Editor's note: Jacob Oberman, a paramedic and New Orleans EMS supervisor, is a veteran of many hurricanes. He kept detailed notes about the EMS response to Hurricane Katrina. This is Oberman's account as told to Robert Davis, a former paramedic who covers EMS for USA TODAY. Davis rode an air ambulance helicopter into New Orleans on Friday, Sept. 2, to report on the city's response to the storm. Involved with New Orleans EMS the next day, he found himself helping evacuate an estimated 20,000 people from the city's convention center.

Sunday, Aug. 28, 2005

As Hurricane Katrina approaches, we gather in a circle inside our ambulance bay on Moss Street. About 80 of us EMS staffers are about to take ambulances stuffed with medical gear to various spots around town to ride out the storm. We listen as Deputy EMS Director Mark Reis reminds us of the key elements of our disaster plan.

We pay even more attention when he says these plans may fly out the window once Katrina hits.

He tells us there will likely be a time when each of the teams will be unable to communicate with others. We may all end up completely on our own. With everyone holding hands, he utters what would become our Katrina prayer: �I hope that we all meet again at the end of this.�

After dark, the first bands of the storm hit, and the communication center is inundated with calls. The 9-1-1 lines are constantly lit up.

Since crews can't keep up, dispatchers make lists of people who need help in hopes that, later, ambulances can answer more of the emergent calls. We never catch up, and dispatchers log pages of these calls that will go unanswered.

By 10 p.m., none of the 20 ambulances on the road are available, the emergency rooms are packed with patients, many are closed, and winds are not yet blowing at hurricane force.

As wind gusts increase, the calls diminish. Lights on the 9-1-1 lines begin to disappear, like candles flickering out one-by-one.

By midnight it is strangely silent inside and getting louder outside. We decide we must close down the communications center and go to the Louisiana State University Dental School to ride out the storm.

We all feel like we should say something profound on the radio, but nobody knows what to say. We duct tape some spine boards to the windows and leave the communications center empty for the first time in the city's history.

Monday, Aug. 29

In the pre-dawn hours, we can sense in every way that the storm is tearing our city apart. We hear alarms going off everywhere.

We smell gas spreading through the building. There are cadavers and experiments that have been interrupted in laboratories, and who knows what kinds of chemicals are in this building.

We see the rain blowing sideways outside. The rain is flying parallel to the ground. Trees are breaking off. Roof shingles are sailing into oblivion. The water is rising. This is the height of the hurricane.

Some of the young people in our group are frightened and crying and screaming and losing control of themselves. The bathrooms are backing up. The floors are slippery with who knows what.

Some of the 39 people in our group feel abandoned. But there is no way for anybody to get anywhere. We're on our own.

We watch a wall�that was keeping the water back from part of the dental school building�collapse, and the flood waters come rushing in below us.

As the floodwaters rise through the building, some pet dogs that were brought in and kept on the lower floors become frantic. A rottweiler chews through his leash and bounds up the stairs to get away from the rising water. As the dog charges toward a female police officer one floor below us, a shot is fired. �Stop shooting!� our medics yell into the halls.

The dog runs to our area, and some of the girls calm him down. He's just a big dog. Harmless. By 5 p.m., we hear on radios that getting us out of this place is a top priority. We're glad because we want to get out to help.

We also hear that the city is totally flooded, with just the tops of buildings and a ribbon of interstate visible. We hear that buses are taking non-emergent patients to the Superdome. But inside the dome, there are gang fights and multiple trauma patients.

It looks bad to the east as darkness approaches. There is a lot of talk about rescuing people from rooftops. They're amassing a rescue operation, but none of us can do anything. If they can be rescuing people from rooftops, we wonder, why can't they come get us?

At 6:30 p.m., communication is lost again. We no longer can get through to anybody on radios. Matt Alewine, an EMT dispatcher and radio geek, uses a radio to hunt for a single working antenna [tower]. He finds one working near the airport.

We start calling our group on that site, and, sure enough, one of our group is doing the same thing. Sean Fitzmorris is downtown near the Superdome. Talking to him, we feel like we're connected once again.

