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The contents of this website are for contemplative purposes only. No medical advice will be given, and emails asking for medical advice will be ignored.

Although patient vignettes are based on my experiences with real individuals, I liberally change details to maintain patient confidentiality.

I also reserve the right to change old postings to correct errors, and to delete comments that include obscene language or that I deem abusive to me or other commentators.  If you are looking for a open mind, I suggest you consult a neurosurgeon.


Climate Change: A Parable

All of the people who deny climate change and the danger it poses put me in mind of a story.

Once upon a time there was a scientist who studied various cultures. He traveled far and wide in his studies, and one day took a journey on a ship that landed on a remote island.

Despite its remoteness, the civilization was fairly advanced. People lived comfortably, and there was enough food for everyone. However, the scientist noticed that there were very few trees on the island. Looking closer at the land, he saw many tree stumps, and realized that at one time the island was lush and green. But today, all the trees, except for a handful, had been cut down.

He saw that the islanders had no plans to save the few trees that were left, and if things continued in this way, the trees would all soon be gone.

The scientist sought out one of the leaders on the island and asked him about this. "I can see that your island was  once lush and green, and covered with trees. You seem to have cut them all down, except for a very few. Soon you will have no trees at all. Why have you cut them all down?"

The man said, "Look around you! We have an advanced civilization. With our technology we have been able to make wonderful things for ourselves, and to live comfortably."

"Yes," the scientist said, "but what does that have to do with the trees?"

"My good friend," the man said patiently, "many centuries ago, we were a primitive people. We needed trees to provide shade from the sun and protection from the weather. But now that we are so advanced, we have comfortable homes, and have no need for the protection of trees."

"Ah," said the scientist, "I see. What do you build your beautiful homes out of?"

"Wood," the man said.


Writing with Pen and Paper

Lately I have been reading The Artist's Way by Julia Cameron, a book that, although ostensibly about the craft of writing, is deep down about the practical problem of curing writer's block.

Ms. Cameron strongly advocates that all artists should engage in an activity she calls "Morning Pages," which consists of 3 pages of uninterrupted longhand writing, to be performed every morning as soon as the writer wakes up. Morning Pages must be stream-of-consciousness writing, set down as fast as the writer can go, must be ink-on-paper and not typed, and must be done daily, first thing in the morning. A fairly strict exercise, to say the least.

I have been trying out Morning Pages for the last few weeks, and have formed a few opinions about the practice. First, while it would be nice to open a day with 30 minutes of writing, this is not possible for me with my job. When I am off, I can do it. On workdays, forget it. It gets done when it gets done, and that is not always in the morning. Second, every day is not possible either. I do it when I can and leave it at that. Thirty minutes is a lot of time, and some days I don't have 30 uninterrupted minutes to spare. (I may have 30 minutes, but all in one block is another thing entirely.)

I do, however, like Cameron's prescription that the Morning Pages be stream-of-consciousness writing, getting words down as fast as possible, as soon as the words come into my head. This, in my view, is critical to Morning Pages, because stream-of-consciousness writing helps the writer to overcome that internal editor that often stands between an artist and a blank page. Stream-of-conciousness also is an efficient way to empty the mind each day, and helps me clear my brain of random thoughts. It is a daily brain dump that gets a lot of rattling concepts out onto paper, distractors that otherwise hinder clear thinking. Morning Pages sets the stage for more constructive writing.

And as a side benefit, it also leaves a written record of this cathatic process, so, if any of the results of the brain dump turn out to be worth keeping after all, I can recover them for later use.

But what I like best about the Morning Pages is Cameron's Luddite insistence that the pages must be done on pen and paper. No computer, no typewriter, and, God forbid, no e-tablets or Dragon Dictates. Just plain old pen and paper.

This has been unexpectedly valuable to me. The Morning Pages, it turns out, are something of a meditation exercise. A way to mechanically, methodically, focus on the process of writing for a finite period of time each day. Essentially, meditation through writing.

And when I do it, I find the best way to push myself through 3 written pages of stream-of-consciousness writing is to focus my attention of the tip of the pen as I write. As I fix my mind on the tip of the pen, the pen becomes the conduit of my mind, the contact point where ideas and the muscular contractions of my forearm and hand become sentences. Because I can focus all my attention in one place, at the pen point, I can develop much better than normal concentration on the writing process.

Compare this to writing at the computer. When I write on a computer, my attention is focused on my fingertips where they contact the keyboard, and also at the cursor on the computer screen. My attention is not in one place; it is divided between two. I can remedy this problem partially with touch typing -- by looking solely at the screen instead of at the keyboard, I can keep my attention mainly on the cursor on the screen. This works until I misspell a word.

But it is not the same as pen-and-paper. Even with optimal touch typing, my mind is still somewhat divided between fingertip and cursor, and this slight division makes a difference in my level of concentration. For the purpose of meditative writing, pen and paper is superior. Meditation is, after all, about developing focus, and centering everything on a pen tip is about as focused as one can get.

