Communities Hospital. It wasn't just physically arduous for them. It was dispiriting and a source of constant anxiety." The dislocation created further hardship for family members, many of whom were dealing with major health problems of their own.

Long Beach Barrier Island has urgent medical needs specific to an isolated maritime community. In addition to such marine emergencies as drowning, and accidents while fishing, boating and surfing, 911 calls respond to incidents of hypothermia year-round. During the summer months, when the population exceeds 100,000, heat exposure and dehydration are not uncommon emergencies.

The island's medical needs will change over the next 30 years. And this presents an opportunity for a new hospital to pioneer research and treatment modalities that can serve as a model for other communities affected by climate change and catastrophic events. A National Institutes of Health report states, "An increasing body of evidence links PTSD with a significant body of physical morbidity." The medical conditions listed in the NIH study include:

. Cardiovascular disease; hypertension
. Obesity
. Diabetes
. Chronic musculoskeletal pain
. Thyroid disease
. Autoimmune disease
. Certain types of cancer

One 2004 study found evidence that these health problems can present up to 30 years after exposure to trauma This list does not include such long-term psychological concerns as: flashbacks, hyper vigilance, and anxiety due to Post Traumatic Stress Disorder; depression; substance abuse; and a higher incidence of suicide.

Building a new hospital in Long Beach -- as FEMA intended when it allocated $154 million for that purpose -- will lead the country as a venue for new modalities of care for survivors of catastrophes. It is an opportunity that FEMA, the New York State Department of Health, and South Nassau Communities Hospital cannot afford to ignore.

"We needed our hospital before Sandy. We need it even more now. We are diminished without it," said Father King at the recent health care forum held at Long Beach city hall. "It wouldn't just be bad, it would be wrong for the people of Long Beach to emerge from this crisis impoverished, and for the South Nassau brand to some out of this enriched -- or, as they say, "enhanced" -- at our expense."

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