California wildfires: Doctors wait for the smoke to clear

After addressing patient needs and personal evacuations, physicians prepare for the aftereffects.

By Victoria Stagg Elliott, AMNews staff. Nov. 24, 2003.

When Lucinda Hill, MD, MPH, realized that wildfires were closing in around her hometown of Lake Arrowhead, Calif., she packed her husband, dog and various valuables in her truck. She headed for nearby Mountains Community Hospital, the small rural health center where she runs the emergency department. A second emergency physician was also on the scene. It was Oct. 26.

"Usually we're a one-physician, one-nurse, one-clerk ER," said Dr. Hill, vice-chief of staff and medical director for the emergency department. But running through her head this day was, "What if there was a major thing where a bunch of firemen got hurt? To have an extra physician here would be a good thing."

Even though the facility's patients were evacuated, the emergency department remained open for much of the disaster to treat firefighters and to care for residents who didn't make it out quickly enough.

It took more than a week for the fires to be completely under control, and Dr. Hill and her co-workers were evacuated several times. Thousands of homes were destroyed. At least 20 people died. The event was devastating.

"Living in the mountains, fire is a constant threat," she said. "But it's never been quite like this."

For the most part, Dr. Hill's facility provided more respite to firefighters in the form of a warm, dry place to sleep than in actual medical care, although she did treat one worker with respiratory problems.

"We were no longer functioning as a hospital but as a community service organization," said Dr. Hill. "We had very few patients during that time, but it's a very good feeling to be able to provide care for the people who did need us. It's a very unique, stressful situation because you just don't know what's going to happen."