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It's MORNING EDITION, from NPR News. I'm Steve Inskeep.
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And I'm Renee Montagne.
Today in "Your Health," a story about the psychological health of a city. Shortly after Hurricane Katrina hit, NPR's Alix Spiegel spent time in New Orleans, riding around in ambulances with Emergency Medical Service workers who were answering suicide calls.
For our coverage marking the fifth anniversary of the storm, Alix went back again and rode with the Orleans Parish EMS. In some ways, what she found was radically different; in other ways, sadly familiar.
ALIX SPIEGEL: On a recent Tuesday night, EMS worker Josh Bell glanced at the sky through the windshield of his van, then warned his colleague Nina Breakstone that rain was on the way. He pointed at the clouds. They looked dark. Breakstone, a 27-year-old training to be an ER doctor, was unimpressed.
Ms. NINA BREAKSTONE: Maybe it'll rain bullets. God, I hope so.
SPIEGEL: EMS shifts, you see, are 12 hours long - a slog. And interesting injuries make the time go faster. And so as they waited for a rain of bullets to save them from boredom, Josh and Nina and a trainee named Dave passed the time another way. Like thousands of New Orleans residents before them, they spent the night arguing about their favorite restaurants.
Ms. BREAKSTONE: Oh, Commanders, weekday brunch with the 25-cent martinis.
Unidentified Man #1: That's the only reason you're going, is the 25-cent martinis.
Unidentified Man #2: What?
Ms. BREAKSTONE: Martinis.
Unidentified Man #2: Get the - out of here.
Unidentified Man #1: Yes.
SPIEGEL: They argued about restaurants. Then they argued about bars. It was a very slow night. A man fell off his bicycle; another had trouble breathing. Finally, an interesting call came over the radio: a serious injury from assault. Nina perked up.
Ms. BREAKSTONE: Sweet.
SPIEGEL: But once they�got there, the scene was disappointing: a teenager complaining of a twisted ankle. Back in the van, Breakstone stared out the window, clearly frustrated.
Ms. BREAKSTONE: Saving lives - that's what we do.
SPIEGEL: Five years ago, my drive with EMS in a nearby parish could not have been more different. There was no talk of 25-cent martinis, no yearning for more exciting cases. The EMS workers I rode with were haunted. They told me they were seeing two or three suicide attempts a day. And even when the calls were routine, as Josh Bell says, it was impossible to escape Katrina.
Mr. JOSH BELL (EMS): Every time we encountered somebody in a patient-type relationship, it was: This happened to me during the storm or, you know, I haven't had my medications because I've been in some other city or, I just moved back from some other city where I was displaced, and I don't have any medical care.
SPIEGEL: But today, Bell doesn't hear about Katrina in the same way.
Mr. BELL: It's occasional. I wouldn't say it's frequent. I wouldn't even say it would be once a day. I mean, unless I bring it up to somebody, it's pretty rare.
SPIEGEL: Today, it's at least possible to live a life in New Orleans without constantly being confronted with the storm. But that doesn't mean that Katrina is gone.
Around 10 at night, Nina Breakstone tells this story. Recently, she was jogging near her home when she noticed a plaque a couple blocks from her house. It was the Vera memorial. Vera was a woman killed during Katrina whose dead body lay in the street for days before her neighbors finally decided they would bury her. Breakstone said she was shocked to see it there.
Ms. BREAKSTONE: I just - I'd been by this corner a thousand times. Like I said, it's all of three blocks from my house. And I never noticed that it's just - it's right there. So that's - I feel like that's what happens here. You don't think about Katrina. You don't notice Katrina and then all of a sudden, it's right next to you.
SPIEGEL: Twenty-five cent martinis are on offer at Commanders. Much of the city has been rebuilt, but traces of Katrina are still around. One of those traces, some people argue, is the suicide rate in Orleans Parish. In 2008 and 2009, the rate of suicide was about twice as high as it was the two years before the levees broke. The rate of suicides in Orleans Parish has basically doubled.
Ms. ELIZABETH LOGAN: Five weeks ago, my son had called me up. Usually when he calls, he, you know, says, hey, mama, how you doing? But that day, I could tell something was on his mind.
