Lost in the Storm

Wayne Dailey sat in a waiting area at a Houston hospital, anxious for word about his wife. He and his sister stared at the television to distract themselves. It was Wednesday, Aug. 23, 2017, and broadcasters described a large storm moving off the Yucatán Peninsula with Texas in its sights, potentially bringing historic flooding to Houston that weekend.

Wayne, who as a child in Galveston County spent hours watching the cloudscapes drift over the Gulf of Mexico, kept multiple weather apps on his phone and had already been tracking the storm. “It’s going to get us,” he told his sister. But coastal storms were a part of life that he had prepared for, and they did not concern him.

He was more worried about his wife. Casey Dills-Dailey was undergoing surgery to remove the adrenal gland above her left kidney. The surgeon predicted an uncomplicated operation, conducted through tiny incisions. Still, Wayne wondered, would the surgery do what it was supposed to do? Was the doctor as skilled as he said he was? It was hard to grasp that the life of his 38-year-old wife could be endangered.

The operation came after years of mysterious symptoms that began when Casey was in her early 30s. She had hot flashes and eventually stopped menstruating. Her face became chubby, and her full-but-shapely figure ballooned to nearly 250 pounds, fattening in odd places, including the space between her shoulders. Ugly red marks appeared on her abdomen. The illness left her in pain, nauseated and unable to stand for more than 15 minutes at a time.

Casey would scour books and the internet to help others solve medical or legal problems — Wayne, 39, called her a doctor without a degree — but the cause of her own health issues had eluded her. She blamed herself, ascribing her weight gain to overeating. Finally, in late March, after an ambulance took her to the hospital for a bout of severe abdominal pain, doctors detected a mass on one of her adrenal glands. Weeks of tests produced a diagnosis: Cushing’s syndrome, a curable but potentially deadly disorder caused by an overabundance of cortisol, a steroid hormone. The mass appeared on a 2015 scan for kidney stones, doctors realized, but because it is a common and typically nonproblematic finding, its significance was missed.

Casey was referred to Dr. Curtis Wray, a surgical oncologist, to remove what doctors suspected was a noncancerous tumor that was releasing extra cortisol, causing her Cushing’s syndrome. The diagnosis helped explain many of her problems, from high blood pressure to erratic moods. Casey could not wait to look and feel like herself again.

That morning, a resident surgeon said Casey should expect to stay three or four days for recovery. He described the operation’s potential complications — bleeding, infection, damage to other organs — which frightened Wayne. Dr. Wray, the senior surgeon, came in and reassured them. His team had performed the operation many times. Surprising Wayne and Casey, he predicted she would be home in 24 hours.

Wayne asked to see the tumor when it was out. After surgery, Dr. Wray called him from the waiting area and showed him an image on his phone. The tumor was the width of Wayne’s two thumbs put together. Most important, to the surgeon it appeared benign.

After Casey was settled in her hospital room, Wayne drove home to spend the night with their two sons. The family lived outside the Houston city limits in northeast Harris County, in a trailer park where homes stretched along fancifully named streets — Drifting Winds, Island Song and theirs, Enchanted Path Drive.

The Daileys were what Wayne called a “simple, simple family”: Casey, a housewife who home-schooled their oldest son, Luke, 14; their youngest son, Ronnie, 10; and Wayne himself, a “middle-class worker, a lower-class worker,” without a steady job. For more than a dozen years, he had operated heavy machinery at oil refineries, clawing trenches into the earth for foundations and pipe racks. The finances were in his wife’s name in case he did not make it home. He had survived explosions, survived co-workers. Lately, he had been working for a friend’s tree-service firm. Casey made their uncertain income stretch, scrapping junk metal and advertising homemade quilts for $50 on social media; it took her about a week to make each one.

Their trailer-park community had its drugs and gangs and violence, the evening cracks of gunfire and whining sirens. But four generations of family members and friends filled the homes on their block. Casey’s parents lived across the street, next to her aunt. Three homes over, there was Casey’s grandma’s bowling partner. Next door was Erasmo Villa, from Mexico, who with his brother-in-law had drywalled the Daileys’ home free of charge just because they were neighbors, and neighbors help each other. Casey cultivated roses that bloomed from pale pink to vivid red, growing impossibly high.

