Kristina Mirabeau-Beale was sure that she and her family were well prepared for Hurricane Ian.
Her one-story house was equipped with impact glass and a generator, and it was built on an elevation well above the predicted storm surge heights.
“I felt safe. My whole neighborhood was staying. We were seeing patients the whole day before,” said Mirabeau-Beale, a radiation oncologist who works at centers operated by GenesisCare in Fort Myers and Cape Coral, “The storm was supposed to hit Tampa. So, it wasn’t like alarm bells, this is going to be horrible and be a direct hit of Fort Myers. It wasn’t like that at all.”
Hurricane Ian, now declared to have been Florida’s deadliest storm since 1935, claimed the lives of over 120 people. More than 50 of these deaths occurred in Lee County, where Hurricane Ian made landfall.
Located in Fort Myers—in the heart of Lee County—is the U.S. headquarters of GenesisCare, Mirabeau-Beale’s employer and the largest provider of radiation oncology care in the U.S. and globally. Altogether, 30 GenesisCare facilities, including surgical, urology, and breast surgery centers, were in and around Fort Myers as well, and caught the full brunt of the hurricane.
Other cancer care providers—including Florida Cancer Specialists, Tampa General Hospital, and Moffitt Cancer Center—were hit as well (The Cancer Letter, Sept. 30, 2022). Now, healthcare providers that escaped direct damage from the Category 4 hurricane are helping to provide care to patients from affected areas.
The storm was supposed to hit Tampa. So, it wasn’t like alarm bells, this is going to be horrible and be a direct hit of Fort Myers. It wasn’t like that at all.
Kristina Mirabeau-Beale
As the storm made landfall on Wednesday morning, the Mirabeau-Beale family’s impact-resistant windows provided a front-row-seat view of the destruction happening outside.
“You see a big pool cage going and you see trees going by, and snapping,” she said.
That afternoon, water started to rise in her backyard.
“We knew that there was going to be a storm surge, but initially I thought it was going to be six to 10 feet in our area, and my house was built to an elevation of about 13 feet. So, I figured it could get intense, but I thought it would still be safe to stay in our home.”
“Pretty quickly, from 2 to 3 p.m., it just started filling like a bathtub around the home. The whole backyard filled, started rising up the front steps, the streets started flooding, and you could see currents. So, then it got really scary,” she said.
Mirabeau-Beale’s neighborhood was communicating over a shared WhatsApp group throughout the storm, keeping each other updated on how the storm was unfolding. One neighbor updated the group message:
“Now they’re saying 12 to 16 feet. Get to higher ground.”
“You’re kind of watching it happen, but we got that group message and then, you’re just looking around your home and thinking, if it gets to a certain point, I won’t be able to get out,” Mirabeau-Beale said. “Now is go time. We gotta get out of here.”
Mirabeau-Beale was at home with her 7-year-old twin sons and her 72-year-old mother. She ventured outside and flagged down a neighbor for help.
Source: GenesisCare
Mirabeau-Beale carried one son on her shoulders, and her neighbor carried the other. Together, they pulled her mother along behind them, wading through chest-deep water teeming with snakes and debris.
They fled their home for the refuge of the only two-story home in their cul de sac.
Mirabeau-Beale and her family were joined by two other neighborhood families, both residents of single-story homes. In total, around 15 people were peering down from the second-story windows, tensely watching to see if the water would reach their front doors.
The six young children, resilient and uncomprehending, played together and told ghost stories. “Meanwhile, us parents were looking from the second floor down at our homes, like, oh my God, please don’t go in the house,” Mirabeau-Beale said.
“The next morning [Sept. 29], at 6:00 a.m., the streets were dry. So, it just was this huge surge of ocean water. There were dead fish in the street,” Mirabeau-Beale said.
Florida’s southwest is home to more than 70 GenesisCare centers. These facilities and others in the area experienced power outages, flooding, and wind damage from the hurricane, with Lee and Charlotte County shouldering the most severe damage.
“We had direct and significant impact on our patients, our employees, our facilities, our physicians. There’s been a dramatic effect, and recovery is ongoing,” Walter J. Curran Jr., global chief medical officer at GenesisCare, said to The Cancer Letter.
Moffitt Cancer Center, in Tampa, had prepared for the worst, but escaped a direct hit as the hurricane’s trajectory shifted south. Still, the institute sustained flood damage in multiple areas of the hospital, and was forced to shut down clinical operations for two days, according to Sabi Singh, executive vice president, chief operating officer and hospital president at Moffitt.
“Elevated water levels, debris, power, and internet connectivity outages were a major challenge in evaluating and assessing the extent of impacts.” Nathan H. Walcker, CEO of Florida Cancer Specialists, said to The Cancer Letter. “Many of our locations in Southwest Florida and along the Gulf Coast suffered the majority of physical and/or structural damage.”
“Cancer care was absolutely disrupted to some degree because of the hurricane. As you know, cancer patients represent the most medically vulnerable of patient populations on a regular basis, so in a storm situation such as this was, our primary focus was ensuring everyone was safe. Pre- and post-storm required us to move patient appointments to nearby clinics that were fully operational and reschedule appointments that could be moved to slightly later dates,” Walcker said.