This raises the question: If this is so, does this mean that all writing should be done longhand?

I don't think so. That obviously takes a good idea too far. However, I do think it would be beneficial for writers if every important writing project involved pen and paper at some stage. An initial rough draft in longhand, longhand notes on index cards, an outline, a hard copy with pencilled in revisions -- at some stage, every bit of writing could involve pen and paper, even if the bulk of the work is computerized. This step could help writers focus on their writing, perhaps improving clarity and concision.

Would it improve the quality of writing in general? There are no studies to show, but my intuition is that it may not. There has been, in the last 20-30 years, a gradual shift from longhand writing to digital creations, and there has been no discernible difference in writing quality over this period. Sure, you will find critics who argue that the quality of writing in the digital age is going to hell, but I defy any of them to pick up a book off any shelf and tell me if it was written on a word processor or by hand. It can't be done.

I think the benefit of longhand writing accrues not the the reader, but to the writer. That is to say, writers should engage in longhand writing from time to time, not because it will improve the quality of their product, but because it make the writing process more enjoyable and therapeutic for the writer.

Since the writing process is a something of a journey, we can compare it to travel. If you travel from your own home to a friend's home, does it matter to him if you took the bus, your own car, or a bike? No, not at all. But it matters to you. The difference between a cycling trip, a walk, or a car ride is significant. On a bike, you feel the wind, the rain, the temperature. You have to be much more mindful of pedestrians, wet roads, mud, and the cold than you do if you ride in a car.

Auto drivers generally consider travel time to be dead time. In a car, you listen to music, adjust the climate control, and think about your destination. On a bike, you check the weather before you leave, both for the time you leave and for the time you will be coming back. You feel the wind, notice the hills, and curse at the indifferent motorist who cut you off. On a bike, you are much more focused on what you are doing than if you drive. The experience is entirely different, even if it has no effect on what happens when you arrive at your friend's house.

This, I think, is also true of longhand writing. Handwriting is more laborious, more careful, and you are aware of more things as you do it. You notice the sensation of your hand on the paper, the flow of the pen, the texture of the page, the ink smears as you write. When you dot the i's and cross the t's (or if you do). When your hand gets tired. The tactile effect the handwriting process has on the writer is much different from more clinical experience of cranking out words on a word processor.

I am not advocating abandoning the computer. I wrote this article entirely on the computer. (Nor would I advocate abandoning cars for every purpose and only relying on the bicycle.) But pen-on-paper is a different traveling experience from computer writing, and if you are the type of writer who writes not only to create product but also to allow the writing process to change you (which is the way I think all writing ought to be), then spending some time with pen and paper will benefit you. It forces you to pay closer attention to every word as it curls out, and puts you in more organic, concentrated, and undistracted connection with the writing process. It makes the writing process more present.

I know of no word that better describes it than presence, being in the moment, and thus being more completely in the writing. Pen and paper writing can take you to places in your mind that digital writing is not likely to lead you.

But like all writing craft, this sense of presence does not emerge immediately. You have to do it daily, and exercise it until, in time, it exercises you.





Katrina, Ten Years Later


This blog began in October of 2005, two months after Hurricane Katrina hit New Orleans and the Mississippi Gulf Coast. I started the blog to write about Katrina and its aftermath, which was a subject very close to me. At the time, I was living in my mother-in-law’s house in Metairie, Louisiana, one of New Orleans’s suburbs, because my house had been flooded with 12 feet of water, and a declared state of emergency prevented us from returning to our home in St. Bernard, because St. Bernard was still considered too dangerous for civillians to visit.

As I recall, the precise impetus was an online post. My mother-in-law didn’t have internet service, so I found one of those AOL CDs that gave you 500 free online hours (yes, it was that long ago) and logged in through dialup. On one of the AOL main pages was a link that said, “Is America Getting Katrina Fatigue?” The link connected me to a forum where posters were complaining that New Orleans had received enough money and it was time to move on. On to the next human disaster, I guess; the next American rubbernecking opportunity, brought to you by your favorite cable outlet. It was the end of October, mind you, not even 60 days after the storm. Half the city didn’t have electricity yet. But floods and hurricanes were so…you know, summer of 2005.

I joined the discussion, identifying myself as a displaced storm victim, and tried to gently push back. This storm was bigger than you know, I said. Over a million people have been affected. They will need time.

The responses I got were casually dismissive -- get a life pal, just move away to high ground, good luck but I pay taxes and we’ve paid enough, so long NOLA and thanks for the redfish -- that sort of thing.

That was when I decided to tell my story, to explain what happened in New Orleans, and why America needed to step up and help one of America’s more remarkable and fascinating cities. I started a blog.

That was 344 blog posts ago.

When I started writing about Katrina, there were dozens, perhaps hundreds of people online just like me, writing about their experiences. There were so many of us that there was talk of creating a Katrina Blogging Association, and from what I heard there was even a planning meeting to get the Association off the ground. But, as is so often true, enthusiasm for new the project peaked at the beginning, and as soon as the first anniversary passed, blogs began to fold and disappear. Today, besides me, I don’t know of anyone in this group who has continually written since 2005.