Casey grew up in the trailer. Her mother had many miscarriages before giving birth to her only child, and Casey quickly took a place at the center of the family, clinging like a bear to her grandpa’s neck. As an adult, she cared for him and other sick relatives until they died.

Having little money did not mean the Daileys could not be generous. Casey joined the homeowners’ board, chaperoned school field trips and led a Cub Scout troop with Wayne because nobody else volunteered. An evicted family with three children had slept on pallets on the Daileys’ living-room floor. Wayne and Casey served as temporary guardians for one of Ronnie’s friends so he wouldn’t be sent to a foster home during his parents’ rough patch. Their Wi-Fi password evinced their Christian faith: 12loveGod.

That night after Casey’s operation, Wayne picked up the boys from their grandparents’ trailer. He ate dinner, put the television on in the bedroom and fell asleep. At around 9:30 the next morning, Casey called him from the hospital. “Come up here,” she said. They were discharging her.

Tropical Storm Harvey was rapidly strengthening in the gulf, and Wayne stopped to pick up necessities. When he walked into the imposing hospital in the early afternoon, though, nothing looked amiss. In truth, doctors at Casey’s hospital, Memorial Hermann-Texas Medical Center, were preparing for a possible hurricane, sending stable patients home. During Tropical Storm Allison in 2001, Memorial Hermann, with 540 patients inside, lost power and was evacuated, as medical workers manually squeezed air into the lungs of patients whose mechanical respirators had failed. Since then, billions of dollars had been spent to protect the hospital and other facilities at the Texas Medical Center campus.

A surgical intern just weeks out of medical school examined Casey. He prepared discharge instructions and wrote two prescriptions: one for a stool softener and the other for 40 tablets of Tramadol, an opioid painkiller. He did not prescribe steroids, which would typically be needed when a steroid-producing tumor like Casey’s was removed.

A nurse went over the bright-orange folder of information, explaining how to keep the incisions clean to avoid infection and emphasizing the importance of being as active as possible to help prevent a potentially deadly blood clot from forming in her legs or lungs. Casey was to follow up with Dr. Wray in a week.

She arrived home that afternoon in pain and ready for a nap. Casey’s aunt from across the street texted to offer help and asked whether Casey and Wayne were ready for the hurricane. Casey responded that they would fill containers with water, hunker down and keep an eye on their outdoor dogs. “It’s all we can do.”

Late the next night, Friday, Harvey barreled into the Texas coastline northeast of Corpus Christi as a Category 4 hurricane, the strongest to strike the United States in over a decade. It stalled, losing strength but absorbing more water from the gulf, before pinwheeling into Houston.

On Saturday night, before 10 p.m., Wayne opened his screen door, stepping barefoot onto the stoop to look at what was coming. Wind chimes tinkled, and the roof dripped a steady beat of rain between crashes of thunder. Branches tipped with small red flowers swayed dizzily above the door. A shock of lightning brought the trees into sudden light. Less than an hour later, he opened the door again to a hiss of sheeting rain that obscured the rumble of thunder. Behind him in the house, an emergency alert blared from one of their mobile phones, a flash-flood warning: “Imminent Threat — Severe.”

As the storm strengthened, emergency officials appeared to have the situation well in hand. Houston’s mayor, Sylvester Turner, had warned that Harvey would be a “major rainmaker” for the city and asked people to stay off the roads over the weekend, but he did not call for an evacuation — he later told reporters that sending millions of people fleeing onto the highways would be “asking for a major calamity.” In 2005, more than half of the county’s population drove out ahead of Hurricane Rita, just weeks after Hurricane Katrina. Traffic stalled, gas tanks ran dry and dozens of residents died on the freeways from the heat, vehicle-fire injuries, traffic accidents and delayed medical attention. Then Rita swerved and missed Houston.

Harris County’s top elected official, Judge Ed Emmett, also decided that there should be no mass evacuations. With a population of more than 4.5 million — about equal numbers outside and inside Houston — Harris County’s roughly 1,700 square miles held more people than half of the states in the country.

Texas law requires every jurisdiction to have plans for managing emergencies, and as the lead county official, Judge Emmett served as its emergency-management chief. On Sunday, he was based at the county’s emergency operations center, in the Houston TranStar building, which houses Harris County’s lead agency for disasters, the Office of Homeland Security and Emergency Management.

As the storm moved into the area, the activity in the vast headquarters picked up. Personnel from various agencies gathered at rows of desks, their partitions marked by edge-lit glass signs with the office logo glowing an eerie white. Just below the room’s high ceilings, giant video screens played the news and tracked weather.

