No therapist can do a decent job unless they lift and clear their own emotional baggage. I know about compassion fatigue. Doing the job that is ours to do, focusing intently on the stories and needs of traumatized clients there is inherent danger of losing our own emotional and spiritual center. If you're not careful, you bleed out energetically, go limp and strain psychological coping mechanisms. That can't happen. If ever there was the chance for compassion fatigue, I will find it here in Post Katrina New Orleans.
I'm ready and prepared...with eyes wide open. Years of clinical work with trauma and grief recovery have qualified me for the job. And my experience has taught me to anticipate the physical and emotional strain inherent from fourteen straight days, twelve hours a day. Westover Consultants, the firm hired by SAMHSA (Substance Abuse and Mental Health Services Administration), an arm of the Department of Health and Human Services, clearly anticipates the need for emotional outlet. They have suggested that the team members "pack a journal."
Even as I look forward to mutual understanding and support from the eighteen member team of professionals - doctors, nurses, social workers, art therapist and licensed professional counselors - I suspect that my greatest support will come from within. If I was an artist, I would draw and paint out this experience. But I'm a writer, and I will depend on my journal, as I would lean on a best friend and confidante. In my daily pages, I can be unedited and real, off-load the experience, fuel my inner self, and be ready for the next day. At least it's a plan...
October 3, 2005
I'm here! I got lost coming in. There are few street signs to navigate by. As if I knew where I was going anyway! I wandered the creepy abandoned city until dark, at least getting a sense of how pervasive the ruin. I found the hotel, Le Pavilion, by following military Humvees down unlit main streets, assuming they would patrol the semi-occupied areas. NOBODY was out there. The city is in lock down, with a curfew, as I later found out. But the soldiers didn't stop me, just watched as I turned off to park. Friendly enough. That's a good sign.
Merging with the New Orleans culture, dealing with the same chaos the Big Easy natives are forced to deal with, learning the ropes in Post Katrina New Orleans there are few answers. The clerks and hotel personnel are frantic. Nobody knows what the plan is from one minute to the next. Clearly, the hotel staff of Le Pavilion is doing their best just to keep the place open, and attempt to maintain their status as a world class hotel, under impossible circumstances.
This process that I and the whole SAMHSA team from all over the country are in could rightfully be labeled acculturation, a sanitized clinical term I remember from college Sociology classes. But there is nothing clean or sanitary about it. Homogenized maybe, denuded of microscopic organisms such as human waste, purified of germs by reeking bleach so harsh it burns your skin, but clean? No.
Six members of the eventual eighteen member team have arrived. Over a pricey meal of no-name food served in the elegant Le Pavilion dining room from paper plates and plastic utensils (The contaminated water supply is unsuitable for washing dishes!), my team members shared war stories from their first day of Katrina Relief work. The Team Leader, a woman from NY, astounded me by suggesting that I turn around and fly back to San Antonio, because the hotel is throwing us out tomorrow. Disconnect. Culture shock. "Overbooked," she said. "Little available space. Pack your bags and leave them at the front desk in the morning."
I called my Tennessee roommate who is due to arrive tomorrow, and told her what was up. Great gal - Tara. Judging from our pre-deployment emails and phone conversations, we seem to have a lot in common. I look forward to meeting her, but will I? And in what room will we stay? I don't think she'll find TARA here. She was furious. Said she would call the home offices in DC and see what was up.
Tomorrow there is a team meeting in Mandeville, across Lake Ponchatrain, to receive our work assignments from the South Louisiana State Hospital Coordinator. I'll throw my bags in the car. Wait and see. It's a war zone. Duck and cover. How could I expect anything else? Tomorrow is another day....
October 6, 2005
Email sent to my daughters
Lacie and Sarah
Yeah! An internet cafe - Tout De Suite - with one computer and I'm ON. In most places around New Orleans and across the causeway where I "work", the floodwaters have receded. But I still feel broken inside every time I zoom around the spaghetti bowl section of elevated highway that takes me past the Superdome. Who can forget what happened there? Swear, I can almost hear the tormented voices as I zip past. The emotional pain that the Superdome evokes makes me doubly grateful for this precious corner coffee shop where ceiling fans lazily stir the air. Tout De Suite is located in Algiers Point where my team is staying, after sleeping only two nights in Downtown New Orleans. Another story.... I'll tell you later.