SPIEGEL: Elizabeth Logan is the mother of four boys, a small- business owner, a conscientious volunteer at her children's school. And her son Lonnie, who's 23, is also a conscientious person, the kind of son who calls his mother every day. But Elizabeth says since Katrina, Lonnie has been having a hard time.�Then, five weeks ago, he called her with more bad news. His best friend had committed suicide.
Ms. LOGAN: And he was saying, I just saw him, mama. I just saw him. We were supposed to go out and everything. And then he, you know, did this. So he cried. I mean, he cried for days, you know.
SPIEGEL: Now here's the thing about the suicide of Lonnie's friend:�It wasn't the first - not by a long shot.
Ms. LOGAN: This made the fourth one. A year after Katrina, you know, that's when he started losing friends - one every year since after the storm.
SPIEGEL: Three boys, one girl, four suicides. Now, it's always, always hard to know why someone commits suicide. And certainly, five years after Katrina, it would be impossible to pin blame on Katrina alone. At this point, it's multi-factorial.
But Elizabeth has her suspicions. She feels the stress of Katrina, and the altered circumstances it left behind, can take a toll.
Ms. LOGAN: You know, Katrina just changed everybody.
SPIEGEL: To make her point, Elizabeth points to her own son, Lonnie.
Ms. LOGAN: I know my son went from going to college and, you know, he was going to UNO, and then when the storm came, he had to transfer to LSU. But then he wasn't really concentrating, so he just got out, you know, because he couldn't concentrate because we all lived in a trailer. There was five of us living in one of those FEMA trailers. And he just felt that he needed to go to work, you know, to help us out, because we were struggling. I think that if it Katrina wouldn't have came, he would've graduated like all his other peers did.
SPIEGEL: Lonnie was always a sweet kid, Elizabeth says. But these days, her son is very clearly depressed. He very rarely leaves his home, except to go to work. The stress of everything - of reduced prospects, of lost friends - wears on him.
Ms. LOGAN: It's just eating him up. You know, it worries me because, you know, will he hurt himself, you know. And he says that sometimes he does think about it, but then he thinks about me and my husband and his brothers - you know, what would we do without him? You know. But I do worry about him. I just think he needs to talk to someone, you know, so he can get some relief.
SPIEGEL: But finding relief these days from a mental health professional in New Orleans isn't an easy thing to do.
Dr. JULLIETTE SAUSSY (Director, Medical Director, New Orleans EMS): There is still a lot of struggle that goes on here, and there's still a lot of brokenness. I mean, I'm reminded - every time this BlackBerry goes off, it's a reminder of somebody out there that's suffering.
SPIEGEL: This is Julliette Saussy. Saussy runs the Orleans Parish EMS. And every time someone in the city of New Orleans hurts themselves or someone else, the BlackBerry on her hip vibrates. It vibrates too often for Saussy. Saussy is not only the EMS administrator, but also a doctor who goes out at least once a week to take care of people. And she says that what's intensely frustrating about her work these days is that when she encounters someone who needs psychological help, there's almost nothing that she can do with them.
After the storm, the state closed Charity - its biggest public hospital - and also the adolescent mental health facility, and in the process, lost hundreds of mental health professionals and many psychiatric beds.
Dr. SAUSSY: We had a very robust mental health system here. It wasn't perfect, don't get me wrong. There was nothing perfect about the system. But it worked, and it worked for the people here. They had access to care. They don't have that anymore.
SPIEGEL: This, in Saussy's view, is part of the reason that the suicide rate in her parish continues to be twice as high as it was before the storm. It's not just that people are in pain. It's that there's almost nothing for them.
Dr. SAUSSY: Think it's a perfect storm. I think you subject people to terrible trauma, and then you take away all their mental health resources. What do you expect?
SPIEGEL: New Orleans, Saussy says, is better. There is no question about it. It's not the broken city it was five years ago. But the BlackBerry on Saussy's hip continues its buzzing - a small reminder that New Orleans still has a ways to go.
Alix Spiegel, NPR News, Washington.
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