By 7:30 p.m., the winds have died down but the flood waters are rising dramatically. We realize this is our worst case scenario.

A lot of people are very anxious about not being rescued. People are just sitting around thinking about the worst. Valarie Ziminsky, a medic from Pennsylvania who had been in town for the EMS Expo that ended Saturday, volunteered to stay with us during the storm. She suggests we divide into work groups to keep people focused and calm. [To read excerpts from Ziminsky's account, see p. 42. For her full story, visit www.jems.com.]

One crew consolidates baggage. One is a cleanup crew. We tell everyone to pack just one �bug out� bag for when we leave. I tell Bill Jackson, a paramedic and former U.S. Marine, that I have my Glock 23 with me. I want him to know in case something happens to me so he can take control of it. He tells me he has his .38 with him.

Paramedic Bill Niemeck has lost communication with his wife in Slidell. She was on the phone with him panicking and screaming, and then the phone went dead. He doesn't know if his wife and daughter are alive. But he keeps his sense of humor. He rises above all of that.

On the dark, slick stairwell, a police officer falls and breaks his ankle and his tibia. We splint his leg, ice it, give him oxygen, start a line and give him morphine. He looks bad, so we call to try to get him out.

Using the airport frequency, we're able to get a wildlife and fisheries boat to come in the middle of the night. The wind is still blowing and waters are still rising. We load him, and he's carried off.

Tuesday, Aug. 30

As the sun rises, the sky is pink and orange over a strangely dark city. There are no lights, just fires all across the horizon.

The water has risen more overnight. We can see the top of the Superdome has been blown off. Everybody looks out the windows, awestruck.

During a general meeting at 7:30 a.m., we tell the crews what police had told us: Military trucks can't reach us. We'll have to go out on boats.

People are less hysterical than the day before. We're getting used to this. We discuss conserving batteries, staying clean and keeping money safe.

The boats arrive in the afternoon, taking police officers first. Then they come back for us.

Leaving the dental school reminds some of us of leaving a sinking ship. It's dark in the bowels of the building, and the passageways are dripping wet. There's a sense of urgency, but as we move medical equipment�90-lb. ALS bags, 12-lead monitors, oxygen tanks�we sweat, swear and move carefully along the slick floors.

The water on the first floor is rising, giving the impression that we're sinking. We wade through chest-deep water holding gear over our heads.

The boats take us to the highway ramp at I-10 at St. Bernard Ave. On the I-10 overpass, the sun is bright and hot. There are hundreds, maybe thousands, of people who need to get out of the heat. They have bags and even wheel barrels full of stuff. Some are just sitting on the side, old people with a piece of cloth on their head to keep the sun off of them.

Choppers land and engorge the elderly, nearly coded people and some fakers. But this is no time to do the arm drop test. This is triage on the run.

A military truck picks us up. As we drive through the masses on the overpass, we keep moving because when we slow down, some people chase us. A SWAT team moves with us to keep the desperate mob away. The officers are nervous. Little kids stand waving at us as we go by.

We arrive at the convention center and unload our bags. The military leaves. Then Mark [Reis] and our director, Dr. Jullette Saussy, make an appearance. They say a temporary communications center will be set up at the aquarium. We take our stuff over there. Mark and Jullette return to the Superdome.

We arrive at the aquarium, where they have generators producing electricity, but the curator says we can't stay. There are already too many people there. We can't reach Jullette and Mark. Somebody says, �We're dead in the water.�

Darkness is coming, and we're outside the aquarium. Seedy-looking individuals start to show up. We've heard about the shooting and the looting. Some in our group get scared again.

We decide to go to a nearby hotel at the end of the convention center. Kenny Knowles, a paramedic who was injured when the storm hit, shows up unexpectedly, in his personal car�a brown Suburban. We load gear in and on top of it, and people ride on the sides of the SUV to the hotel.

At the hotel, there's a pool that has been untouched by the flood waters. Most of us jump in with our clothes on for a chlorine bath. We're concerned about the filthy water we've waded through. One person already has a sore throat and fever.

At a condominium next to the hotel, we find a generator and some showers. The operator says he's happy to host us if we can help get him diesel fuel to run the generators.

But police come to say that another levy is breached. The water is rising. We must leave again.