You've probably seen the Algiers Point neighborhood on the news: The site of looting and riots with rifles taking aim from roof tops only a month ago. Welcome to Katrina's Brave New World. Not to fear. The violence has settled down. Soldiers toting assault rifles do the trick. I've gotten over the gut uneasiness that assailed me when I first drove down the street of this edgy neighborhood. I don't look over my shoulder anymore. I'm not paying attention to skin color. We're all just shades of humanity.
Algiers Point, although beaten up by the storm, is one of the few places where life in Post-Katrina New Orleans feels almost normal. It's my normal anyway, home base for the duration. My team and I live in a restored house that is advertised as a "bed and breakfast." The bed part is right anyway, and I'm grateful for it. Painted a hospitable yellow and red, some of the windows are still covered with protective plywood, and furnishings are sparse. Storm damaged contents and garbage have been dragged to the street, where dogs poke around in the decaying matter. Who knows when the city can get it together and haul the debris away? Still the digs are adequate and a great improvement from the chaos I've encountered.
Inside Tout De Suite - a walk of ten blocks from our B&B - the air is cool, the walls dark, paneled in worn shiplap. In this safe womb there is a feeling of permanence, in stark contrast to hurricane damage everywhere. Life as it was is clearly no more. Roofs are temporarily covered by heavy, FEMA, blue plastic sheeting. Cars stop for chickens to cross the street. Even the street signs can't be trusted. It's a hit-and-miss process to find your way around. Outside of Tout De Suite, most stores and cafes show no sign of life. Once the sun slips away, the streets deepen into spooky, absolutely quiet darkness. The birds have yet to return. No insect makes a sound. It's eerie. Nature has deserted this place. Run for cover.
Victorian Era front porches, painted bright Creole colors and trimmed with white gingerbread molding, have been knocked caddywampus by Katrina, even though homeowners secured their residence before they evacuated. The majority of residents are no where to be seen, and people wonder if they will return. In the meantime, locals are watching after their houses and cleaning refrigerators. The food would go bad if not used, and clever neighbors are combining resources to provide meals for the whole neighborhood. The sense of community is inspiring.
Like NY after 9-11, what goes on in this place feels like it belongs to me. Maybe it's the soul music, the timeless Mississippi which I could see if I walked up the levee a few blocks away. The Ninth Ward was flooded and lives lost because of 17th Street Levee break -- and the Ninth Ward is just across the Mississippi River. I keep eyeing this perfectly innocent, functioning Algiers Point levee like it is the enemy, too. But still.... I need to climb to the top and take a look across the Muddy Mississippi, extra muddy now. I haven't gotten up the courage yet. It's enough to see buildings become scrap heaps right under my nose here in Algiers Point. I'm afraid I'll see it at a distance too, and know how real it is. You don't want to see, even as you're living the big New Orleans picture. It's best to do this work one day at a time, careful not to swamp your emotions with too much pain all at once. I'll have to look though. Eventually....
Today when I finished at the clinic across Lake Ponchatrain in Mandeville, it got to me that I couldn't find a restaurant or store open. Ridiculous! I felt so silly! But I kept driving and searching anyway.
It's a ghost town out there. Katrina turned forests of towering pines into battering rams, crushing roofs, smashing windows and walls. Remember Houston after Alicia? We thought that was bad. It was nothing compared to this. The air is thick with the smell of cut timber. Clean-up crews and their yellow trucks line the roadways, and snarl traffic on picturesque winding lanes intended for elegant seclusion. The return of homeowners, insurance adjusters, a flood of contractors and endless stream of huge yellow repair trucks have created a logistic nightmare. The quadrupled flow of traffic is one of the main points of distress for the people I work with. Like all traumatic events, it's safer to feel angry. Traffic is a convenient target. Naming and talking about the deep grief - that every single person feels - takes longer to get to, and even longer to talk about. Now it's, "The traffic!"
