Hurricane Katrina, 14 years after deployment

It’s a bit hard for me to believe, but 14 years ago right now, I was serving with the American Red Cross on Hurricane Katrina, providing disaster mental health services in the Gulf Coast. Many stories were written by those who responded to the disaster.  My account of my deployment was published in the July 2007 issue of Counseling Today, the monthly magazine from the American Counseling Association. I’m fortunate to still have the text of what was published, and I will copy that below.

The article speaks for itself, for the most part, but I can also see the experience within the larger context of my life. Going to Katrina was a “put up or shut up” moment. I think that I am brave and strong and caring and capable and good in a crisis, but am I really? It would have been tough to keep telling myself those stories if I hadn’t gone. Since that time, I have been tempted to decline things that I wanted to do because they seemed hard, or scary, but then I have come back to what I did in Alabama in 2007 and remember that this was and is who I am. I’m 14 years better than I was on Hurricane Katrina and I have to maintain the standard that I set for myself.

I served from 9/8/05 to 9/22/05, a period that encompasses the commemoration of the terrorist attacks on 9/11/01. I saw two connections between these events. The first, for me, was that I had wanted so badly to respond to the terrorist attacks, but I lacked the necessary qualifications and I could not get them in time to help. I sought the necessary training and the credentials and I was “ready,” if anyone can be, when Katrina struck. The other connection was that many of the volunteer leaders on Katrina gained their early experience and training by providing support to those who served at Ground Zero. As a field and as a country, we learned from the 9/11 attack and we used what we learned four years later.

This week, I have been thinking about the people whom I met in Alabama. I hope that they are OK, that they rebuilt and recovered. Everybody wants to talk about PTSD but the prevalence rates for natural disasters are lower than they for other kinds of events. I hope that the survivors and other volunteers moved on to good lives, and I hope that I helped.

Today I volunteer with about a half-dozen disaster response agencies in Pennsylvania, the Philadelphia region, and the State of Delaware. I have declined a few smaller deployments that I could not make for various reasons, and that’s understood and expected, but if my phone starts buzzing with calls and text messages then something bad has probably happened and I’m going to want to grab my identity badge and head out.

There’s probably more to say. I suspect that I want to post about what I remember from 9/11/01, too, but for now, here is what ran in Counseling Today in July 2007.

Reader Viewpoint – By Brendan Hickey 

The highs and lows of volunteering in the wake of natural disaster 

The news stories about Hurricane Katrina bothered me immediately, and I wanted to be bothered while doing something useful, so I faxed my application to the national office of the American Red Cross on Labor Day 2005. I returned home from work the following evening to a message that I was authorized to travel to Alabama. The message gave me directions on how to proceed and instructed me to arrive no later than Thursday. I had one day to prepare my employer, my fiancée and myself for a two-week commitment.

I thought I would return with ready stories about the impact of the storm on the Gulf Coast and its people. I thought it would be easy to help others see what I had seen, to guide and inform and motivate others to respond. By my third day of service, however, I knew any article or workshop would be long and hard in the preparation.

The easiest part of my story is a description of how and where I served. I flew to Montgomery, Ala., on the evening of Sept. 8, 2005, then went to the American Red Cross disaster relief regional headquarters, in a former Kmart building, the next morning. I went through orientation and processing that morning before riding with three other disaster mental health specialists to the American Red Cross chapter in Mobile. We received a brief introduction to the task ahead, then headed to our hotel in the slightly damaged resort town of Orange Beach. Hurricane Ivan had done considerable damage when it struck this region on Sept. 16, 2004, and, one year later, recovery efforts were variously complete, still happening or yet to begin.

I worked in three different service delivery sites from Sept. 10-15, then rested and did tourist things on Sept. 16. I spent the next day visiting the shelter at Citronelle United Methodist Church and preparing for reassignment there. I stayed at Citronelle on Sept. 18-19, leaving on the morning of the shelter’s last day.

On Sept. 20, I returned to Mobile, where I helped for a few hours at the Michael A. Figures Community Center shelter, which also closed that day. I then spent the night in Mobile, finished my discharge paperwork and traveled to Montgomery Sept. 21, returning home the next day.

