Down in New Orleans

Published in: Health Affairs, v. 26, no. 5, Sep./Oct. 2007, p. 1426-1430

Posted on RAND.org on January 01, 2007

by Benjamin Springgate

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Everyone is vulnerable. One day we can be fine, the next day we're definitely not. On 29 August 2005, Hurricane Katrina slammed ashore in New Orleans, rending levees, flooding much of the city, and leaving death and devastation. Now, two years later, the city still struggles to regain its footing. Progress is slow, and dislocation remains a prominent feature of life. Sleeplessness, depression, and fullblown post-traumatic stress disorder are a part of life for many. Physician Ben Springgate, a New Orleans native, returned to his hometown to help after Hurricane Katrina, and he's still there, still helping. His patients are exhausted, he tells us, and so is he. Meanwhile, writer Judy Karasik knows what it means to deal with an ongoing vulnerable medical reality. Her fifty-nine-year-old brother, David, has autism and mental retardation, disabilities that have always been a part of her life. Now, with their mother approaching age ninety, Judy is taking on a new role: sibling advocate for David. Instead of having him become increasingly unconnected to anything but his private world, she wants him to have a job, to be with others, to make a contribution. But systems that could work to help employ people like David are piecemeal and improvisatory, leaving Judy, her family--and us--unsure about what tomorrow will bring.

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