Like everyone else here, I'm hungry for a momentary blip of superficiality. I don't actually NEED anything but I WANT... To walk into a store and shop for soft comforting stuff like lip gloss.... To pick up a magazine and find out what the rest of the world is up to. Running everyday errands gives the illusion that things are getting back to normal. People Magazine was Food from the Gods today. This isn't Baghdad. I'm definitely not Christiane Amanpour, but Walgreens has never looked so good.
The old door cracks open, and shuts with a reassuringly solid thud. I stop for a second to see what I can see. Locals stroll into Tout De Suite. These are the tough ones. Hardened veterans of many a hurricane, they chose to stay and ride it out, instead of evacuating. They have a right to feel proud of their courage. I am. It's dinnertime. The brave neighbors are gathering, and they welcome all. The neighborhood is swarming with soldiers, police and disaster relief helpers of all sorts. Algiers Point is a mecca of salvation.
A crooked older man with a bald head and full grey beard shuffles to the counter, smiles beneath heavy-lidded eyes and orders a mocha. I pause as I'm writing. "Oh! They have the chocolate today!" I say. Our eyes meet, and we smile with unspoken understanding. Recovery is hard. This place is open for business. There is food and company. It will be alright.
I'm starting to recognize familiar faces, and know the questions to ask. "How is your Mimi today?" I inquire of the aging woman, with dangling earrings and a silver comb in her hair, whose little white dog was trapped outside and banged up by Katrina. Or I joke with the policeman who arrives at 7:am every morning for his two blueberry scones, "So....They didn't give your scones away today, huh?" This place is starting to feel like home. I need it. We all do. A sense of belonging is the best therapy I can think of.
The owner, a wise looking woman with long brown hair tied at her neck and eyes that laugh, carries herself with a forward surge. Her presence convinces me she could weather any storm. With a quick flick of her wrist, she unties the white apron from around her waist, grabs for a stack of stamped letters lying on the countertop, and shouts over her shoulder to anyone who will listen, "I'll be back in a second." She slams out the door.
I crane my neck and see her hop on a scooter propped against a post outside on the sidewalk. The engine sputters. She's off. I have no idea where she is taking the mail. I don't think the postman is back on his route yet, but I'm involved and wanting to know. So odd. I've started wondering what it would feel like to live here! NOLA is under my skin. Once my two weeks is up, I KNOW I'll have a hard time detaching from people and their stories. I didn't expect this. Whew. It's a love thing.
Seated beside me - waiting for the computer I suspect - a honey-colored young man with bright, intelligent eyes, wire-rimmed glasses and a green back pack stirs a memory. He looks familiar. He smiles, I smile back, and we introduce ourselves. Then I remember. He reminds me of the college students that I people-watched, and admired once, on a trip to Boston. I was entranced, and couldn't get enough of their nonchalance. On their way to and from class at BU they seemed charmingly unaware of their potential. The world was waiting out there, and it belonged to them. That day I fell in love with the whole East Coast way of life, and wished that for you two. Look how well our dreaming manifests reality! Who knew you would BOTH live there someday? Well...maybe I saw it coming.
Today, this beautiful young man - who knows what his hurricane horror story might be - is smiling in spite of it, and filled with the same self-confidence. I so get it. It's not the place or circumstance. It's the sense of self that matters.
Meanwhile, my team members are out there on the highway, returning from far flung work assignments. Some travel //////// Computer timing out! Wow! I've gone on. Thank you. I needed you. Miss you! Gotta' run. Love you. You are SO important to me. Family, people, you and me, LIFE is all that matters in this crazy world. Later! Mom
October 8, 2005
Day Six. Tara, my Tennessee roomie and I carpooled today. Tara drove. This was our first assigned relief work in the Slidell Shelter, a state-of-the-art civic center, now home to Katrina's homeless. It's a miracle that it has remained standing. On the eastern side of the storm, Slidell took the full force of the counter-clockwise, most wicked hurricane winds. The farther we drove across the Twin Span Bridge, with only one span functioning, evidence of the absolute devastation became all too real.
