DIARY OF A VOLUNTEER PSYCHOLOGIST
Susan F. Franks, PhD, associate professor in the Department of Family
Medicine and the Department of Psychology, wrote this account about her
experiences volunteering with the Hurricane Katrina victims.
Sunday, September 18, 2005, 1:30am
Tonight was difficult; much harder than I thought it would be. I ended up working until midnight. I didn't think I would hear or know any more things that would be bothersome. But I was wrong.
I didn't know that people in the Superdome hid behind dead bodies to try to stay safe from the gangs. I didn't know that people fell to their deaths as they reached the top of makeshift ropes of their own clothing, attempting to get to the roof in desperation to flag down helicopters. I didn't know that gang members were shooting out the damaged roof, trying to down the helicopters, thinking they would then be able to retrieve water that they were convinced was aboard.
I did know that women at the Superdome were afraid to sleep at night because gang members "crawled like alligators along the floor" seeking to use them at will. I did know that food and water became commodities that were handed out in exchange for demanded services. I did know that children were not safe from their attacks. I did know that the bloodied, brutalized body of a child was carried tenderly from the garbage.
I did know that people would be re-experiencing their trauma in various ways. I didn't know there would be so many, and I guess I didn't expect so much of it to be from this. Human destruction is on an entirely different level.
On a brighter note, I happened to come across EJ. He found an apartment for himself, and has registered with Texas Rehabilitation Commission to get job training. He is trying to keep a positive outlook. He feels lucky to have gotten out of his second floor apartment after 3 days without power. The water had reached the balcony, and his ceiling was damaged from the storm. At night he lay in bed, worried that snakes would crawl though the hole in the roof, while he listened to the eerie bumping "ghost-ship" sounds of floating furniture in the water-filled apartment below. Now he dreams of someday becoming a pilot.
People still speak of not being able to get the feel of oil and the smell out of their skin from walking through so much contaminated water. They speak of the stench, the waste, the floating dead animals, the human bodies. Some say that no matter how they scrub, they can't get away from the smell and the feel.
Tonight was their last night in the shelter in Dallas. They will be moved to temporary housing...hotels and such...until they get something more permanent. I hope that Patrick gets his medications refilled before he gets moved out tomorrow. They were all stolen today while he was gone to be reunited with his Aunt who was separated from him during the evacuation. She is elderly and on dialysis. He has been so worried about her that his depression and anxiety were getting worse without his medications. All his money, his medications, and what he had left of his personal life were taken. He had already sent back his check to FEMA, trying to tell them that others needed the money more than he did, but they sent it back to him. I hope he decides to keep it this time.
Apparently, there were a number of loopholes in various systems, that unscrupulous people were able to take advantage of. Some people, desperate for money, sold their arm bands that allowed entrance to the shelter, which created various problems.
It's good that they are moving people out. But some people are not ready. Like the previously homeless, unmedicated young woman with paranoid schizophrenia. She is functional, and knows to be so vague as to avoid hospitalization. She is not getting psychiatric care, but does not want it. We only know of her diagnosis because her family tracked her down and made contact with us by phone. There is little we can do, although I understand they are getting her a flight back to New Orleans to try to get her back to family. I hope that the night shift psychologist can convince her to go in the morning. I hope she is going back to someone.
They will all be gone tomorrow; spread out into our communities. I suppose that this will be my final entry. It's just that it's not really over.
Susan
Saturday, September 3, 2005, 1:30 a.m.
Wow. I am exhausted. I just got home about 15 minutes ago; worked until midnight at two different convention center shelters. One was huge, tense, and more chaotic than the other. Outside the arena, people were milling around looking for people. Some have clothes and belongings in trash bags sitting on the sidewalk. Police and National Guard were everywhere. Camera crews and news reporters were everywhere. It took me 30 minutes just to get through to find a place to park once I got there.
At the larger convention center, there weren't enough cots or blankets. People have to use towels. Some of the bathrooms don't work, and there is no shower facility at this one. A fight broke out inside while I was there; police took someone away in handcuffs. Some of the fluorescent lights buzz constantly, adding to the tension. It is huge in there. One man asked me to come back to speak with him tomorrow. I hope I can find him again.
