When you hear "disaster," you probably think earthquake, hurricane, plane crash, train wreck or perhaps even nuclear meltdown.
But the biggest disaster of all is, of course, war.
It's the sort of disaster that Dr. James D'Orta of Baltimore is prepared to respond to should Kuwait call for his particular brand of medical 911.
At 39, he is a veteran of rescuing the distressed, whether they are victims of the Amtrak derailment in Chase or of earthquakes in Mexico City, Armenia or San Francisco. That's what he does when he isn't saving lives in the emergency room of Franklin Square Hospital, his "day" job, or patching up movie stars on various location shoots, his other and more occasional job.
As far-flung as his medical ministrations may seem, Dr. D'Orta sees them all as part of the same healing process that convinced this one-time firefighter to become an emergency room physician.
"People are people," Dr. D'Orta says by way of simple explanation. "It doesn't matter where they are or who they are. The language of interpersonal relations is universal -- pain is reflected from the heart, not the spoken word.
"We try to expand beyond the emergency room walls," he adds. "You have to be part of the community."
By that he means both the immediate East Baltimore County community that Franklin Square serves and the international community that, at least medically, knows no bounds.
And, currently, it is the Kuwaiti part of that community that Dr. D'Orta is most concerned with. He has put together a plan to tend to the postwar medical needs of that devastated country, which Gov. William Donald Schaefer personally presented to government officials on his recent visit. Dr. D'Orta said yesterday the Kuwaitis have not yet decided on whether to accept the offer.
According to unofficial reports, the Kuwaitis' medical needs seem immense, he says.
"What we have now are the diseases of a developing nation -- typhoid, cholera, anything that lives in poor sanitary conditions. Environmentally, these people are inhaling toxins, so you would expect respiratory problems, asthma," he speculates. "We heard only two hospitals are still standing. It's a bombed-out disaster."
The appeal that emergency medicine has to him is perhaps only natural.
"I started in emergency medicine literally from the street level," he says.
He was in his early 20s, working for his family's manufacturing business and volunteering as a firefighter and paramedic on Long Island when he realized just what he wanted to do with his life.
"I was interested in the immediacy of response that a fire department can provide," he says. "I wasn't really interested in the fire science of it. I felt that my ability to serve in that puzzle was to work with people on a one-to-one basis. I felt something in my gut that emergency medicine was my future."
Another contributing factor was his father's death at age 44 -- he had suffered a heart attack and was taken to a hospital emergency room that was staffed by interns in training rather than specialists.
"That was a tremendous shock in my life," Dr. D'Orta says now.
He ultimately enrolled in medical school and came to this area to do his internship and residency at institutions including the University of Maryland and Georgetown, where, cyclically enough, he now holds faculty positions.
In addition to treating victims at the site of disasters, he's particularly interested in what he calls a "planned system of disaster" -- not as oxymoronic as it might seem.
"What we do is pre-plan -- that's how you prevent things from becoming a disaster," he says.
That is what he has done for Kuwait. It is a plan that, even if it is never implemented, gives him great satisfaction because it pulls together the considerable medical resources that Maryland can offer. While usually these medical institutions are competitors, they united behind a non-profit corporation, the Maryland International Health Task Force, that has been formed to offer medical services to the Kuwaitis. Among the board of directors for this venture are Dr. Robert Heyssel, president of the Johns Hopkins Medical Institutions; Dr. Morton Rapoport, his counterpart at the University of Maryland system; and officials of other private and public health cares systems in the state.
"All of the politics of medicine are laid aside for this," Dr. D'Orta says. "It's the situation of Kuwait that's opened up our eyes to put together a dynamic task force and cohesive plan to attack this strange disease known as disaster."
While he seems fascinated by the planning involved in responding to a disaster, it is his humanism that first comes to mind among those who have worked with him.
"He's a devoted humanitarian," said Louis Grasmick, president of the Louis Grasmick Lumber Co. Inc. and vice president of the Kuwait-Maryland Partnership, a coalition of businesses hoping to land contracts to help rebuild Kuwait. "He's dedicated to his profession."
Mr. Grasmick said Mr. Schaefer said the Kuwaitis were most impressed that Maryland offered the humanitarian assistance of its medical resources along with its money-making businesses.
Even if Kuwait ultimately decides against the Maryland medical offer, Dr. D'Orta won't be at a loss for work. He also heads a group that provides medical services to moviemakers.
That venture began with a family connection -- Albert "Cubby" Broccoli, producer of the James Bond films, is a distant cousin and first hired him to tend to the medical needs on the Moroccan set of "The Living Daylights" in 1987. Having a doctor or other medical personnel on site can lead to a reduction in insurance rates for the producers, Dr. D'Orta said.
Since his first break in the movies, he's been hired to watch over others such as "Total Recall," "The Abyss" and the coming "K2."
While there have been no medical disasters on those sets, there was always the potential for financial disaster, he notes.
"Every minute you lose filming," Dr. D'Orta says, "costs something like $500."