Accounts From the Front Lines

Among those volunteering to provide mental health services after Hurricane Katrina was the Massachusetts husband-and-wife team of psychiatrist Jay H. Holtzman, M.D., chief of psychiatry at Cooley-Dickinson Hospital, part of the Dartmouth-Mary Hitchcock Alliance, and psychotherapist Rorry Zahourek, Ph.D., A.P.R.N., B.C., who served in both New Orleans and Baton Rouge at an evacuation center. Below are edited excerpts from the e-mailed diary they sent to friends.

New Orleans—Everywhere we saw people looking at or going through their houses, actually, their rubble. We stopped and offered them water, snacks, masks to prevent inhaling crud, and just made some small talk. Don't know whether we helped, but most of them seemed happy to talk with us, share their stories and sometimes their photos, and expressed real gratitude that we had come down to help out where we could. We realized after a few days of this, that this was “Disaster Psychiatry.”

—Holtzman

Baton Rouge—People who had mental health problems before are really suffering now—many don't have their meds, and others are so traumatized they are not doing well. The three I saw today were remarkable. One woman with a long history of psychosis said this was the first crisis of her life that she didn't go back into the hospital. Another schizophrenic woman who just had had a mastectomy for breast cancer the beginning of August was doing relatively well. A severely drug-addicted, alcoholic woman said this was the closest she has been to her children in many years, and so, in a crazy way, the storm may be a blessing.

—Zahourek

New Orleans—One thing that I don't see written about is the degree of trauma and destruction to the mental health infrastructure in New Orleans. Not only have the clinics and hospitals been destroyed, but also the staffs have been displaced and made homeless. Many are still living in hotels and are themselves struggling with FEMA and insurance.

—Zahourek

Baton Rouge—It is frustrating to know that we could be doing more if the local agencies weren't so battered that they are having trouble using us efficiently, but that's part of the devastation. I believe that understanding that, going with it, and being flexible and creative about how you can best function and contribute is essential to feeling positive about disaster work.

—Zahourek