There are so many people. Many of them don't trust anyone because of what happened in New Orleans. So they won't even leave their cots or belongings to go get medical help. So most of what I did was convince people to get medical care. Lots of foot problems from walking so much and in contaminated water. People are also starting to go through detox of various sorts. There was one demented man in a wheelchair with a sign propped on him stating "Feed me...." who was refusing to be taken to a nursing home.
People get distressed when one of their family members stays gone a little longer than it seems they should. Some people got inadvertently separated. I worked with one 14-year-old who is six months pregnant, who got separated from her family while she was at the hospital today for spotting. Her family got housing, and when she came back they were gone with all of her belongings. No one could find out where they went; mess-ups with the sign-in/sign-out sheets.We finally managed to locate them; I couldn't believe it. She was so relieved, but she didn't want me to leave her until someone came to pick her up to take her to her family.
There’s another 32-year-old who keeps wandering around as she tries to deal with her grief over having lost everything and then holding her grandmother in her arms as she died. The woman was too frail to make it. Now her own 11-year-old daughter is starting to have problems because she is concerned about what her mother is going through. The woman still refuses meds to help her relax because she is afraid to go to sleep.
I go back tomorrow at noon, and then again on Monday at 8 a.m.. We work in four hour shifts, but I did eight hours tonight. I'm tired now, and think I can go to sleep.
There are just so many people.
Susan
Sunday, September 5, 8:30 a.m.
I was so tired last night, and surprised that I had trouble falling asleep. It was probably after 3 a.m. before I finally fell asleep. I'm tired today, but ready to go back. They need so much help. There are just not enough mental health workers volunteering.
People won't generally just start talking. You have to start by asking them if you can get them anything, then follow through on what you said you'd do. Then they will start opening up. Usually, it's not even until much later in the conversation that I'd find out that they had something physically wrong that needed attending to. Then, they are hesitant to go over to the medical section to get help. They don't want to leave their family members or their belongings.
One man spent all day at the hospital getting his blood pressure meds, and pain meds for a kidney stone. He got back to the shelter, and then left his cot to go to the bathroom. When he came back, someone had taken his cot, all his belongings, and his medications. The papers with the diagnosis and prescriptions were in with his belongings. His blood pressure was over 220, and he was so upset, angry, and agitated. He said he lost his business and everything he owned. He kept saying that just when he thought it couldn't get any worse, it does. What little tiny bit he had managed to salvage was taken. Yet, he didn't want to leave the shelter. I had to convince him to go to back to the hospital.
Their problems keep getting compounded. It's very sad.
Susan
Monday, September 5, 2005, 6:30 p.m.
Yesterday, I thought maybe things were settling out. When I arrived around noon, there was so much less activity outside the arenas. But, it must be a function of the time of day, because when I left around 5 p.m., it was very crowded again with families and people’s belongings stacked on the sidewalk in trash bags. Yesterday, however, things were a bit more organized outside the Dallas Convention Center. Rather than have everyone entering at the same place, evacuees come and go in one entrance, volunteers line up to get registered at another entrance, and medical team members all enters at another. They wouldn't let people in without an official tag, but they ran out of these early, which created complications throughout the day.
Inside, things seemed a bit calmer; a function of people settling in to some sort of routine. However, now that people are starting to get registered for services, there were extremely loud announcements calling for various persons to come here or there. These happen quite often, and when they do they are so loud that you can't even hear the person standing next to you. The overall noise level is still quite high. The clothing has not been organized and just really started coming in yesterday, so people still don't have shoes and other things here. Their feet are so swollen and sore.
It is so different between the Dallas Convention Center and Reunion Arena. Our job at the Convention Center is to walk the floor and try to identify people in need of mental health services, particularly those that need meds.