Until today I thought I'd seen it all, from the desolated North Shore to the historic French Quarter and elegant Garden District. The old part of New Orleans got it's name, Crescent City, because it hugs the Mississippi in a half-moon embrace. Even after Katrina, the original NOLA - The French Quarter and Garden District - has feet planted on high ground. This Civil War Era, National Register of Historic Sites, is standing firm, but wind and water made a mess of the interiors. From the street, the Garden District looks almost unaffected, but you know different. Opulent boulevards are littered with repair contractors' posters, which stab the once pristine pathways like advertisements for a garage sale orgy. And romantic French Quarter streets, normally populated by throngs of holiday crowds, no cars permitted, are lined with repair vehicles. New Orleans is closed for business.
You can almost taste the anger and sense of betrayal in the air. A military presence is everywhere, even on Jackson Square in front of the St. Louis Cathedral where President Bush delivered his Katrina Recovery Speech. Essential Port-a-Potties mark street corners and serve as bulletin boards which express local sentiment. "Jail Bush!" one bumper sticker reads.
The Ninth Ward is also an old part of the city, but for a less advantaged population. It's heartbreaking. Few people could afford to evacuate. This vintage neighborhood was framed over land-fill swamps, behind levees never meant to sustain a Category 5 hurricane. The flooding of these low-lying areas inundated homes and left a killing wake. There are houses still standing that appear OK, but the interiors are completely destroyed. Nothing and nobody escaped the effect of Katrina. I don't know how those homes or lives will ever be made right.
Now Slidell...farther east across the Twin Span Bridges which were only repaired, and one span reopened, this week. Never before have we seen anything like this on the Gulf Coast. The fifteen to thirty foot storm surge pushed onshore by Katrina's rage, slammed into houses, boats, cars; disgorging contents of human life like a sea monster vomiting its last meal. It hardly seems real, huge metal vehicles indiscriminately piled on top on each another, atop mounds of debris that were once homes...traditions...lives. Structures were completely knocked off their moorings and torn apart. Mountains of raw lumber are littered with personal belongings. What goes with what? My mind wants to sort, but it's futile. None of the pieces - a sofa here, doll there, washing machine, bicycle - fit together in any cohesive way.
The destruction is horrendous, and my emotions today took me completely by surprise. This whole first week of Katrina Relief work I've operated solo, only today have I had someone to share the experience with. Silly me, I was looking forward to it. Who knew I'd feel worse? But of course.... When you talk out loud, you hear what you're thinking and feeling a lot clearer than when you handle it alone. It's what makes therapy work. It's all in the telling. But I'm not here to BE in therapy, I'm here to DO therapy! It happens to all relief workers sooner or later, but I thought I had escaped the dreaded melt-down.
Tara was great. She listened while I made no reasonable sense...but oozed with shock and grief. She kept steady and found the way here. Next week I'll drive and she'll have the luxury of feeling her feelings at the time she is feeling them. This is the down side of mental health work. When you are in it there is no time to process your emotions. Your job is to keep it together and deal with the issue at hand. Fact is, I operate much better when I keep my own counsel, just me, God and Goddess. I've even experienced a transcendent moment or two.
Sharing with my new best friend, I feel doughy, uncooked, exposed and served up undone. My emotions and I are normally best friends. That guru, The Velveteen Rabbit, says that by the time you're real you've got your fur loved off, your eyes bug out and your ears are crooked. But no one can ever think you're ugly except people who don't understand. There is a lot of understanding in this work. The lesson applies, and I'd much rather be real and feel, than not.
Back when, in my Super Christian Days, I was one of God's Frozen Chosen, expressing spiritual joy through the mask of my perfectly radiant face. I didn't like myself a whole lot. Guilt, always guilt for being human -- and never doing enough -- hung out in the shadows of my psyche like the ghost of Christmases Past. Amazing how I tricked myself into believing I was a saint. And that's the point. For me, real is much better, and more balanced.