Among those who served, my experience was not exceptional. I fulfilled the two-week obligation expected of mental health workers, but many volunteers served longer or under harsher conditions. I did not rescue the living or retrieve the dead, and others achieved more under worse circumstances. I am not a hero.

My responsibility was the mental health needs of those around me — American Red Cross volunteers, clients and other service professionals, including the police and security, medical and military personnel. I focused on clients with evident physical or emotional distress, responded to family service workers or other professionals reporting a client who seemed to need extra care and found a “private” place on the edge of a bustling room to spend a few focused minutes with anyone who needed it.

Normal behavior

A disaster is an awful thing, but not everything that happens because of a disaster is awful. Yes, there is death, destruction, agony, terror, cruelty, humiliation and disabling loss. But there is also hilarity and joy, beauty, generosity, honesty, courage, strength and faith. Where evil increases, grace also increases.

I served on Disaster Response 871, an identifying title that went on every form I completed. Each day I reported “significant contacts” — supportive interaction in 15-minute blocks — with hurricane survivors, American Red Cross volunteers and other support personnel. I shared hotel rooms with a fund-raising specialist from Springfield, Mo., and a psychologist from Elko, Nev. We stayed in the same hotels as insurance adjusters, whose morale was high, and staff from the Federal Emergency Management Agency, whose morale was not. I learned to “stand down” one day out of every seven and just how much can change in that one day. I also learned that a police officer can work “30 hours per day” for weeks on end, a statement I took for grim humor until an officer explained that he worked for 30 hours at a time before going home.

Nightmares were a staple, at least among the mental health workers. It was as if the bad dreams were issued along with the nametag and vest. I had my first nightmare on Sept. 10, and they continued for a few weeks after I returned home. Some evenings I found myself waking up every 90 minutes or so because of the dreams. Other times I slept straight through to morning, only to awaken and know that I had dreamed of horrible things all through the night.

This was normal. In fact, it was a reaction we taught Hurricane Katrina’s survivors to expect. We often had to persuade clients that they were not crazy. The post-traumatic stress disorder diagnosis appears to have ventured from the clinical realm and into pop culture, with the result that the experience of trauma is practically synonymous with instant mental illness. However, PTSD cannot be diagnosed prior to 30 days after the incident, and not everyone who has a traumatic experience will develop this condition.

Flashbacks, hypervigilance, avoidance and disruptions of sleep, energy and appetites are normal responses to trauma. A diagnosis of acute stress disorder can be made within 30 days of an incident, but rather than offering a label or a crutch, all the mental health workers I knew encouraged clients to anticipate the aforementioned symptoms and to expect their gradual decline with a detached interest during recovery. “Go easy on the carbohydrates, nicotine and alcohol. Get what sleep, exercise and good nutrition you can. Be gentle with yourself, but expect a gradual lessening of discomfort. Look for help if you still feel in a few months like you do now.”

Reaching out to help

We also turned the power of Hurricane Katrina and the natural chaos of the relief effort to the advantage of its survivors. Hundreds of individuals heard some variation of the following from me or other disaster mental health specialists: “You survived the worst natural disaster ever to hit this country, then you managed to find food and shelter and to take care of yourself and your family. You found a safe place to stay, then you found your way through the heat and crowds and different relief systems so that you could get some help. Once here, you could have stonewalled the family service worker, but instead you talked about the pain that you feel, and that brought you to me for additional support. It takes courage, strength, determination and intelligence to do what you did. We just met, but I know that you have those qualities, so I also know that you already have some of what you will need to rebuild your life.”

There is no time to use conventional therapy during a disaster. Instead we relied on Rogerian attitudes and whatever training we had in very brief, solution-oriented methods and crisis management. In a shelter, there may be a chance for repeated or longer conversations, but at a service delivery site, a “long contact” is 15 or 20 minutes with someone whom the mental health specialist will almost certainly not see again. After a disaster, a sandwich, a bottle of water and a few minutes of concerned and skilled attention in a safe, comfortable place are powerful therapeutic interventions.