Yesterday, I found a mentally retarded man who had been living semi-independently with his brother overseeing his care. His brother left early, and he chose to stay, but had to be evacuated from his home by boat when the water got about chest high. He is clearly traumatized by his experience, and what he subsequently went through and saw at the Superdome. He managed to make it to Dallas with the help of some neighbors. But, at the shelter here, he just sits. He is not independent enough to go seek out shoes, clothing, food, or other items; and had no idea about getting registered for housing or services that he will need. He wonders how he can get his money, and hopes that the bank he uses still has it; that it didn't get flooded and the money ruined. He has limited understanding of how to live independently, and has no other family. He is so well-behaved, and looks so pleasant that I wouldn't have identified him as someone who needed my assistance. I discovered him because I saw he needed help to open a small snack bag of Teddy Grahams. We started talking, and it became obvious to me that he was mentally challenged. Today is Tommy's birthday; he turns 48.
People want to be touched. They want the human contact of reassurance and compassion. It is an overarching theme. That, combined with not wanting to be abandoned. Several people I saw the day before came and found me as I worked. Some people sent others to find me if I didn't return quickly enough from whatever information I was trying to find for them. I never found E.J., the man from the day before that wanted me to come back and talk with him. He has MS. I kept going back to where I thought his bed was, and he was never there. There wasn't a very good organized accounting the day before of people coming and going. I'll try again the next time I'm scheduled to work there. I hope he is okay.
People need to be touched. It's such a simple thing.
And, yesterday, the Infectious Disease specialist told us that we are to stop touching people if it is not necessary
But it is necessary, isn't it?
Susan
Monday, September 5, 2005, 11:30 p.m.
I worked at Reunion Arena today. The contrast between there and the Convention Center is still so striking to me. Most of the people in need of psychiatric medication have been identified at Reunion, so they are stable but just need to be monitored and assisted. This probably changed today, since they were reportedly bringing in about 200 more people. I understand from the night shift that people are waking up screaming from time to time. One older gentleman became confused and disoriented last night. I suspect that he is demented, but I never had the opportunity to see him although I stayed an hour later than my shift waiting for him. No one knew where he had gone.
We now have the extra task of attending to the volunteers as well. We are to walk around the break areas and see how they are doing. Today, a National Guardsman broke down crying during his break. It is an emotionally intense time for everyone. It doesn't help much that the procedures change day by day. When you arrive for a new shift, none of the routines are the same as the day before. Understandable, but some added stress to have to re-learn how everything is supposed to work. We finally have a manageable system in place to keep more consistent track of people, their diagnosis/situation, and how it is being managed.
You meet inspiring people from time to time; I'm amazed at the resilience that some can have in the face of such adversity. I spoke with a 91-year-old woman as I helped her fold the blanket for her cot. (She's particular about how blankets are to be folded; there's a right way to do it I learned.) It's also encouraging to hear the bits of tangible progress being made by our efforts. A child was able to climb the steps to get to the bathroom area today, with minimal assistance. She has been afraid and unable to climb steps since the stairs in her home washed out from underneath her feet during the evacuation. The police have assisted us in desensitizing a young man to police presence in the shelter.
Still, other problems are more subtle. Some people seem not able to psychologically grasp that there is nothing left to go back to. Today, a schizophrenic woman tried to insist that I contact her pharmacy to find out about her prescriptions. She got separated from her son in the evacuation, and her stability seems tenuous without him by her side. I worked with a gentleman who previously worked on Bourbon Street as a saxophone player. He is holding out on leaving the shelter, thinking there may be some work for him in New Orleans, and that he will be able to return soon. His wife and severely mentally retarded brother are here in the shelter with him. They will probably get an offer for housing very soon. I believe that he is too anxious to leave the security and support of the shelter. He is almost constantly speaking with a volunteer, just to keep distracted. He will need help to transition out.
There are some who may have needed services before leaving New Orleans. I worked with a brain-injured woman who was injured years ago in a car wreck. I'm not certain she was functioning successfully before all this. She was so happy she was being helped at all she hugged me and kissed me on the cheek.
The outpouring of gratitude from these people is humbling. We are constantly being hugged, kissed, and thanked.
Thanked for being decent to another human being.
That says a lot.
Susan