Cold Spaghetti

It wasn’t about football.

It isn’t about a game.

When so many had doubted the possibility, belittled the successes, and ignored the reality — in that moment, with the whole world watching, our Saints emerged on top. The similarities between that story and our own are so obvious that it shouldn’t be a surprise that yesterday, today, and tomorrow are not because or about or for some sport. What is there not to get?

—

The scoring drink was New Orleans rum, fresh pineapple juice (yes, Ann Marie juiced a pineapple, do not doubt this woman’s dedication to doing things right), lime, and bitters. Good thing that we decided to celebrate in this way, or else the moments of the game may have been more of a blur — because what a game!

Thanks to the short-cut Emmy had learned earlier in the day from a friendly taxi-driver who was stuck in traffic near her (think: banging on window ‘hey lady, you must take secret road! trust me!’) we made it around traffic, into downtown, and safely within a parking space in record time. Then hoofed it down to Canal.

Which, to the first time in my memory, was completely closed to traffic.

I’ve heard about destruction in celebrating groups; when Virginia Tech won a key basketball game while I was a student there, I remember some car destruction and something about a street light coming down. That sort of thing is what police ready for after big game wins, so I hear.*

This didn’t happen here, at least not last night. And I doubt that it is the sort of thing that locals would do; there are other ways of celebrating.

Like doing the jitterbug.  To hip-hop Saints re-mixes.

But then a dixieland jazz song starts.  And you may need to learn some crunk moves.  Someone in the crowd will teach you.

I know this sounds flip, but I’m really reporting what was happening.  What happens here.  The sort of party our City throws.

Here’s the thing.  In other places, you get up and get dressed or cleaned up or whatever so that you can walk out of your house and go see something, go experience some cultural thing.  In New Orleans, we get up and get dressed and go out of our homes and we ARE that cultural thing.  It happens because we create it.

There is something very satisfying about living here that fulfills a natural and often forgotten part of life in the United States: that we long to have responsibility in making happiness and celebration in our communities.  Purposefully making time and putting energy into merry-making seems very irresponsible in the specter of the American work-ethic.  Energy into something that seems so opposite from work comes across as lazy and extraneous; and over time, I think we forget to really appreciate the beauty of life and the necessity of celebrating a moment.

This correction of priorities is something I learned living abroad.  It wasn’t an easy lesson, either.  It STILL isn’t.  But it is the way of life in New Orleans, and gives us incredible rich experiences that remind us of what life is about and how we truly want each day to be.

And so we went.  Into the Quarter and through the Quarter.

Stopping for high-fives, dancing with strangers, listening to musicians on the street, following bands in a second line.

This picture is silent, but the reality was full of voices and music and joy and laughter.

Here’s a video of a second line that passed us on our way to Frenchman Street.

Most bars and clubs were empty — everyone was out on the street — but we did stop into a few to listen to who was playing inside.  (Including these kids below, who were very good and also seemed very young; I’m officially a woman who says things like, ‘does their Mother know they are out this late?’)

Paul took the pictures above and below.

But like I said, the party was really in the streets.

Eventually, we got back into the Quarter and into Jackson Square — note the quiet below — but Cafe du Monde, right across the street, was filled at 2:30am.  We had to wait for a table and wave down a waitress.  (Worth it; the cafe au lait helped get us the rest of the way to the car.)

How wonderful that we were able to celebrate the Saints with so many — and right here, in New Orleans.

Even if you’re not here, please do celebrate with us!  Here’s the soundtrack.  And here’s something else, something wonderful, to read.  Geaux Saints!  And bless dem boys and New Orleans!

—

* Something crazy did happen — along Bourbon and Iberville — though I don’t know much more than this report.  We were around that area, at roughly that time, and didn’t see or hear anything alarming.  What a shame that someone had to ruin the night for others and what a blessing it wasn’t any worse.

Hello, world. Are you still there? It’s been about 24 hours now and everything is still coming into focus.

It’s sort of like every holiday, event, celebration, party, and tradition all converged on one point.

If you want particulars or specifics or play-by-play or impact, go here. Oyster’s got the line-up well represented.

