The Power of Community: USACS Clinicians Respond to the Kerrville Flash Flood
When our communities are faced with unforeseen catastrophic events and the inevitable chaos that follows, one constant remains: our clinicians’ unwavering commitment to our mission—to care for patients. With hospitals as the primary clinical setting for USACS, our Physicians and APPs stand ready to provide care in any circumstance, often putting their own safety aside and leaving loved ones behind to ensure those in need receive the medical attention they deserve. While this reality always looms and plans are in place should these unfortunate circumstances arise, no one can ever be fully prepared for what they will face in real time or for the cascade of events that emerge in the critical hours and days following such a crisis.
For our colleagues at Peterson Regional Medical Center in Kerrville, Texas, where USACS provides emergency, hospital, and critical care medicine services, the stark weight of disaster tore through their community unlike ever before. On the eve of the much-anticipated July Fourth holiday, residents of Kerrville, which is situated alongside the Guadalupe River, began receiving alerts about potential flash floods in the area. While they are no strangers to flood risk, being in an area deemed as “Flash Flood Alley,” no one could have predicted the turn of events that unfolded in in the early hours of that morning.
In just under two hours, the Guadalupe River surged, reaching water levels as high as 30 feet and creating a powerful current that began to wreak havoc on the Kerrville community. Although residents were alerted to seek higher ground for safety, the rapid onset of the flood prevented many from doing so, leaving them vulnerable and at the mercy of the rising waters. As the only hospital in Kerrville, Peterson Regional Medical Center became a critical hub in the community’s relief efforts. Leading the way were our emergency and hospital medicine medical directors, Dr. Aaron Morgan and Dr. Paul Gravel, alongside their incredible teams.
“I was off shift and in a neighboring town for a weekend away with my family when the storms hit Kerrville,” shared Dr. Morgan. “When I checked my phone on the morning of July Fourth and saw several text messages and missed calls, one specifically from our chief medical officer at Peterson, I knew something was terribly wrong.”
After attempting to coordinate efforts from afar, knowing his team was already working to adequately staff the emergency department (ED), Dr. Morgan made the selfless call to head to the hospital to navigate the uncharted circumstances. As he approached the hospital, which is accessible by a bridge crossing the Guadalupe River, Dr. Morgan was shocked by what he saw.
“The rain was increasing as I made my way into town, and by the time I reached the bridge, the water that is typically about 25 feet below was now less than two feet below, with vast amounts of debris floating downstream,” said Dr. Morgan. “It was jarring, and in that moment, I realized the severity of the flood. It solidified that I was where I needed to be—at the hospital, ready to support my team and our community.”
Similarly, Dr. Gravel had been on shift the night before the storm and was due back at the hospital the morning of July Fourth. “As I left the hospital on July 3rd, I noticed the local park I pass on my way to and from work was set up for the holiday celebrations—a stage with all the fanfare to host a community event, likely for hundreds of people right by the river— something I thought I might be able to catch the tail end of after my shift,” Dr. Gravel recalled. “By the time I got back to the hospital the next morning, the whole park was underwater. Everything I had seen not even 12 hours before was gone. It wasn’t until I got into the hospital and started hearing reports that I knew this was going to be a devastating event for the Kerrville community.”
The ED team had recently updated its disaster response plan at the beginning of the year and completed an exercise to enact it, helping them efficiently navigate the likely mass casualty event at hand. That, paired with Dr. Morgan’s extensive background—having served as a firefighter in the Air Force Reserves, an EMT, 911 operator and EMS helicopter dispatcher, and later as a flight physician in both aerospace and expeditionary medicine for the U.S. military—meant the team was well-prepared to manage the influx of patients with varying severities of injuries sustained in the flood.
Additionally, given USACS’ integrated acute care model, the well-established throughput process allowed both the ED and hospitalist teams to continue working side by side with efficiency and maintain their high quality of care amid the commotion. While both teams anticipated a high volume of patients, they came to realize, as the stream of patients slowed to a steady pace just a few hours after the peak of the storm, the bone-chilling truth. It wasn’t that there weren’t people in need of medical attention; they simply couldn’t reach the hospital due to inaccessible roads that left them stranded.
“We began to prepare for the next wave of patients that we assumed would arrive in the early evening as the water receded and opened access to the isolated areas where people were stuck, but that didn’t occur until more than 24 hours later,” explained Dr. Morgan. “It was yet another sobering moment where we realized the devastating severity of the flood.”
While the immediate outpouring of local, state, and federal support, including search and rescue teams, made progress on the ground, the entire staff at Peterson remained diligent in their collective efforts to provide care and comfort to those who were able to reach their facility. Dr. Morgan recounted that the hospital became a safe haven and gathering point for community members who had nowhere to go, or who were looking for family and friends from whom they had been separated during the storm.
Although it was uplifting to see patients safe, recovering, and reunited with loved ones, that wasn’t the case for everyone who walked through their doors. Dr. Gravel reflected on the unique challenges faced by his hospital medicine team as they cared for those admitted as inpatients, who remained in the hospital for longer periods during the crisis.
“What was really challenging for our team was navigating the emotional trauma that our patients experienced,” expressed Dr. Gravel. “We were ready to manage the physical trauma because that’s what we’ve trained for in our careers, but you truly can’t prepare for the emotional toll that results from these events. Most of our patients were with us for days. We sat with them through the full spectrum of emotions, from grief and anxiety to anger and desperation. Though challenging, I feel blessed to have been able to provide care for these individuals during their most vulnerable time.”
As with any devastating event, the days, weeks, and months ahead will continue to pose challenges as the community looks to rebuild and recover. But one thing remains intact even in the most difficult times: a community’s ability to come together and provide support for one another. Both Drs. Morgan and Gravel applaud their teams and community members for their ongoing efforts to do whatever it takes to ensure Kerrville comes out of this even stronger than before.
“The part of this story that I don’t want lost is the amazing outpouring of help and support we’ve received,” said Dr. Morgan. “From USACS, our leaders reached out immediately to offer support however possible. The USACS Foundation has now aided our two colleagues who lost their homes to the flood, and numerous colleagues across the country have reached out to offer their thoughts and prayers. Within hours of the flood, we had thousands of people from near and far on the ground risking their lives to rescue others. Countless organizations and relief groups have come to help clean up and restore our community. It has been deeply inspiring and uplifting to watch so many people come together.”
Dr. Morgan also shared that over the last month, there has not been a day without food being brought in or donated to the staff on shift. These offerings serve as a thank-you for their efforts during and after the flood—a true testament to the tight-knit community that exists in Kerrville.
“It was physically and emotionally exhausting, but I am so proud of my colleagues for their clinical excellence and their ability to take a step back and empathize with their patients, witnessing the tragedy and grief so many experienced,” said Dr. Gravel. “I think we all went into medicine to help people, and these scenarios remind us how our ability to provide empathy in the midst of our care can make a lasting impact. I also have a newfound appreciation for those who set out to rescue others, as they were the ones risking their lives to save more than 1,500 people. I remember thinking, as we cared for our patients, that each of these survivors now had a hero — whether it was the helicopter pilot who rescued them, the neighbor who came back to help them out of their home, or the EMT who got them out of the water and to the hospital. Those were the heroes of the flood, and each has my profound respect and appreciation.”