Despite my longevity, I cannot claim that even I have maintained a laser focus, and over the years my posts have been less and less often about the New Orleans recovery and more and more about whatever else was on my mind. But Katrina has never been far from my thoughts, and I have always returned to it. Like it or not, it was one of the defining moments of my life, and I am certain for the rest of my days I will think of my life as having two halves: Before Katrina and After Katrina. No one goes through something like that without being effected by it.

As the last man standing, I can tell you that even though blogs have gone out of style in favor of Facebook and Twitter and Tumblr and whatever else is coming next, I still prefer the freedom of this medium and have no intention of stopping any time soon. I hope to be writing about Katrina’s 20th anniversary, and the 25th as well. There is no reason for me to stop. It has been therapeutic work.

My family belongs to that part of the Katrina diaspora that never returned to New Orleans. Right after the storm, I would not have considered not coming back, but things didn’t turn out as I had planned.

Before the storm, I was working in St. Bernard Parish — a parish being Louisiana’s equivalent to a county — just east of New Orleans. St. Bernard was devastated as badly as any area hit by the storm; about 90% of the land in the entire parish was flooded. The parish was closed to residents for almost 2 months after the storm because all of the roads were impassible and it was unsafe for people to live there, or even visit. (Hence my exile to my mother-in-law's house.)

I admitted patients to two hospitals in the St. Bernard region and worked at an outpatient primary care clinic across the street from one of them, a 150-bed facility named Chalmette Medical Center. After the storm, the company that owned both of the hospitals, Universal Health Services of Pennsylvania, decided to cut its losses and never to reopen. That left me without a job. Facing student loan payments that the U.S. Government politely refused to offer an emergency deferment for, I took a job in McComb, Mississippi, about 100 miles north. After three years, I relocated to Jackson, MS, 200 miles from New Orleans, which is where I am now.

My job in McComb was a little better than the job I had in Chalmette, and my job as a hospitalist in Jackson has been much better for me than my job in McComb. If I had returned to St. Bernard, I would still be doing outpatient medicine instead of the inpatient medicine I am doing now, because St. Bernard did not have a hospital and would not get one again until 2013. Once I decided I liked hospital work better than the clinic, there was no opportunity for me to go back, because there was no hospital in my old community to go back to.

Overall, the drift 200 miles north allowed me to change my career arc, going from mainly outpatient medicine to 100% inpatient. The change agrees with me, and so I find, a decade later, whether I like it or not, that Katrina opened the door to a career path that has been better for me more than I ever would have thought.

This is one of Katrina's lessons. Change is often good, even if it is painful. New Orleans was always a city that resisted change, sometimes with a supernatural fury. Outside of the South, it is probably very difficult for most Americans to appreciate how little New Orleans wanted to change before Katrina. New Orleans was a place that treasured the tiles in the cracked sidewalks that spelled out the names of the streets. It was a place where a restaurant could trigger a customer revolt by changing its menu. Parents sent their kids to the same schools they went to, and their kids sent their kids to the same school again. Moving out of a neighborhood was the act of an expatriate. Half of the cultural calendar revolved around a social behemoth called Carnival, and the other half around a series of outdoor festivals that ran through the spring and fall. It was cozy, but closed. If you weren’t a native, it was nice to stand on a corner in the French Quarter with a hurricane (the rum drink) in hand and take it all in, but if you stayed — and for most people the crime rate was way too high and the schools way too bad to consider a thing as rash as that — but if you did, it would take years for you to break through and understand it. It was beautiful, and crazy, and closed, and corrupt, and violent, and poor.

New Orleans had to change, just as I had to. Some of the change Katrina brought has been good, some of it bad. But on balance the change has been good, because it has shown so many people in the city that change is possible, and that it is also possible to let go of things that seemed very dear, too dear to be parted with, and yet go on.

It is hard. It is necessary.

As a physician, I feel I have something to add here. Taking care of hospitalized patients all the time, I see death up close, sometimes on a weekly basis. I have personally witnessed the death of a patient probably 20 times now. About once a week I have to walk into a room and tell a patient he or she has terminal cancer. It is not something you ever get used to. But it is necessary. Death is necessary.

If no one ever died, there could never be change. Imagine if the plantation slaveholders were still alive today. If the Nazis still lived. If the ancient Romans still walked among us. How could we, with people like this in our midst, move forward? Humans can adapt to change, and some humans are better at it than others, but no person is capable of infinite change. So we all most go when our time comes. And at last, it is best that every one of us gives up our purchase on earth and move on, leaving it to future generations to use as they see fit, without having to worry about what we would think.

Officially, 1,833 people died in Katrina, but there were many smaller forms of dying that occurred. People who lost their churches. Their homes of many generations. Their pets, their schools. Their best friends and neighbors. In this sense every one of us, all the 1.5 million people who were displaced by that terrible storm, had something within us die.

