Lessons of the Hurricanes

Today's Wash Post Outlook section has two articles drawing lessons from the response to the hurricanes:

A doctor who traveled to Louisiana to help opines:

Good Samaritan Overload: "First, I don't think there's any doubt that there will be an intense medical response to any tragedy that strikes this country. Our doctors and other medical personnel, like people from scores of other fields, will react with an outpouring of time and effort to help their fellow citizens in any way they can.

The second lesson, though, is that this response should be coordinated and stratified. There should be a pre-set list of first, second, third and fourth responders ready to be activated and sent to a disaster area as needed by a central command. "

A science writer, observing reports from the scene, says:

"Overruled.

But preparation -- even when it hews closely to the "game plan" -- only gets you so far. In the coming days, people with varying levels of authority all along the Gulf Coast will likely have to make many decisions. Often they'll have to make them quickly, alone, and without experience to guide them. Let's hope they have learned one more thing from Katrina: Sometimes you need to break the rules to avert greater disaster."

So, one asks for more bureaucracy, more coordination, more rules; the other says we need to break the rules. Which is it?

As usual, I think "Both". There's an absence of coordination among different bureaucracies. There's a report that the military has learned to apply a standard grid to the landscape, as they do in military operations, just to coordinate rescue flights from different organizations. And there's the danger of a bureaucracy following ordinary rules in an extraordinary situation. (I remember in the aftermath of the 1991 hurricane that devastated Dade county, we had to bypass our normal validity checks so that data could be quickly loaded.)

Mr. Brown cites liability issues and tunnel vision issues. We need to come up with a list of Good Samaritan waivers--I believe that doctors in some states who pull over to treat an emergency patient on the road are given immunity from liability. And we need to encourage initiative. But the public also needs to recognize the tradeoffs. There's a report today that the bus involved in the fire in Texas that killed 24 people was operating under a waiver granted by the governor of Texas. Bureaucratic rules often have a valid purpose, and bypassing them carries risks that we must recognize up front.