When our car pulled up in front of the shelter this morning the same sun which had seemed inspiring for most of the week, seemed cruelly revealing. Tara and I sat in the car for a few minutes before we could get it together and go in to work. Because of my Red Cross Shelter experiences, I knew what to expect. The dear human souls inside would be too sick, too emotionally ill, and too down on their luck to have any other opportunity of escape available.
Throughout the day, I managed to keep it together by escaping through the wide glass doors and onto the covered porch - several times. The well-designed circular civic center, wrapped with bold splashes of primary color, seems out of place beside the mute chaos of the surrounding landscape. I'm losing my objectivity. The stories are piling up inside. I need to write them all out and put them in some manageable order in my mind. I don't want to. It's a lot....
I still think I can safely say that the work hasn't suffered. So far so good. Before I ever stepped inside the multi-paned front doors of the shelter, I was deep into a soulful connection, right there on the front porch in the glare of too revealing morning sunshine. But the week-long stress is definitely getting to me. This first therapeutic contact of the day, with a tearful Red Cross worker from Buffalo named Mo - on site one week and one story too many - was the occasion for an addictive relapse. Mine, not hers. As we soaked up the warmth of the sunrise, Mo gave me the run down and familiarized me with what to expect once I went inside the shelter. The stories of survival broke both of our hearts, but these stories were predictable, and therefore emotionally manageable.
The unpredictable takes you by surprise and does damage. With fear-filled eyes, Mo lit a cigarette and shared the horror that had pushed her over the emotional edge. Poisonous Water Moccasins have apparently become more fond of the clean water in the shelter toilets, than the polluted swamps outside. "I just killed the third one this week!" Mo shrieked. "We can't let the people know! They would panic. Wait until you see how close together their cots are!" It had been twenty years, but my only reasonable response seemed to be, "Mo! I need one of your cigarettes!"
On the lookout for poisonous snakes, I'm thawing out from the shock of this overpowering experience. Some of the Ninth Ward survivors here in the shelter were trapped in attics for a week. Starving, they hacked a hole in the raw floorboards, and dove under the polluted water, in search of cans of tuna, beans, even dog food; anything in order to survive. Their ankles are swollen and their bodies are bloated, as much from the toxins as anything else. Even after the black watery goo was pumped out, New Orleans' Ninth Ward is left with several feet of nasty smelling sludge, and black mold crawling up the walls.
It's almost too awful to write down, even though I know I must for my own mental health. As if in the telling, I'm invading the sanctity of sacred pain. A clinician in one of the Mandeville clinics spent a tear soaked two hours with me this week. Her story is the first in depth account I've heard from the senseless levee break and the holocaust afterwards. She showed me photographs of the family barber shop located in the Ninth Ward. The images looked filthy black and white, but were photographed with color film.
I turned each grim picture over and studied them intently, while my client shook her head in disbelief and interpreted what I was seeing. "Look at it! Nothing there but black goo... There's the water line... Mildew all the way up the walls... But my daddy won't see it. It's his shop. Has been the family shop all these years. He can't see it...."
I looked into her eyes and nodded in agreement. "He's probably in denial honey. You know...that's the first stage of grief...."
She shook her head up and down. "I know...."
I say, "You're right... It's awful. Hard to put that back together again.... The mold.... The muck.... It's covering everything."
She nods, comforted to have her truth validated. Then she goes on, "But my Daddy says: 'It's not bad.' He mucks around in it." Her eyes fill with tears. She struggles for composure, gets herself together, continues.... "I wanna' cry, but I can't. Daddy says all bossy-like: 'Come on girl. He'p me!' So I do it."
She stops now to cry the tears she couldn't shed when she was being strong for her father. I offer Kleenex. She wipes her eyes. Then looks up at me as if to measure my ability to tolerate her pain. "But that's not the worst."
"Go on," I say. "I'm with you."