I tell the crews to pack a single bag. There is much bitching and crying, whining and complaining. �Fuck the city,� some say. �I'm quitting. Fuck Jullette and Mark for leaving us.�

I feel as if we're an army retreating into a starlit night. With most of the lights off across the city and the skies clear, the stars are seen with vivid clarity.

Despite the one bag limit, most people bring two or three. One wheels an ice chest big enough for a body. We gather under a solitary light near the convention center. A group of police officers driving cars taken from the Sewell Cadillac dealership drive toward us. We've heard the police were commandeering Cadillacs.

Here come a Hummer, an Escalade and other Cadillacs. And there they go. They pass with some of our crews banging on windows yelling, �Stop!�

We set off to walk across the Crescent City Connection�a two-mile hike over the Mississippi River into Algiers. We don't have any specific place to go, but we know there are more options on the other side.

We've abandoned all of our medical supplies, monitors and oxygen.

As we walk across the bridge, we call for help on the radio because some of our people are getting sick. One paramedic with hypertension and migraine headaches is having stroke-like symptoms. Another staffer in her 60s is struggling to make it across.

Out of the dark, here comes the New Orleans Fire Department. Some in pickup trucks and Expeditions; some in their own cars. They take us to the nursing home where they're staying.

Fire apparatus are parked all around the nursing home. Inside, firefighters walk around with shotguns and side arms. There are showers and food.

For a few years, they have been first responders with us, and we've developed a good relationship with the fire department. But on this night, they rescued us.

Wednesday, Aug. 31

At 7:15 a.m., we wake up suddenly with people running through the nursing home saying the Superdome is on fire.

We're sent to give medical support to the firefighters. We load two ambulances with medics and follow the trucks across the river.

There are fires everywhere in the city, but the Superdome doesn't appear to be burning. We end up across the street from the Superdome, but we can't reach it because of the water. We're close enough, however, to see that the dome is not burning. It's a dumpster fire.

Stranded residents and rescuers alike were often forced to wade through highly contaminated chest-deep water to reach safety.

While we're sitting there, a man drives up in a pickup truck and tells us that he has several old ladies at his hotel, ages 80�100, who need help. At least two of them are already dead and several will die in the next few hours. We tell him we can't help them because we're here to help the fire department. He leaves, dejected.

This is only the first of many such pleas we must decline. Over and over people say, �Can you help us?� and we say, �No, we can't.�

We hear that bands of thugs are still roaming with assault rifles and shooting people. We go back to the nursing home for a shower, food and rest. Some people watch scratchy news on the crawl. It doesn't look good.

Somebody has some rare bourbon. It tastes good and warm. Things slow down. The air is cool.

Thursday, Sept. 1 

We arrive at the Superdome to find a war zone. A friend from the New Orleans Police Department asks if we have any body bags. They've run out. Amid the garbage and the feces, there's this sign: �Lost child. 3-years. Black shirt. Braids. Name Faith. Kaki pants.�

Helicopters land every 30 seconds or so, bringing troops and supplies.

The situation is grim. There are rotting dead lying in garbage. It smells terrible. We're here to organize relief and check the units left here.

People come and say, �I am out of insulin.� We can do nothing but try to be positive.

We take an armored personnel carrier to Charity Hospital where Jullette [Saussy] organizes staff relief. Charity is dark like the dental school, and it's wet. Water is everywhere. And there are very sick people inside the hospital.

Charity is about to be evacuated, and the staff fears that looters will come in and take over the hospital. The druggies in town know that the pharmacy is on 9, so they plan to put up signs that say the pharmacy has been moved to the 12th floor. On 12, they'll put a sign that says the pharmacy has been moved to the 3rd floor.

We leave Charity in an airboat.

We appropriate a postal truck and load it with thousands of dollars of supplies from Wal-Mart, including shampoo, soap, toothbrushes, socks and underwear�things lost that we need day-to-day.

Then we raid a Walgreen's pharmacy. We're literally taking the law into our own hands in a limited way. We have people who need medicine, and the plan is to turn the drugs over to the DEA when we get a grip on things. We take antibiotics, pain killers, antihistamines and asthmatic drugs.