Which also is hard. And also necessary.

The great lesson I learned from Katrina, one I paid a high price to know, I offer free of charge. I learned that there is no physical possession that a person has that he or she cannot afford to lose. When we left our home in Chalmette for the last time on August 28, 2005, I knew there was going to be water in our house. We tried to put everything of value up high, on shelves, on top of kitchen cabinets, on top of the refrigerator, and in the attic. But our attic got 2 feet of water. Absolutely nothing that we had was untouched by the floodwaters. What we packed in the back of our car — a few suitcases and a few household items we knew we might need if our exodus was more than a few days — was almost all we had left when it was over. I forgot to bring socks. I lost all my socks. Shoes, combs, books, family pictures, my CD collection, winter clothing, neckties, dinner dishes, Christmas decorations — every single thing that you can think of that you use on a daily basis, plus everything you don’t. Nails, wood screws, wash cloths. Extra light bulbs. Packing tape. Extra buttons. It takes years to accumulate all the crap the average American has lying around his home, most of it only there for the rare occasion when he needs it. But it is only when all that stuff is buried under 2 feet of swamp mud that he realizes how much of it there really is, even in the most modest of homes.

And you know what? We lived. Got it all back and then some. Bought new coffee cups, new T-shirts, new throw rugs, mechanical pencils, letter openers, staples, wicker baskets. A back yard thermometer. Electrical extension cords. A Snoopy with a Santa hat that stands on the front lawn and lights up. It took a long time, but we eventually replaced it all. And it wasn’t all that horrible. You learn that you are surrounded by junk, junk you spend years and years of your life accumulating, junk you are afraid to throw away because somehow you just know that one day you will need half a roll of electric tape and a 1994 edition of the Guinness Book of World Records. So you keep all that garbage, and it piles up, and it drowns you.

But it isn’t necessary. All you ever needed is people who love you. The rest can all go. It really can. You can try it and find out, or you can save yourself a lot of money and trouble and take my word for it.


Tragedies are never desirable, but this one did increase my faith in the relationship between loss and renewal. I have found that there is renewal in loss, although if you lack faith in this precept you may never see it. But it is there. My Katrina experience greatly increased my belief in this. What you lose, you will get back in another way. I think of it concretely, as God’s plan for the world. Part of the Divine plan is that there is gain in losing. Sometimes, it is impossible to gain without losing.

This does not mean we cannot enjoy the things we have. But we have to be careful not to cling to them. What we have may be taken away from us at any time, but in time we will receive more. Even people who have little religious faith must appreciate this — destruction is rebirth; with every death there is a successor, and sometime two or three.

To understand this is to see loss differently. Those who cling to their possessions do themselves no service. Every day has to be a preparation for loss. This does not mean rejecting what we have, or resisting putting down roots again. Of course I have begun my life again, and once again put down roots. But now I know that if I fall too much in love with what I have, then what I also am nourishing is an unhealthy lack of faith in myself, in my values, in my God. I have to trust that whatever I lose can be replaced by something new and better, just as New Orleans must trust that it can replace its past with something new and better.

To a large extent, the ability of New Orleans to recover finally from Hurricane Katrina depends on its ability to let go of its past. If it does, it will discover what I have — that many things can pass away, but that does not mean you will lose your identity as a result.

I have lost so many, many things, and yet not lost a single thing. I am more myself than I have ever been.


A year after Katrina, when I was still working in my clinic in McComb, I saw as a patient well-dressed African American woman who was clearly angry about something.

“Everyone talks about what happened in New Orleans,” she said. “It’s all over the news, all the time. No one ever talks about what happened in Mississippi. Katrina missed New Orleans. It hit the Mississippi coast head on. People act like Mississippi doesn’t even exist.”

To this day I am not sure what prompted that outburst. I don’t ever volunteer that I lived near New Orleans and in the path of the hurricane. It could be that she had read my blog. I also did a radio interview at a local station about my medical practice, and talked about Katrina and New Orleans briefly. Perhaps she inferred that I was from New Orleans because of my name, or perhaps my nurse said something. But I don’t know.

I must confess that her remark turned me against her. I was directly affected by the storm in a major way. I lost as much as anyone, except for those who lost their lives. What right did she have to say that to me? Did she know who she was talking to?

Although I kept within professional bounds, making no attempt to argue with her, she must have detected my attitude, because she never came back to see me again.

She had a point, though. Mississippi has been overlooked in the Katrina discussion on a national level. There were many more affected citizens in New Orleans, to be sure. But I passed through the Mississippi Gulf Coast several times in the months after the hurricane, and I can attest to the brutality of the storm there.

On refection, I have come to realize that I can relate to her complaint, because in a way, I experienced the same thing. Before Katrina we lived in St. Bernard Parish, which directly borders the city of New Orleans. The Lower Ninth Ward, the famous area that got so much press coverage, the area that President Obama visited on Katrina’s tenth anniversary, is no more than 3 miles from Chalmette, the town I worked in. What the Lower Ninth got, St. Bernard got also, in every way. We had to; there was nothing separating us from the Lower Ninth but a skinny little drainage canal. The water passed right through from them to us. (And just as much passed right through us to them.) But the whole world knows what happened in the Lower Ninth and Tremé. There was a story in the New York Times and the New Yorker just this last week about the Lower Ninth and Tremé. St. Bernard, equally devastated, was almost unmentioned.