Webbed with rivers, creeks, lakes, bayous and reservoirs, Harris County had experienced a notable increase in severe, storm-induced floods in recent years. Storms in 2015 and 2016 killed more than a dozen people and swamped parts of the “500 year” floodplain — an area that according to previous models had only a 0.2 percent chance of flooding in a given year. Climate experts predicted that the trend would continue as the atmosphere warmed and extreme weather rose in frequency and intensity. The built environment worsened the problem: Concrete covered ever more miles of rainfall-absorbing prairieland, and sewers and ditches were designed by the local government to overflow into the streets, which were considered part of the drainage system. This helped protect homes and businesses from flooding, but it could trap their inhabitants when streets became canals.

A dizzying array of agencies participated in emergency response, coordinating their activities using the National Incident Management System, a protocol that arose from efforts to jointly battle wildfires in the 1970s and that was adopted nationally after the attacks of Sept. 11, 2001.

The concept was simple: Disaster response, and the responsibility for it, started at the point of impact and moved out and up as resources were overwhelmed. Individual and local-community preparedness — stocking food, water and medicines and looking out for neighbors — was the initial safeguard. The 911 system was the next, connecting people with police, fire, rescue and emergency medical assistance. The circle expanded from there. If one of the county’s 54 independent fire departments, which were responsible for water rescues, found itself overwhelmed, it could reach out to the fire desk at the county emergency operations center in the TranStar building, which could request assistance from other local fire stations or from representatives of the Coast Guard or the Federal Emergency Management Agency sitting nearby. Health and medical services had a separate hierarchy of support agencies.

When Harvey reached Harris County, beginning to release what became a once-in-a-thousand-years rainfall of more than 1 trillion gallons, officials were confident they could prioritize people in life-threatening situations. But as the water rose on Sunday, it overwhelmed those preparations. Many local fire departments lacked boats or trucks that could handle flooded streets, and those that had them could no longer share. A Houston police sergeant drowned in his vehicle trying to drive to work. The flooding was so widespread that it impeded the arrival of additional state and federal teams.

At TranStar, officials felt agitated and helpless. They were getting personal emails appealing for rescues, sometimes with photographs of elderly relatives attached. There was no time to wait. “I got a crazy idea,” Rodney Reed, the assistant chief for operational support for the Harris County Fire Marshal’s Office, said as Judge Emmett walked into a snack-filled room. “I need you to support it.” Reed argued that they should invite unaffiliated volunteers into the rescue effort. According to conventional wisdom, they get in the way and often end up needing help themselves. But Reed assured the judge that taking the step would save lives.

And so at noon on Sunday, Judge Emmett stepped to a lectern before news cameras to make an unusual statement. A large screen looped colorful radar images of the storm behind him. “Those of you who have boats and high-water vehicles that can be used in neighborhoods to help move people out of harm’s way, we need your help,” he said. “Government assets are fully utilized.”

Judge Emmett asked the public to call the emergency operations center if they were willing to volunteer. County officials wrote each offer on a sticky note or scrap of paper, affixing it to a wall with blue tape in neat rows according to geographic quadrants, ready to be pulled whenever a fire department called requesting boats.

The perhaps-even-greater challenge was connecting the volunteers to the people who needed rescuing. Callers had trouble getting through to 911 as the volume of calls for assistance more than quadrupled. Judge Emmett asked people to stop calling unless they faced immediate danger. “The phone lines are backed up,” he said.

Like most other emergency agencies, the Coast Guard, which controlled many boats and helicopters, had not prepared to respond to distress signals posted on the public’s technologies of choice: Facebook and Twitter. Instead, it used social media to disseminate five emergency numbers for the local Coast Guard station, setting up a separate, parallel dispatch system for residents in need of rescue. In a sign of the ad hoc nature of the triage system, personnel tracked urgent medical cases with a pencil-and-paper checklist. In its postings, the Coast Guard instructed people to mark their roofs or “wave sheets, towels etc.” to get rescuers’ attention.

Identifying who needed help the most was the crucial first step to responders saving lives. During the county’s news conference, authorities sent a wireless emergency alert to cellular customers, including Wayne and Casey: “Call 911 for LIFE THREATENING emergencies ONLY. STAY PUT IF SAFE.”