"Then we went to look for my Grandma. She's ninety-two. Lived even deeper in the Ward....stubborn...wouldn't leave...." She stops, stares through the high clinic window to tall pines just outside. I can feel her gathering the memory of the harder story. Her words spill out in a flood of emotion. "So we went to my Grandma's house.... Scared she couldn't get out with the windows barred....but we didn't find her...at first... She wasn't there. Her things were covered in mud. We stood around, lookin' for I don't know what. I opened her china cabinet. She was so proud of those dishes. I was tryin' to wipe the mud off a white plate...then I saw...at my feet....under my feet...white hair. My Grandma's white hair."
"Oh....I'm so sorry," I whispered, reached out and touched her arm.
Her head bobbed up and down, up and down. Involuntarily my head bobbed up and down in rhythm with hers...like rows of church-going believers' heads nodding in mute agreement to unspeakable truth the preacher just shared. Tears splashing down her cheeks she looked at me. Neither of us spoke, but held the gaze, neither of us flinching from what must be acknowledged. When she could finally speak, she said, "She was in the mud...just like the mud...couldn't tell the difference...and I was standin' on top of my Grandma."
The look on this young woman's face is still with me today, mixing and mingling with the plague of death and despair infecting New Orleans. I feel tender, raw and sad. Much of the tragedy which might have been prevented through foresight and preparedness, was not.
As this day played out, several clients and I visited the Slidell Shelter front porch for therapy sessions over mutual cigarettes. I haven't seen this many smokers in one place since I did inpatient work with drug addict and alcoholics. The level of desperation feels the same. Looking out on the upscale Slidell neighborhood, artfully placed along inlet harbors that trace beside the civic center, or taking a walk and sitting beside the recently invading swamp, I've realized something. This is no natural beauty. It's bad Botox, contrived, man-made and snatched from the wetlands.
The wetlands are wet again, I thought. Where is the developer that created this nightmare? Greed. Human greed did this.
Then I told myself, "Be nice." But I don't feel nice. Apart from the uncontrollable force of nature, I can't accept what has happened in any way. Not the greed. Not the levee that didn't have to break. Not the lack of preparedness. Not the failure of government on any level -- city, state, federal -- to meet their elected and mandated responsibilities for the people. Acceptance has to come for the sake of human peace, but it won't fix the situation. Outrage has a place here. What else will motivate a different future?
As for me, right here, right now, with a job to do. I need to get over it. Prioritize. For the sake of sanity, I can only accomplish the work I came here to do for my clients: Normalize the chaos, restructure the memories, define a future and grieve what is lost.
After the surge of repressed emotion which I've experienced today, I need to keep short accounts. Don't allow my feelings to build up. Stop expending futile energy on judgment. There will be time enough to assess and shape the future of New Orleans. I must take care of myself and leave wind, weather and irresponsible politicians in the hands of a power greater than myself.
When Tara and I drove away today, it was obvious that Mayor Nagin had opened up the hurricane ravaged communities to returning families and business owners. The solid line of cars crept along like a funeral procession. The mourners are back to assess the damage and nothing more. There is no place to inhabit. "Look and leave," home and business owners have been instructed. Tara and I pulled off the road and got out.
I'm not taking photographs of clients. It's a violation of the confidentiality they are due. I did see a psychiatrist taking pictures with her "patients" today. Maybe it's not a part of her ethical code as it is mine, but it feels wrong to capture people in the lens when they are in such a bad way. OK for television if the people grant an interview. The nation needs to have ongoing understanding to prevent recurrence. Clinical work is different, just as sacred as if these were paying clients in private practice.
I did want to capture some of the experience though, for privacy's sake, faces not included. At the end of our last day in the Slidell Shelter, as we drove past the line of cars reentering their destroyed communities, Tara and I pulled out our cameras and fired away. The most amazing thing....a family of ducks survived and have returned home. They were precious, so proud and prissy, walking across the road and stopping traffic. I crouched down on the ground to get the best shot. An instinct for grounding myself, no doubt. They were so beautiful...so alive...so brave... and THAT made me cry! Oy vey! I'm a mess.
Best to say goodnight to this sad day. In the morning I'll take care of myself like I learned to do when I was a child. Nature is my Neosporin for banged up emotions and a skinned heart. First thing in the morning, I've got an appointment with Lake Ponchatrain and the sunrise. It will do me a world of good.