Despite widespread destruction throughout the region, Florida Cancer Specialist clinics have been quick in their reopening. “A little more than a week after the storm, all of our clinic locations are fully open across the practice. Many of our clinics throughout Southwest Florida that did sustain damage were able to quickly reopen and resume services,” Walcker said.
Similarly, only one GenesisCare radiation oncology center is yet to be reopened. As of Oct. 12, GenesisCare was able to ensure uninterrupted treatment for all but two of their hundreds of patients, who opted out for personal reasons.
“We took the point of view that no patient would be left behind. For patients whose centers took more than a few days to open, or were in a radiation therapy course where we didn’t want treatment interruptions, we redid their radiation planning so they could be treated on other systems at other centers,” Curran said.
Source: Florida Cancer Specialists
Mirabeau-Beale played her part in getting GenesisCare back up and running.
“There were patients I saw the day before the storm, where I said, ‘Don’t worry, we’ll start you Monday.’ Clearly, we couldn’t start the Monday, because no one had power. But you have to reach out to your patients and communicate with them to give reassurance and make sure that no one’s care falls through the cracks, even though it’s a disaster situation,” Mirabeau-Beale said.
In Tampa, Moffitt Cancer Center was able to reschedule almost every patient within three weeks of the event.
“Closing for any length of time affects clinic visits, treatments, surgical procedures and more. Once the hurricane passed, substantial efforts were made to reschedule patients, including doing extra radiation and infusion treatments that first weekend,” Singh said. “We also had physicians available to field calls from outpatients while the hurricane was passing through.”
Institutions throughout the state, particularly centers out of harm’s way, were poised to offer assistance if and when necessary. On the opposite coast from the storm’s impact, the University of Miami Health System and Miller School of Medicine, which includes Sylvester Comprehensive Cancer Center, received one patient from Lee County at their main acute care hospital, UHealth Tower.
“Sylvester Comprehensive Cancer Center maintained close contact with the Moffitt Emergency Management team throughout,” Vincent Jesus Torres, emergency management director at University of Miami Health System and Miller School of Medicine, said to The Cancer Letter.
Moffitt Cancer Center, too, received several outpatient transfers from local oncologists.
“We reached out to oncologists in the affected areas to offer assistance with both inpatients and outpatients until they could get back on their feet,” Singh said. “Moffitt sheltered local and community law enforcement during the hurricane since their facilities were not hurricane resistant.”
GenesisCare similarly extended its radiation oncology resources for this same goal: to treat patients from nearby institutions.
“We made ourselves available to patients of some of the other providers in the area that didn’t open as quickly as we did,” Curran said. “So, we did see some patients who might have normally gone to a provider, because we were open. We made ourselves available.”
In the aftermath of the storm, one of Curran’s primary concerns is the disruption to routine screening, prevention, and symptom management work.
“We can look back to Katrina to see how disrupting that was to the community in New Orleans, to know that even if the lights are back on and medical care is being given, there are so many families that have been disrupted that the last thing that a lot of people are thinking about is, when do I go for my next mammogram?” Curran said.
Curran hopes to mitigate the risk of hurricane-mediated diagnosis delay by promoting follow-up visits for their own patients and supporting community screening programs, such as Prostate and Breast Cancer Awareness Month.
“The signal often gets muffled if you’re dealing with a catastrophe like this,” Curran said. “The issues today are not so much about getting water out of your first floor, but about getting insurance to cover the cost,” Curran said.
Alongside their patients, GenesisCare staff and faculty are facing debilitating and extensive damage to their homes, despite the radiation centers escaping relatively unscathed.
Pretty quickly, from 2 to 3 p.m., it just started filling like a bathtub around the home. The whole backyard filled, started rising up the front steps, the streets started flooding, and you could see currents. So, then it got really scary.
Kristina Mirabeau-Beale
“All of our staff and physicians are accounted for, but I would estimate 30 to 40 had catastrophic damage to their homes or apartments, to the point where they really don’t have permanent domicile for this moment,” Curran said. “Despite that, many of them were still coming in working hard to get our centers up and going.”
One GenesisCare staff member lost everything. “She lived in a mobile home unit. It was totally destroyed, and everything she owned. And yet, she was fully committed to being there and helping our patients get back in their treatment course,” Curran said. “Every day, there’s a new personal story of bravery and heroism that goes on.”
Her terrifying experience the day of the storm notwithstanding, Mirabeau-Beale didn’t miss a day of work.
“We’re in this together. We’re part of the community. It’s no different than needing gas and the people at the gas station are there, or needing food and the people at Publix’s open up right away. I mean, I’m a cancer doctor, I have patients under treatment.”
As an international organization based in Australia, support is flooding in from fellow GenesisCare employees around the world. They have mobilized resources from their own foundations to launch a fund for employee assistance, and connected staff and faculty to groups like FEMA and Red Cross.
“The doctors are part of this, but I mean, we had a whole team behind us like in terms of center leads and engineers and radiation therapists and just so many people behind the scenes who were really trying to maintain continuity for our patients while also dealing with the personal upheaval. And so I was really proud of our team, how we handled it.” Mirabeau-Beale said.
“I think it shows we are also part of this community, and a lot of us were dealing with the same struggles. Even now, we are still dealing with meeting adjusters, repair people, etc., while also still working long days. So it’ll take time.
“But I think we’re rebuilding.”