This bothers me, but only a little. The Lower Ninth’s story was our story, in the end. Same hurricane, same degree of destruction. I would rather the reporters that cover the storm know one area well than skip back and forth between neighborhoods, confusing the whole thing. When I think about Hurricane Sandy as a counter example, this becomes clear -- I know the storm hit Staten Island fairly hard, but with limited knowledge of New York geography, I understand very little about the variations in damage between one neighborhood and another, or between New York City and nearby New Jersey. And I probably never will. TV cameras (and my mind) work best when they focus on one thing. It is simply the way things are.

While I realize that the Mississippi Gulf Coast was just as devastated as Chalmette was, I have to commit to the reporter’s mistake as well. I have to tell the New Orleans story. The St. Bernard story. Focus on one thing, and let the others slip. I have never concerned myself much with telling Mississippi’s story. Maybe that is unfair, maybe I owe my patient an apology, but I wasn’t living in Mississippi when Katrina hit, and I have written from personal knowledge and experience about a city I know intimately. I must write about what I know.


Because the tenth anniversary is upon us, there has been a resurgence of Katrina stories in the media. There have been stories in the New Yorker and the New York Times, in USA Today, stories in the local papers here in Jackson, specials in many of the national news networks and PBS. And NPR. Interestingly enough, only NPR is the only entity I know of that covered St. Bernard Parish in any depth.

The Katrina Revisited stories that I have seen so far fall into two categories: the New Orleans Overcame stories and the Katrina-as-racial-microcosm stories. Both are slightly discomfiting.

The NOLA Overcame stories are a varnishing of a terrible story. An attempt to fit Katrina into a familiar story arc, the tragedy that leads to a happy ending. Even President Obama was doing that when he told a crowd in the Lower Ninth that "there's something in you guys that is just irrepressible….The people of New Orleans didn't just inspire me, you inspired all of America.” As in most NOLA Overcame stories, the President proceeded to backtrack and say there is a lot of work ahead, but the damage was done. In these stories, Katrina has morphed from an inscrutable calamity into a good ol’ American success story.

Robin Roberts’s reporting for ABC follows the same script: “At the 10-year mark there has been great progress. There are more restaurants in New Orleans than ever before….The area is not only being rebuilt, but revitalized as well. But there is still much work to be done…Katrina is a story that's still unfolding. There are many wonderful chapters left to be written. It takes courage to believe that the best is yet to come.”

Yes, New Orleans has bounced back remarkably, but these bootstrap stories oversimplify the great challenges that faced New Orleans in September of 2005, and fail to come to terms with the successes and failures such as they are. New Orleans has always had a polarizing effect on visitors, and it has a history of inspiring both positive and negative national news stories in nearly even measure. This is because New Orleans has always been complicated, and doesn’t fit into any easy category. But post-Katrina, now it does. It can be slipped into a neat, familiar story form, complete with stunning visuals. But like all nonfiction storylines, it is partly fiction.

I would be remiss if I did not admit that it is gratifying to see so many positive stories about my hometown. It is always good to have your image buffed up. That being said, it isn’t the truth, at least not the whole of it, and I don’t cotton to myth-making.

The second type, the type the focuses on race and Katrina, troubles me as well. These stories take a national disaster and turn it into a controversy, something edgy and topical that fits into a different story arc: the national narrative that has emerged out of big stories like Ferguson and Baltimore and Charleston in the last year.

Clearly the Katrina story had a lot of racial tension in it. It was plain what color most of the people who stayed behind were. It was also clear that the Bush administration’s slow response to the storm had something to do with its congenital inability to empathize with the poor and people of color. Equally galling is a recent poll by Public Policy Polling showing that 29% of Louisiana Republicans blame Barack Obama for the poor Katrina response. Salt on a wound: It isn’t enough that racial prejudice underlay the anemic federal response; racism has to be involved in assignment of the blame.

Yes, all this is granted.

But it is easy to oversimplify. I have repeatedly heard the argument that in New Orleans the rich people lived on high ground and the poor (i.e., blacks) lived in the low lying areas. This is only partly true. I wasn’t poor. My house flooded. The Ninth Ward flooded, and it was poor. But so did Lakeview, a rich neighborhood, and Mid-City, which was racially mixed. Tremé, which was poor and black, got some water but is actually on relatively high ground; most of it was covered in only 1-2 feet of water, which is not extreme in a flood-prone city like New Orleans. Perhaps the fairest thing to say is that the flooding affected the poor and the African-American disproportionately, but some of this is because New Orleans was 67% black to start with, and in the black population, citizens were disproportionately poor. So statistically, if you were to flood New Orleans, the largest identifiable affected group would be poor and black, no matter how high above sea level they lived.

