After Hurricane Dennis, emergency room patients kept coming in with heat stroke.
After last year's Ivan, patients limped in, feet punctured by nails hidden in boards deposited by floodwaters.
After 1995's Erin, the injuries were from chain saws, used to cut fallen trees.
Dr. James Leker, an emergency medicine doctor who has lived in Pensacola since 1976, knows how wide a range of illness and injury Gulf Coast doctors face in the wake of Hurricane Katrina.
"It's a mess," Leker said Wednesday. "My heart goes out to those people in Mississippi and New Orleans."
Leker and other doctors know all too well that even though Hurricane Katrina has passed, a wave of further suffering will follow. They expect a broad range of health problems and injuries related to storm damage, blistering heat and filthy conditions.
In New Orleans, persistent flooding poses more perils than a typical hurricane because so many people can't avoid polluted water.
"Human waste, animal waste, rotting food - all sorts of stuff starts floating in the water," said Dr. Richard Paula, an assistant professor of emergency medicine at the University of South Florida who works at Tampa General Hospital's busy trauma center. "There's a lot of disease."
To E. coli bacteria and other diarrheal diseases, add contamination by gasoline and toxic chemicals.
With flooding likely to remain for weeks, there's an increased risk of disease carried by mosquitoes. Skin infections are likely as people with open cuts from debris get into contaminated water.
High water also will force animals that are dangerous or carry disease into closer contact with people left homeless by the storm, said Paula, who worked in New Orleans for four years.
Technology brings more dangers, including carbon monoxide poisoning from generators.
"Your generator needs to be outside and away from your house," said Doc Kokol, communications director for the Florida Department of Health. The state had 38 poisoning cases, two fatal, this year, Kokol said.
In Pensacola, Leker's emergency room usually sees 150 to 175 patients a day. For several days after Dennis, that number climbed to 250.
Staff members weren't seeing just injuries and illness related to storm damage, said Leker, medical director of LifeFlight air ambulance service at Baptist Hospital.
Many people with chronic illnesses become sick because they don't have their medicine or because poor conditions aggravate existing health problems.
Generally, Leker said, there's only one type of injury that drops after a big storm. "We didn't see many car crashes," he said. "Nobody could drive."
