On a recent Tuesday night, emergency medical services 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 hanging above the New Orleans skyline. They looked dark.
Breakstone, a 27-year-old training to be an ER doctor, was unimpressed.
"Maybe it'll rain bullets," she said flatly. "God, I hope so."
EMS shifts are 12 hours long and are often a slog. Interesting injuries not only give you more experience, but they also have a fringe benefit: They make the time go faster.
And so as they waited for a rain of bullets to divert them from their boredom, Bell and Breakstone and a trainee named Dave passed the time another way. Like thousands of New Orleans residents before them, they spent their night reviewing their favorite restaurants.
"Commander's weekday brunch with the 25-cent martinis!" Breakstone said.
"That's the only reason you're going, is the 25-cent martinis," Bell countered.
"Get the [expletive] out of here," Dave said.
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. Breakstone temporarily perked up.
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.
"Saving lives," she said, her voice dripping with irony. "That's what we do."
A Completely Different Kind Of Ride
Five years ago, I went on a similar drive with EMS workers in a nearby parish, and the experience 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. In fact, there was one the very first hour I was in the car.
And even when the calls were routine, as Bell will tell you, it was impossible to escape Katrina.
"Every time we encountered somebody in a patient-type relationship," Bell says, "it was, 'This happened to me during the storm,' or 'I haven't had my medications because I've been in some other city,' or 'I just moved back, and I don't have any medical care.'"
I think it's a perfect storm. You subject people to terrible trauma, and then you take away all their mental health resources. What do you expect?
But today, Bell says, he doesn't hear about Katrina in the same way.
"It's occasional," Bell says. "I wouldn't say it's frequent. I wouldn't even say it's once a day. I mean, unless I bring it up with someone, it's pretty rare."
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 p.m., Breakstone tells this story:
Recently, she was jogging near her home when she noticed a plaque a couple of 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.
"I just had been by this corner a thousand times, and I had never noticed it's right there," she says. "I feel like that's what happens here. You don't think about Katrina. You don't notice Katrina. Then all of a sudden it's right next to you."
Twenty-five cent martinis are an offer at Commander's, and 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.
Lonnie's Story
"Five weeks ago, my son had called me up," says Elizabeth Logan. "Usually when he calls he says, 'Hey Mom, how you doing?' But that day I could tell that something was on his mind."
Logan is the mother of four boys. She's a small-business owner and a conscientious volunteer at her children's school.
And her son Lonnie, who is 23, is also a conscientious person, the kind of son who calls his mother every day.
But Logan says that since Katrina, Lonnie has been having a hard time. Five weeks ago, he called her with more bad news. His best friend had committed suicide.
"He was saying, 'I just saw him, Momma! I just saw him! We were supposed to go out!' " Logan says. She says her son cried for days after he found out, and for good reason: This was not the first suicide by one of Lonnie's good friends -- it was the fourth.
"A year after Katrina -- that's when he started losing friends," Logan says. "One every year since after the storm."
Three boys, one girl. Four suicides.
It's 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, at a minimum, it's multifactorial.
But Logan has her suspicions. She feels that the stress of Katrina and the altered circumstances it left behind can take a toll.
"Katrina just changed everybody," she says. To make her point, Logan points to her own son, Lonnie.
Before Katrina, Lonnie was going to college -- the University of New Orleans. But after the storm, he had to transfer to Louisiana State University.
Then Lonnie had trouble concentrating. At that point, the family was living in a FEMA trailer -- five people sardined into a tiny space. So Lonnie decided to drop out of school.
"He just felt like he needed to go to work to help us out," Logan says. "Because we were struggling. I think if it hadn't been for Katrina, he would have graduated like all his other peers did."
Lonnie was always a sweet kid, Logan says. But these days her son is very clearly depressed.
He rarely leaves his home, except to go to work. The stress of everything -- of reduced prospects, of lost friends -- wears on him. And Logan says that she's now worried that Lonnie will take his own life.
"He says that sometimes he does think about it," Logan says. "But then he thinks about me and my husband and his brothers. You know, what would we do without him? I worry about him. I just think he needs to talk to someone so he can get some relief."
A Fragmented Mental Health System
But these days, finding relief from a mental health professional in New Orleans isn't an easy thing to do.
Jullette 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. And it vibrates far too often for her.
Saussy is not only the EMS administrator, but she's also a doctor who goes out at least once a week to take care of people. She says that what's intensely frustrating about her work these days is that when she encounters someone who needs psychological help, there is almost nothing she can do with them.
After the storm, the state closed Charity Hospital -- one of the city's largest public hospitals -- and also the adolescent mental health facility. In the process, the city lost hundreds of mental health professionals and dozens of psychiatric beds.
"We had a very robust mental health system here," Saussy says. "It wasn't perfect -- don't get me wrong. There was nothing perfect about the system. But it worked for the people here. They had access to care. They don't have that anymore."
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.
"I think it's a perfect storm," Saussy says. "You subject people to terrible trauma and then you take away all their mental health resources. What do you expect?"
New Orleans, Saussy says, is clearly better. There's no question about it. It's not the broken city it was five years ago, but the BlackBerry on her hip continues its buzzing -- a small reminder that New Orleans still has a ways to go.
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