It isn’t that I object to looking at race as a factor in the outcome of the hurricane. But putting race in the center stage encourages the assumption that only black people were affected by the storm, which isn’t even close to being true. Kanye West’s assertion that “Bush doesn’t care about black people” was a welcome statement for me, but it wasn’t entirely true. President Bush wasn’t just ignoring black people. He ignored plenty of white people as well. Just the other day I saw a graphic on the news observing that 75,000 African-Americans in New Orleans left after Katrina and never came back. True. But even more white people did the same, and I have never seen a graphic indicating how many whites left and didn’t return. I am one.

Katrina was a natural disaster, which means it did not discriminate. Making the story about race confuses this truth. One might argue that this is acceptable because the African-American story is rarely told, and Katrina is an opportunity to tell it. Also that Katrina unearthed racial inequality in Louisiana that was already there. I fully understand that on occasion we have to let minorities have the center stage, without allowing other voices to run out into the spotlight and dilute the story. Cultures that are not heard from often enough need the microphone, and need not be interrupted. But while this is permissible, even right, it has to be acknowledged that this filtering is contrived. Focusing on one group by definition means that something else is being left out.

Maybe this is just a what-about-me cry, but I don’t think so. The problem with the Katrina-as-racial-microcosm story is it obscures what I think is an equally important, if not more important matter. Katrina unearthed a second problem, one not often talked about, because most discussions about what happened 10 years ago devolve into how much better things have gotten, or how much the disaster was all about race.


The great question Katrina leaves open is this: What resources should we mobilize to save our cities? This is a much more important question than most people realize.

America has always been a lucky nation. Up to now, or at least up to around the 1970s, we have grown and expanded without much effort. We moved west, we built upward, our cities sprawled, we migrated from one boomtown to another, and all without any planning or, really, without anyone even wishing it. No president led the migration to the Great West; no Congress authorized skyscrapers or ordered up the silicon chip. No one called in millions of immigrants at the precise time our great factories revved up. No one told hundreds of thousands of African Americansin the early 1900s to flee segregation in the South and move to the north just in time to help Detroit build the world’s largest transportation manufacturing hub. All of these things happened naturally, with very little oversight. This has led Americans to think that growth occurs without planning, that letting events run their wild course is the best way to keep a country strong.

But like a stock broker who rides a bull market to the top and mistakes his dumb luck for stock picking skill, America has given itself too much credit. The wind was always at our backs. We always had land, natural resources, enough able bodies, and isolation from the problems of the world to grow as we saw fit.

New Orleans is the counter example. Before Katrina, New Orleans was one of the poorest of America’s great cities. High crime, poor schools, corrupt politics, racial segregation. The city, once the largest and richest in the South, had hit the wall that many American cities will eventually hit: It ran out of easy resources. The wind stopped blowing at its back.

New Orleans is a river city, and its problems began when America built a rail and later a highway system that diverted the freight business away from river shipping. At first, as the shipping business ebbed, New Orleans simply shifted to another natural resource, oil, which Louisiana had a lot of. This secondary boom lasted until the late 1970s when oil became a global business. People didn’t talk about (or fully understand) globalization back then, but as oil became an international business, the city was deeply hurt. New Orleans lacked the big banks and financial markets to hold onto the real oil money. The globalization of oil meant consolidation of corporate oil into huge financial centers. In short, the big money went to Dallas and Houston.

Since the city was so heavily dependent on oil, the loss of big oil money devastated New Orleans, and it has never really recovered. I remember those days, during the recession of the early 1980s (few Republicans remember that Ronald Reagan presided over a deep recession during his first term), when unemployment reached nearly 20% in Southeast Louisiana. It was a very painful time for the city, one that is strangely forgotten. In Louisiana, the recession was so very deep because the economy in the city, and in Louisiana in general, was so dominated by the oil business that its withdrawal left it with little to fall back on. Everything in New Orleans since about 1980 has been about tourism, because after the big oil money walked, that is all that was left.

What Katrina exposed in New Orleans was a city without a vision. What the city needed in the 1970s and 80s was for the city and community to step in and step up civic planning, education, and infrastructure. It is possible to survive the loss of a huge industry like oil if you replace it with the proper long term planning. New Orleans was always too corrupt for planning, and so it slowly rotted instead. But the city remained interesting and different during this period for a peculiar reason — New Orleanians have always had a sense of easygoing resignation and a comfort level with dysfunction and decay that makes the place fun to be, even in bad times. Yes, New Orleans says, we’re on the train to hell, but we are going to have a good time on the ride down! There is something touching and charming about this devil-may-care attitude, but only up to a point. That point is the moment the hell-bound train reaches the terminal station. That point was called Katrina.

I could go on and on about the social and economic factors that I think led to the disaster of Katrina. But we can now go straight to the point. Once a city reaches the edge of disaster, once a town has fallen so far that it is almost — almost — beyond redemption, the question arises: What is a city worth? How much should a nation pay to save one of its own cities? What does culture and cultural diversity mean to a huge nation like the U.S.A? What is lost, if we leave one of our own cities to be reclaimed by the kudzu?

