By the time Dr. Farid Farid reached his Sherman Oaks medical officeafter last week's earthquake, the floor was knee-deep in water.
Dozens of patient records were scattered everywhere. All the windows were broken. There was no telephone service, electricity or heat. And when Farid refused to pay a plumber $300 to fix the water heater, the man cut the pipe he had just fixed and left.
By Monday, Farid, a family physician who runs another office near Koreatown, was still struggling to get his practice back to normal, trying to reassemble his clinics while soothing patients anxious about their next examinations or prescriptions.
"They're kind of shaky, of course. Nervous wrecks. That's understandable. But unless it's a real emergency, high fever or pain, they've had their appointments postponed," Farid said.
His experience is hardly unique. Across Los Angeles, hundreds of doctors, dentists and other medical practitioners have seen their offices damaged or closed by the quake. Combined with the damage it wreaked on local hospitals, the temblor has seriously disrupted the city's medical network.
Patients have missed kidney dialysis treatments, psychotherapy sessions and dental appointments. They have developed infections from untreated cuts and been unable to get prescriptions refilled. At some medical offices in the San Fernando Valley, the phone goes unanswered.
Confronted with customers without prescriptions, some pharmacists have given away small amounts of non-narcotic drugs. X-rays have been ruined and patient files upended, turning records rooms into vast heaps of jumbled paper and leaving physicians without vital data about patients.
"Everything twisted and turned and they all came down," said Doris Skouros of the 90-doctor Facey Medical Group in Mission Hills, as she ruefully watched more than a dozen workers painstakingly replace thousands of fallen file folders on shelves Monday.
Jim Hillman, executive director of the Unified Medical Group Assn., a Seal Beach-based organization that represents large doctors' groups, said Facey and two other San Fernando Valley-based medical groups were the hardest hit by the quake. Combined, the three groups serve more than 170,000 people.
"The problem they have now is finding exam rooms and adequate space to see patients," he said.
At Facey, doctors worked two to an office because the front portion of the building was badly damaged by the quake. They worked in shifts, one physician seeing patients from 8 a.m. until 2 p.m., and another taking over from then until 8 p.m.
At a front desk, sick people crowded a waiting room while nurses frantically tried to reschedule appointments. There was no heat, and a large rooftop air conditioner sat in what had once been a garden atrium. The machinery had toppled from two stories above.
Facey was forced to close down its Porter Ranch office indefinitely because of heavy damage, and other offices in Canyon Country and Valencia were also damaged. Because the group's regular medical courier service was not operating, Facey employees had to carry needed medications to Santa Clarita Valley offices.
Gail Dellavedova, executive administrator of Greater Valley Medical Group, which has 30 doctors, nine offices and 50,000 patients in the San Fernando and Santa Clarita valleys, said the group's buildings and equipment may have suffered $1 million in damages.
Its offices in Granada Hills and Mission Hills could be condemned, but its other offices were being reopened Monday. The group has no earthquake insurance, she said.
Displaced group doctors have been offered temporary office space by both Holy Cross Hospital and Granada Hills Community Hospital, she said.
Bob Calverley, spokesman for the Los Angeles County Medical Assn., said that so many doctors were knocked out of their offices that the association is sending faxes to its 1,000 members listing space to lease elsewhere.
Dr. Walter Murrell, a psychologist, got hit with a double blow. His offices in Sherman Oaks and in West Los Angeles were both ruined by the earthquake.
At his West Los Angeles office, in the condemned Barrington Building, all his patient records were destroyed. But he hopes to be able to salvage some records in his Valley office.
Nonetheless, Murrell is already seeing patients again at newly leased offices in Santa Monica and the Valley. And he is turning the move into a test of sorts for his patients.
"The offices were a stable influence in my patients' lives, a place where they could go and let their hair down," he said.
"Now they are gone. But it's been a good barometer for me of how well they are doing. It shows who can adapt to change and who cannot."
Many pharmacies were shut down for several days last week, while telephones at others were still tied up continually Monday, as pharmacists continued to reshelve medications.
Timothy P. King, a pharmacist at Patton Pharmacy in Santa Monica, said his building was so badly damaged that he moved to another a mile away, where he shares space with St. John's Medical Plaza Pharmacy.
"I think our roommates are going to get real sick of us. It's stressful but I try to remind myself this is an adventure," he said.
Times staff writer John Schwada contributed to this story.