We also ask for people outside the city to fly in badly needed supplies, everything from chain saws to �whore-red nail polish� for a female paramedic.

Friday, Sept. 2  

Jullete is working the phones trying to set up a MASH unit. She starts in the city emergency operation center, but when she can't reach officials in Washington, she goes back to the Superdome, wading all the way.

Jullette meets with federal officials inside the darkened arena next to the dome to discuss setting up the MASH. A representative of the Dept. of Homeland Security rejects the idea, saying the larger plan calls for evacuation first, then treatment.

As we walk away, a soldier rushes up and asks Jullette to come see Lt. Gen. Russel Honore, commander of the 1st Army, who is coordinating the military rescue operation. Inside his command center at the Superdome, maps are hanging on the wall and soldiers talk on radios and phones.

Jullette questions part of the general's plan, and he yells at her. �I know what the fuck I'm doing,� he says. �Now get your EMS moving.�

This rattles Jullette, but soon the general is taking her to his truck with his arm around her, telling her that everything is going to be OK. We ride in his truck to the convention center, where we see the faces of an estimated 20,000 people who line the streets waiting for help.

As we drive away from the convention center, Police Chief Eddie Compass blocks the general's truck. He begs the general for help, saying that with darkness coming, his officers can't keep control of the streets around the convention center without military support. The general reminds Compass that he's �pissing away daylight.�

As we drive away, we hear on our EMS radio that a crew is responding to an officer with a gunshot wound to the head. We later learn it was self-inflicted. Jullette pronounces the officer, saying, �We don't have any place to take him anyway.� I never thought we'd see the day when we could not transport a New Orleans police officer.

Gen. Honore tells Jullette, �Chin up. It's all going to be fine. It could be worse. It could be raining.� After silence, Jullette wipes tears from her face, and the general says, �Listen, if lesser people could do this, they'd be here.�

Saturday, Sept. 3 

As we gather in front of the nursing home for breakfast, firefighters let us eat first because we're going to the convention center to evacuate the masses. Some firefighters line up to be commissioned as captains in a ceremony on the lawn.

Then, many are dispatched to a downtown fire by bullhorn. A chief stands near the breakfast line announcing the assignments as they would normally be aired on the radio. The firefighters leave for a day of fighting fires before they can eat.

At the convention center, the sidewalks are lined with people who need to get out of the sun and get some medical help. A murdered man is lying out on the street, his throat slashed, a pair of scissors next to the body. A block away, the body of an elderly man is lying in the median. Both are covered with blankets.

As we approach in our EMS shirts, people start to cheer. Our guards wear bulletproof vests, but we find that these people want help, not a fight.

Our assignment is to reach the sickest of the sick and to load them onto whatever we can find with wheels to take them to the helicopters.

We load people onto shopping carts, mail carriers, anything we can find to roll them toward the choppers. The helicopters come from all branches of the armed forces, and they're set down three at a time with others hovering in line waiting to land, load and go.

As I stand and watch the helicopters, I'm reminded that I am proud to be an American.

Our medics work tirelessly in the blazing heat. They refuse to rest, and by 5 p.m. the crowd is almost gone. One group of medics goes inside the convention center, where people say there were rapes and murders in the past several days, to see if there are others who can't walk out for help. They carry flashlights into the darkened maze of corridors in the center, and they find several bodies near the kitchen. They appear to be elderly people who died of natural causes.

National Guard personnel help load patients into an Acadian paratransit van at the Superdome.
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Back at the nursing home, we take cold showers and eat delicious food. We have another meeting. People ask if we will have jobs a week from now, if we should make a patch to commemorate our efforts, or design a badge. One suggests tattoos.

Are we getting paid? Nobody knows.

I think back to our meeting inside Moss Street when Mark told us that we were going into battle and that we would be on our own. He told us that some of us could be injured and possibly killed.

In the end, we lost some people to fear and frustration. Some left, and we never saw them again. But those who stayed have a new sense of pride. Even though we don't know what the future will bring, we feel like we accomplished something.

We're going to be a better medical corps, a more cohesive group. And although we're depleted in numbers, our esprit de corps is much stronger.