October 13, 2005 - Many articles are now appearing telling of the insights and lessons learned by health care providers during Hurrricane Katrina and the collapse of city services in New Orleans. This week's issue of The New England Journal of Medicine (NEJM) contains eight free, full-text perspective pieces:

"Volunteer Work � Logistics First"

"Finding Supplies"

"Public Health Response � Assessing Needs"

"Aftershocks"

"Evacuated Populations � Lessons from Foreign Refugee Crises"

"Lethal Levels"

"Unexpected Necessities � Inside Charity Hospital"

Based on her experience at New Orleans' Charity Hospital, Ruth Berggren, M.D. writes, "Survival, functioning, and sanity, for both patients and care providers, depended critically on a number of unexpected necessities, ranging from simple commodities to principles and codes of behavior. My list of 10 of these necessities begins with the seemingly trivial and progresses to those that became the most critical as the crisis deepened from Sunday through Friday." :

Shoes. Running shoes were perfect for the countless trips up and down nine flights of stairs after the power went down.

NSAIDs. For lack of brewed coffee or cold Cokes after Monday, we all had severe caffeine-withdrawal headaches.

Clean underwear and fanny packs (packs to carry items usually carried in pockets of lab coats).

Flashlights and "D" batteries.

Toilets. An enterprising nurse spent her off time setting up temporary latrines.

Shift work with adequate sleep. Nurses fared better than physicians because they adhered to a disciplined schedule - 7 a.m. to 7 p.m. or 7 p.m. to 7 a.m. with sleep in-between.

Morale-boosting activities. "I will never be able to sing "We Shall Overcome" quite the same way again."

"Strength of initiative to make your rescue needs known." In this case, she contacted news organizations, including CNN to ask for help - and she got it.

Self-possession in the face of desperate, armed men - even men who are the designated rescuers.

A team. "The most critical necessity is a team of professionals who care about their patients and one another."

"Triaging Tragedy"