New Orleans may have been the first American city to face total destruction, but it won’t be the last. After Katrina, cities like Detroit, Flint, and Newark, NJ complained that their towns are also falling apart, but lack the glamour of a major hurricane to attract national attention and emergency help. And they are right. Many American cities are falling apart, not as dramatically as New Orleans did, but falling apart nonetheless, and we seem inclined to just let it happen.

Shortly after Katrina, Speaker of the House Denny Hastert (today of statutory rape fame) told the media that he thought New Orleans “could be bulldozed.” Hastert has been hated in New Orleans ever since for saying so, but he was only voicing a common thought. How much should we pay to save a city?

Given global warming, this is a question we will be asked again. In 50-100 years, rising seas will claim Miami. Most climate change models have all of Florida going under if seas rise as predicted, assuming we continue to do what we have been doing to control carbon emissions, which is nothing. So how much is Miami worth? How much is Lower Manhattan worth, which will also go under? What about Boston Harbor?

In the wake of Katrina, this question has barely been answered. As a native New Orleanian, I feel my hometown is absolutely worth saving. America sort of agreed, and shelled out just enough money for a partial rebuild. The city is trying to do the rest. It isn’t clear yet if its best effort will be enough. Another storm could take it out just as easily — while the levees have been rebuilt and even strengthened, little has been done to fix the massive damage to the wetlands around Louisiana that protect it from hurricanes. These wetlands have been largely destroyed as a result of decades of oil drilling and the dredging of shipping lanes. If this problem is fixed, New Orleans has a chance. If not, the rising ocean will take the Crescent City along with many other coastal towns throughout the world.

So the real question raised by Katrina isn’t merely a question of race. It is a question of culture. How much do we value New Orleans? Detroit? Miami? Newark? If we care about our great cities we will care for them. Detroit’s manufacturing money has run out, just as New Orleans’s oil money did. Are they disposable?

I think not. But the challenge in that answer is this: America has passed the stage where it will continue to remain strong despite neglect. We are at the point where, if we want to save parts of our nation, we will have to go out and do it. Actively, aggressively. Letting things take their natural course will not suffice. If we do, these great cities will dissolve and collapse.

You can’t always solve the problem of a blighted community by abandoning it and building beautiful tract houses somewhere else. We all know how that ends up — with a city where all the vitality is on the surface, out on the edges, and at the center is a rotten, empty core.

Ten years ago, New Orleans had its own rotten, empty core torn wide open. It was lucky. Most cities never get the chance to be cored out, washed clean, and to start again. The cities that do not get that opportunity have my sympathy. Katrina was not entirely unlucky.


Sunday, August 28, 2005. The last time I stood outside my house in Chalmette before it was destroyed, a neighbor approached us from across the street.

He was a retired widower in his late 70s. His son lived just down the street, and his daughter and her family were around the corner. He had spent his entire life in St. Bernard Parish.

“Looks like this is the big one,” he said. “I’m headed north with my daughter but all of this is going to flood. I hope you are leaving, too.”

“Yes, we are packing up,” my wife said. “I guess the river is going to overflow.” She meant the Mississippi, which roiled its way towards the Gulf of Mexico about a mile from where we stood.

“Oh, no,” he said, “The water will come from that way.” He pointed to the swamp on our east, to wetlands that were defended by a sagging 14-foot levee but were in tatters from decades of costal erosion.

He was right of course. The Mississippi levees held; instead, the storm surge came up the Mississippi River Gulf Outlet, a manmade shipping channel that for decades had been causing of vast wetland destruction in St. Bernard. MR GO, as everyone called it, formed a huge funnel that concentrated Katrina’s storm surge and injected it directly into Eastern New Orleans. MR GO was badly planned and rendered the eastern side of New Orleans extremely vulnerable to exactly the kind of storm Katrina turned out to be. MR GO is the reason New Orleanians blame the Katrina floodwaters much more on poor government planning than on the storm itself.

“Good luck to you,” our neighbor said. “I hope we all make it back.” We said goodbye, and he turned and disappeared into his home, where he continued his storm preparations.

We never saw him again. He evacuated north, headed towards the Midwest, and somewhere along the way contracted pneumonia and died in a hospital far from home.

Of course he didn’t die of pneumonia. He died because his heart was broken.

New Orleans is being rebuilt on a shoal of broken hearts. Sometimes when I think of the storm, I think of our neighbor, who technically is not included in the 1,833 people said to have died from the storm. But he was a Katrina victim nonetheless, as were countless others who fled the storm and died in exile.

The forgotten victims. This day is for them.


Program Note

Yes, I am working on an essay about the 10th anniversary of Hurricane Katrina. It will appear sometime around August 29.

