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A Piece of My Mind
April 3, 2018

Sharing Connections

Author Affiliations
  • 1Department of Veterans Affairs, San Diego Healthcare System, San Diego, California
  • 2Office of Telehealth and Office of Primary Care, Department of Veterans Affairs Central Office, Washington DC
JAMA. 2018;319(13):1323-1324. doi:10.1001/jama.2018.2717

From behind my computer monitor, more than a thousand miles away, patients came through the exam room in Houston, Texas, with their ailments: back strain from lifting sand bags, urosepsis from deferred access to antibiotics, an infected scratch while trying to rescue a lost cat, and worries about fever and Zika.

After Hurricane Harvey struck Houston and floodwaters destroyed homes and clinics, the emergency telehealth team at the Department of Veterans Affairs (VA) was launched. I was charged with assisting clinicians at a VA clinic spared hurricane damage, acting as the contingency coverage for another clinic flooded by the storm. My first patient was Mr V. He limped onto the examination table, waving in my direction as the nurse helped him take off his shoes. Mr V is a Vietnam veteran with uncontrolled type 2 diabetes, who, despite a poorly healing foot ulcer, insisted on being the full-time caretaker for his wife with stage IV breast cancer.