Tuesday, September 06, 2005

DIARY OF A VOLUNTEER PSYCHOLOGIST - Dallas Reunion Arena

[The following are excerpts from a journal kept by Susan F. Franks, PhD, which were written about her experiences volunteering with the Hurricane Katrina survivors over the weekend. Dr. Franks is an associate professor in the Departments of Family Medicine and Psychology at the University of North Texas Health Sciences Center in Fort Worth.]


Written at 1am.

Wow. I am exhausted. I just got home about 15 minutes ago; worked until midnight at 2 different convention center shelters. One was huge, tense, and more chaotic than the other. Outside the arena, people are milling around looking for people. Police and National Guard everywhere. Camera crews, news reporters. It took me 30 minutes just to get through to a place to park once I got there.

At the larger convention center, there aren't enough cots or blankets. People have to use towels. Some of the bathrooms don't work, and there is no shower facility. A fight broke out inside while I was there; police took someone away in handcuffs.

There are so many people. Many of them don't trust anyone because of what happened in New Orleans, and so 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 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 6 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 her belongings. No one could find 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 didn't want me to leave her until someone came to pick her up to take her to her family. 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; too frail to make it; and then her own 11 year old daughter is starting to have problems because she is concerned about what her mother is going through.

I go back tomorrow at noon, and then again on Monday at 8am. We work in 4 hour shifts, but I did 8 hours tonight. I'm tired now, and think I can go to sleep.

There are just so many people.

Susan

Sunday, Sept. 4

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's just not enough mental health workers volunteering.

People won't generally just start talking. I have to start by asking them if I can get them anything, then follow through on what I said I'd do, and 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, Sept. 5

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 teams all enter 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 more calm, 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 his 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 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 want to be touched. It's such a simple thing.

And yesterday the infectious disease specialist told us that it looks like we are starting to see cases of diarrhea at the Convention Center. We are to stop touching people if it is not necessary. But, it is necessary, isn't it?

I'm at Reunion Arena today.

Susan

Sept. 5

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 though 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 managable 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 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 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 woman who suffered brain damage 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

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