RACHEL MARTIN, HOST:
This is WEEKEND EDITION from NPR News. I'm Rachel Martin. President Obama is scheduled to visit Moore, Oklahoma today, the site of Monday's tornado that killed 24 people and destroyed or damaged thousands of homes and businesses. One of the many challenges facing the residents of Moore is dealing with the emotional aftermath of the trauma. NPR's Ted Robbins spent time with a family doctor in Moore who's trying to take care of his patients while weighing tough choices for himself.
TED ROBBINS, BYLINE: Keith Layne is a young-looking 46-year-old in jeans and a red T-shirt. His practice has 2,500 patients and a staff of seven, but no office.
DR. KEITH LAYNE: No, there's nothing. Zip, nada, zilch.
ROBBINS: The ranch-style clinic was swept away, down to and including most of the flooring. Everyone left before the tornado hit. He agrees with the survivors' initial reaction: what was lost were just things. But then it sinks in that those things have meaning.
LAYNE: This empty concrete pad represented the culmination of the work that I put into my life. This was everything I had built.
(SOUNDBITE OF CASH REGISTER)
UNIDENTIFIED WOMAN: This is your change.
ROBBINS: Since the tornado, Keith Layne has been working out of the Blue Bean Coffee Shop, a couple of blocks north of the damaged area. Owner Danae Leverett won't let him pay for his smoothies. Leverett's mother and sister are patients of Layne.
LAYNE: Today's Saturday, OK.
DANAE LEVERETT: Hard to keep track, isn't it?
ROBBINS: First thing Layne did was get Internet phones for his staff so they could answer patients' calls. Then he arranged for rooms at a lawyer friend's offices to treat people starting Tuesday. He wants to treat patients, and if he doesn't he could lose his practice.
LAYNE: After about two to three weeks, if there isn't some income significantly coming in, we're going to have a real financial problem. And from a small business perspective, it may not be surmountable.
ROBBINS: He needs to stay in business to help his patients deal with the stress of the tornado.
LAYNE: The wounds will heal, the bones will mend and the debris will be carried away and some of the things will be reconstructed, but the problems come down the road. The problems come with the deep-seated damage that gets done to our belief structures and our confidence in ourselves and in our world.
ROBBINS: Keith Layne is acutely aware of the studies showing early treatment of posttraumatic stress helps head off problems longer term - whether that help is from a doctor, a counselor or a pastor. Oklahomans wants to move on, he says, but he's seen what happens when they do it without getting help.
LAYNE: It shows up in your ability. It shows up in seasonal mood changes, shows up in memory problems, shows up in insomnia, shows up in alcohol, shows up in violence. I can rattle off the patients I've seen this with.
ROBBINS: He's having problems. Dozens of dead horses and dogs horribly mangled were strewn outside his office. Their remains are gone now, but he's constantly reminded of the sight.
LAYNE: When I drive past the field of horses I see that. And I see that every time I drive anywhere, because we're in Oklahoma. We like horses. So, the smart answer for me is to do something about that now. And I haven't yet.
ROBBINS: For God's sakes, it's only been five days.
LAYNE: Yeah, well, you know.
ROBBINS: Give yourself a break.
LAYNE: Ah, well, you know, we're not good at that either here. Like I said, we're not real good at taking help; we're good at giving it.
ROBBINS: Oklahomans handled this emergency expertly. It's the long term they need to deal with now. Ted Robbins, NPR News, Moore, Oklahoma.
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