The Confederate Flag: Get It Off the Mississippi State Flag

Should anyone doubt that the Confederate flag is a symbol of hatred, consider two recent events. The first occurred in Oklahoma City in July while the Confederate flag controversy in South Carolina was still brewing. A group of Confederate-flag-bearing "citizens" appeared along a presidential motor route, waving their flags at President Obama in protest against his recent statement that the Confederate flag "belongs in a museum."

The next event occurred on July 30, when members of Ebenezer Baptist Church in Atlanta, a congregation once led by Dr. Martin Luther King, awoke to find Confederate flags scattered around the church campus.

A simple thought experiment will convince anyone that the Confederate flag in both cases was chosen specifically because it is an insult. Would anyone consider waving the French flag, or the German flag, or the Brazilian flag in the face of the president of the United States?

Would anyone plant Italian flags in the lawn of Martin Luther King's church, or Canadian flags? If members of the congregation of Ebenezer woke up in the morning and found their churchyard covered with Danish flags, they might be confused, but probably not offended.

The only reason anyone thought to plant Confederate flags in front of a black church is because he or she knew the flags would offend. The only reason anyone would wave the Confederate flag in the face of Barack Obama is because he thought it would be offensive to a black president.

Which leads us to the Mississippi state flag, which has an image of the Confederate battle flag in the upper left hand corner, where the 50 stars are in the American flag.

Most of the people who support keeping the Confederate flag as part of the Mississippi state flag argue that it should not offend anyone because it merely represents Mississippi's history. But if the flag is not an offensive symbol, how can it be used in an offensive manner?

Why is it the flag of choice for most racial supremacy groups in this country? The Ku Klux Klan would not display it unless it thought it was offensive to black people. But they do. It is a common component of Klan rallies.

Any flag which can be used as an insult is not a flag that should be a part of official public life, much less the official flag of a U.S. state.

That doesn't mean the Confederate flag has no place in private life. Or even, in the right context, in public places. We still have a First Amendment in this country, and I would never argue that the Confederate flag should be banned. From a historical standpoint, it is appropriate that the flag fly in Civil War cemeteries and at Civil War monuments. It would be strange, for instance, if Fort Sumter in South Carolina did not display the Confederate flag. It was a Confederate fort, and the flag belongs there.

But the flag should not fly over any government building, nor should it be incorporated into any state flag. It makes no sense that a flag containing a symbol that represents slavery should fly over any US or state government building.

The city of Jackson, which has a large African-American population, has banned the Mississippi state flag from flying over all city buildings. Which makes Jackson, MS something of a Jeopardy question. What U.S. state capital is the only capital city to ban its own state flag on City Hall property?

I find it mystifying that anyone would argue the Confederate emblem on the Mississippi state flag is only a historic symbol. Walk with me through history for a moment. Real history, not the garbage that passes for it in public conversation.

Before European settlers came to Mississippi, the state was occupied by Native Americans for at least ten thousand years. From 1699 until the early 1700s the state was owned by the French. It was then transferred to the Spanish for a time, and after the French and Indian war, the French gave up all pretenses to the territory in 1763.

From 1763 until 1776 Mississippi was uncontestedly British. The American claim theoretically began in 1776, but the U.S. didn't gain absolute political control until the Treaty of Ghent, in 1814. Mississippi became a state in 1817.

Confederates controlled Mississippi from 1861 until 1865, and that's being very generous since much of coastal and northern Mississippi was controlled by the U.S. Army by 1863.

To summarize, Mississippi has been controlled at various times by Native Americans, the French, Spanish, the British, the Americans, and the Confederates, with the Confederates in control for by far the shortest length of time. Therefore, if someone were to design a flag that was supposed to represent "history," it would make sense that the flag would represent a nation-state that was in control of the territory for longer than about 3 1/2 years. Any attempt to recognize the Confederacy as a uniquely important period in the state's history is a distortion. It was 3 1/2 out of 300 years.

To be fair, if any symbol should be included on the flag to represent a predominant historical dominion, it should be a Native American symbol. At 10,000 years, the Indians win the race going away.

It is simply a fact that incorporating the Confederate flag into the state flag of Mississippi is both offensive to many of its own citizens, and factually inaccurate. I'm not sure what other reason anyone could ever possibly need to change the flag.

The state of Mississippi has many things to be proud of, and it seems silly that it would choose a symbol of slavery to dominate a state symbol when there are so many other things that could be up there. Mississippi is the birthplace of the 12 bar blues. This is a great achievement, one that changed the world, and one that could easily merit placement on the state flag. It could even be fairly argued that Mississippi is the birthplace of rock music, since the song many people acknowledge is the first rock 'n roll song ever, "Rocket 88" by the Mississippi band Ike Turner's Kings of Rhythm, was recorded at Sun Studios in Memphis. Why not put that on the state flag?

The state flag should represent something that every Mississippian can be proud of, not just something that warms the hearts of racists. To me, the presence of a symbol of the Confederacy in the state flag does not commemorate history, but of the determination of one ethnic group to trump the desires of an another.

That constitutes racism by almost anyone's definition.