I had a conversation with one woman who knew the five stages of grief as posited by Elisabeth Kubler-Ross. The client expected to receive a few days of therapy with me, during which time she thought she would move through each of the stages of grief so she could be strong for her family and get on with her life. She wanted to accept the entire disaster immediately and return to normal in less than a week because the fact of having lost something, and of becoming dependent, was a crisis in itself.

Worse off were those who faced serious problems before Katrina struck. I met a woman who buried her mother on Aug. 26. She was far from peace with this loss even before Katrina scattered what remained of her family. Another woman complained at first about the tree overhanging her home in what appeared to be either an objective problem or hypervigilance. As the conversation progressed, I realized she struggled with paranoid psychosis, in part because she thought her psychotropic medications were actually poison. She had two weeks of pills remaining on a prescription filled five months earlier. Katrina had not damaged her home, but the storm had strained and altered the community supports upon which she normally relied as she coped with chronic mental illness. Local social service agencies struggled to meet both their normal demands and those caused by the hurricane.

Persons with developmental disabilities — those whose sense of safety often relies upon a day filled with familiar and expected events and who may suffer considerable stress from a schedule disruption or a variation in support staff or a minor change in medication dosage — also felt the pain from Katrina more deeply than others. My encounters included a child with autism, a woman with Rett syndrome and a man with Down syndrome. Each had lost most of the elements of a life designed around their individualized needs. Added to the trauma of the disaster itself, these losses were a source of distress and increased their need for mental health services adapted for persons with developmental disabilities. Yet these clients found themselves in a disaster relief system doing all it could to meet simple and common needs.

The disaster relief effort became the dominant form of human service in the affected zones, and relief agencies often became human service generalists. The person already struggling with addiction in New Orleans or bipolar disorder in Gulfport, Miss., brought those struggles to the shelter in Alabama, and Katrina allied with the destructive forces in each. Non-local volunteers will typically leave within about three weeks, and shelters and service sites will eventually close, so we worked hard to build connections with the agencies and systems that would remain after we left.

The bond of volunteers

Many of us traveled thousands of miles — I met volunteers from Alaska and Britain — and stopped our own lives to offer help and share some of the discomfort of those who were affected. Often, the mere declaration of our volunteer status was enough to defuse a hostile situation. Yes, we knew that we would go home in a few weeks, but that fact gave us the strength to be useful and the luxury of being safely used up. To quote the rule for iron workers, “One hand for the company, one hand for yourself.”

A fast and close bond developed among the volunteers. Despite being an introvert given to glacial friendships, I feel incredibly close to about two-dozen colleagues with whom I shared only two weeks. I continue to feel that bond and know whom I would like to see on a future deployment, and I remain in touch with several friends. Any statement to the effect of “I would serve again with you” is considered high praise among relief workers. The intensity of the situation and the need to support each other, sometimes for actual survival, left no room for the petty grudges and other garbage that normally clog working relationships.

Most of my peers had stress-hardy personalities, which seems to be the self-selection aspect of a volunteer corps. It is not a common decision to take time away from family and friends, pleasures and responsibilities, and insert oneself into an environment that is often harsh, hazardous and unpredictable. I found a level of compassion and dedication that one might expect, but the volunteers who did well (which was almost all of them) were also flexible and patient, able to stay in the moment and capable of focusing on others’ needs instead of their own. They exhibited a sense of humor, alertness and a sense of their own competence. They seemed to search for adventure, seeing stress as excitement and uncertainty as an opportunity to explore something new. They remained energetic after consecutive 16-hour days. Some had to be ordered to take the one-day break that was earned for every six spent working. I saw sensitivity mixed with pragmatism and witnessed deep concern put to effective and powerful action.

Here to help, not complain

A disaster is no place for whiners, and there is no time for subtlety or passivity. If something failed five minutes ago, then you are five minutes too long in worrying about it. To anyone who disagreed with a particular rule or procedure, I advised simply waiting a few hours or maybe a day for it to change. Rare was the afternoon that resembled or honored the morning’s or previous day’s tradition.

