Disaster Doctor

David McCann prepares physicians to respond when tragedy strikes

By Rebecca Pollard Pierik
http://www.umassmag.com

On the morning of September 11, 2001, after hearing that the Twin Towers had fallen, Dr. David McCann ’09G bought a train ticket in Georgia and headed for Manhattan. The family practitioner and emergency-room physician treated rescue workers and firefighters in an armory near Ground Zero in the days after the attack. Seeing New Yorkers “brought instantaneously to their knees� made him determined to improve the way our nation responds to emergencies, says McCann.

Since then, McCann has made it his practice to save lives and spread hope in the aftermath of our nation’s most infamous disasters.

After 9/11, McCann returned to Georgia and became chief medical officer of FloridaOne DMAT (Disaster Medical Assistance Team). Operating under FEMA, which is part of the Department of Homeland Security, DMATs are volunteer teams of doctors, nurses, emergency medical technicians, and pharmacists who enter disaster areas when hospitals are closed down or inundated. McCann’s team cared for the victims of hurricanes Katrina and Rita in the hardest-hit parts of Mississippi and New Orleans in 2005.

Now the doctor is leveraging his firsthand experiences and his clinical expertise to shape the burgeoning field of disaster medicine. As incoming chair of the American Board of Disaster Medicine, McCann has worked to create a board-certification process for doctors to specialize in caring for victims of catastrophe. With the first certificates awarded last fall, his efforts are bringing more trained physicians to the front lines in times of crisis.

“With the ongoing war on terror and the threats of severe tropical storms and disease pandemics, it’s critical to prepare physicians to practice medicine under emergency conditions,� says McCann, a graduate student in public health at UMass Amherst. Just as important, he says, disaster physicians will help communities prepare for catastrophes. “The medical community has abrogated its responsibility to get in there and help plan for disasters,� he says. “But during these times, hospitals are often overwhelmed or shut down and greater numbers of people need medical attention. So physicians must play a central role in planning for emergencies and responding to them.�

Doctoring through no less than six major hurricanes in the Gulf Coast, McCann has seen the most gruesome side of human tragedy—but he has also witnessed inspiring heroism.

In Missisippi after Katrina, McCann met a young National Guardsman, just back from Iraq, with a deep puncture wound in one eye—a potentially blinding injury. The patient pleaded with the doctor to save his eye so he could continue his tour of duty. “I found it incredible that this young man must have been in debilitating pain, but all he could think about was how he wanted to keep serving his country,� says McCann.

Working in St. Bernard’s Parish in Louisiana in the days following Hurricane Rita, he treated patients who suffered painful rashes after slogging through the sludge of storm water, chemicals, crude oil, and sewage that filled the streets. “You never know what you’re going to see out there,� says McCann. Some victims came to his DMAT camps with standard bone breaks or deep abrasions. Others arrived in cardiac arrest, preterm labor, or diabetic comas, all brought on by stress.

In all instances, the medical team must stabilize as many patients as possible, determine what level of care they need, then transport them, if necessary, to the closest functioning hospital, which may be hundreds of miles away. And the team must accomplish this without many of the technologies available in modern hospitals, while under ongoing threat of inclement weather, rising waters, spreading diseases, or even terrorist attacks. “It’s a special kind of doctor who’s drawn into this field. It takes a good commonsense clinician who can keep a cool head under stress,� says McCann.

At present, no medical schools offer comprehensive training in disaster medicine. Instead, physicians applying for the new specialization must be board-certified in other specialties. To prepare for the boards, they must cobble together disaster response, life support, and hazardous materials courses from a number of different institutions, including FEMA, the American Medical Association, and the U.S. Department of Justice. As more doctors seek certification in disaster medicine, McCann predicts that more medical schools will begin to offer the training.

McCann says these physicians also need strong public health skills, which is why he entered the master’s program at UMass Amherst. “Medical skills prepare professionals to diagnose and treat individual patients,� says Linda Landesman, a professor in the program and author of Public Health Management of Disasters: The Practice Guide, a seminal text in the emergency-preparedness field. “Public health skills prepare a professional to work in multidisciplinary teams, understand health issues from a community view, and understand the factors—social, behavioral, and otherwise—that contribute to disease.�

Because he can complete his degree online, McCann is learning from top experts while maintaining a more-than-full-time medical practice and, alongside his wife, home-schooling his five children. No doubt, he has plenty of practice staying cool under stress. Despite the pressures it brings, McCann says that doctoring under duress brings him great satisfaction. The chance to be a hero among heroes—and to witness humanity’s triumph in the face of unthinkable tragedy—makes the hard work worthwhile.

“Doing this work takes a lot out of you,� he says. “But the people we help, who turn around and help others . . . they keep us coming back.�
see original