here we go again …

Editorial

ANN OPHTHALMOL. 2006;38 (1) .......................................................1

HERE WE GO AGAIN. . . The Annals of Ophthalmology has a tradition of ap-proaching science as well as the foundation of societyin a bold, straightforward fashion. We believe this issueis another example of this tradition. Beginning with a thought-provoking consultation by Drs. Roy andShepard, this edition then presents a gripping story ofthe Hurricane Katrina disaster that hit New Orleans andthe Gulf Coast a few months ago. Here, readers are pre-sented with an insider’s view from the Louisiana StateUniversity (LSU) physicians that were on call andremained on call throughout the crisis. Demonstratingthe vulnerability of the United States when faced with amajor natural disaster, this compelling first-handaccount of what took place with the LSU residencyprogram is absolutely gripping. Usually such articlesare abridged and edited, as physicians are not alwaysprofessional writers. In this case, we felt it best toprovide a raw article in order to convey accurately thetrue events and feelings of these heroic doctors. Quitefrankly, this story gives me great solace for the futurebecause these ophthalmologists-in-training will be partof our next generation of ophthalmologists entrustedwith the country’s health care. Their courage and braveryis noble and we should all hope that there are more doc-tors (and citizens) out there that would do as they haddone...all that was necessary! There is a much biggerquestion here that must be addressed because of whathas happened to the Gulf Coast. Clearly, there is a greatvulnerability imbedded within our health care systemshould the United States be faced with a major natural

disaster. I have used the word “vulnerability” because Ifeel it accurately captures all that has happened and allthat continues everyday in the aftermath. Perhaps theUnited States is one of the wealthiest and most power-ful nations, but what does this actually mean whenMother Nature takes a change of course...a course manyhoped a powerful hurricane might never take. The limi-tations are real and must be addressed. Inspired by aconversation with Dr. Herbert Kaufman of LSU, thiseditorial serves as a reminder that we must address thereality of serious natural disasters, as 2005 saw both thetsunami in the East Pacific Ocean and Hurricane Kat-rina in the United States. It is not just a topic of nationaldiscussion, but also a global one. The scope of the nat-ural disasters that we have experienced should fuel therealization that all nations are closer in vulnerabilitythan one can imagine. No matter how wealthy you areor how advanced your national infrastructure may be,Mother Nature does not discriminate between the richand poor. Major natural disasters can almost incapaci-tate first responders, making the mission that muchmore difficult. As each hour passes, the chances ofsuccess dramatically decline allowing lives that are soprecious to just slip away. What has happened in NewOrleans and to the Gulf Coast as well as the tsunamihas affected how I feel about both the United States’and the world’s ability to respond to disasters of cata-strophic proportions. Finally, this article is a personalaccount of bravery in the face of great adversity, to dowhat was right and honorable.

Richard J. Fugo, MD, PhD