WHITESBURG, Ky. — By 10 a.m. on Monday, Dr. Van Breeding was already on the phone with Colleen Swartz, vice-president of operations at UK HealthCare, begging for supplies.
“I think we’re going to need 5,000 shots of tetanus and Hep A,” he told her. “We’re completely out. The workers all need the vaccine, too.”
As director of clinical operations at the Whitesburg Mountain Comprehensive Medical Clinic, Breeding and his employees have hardly slept since Thursday, when floodwaters swamped Whitesburg at unprecedented levels. They evacuated a nursing home, they rescued people from their homes with kayaks, boats and jetskis, they helped set up a shelter at the CANE Kitchen in the old high school, and by Friday, they turned their attention to the flood clinic on Medical Plaza Lane. It wasn’t as bad as some places — just a few inches of mud as opposed to total immersion — but patients were already starting to trickle in. By Friday, the clinic was back open. On Monday, the clean waiting rooms were filled, as nurses and aides cleaned others.
“It’s a miracle, we worked around the clock and reopened,” Breeding said. “You don’t have time to think about it, you just do it.”
“We need oxygen, at least 1,000 bottles because so many people lost their oxygen,” he said. So many people lost everything in an already medically fragile and under-served region. Breeding said one of his elderly patients had died from a lack of oxygen. So many people in so much shock and pain and bare feet, pulled from their houses without their medications, without anything. All the victims and all the helpers have been exposed to toxic floodwaters — full of mine runoff and flooded sewer systems — that can cause tetanus and hepatitis. They need Breeding’s help.
And he needs help, too: Oxygen and insulin and IV tubing and IV solutions, and more tetanus and more of everything, including money, since medical supplies are a bit beyond the average citizen. So in between seeing patients, Breeding is talking to his medical network and posting pleas for help on Facebook and coordinating phone calls. Many of his nurses have gone out looking for their patients, taking food and water and doing general wellness checks because so few people have any kind of phone or computer service right now. The Mountain Comp system has 10 clinics around the region serving 50,000 patients for a full range of care. At least 30,00 patients have been affected by floods, Breeding estimates while the Isom clinic was totally destroyed by floodwaters.
“Because we don’t get a lot of help, we have the ability to think on our feet and get things done,” he said.
More than medical care
Breeding is 60 and a native of Whitesburg, and as many have recounted, the worst flood in Whitesburg’s history was in 1957 and this was far, far worse. The clinic itself has never taken on water.
By mid-morning Thursday, the water was doubling in volume every 30 minutes. Byron Thomas, a doctor at the clinic, was at the ARH Hospital on Thursday morning when he started hearing about nurses unable to get to work. He joined an informal rescue corps of emergency workers and civilians who commandeered boats and kayaks and even a jetski to rescue people from their houses. They rescued dogs and cats and children and neighbors, including Thomas’ fifth-grade teacher.
“The community came together in such a way, I’m so proud to be called a hillbilly,” Thomas said. “Everyone risked everything. I’m so proud of this community.”
On Monday, Thomas was seeing patients at the clinic and pondering whether he, too, should get another tetanus shot.
Isom’s loss
About 10 miles outside of Whitesburg, nurse practioner Shana Banks and medical assistant Jennifer Shepherd were trying to salvage supplies from the Isom Medical Clinic, which for several hours on Thursday lay under a floodwater lake. Four feet of water rushed through the clinic, moving a refrigerator, overturning tables and pushing carts around the examination rooms. In between showers, the heat already steamed, and mold was already starting to grow on the soaked walls.
They see about 25 people a day, patients who usually received their prescriptions at the Isom Community Pharmacy next door, also wiped out.
In between salvaging, Banks was also making calls to find tetanus and Hep A shots, as well as trying to set up a mobile health center. A Virginia medical team drove over from Buchanan with The Health Wagon, a large RV that serves Central Appalachia in times of need.
They brought 90 tetanus shots, but by noon, they were used up. Banks was waiting for Mountain Comp executives to come and decide if the clinic would have to be torn down, or if it could be salvaged. For Isom, which lost the nearby IGA grocery on the same day, losing the medical clinic would be just another blow.
“People here have just lost everything,” Banks said, in a common refrain.
Moving forward
The dramatic rescues are over, but Breeding doesn’t think he or any medical staff in the region will have time to rest — now they’re facing dangerous heat for many without power, mold that can cause Legionnaires disease in compromised lungs, and mental health issues with people still in shock and grief from their trauma.
Substance use disorder has also been a huge problem in Eastern Kentucky that Breeding works on. There was a long-planned festival set for Thursday to celebrate those in recovery and highlight resources, but worried about the rain, Breeding canceled it.
Now many have lost suboxone and other medications, and Breeding is worried about another flood-related problem: drug overdoses. They need more Narcan and clean needles for exchange. People, including health care workers themselves, need homes and money and clothes, and it’s not at all clear when they will get them.
UK HealthCare and other organizations are sending vaccines and supplies. People are sending aid through various organizations. But the medical needs for Eastern Kentucky, already serious, are going to get much more dire in the short and long term.
“We need all the help we can get,” he said.
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The Venmo for the Whitesburg clinic is @wbmchc and Paypal is @wdmchc. Find other ways to help Eastern Kentucky flood victims here or visit Appalachian Flood Support Resources. Appalachian Regional Healthcare is also collecting donations flood victims.
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