So often in my life before Katrina, I would find myself thinking, “I need this, but …” or “This needs to happen, but …” On a disaster response, if you or another person needs something or an event needs to happen, then the only reasonable next step is to acquire the object or initiate the event. To paraphrase Gunnery Sgt. Tom Highway in the movie Heartbreak Ridge, one either improvises the solution or adapts to circumstances without the solution. Either way, you must overcome the problem and move on.

We had periods of inactivity, mostly caused by administrative adaptations to an incredibly dynamic situation. During these quiet times, I met a few volunteers who were stress-dependent rather than stress-hardy, determined to create chaos when the hurricane’s aftermath seemed insufficient. For some inclined to rush to a disaster zone, boredom is the greatest stressor.

At one point, I found myself in a tornado created by a probable histrionic personality and a narcissistic personality spinning around each other, with the circumstances drawing out the worst in each. During our first conversation, in an occupied break room, she disclosed untreated sexual trauma and a dramatically dysfunctional home life while accusing him of sexual harassment. He, in turn, ran past American Red Cross security and police to speak his “universal truth” to an angry crowd that could “never harm (him).” He later offered me therapy based on his “impressive insights” and “special knowledge” gleaned from a weekly abstract of the latest research in a variety of scientific fields, delivered right to his door. Happily, this twister was short-lived and the damage limited.

An established corporation can have periods of turbulence and confusion even in stable circumstances. The American Red Cross regional disaster headquarters in Montgomery did not exist in mid-August 2005; by mid-September, it was dispatching hundreds of volunteers — sometimes more than 1,000 — in a single day. “Relief” came from many sources, often with varying strategies and rules or, sometimes, none at all. Uncertainty seems reasonable following a disaster; so does the survivors’ need for certainty following the same.

Becoming targets for anger

Most service centers and shelters in Alabama became the focus of frustration and feelings of betrayal at some point in the weeks after the storm. Many Katrina survivors moved east along the Gulf Coast until they found towns and supports intact enough to offer help. In Mobile, I served people from New Orleans, Metairie, Kenner, Gulfport, Biloxi and other towns that were fixtures on cable news broadcasts after the hurricane.

Mobile had the dry tinder and the gusting winds, and the slightest spark — a car accident, a rattled volunteer, an exhausted police officer, any friction at all — potentially would have set the vicinity ablaze. At one point, my fiancée called to tell me she was watching — live, on CNN — large, angry crowds expected to riot just outside the Mobile Civic Center. Concerned, she asked where I was.

I was inside the Mobile Civic Center and dearly wishing that CNN was not outside. Otherwise, I might never have told her that story. Certainly, I had no intention of telling her while things were actually happening. I was honest with her about my location, though somewhat less forthright about my appraisal of the situation. The danger my friends and I were facing at that moment was real, though I cannot share the details.

On another occasion, I found myself inside a union hall with a stressed, angry father of six small children while a frustrated, confused, uncomfortable, enraged group gathered outside to pound on the doors. To break the tension, I taught the children a little bit of American Sign Language that my fiancée had taught me — hot dog, soda, French fries. That didn’t seem nutritious, though, so I added lettuce, carrot and celery to their vocabulary. The children were fascinated and learned quickly; presented with an occasion to feel proud of his children, the father relaxed a little. This was an odd idea that happened to work. I would have found something else if it had failed.

I remember thinking I was in danger many times and being extremely vigilant, but I also remember being too focused and too busy to feel afraid. When suitable, I did what I could to diffuse situations and lighten the mood with a handful of soon-overused jokes. To be honest, I don’t actually know what would happen if a set of jumper cables walked into a bar.

I cried once, during a communion service on the beach a few days before I demobilized. My few minutes of tears seemed garishly self-indulgent and likely would not have happened had I not been nearing the end of my commitment, when I allowed a bit more time for my own concerns, such as my flight home.

I used up three disposable cameras and kept something approximating a journal, but I wanted to remain clear about my purpose. There would be time enough for reflection later. While on deployment, I wanted to work.

For me, responding to Katrina was a hike to Walden. I spent my days deliberately, learned some of what life has to teach and lived a Spartan existence. Distractions and false dichotomies vanished, leaving only moments and choices.