Hurricane Katrina came ashore in Louisiana at approximately 07:00 hours on Monday, 29 August 2005. The storm washed away a swathe of the Louisiana coastline, destroyed large portions of the city of New Orleans, and forever changed the state of Louisiana. Our Lady of the Lake Regional Medical Center in Baton Rouge, Louisiana was one of the receiving hospitals for evacuees from the New Orleans area. This commentary briefly describes the hospital's preparation before the storm and the activities during and immediately after the storm came ashore. Author commentary of the process is included to cover anticipation of the patient surge, transport of critical patients, and communication across all agencies--interhospital, local, state, and federal. It is beyond the scope of this report to judge the performance of agencies outside Our Lady of the Lake Hospital.