Us? Well. We went out to watch the game with the intention of leaving “soon.” Several hours later we rolled home, threw the kids through the tub-teeth-bed routine, and then I left. Off to the Quarter to celebrate our Ah-Maze-zing win (!), that Fan-Fricking-Tastic kick, and the joy of Favre’s last pass to… our Porter. E, G & I were out until 3am and are still a little loopy.

In other surprising news, my 16-year vegetarian husband makes pretty darn incredible blueberry barbecue ribs. RIBS.

But back to the Quarter. Here are some highlights:

• Fireworks, music, dancing, costumes, high fives, kisses, and singing… all before we even got to Canal.
• It was insane.
• It was packed. PACKED.
• We shook hands and thanked every Vikings fan we saw. And you know what? The ones I saw, who were there, I believe they got it. They understood.
• I was the envy of co-eds for the cool beads I caught (lordy, people, forget the stupid flashing thing — that is what tourists who don’t know any better do for other tourists), though when they asked how I got them when they were stuck with “only shitty beads” I should have responded that clearly my rack was superior.
• Emmy and Georgia broke a few dozen hearts.
• Music was everywhere.
• No one should name a bar “Napoleon’s Itch.”

Photo Highlights below.

It’s playoff day. The entire city is buzzing. Everyone is happy. Even people in work uniforms are wearing black and gold.

Football? What’s that? I’m talking about the Saints!

We go blue in the face talking about this adopted home of ours and in light of the questions — How can you live in New Orleans?  Why do you stay there?  How IS New Orleans these days? — I was hoping to find some words to describe what it’s like to be here right now.  In this season, this day, this moment, where every living thing is thinking and wishing and hoping for the same thing.  This particular marvel of unified thought and energy is actually quite common in New Orleans — we all come together each and every Mardi Gras Day, when we reach up hopeful hands for a Zulu Coconut — but in this instance, in this time and place, we are coming together in a whole different way.  This is something that we can be proud of on a National scale.  In a way and with a spirit that is unique.  The examples are everywhere, but it’s still hard to explain; take this, written last month while we were still undefeated:

… These are strange and beautiful days in New Orleans, and they must be seen to be believed. …  Last week, when I went down to experience the mania over the Saints’ undefeated season firsthand, I found myself not sure whether every street was a dream. Some moments made me laugh, and others were so full of a desperate love that I had tears in my eyes.

Where do you even begin? Maybe you describe the couture shops that have replaced the latest fashions on the storefront mannequins with Saints T-shirts? Maybe you tell how vampire novelist and native New Orleanian Anne Rice, never much of a football fan and now living on the West Coast, recently ordered a Drew Brees jersey with “Anne” on the back. Maybe you use numbers: 84 percent of the televisions in town were tuned to the recent Monday night game against the Patriots. Maybe you use bizarre trends, such as an NOPD cop telling me the 911 calls almost stop when the Saints play …

There are other things, too.  The Cinderella story of our Saints resonates far beyond the football fan base.  Read any article about New Orleans then go to the comments and it all makes sense.  We see the hate: the assertions that the city should be left to rot, the value judgments on our population, the incredible lack of compassion and ignorance of fact.  Yeah, we know it’s some Ditto-head in dark, lonely basement apartment, spewing hate while some porn site loads on another browser window.  But we also know that this loser isn’t spouting off thoughts that haven’t occurred in the minds of more reasonable people.  The fact that our team is composed of players who were similarly doubted, or misjudged, or miscast is simply part of our shared history, where defeat, resurgence, rebuilding, and celebration are all part of the package:

” … They are a motley group, undrafted guys and late-round fliers, players cast off from other teams. Brees landed in town after an injury convinced the Chargers that his best days were behind him. “When we came here,” he has said, “I was in the process of rebuilding, as well.”

Running back Mike Bell was out of football. So was cornerback Mike McKenzie, who watched the games from the stands with a mouthful of food before getting the call a few weeks ago. Darren Sharper arrived unwanted and has resurrected his career. Running back Pierre Thomas wasn’t drafted. Star wide receiver Marques Colston wasn’t drafted until the seventh round of the 2006 draft, and his college football program, Hofstra, just folded.

It goes on and on. This is a team of underdogs. …”

I know that folks love their home teams, their home cities, and all stuff that comes with it.  Every place has something special about it.  But today?  This season?  Well, the professional sport writers put it best:

May I root against the New Orleans Saints?

No, you may not. Rooting against the Saints is like rooting against Elin Nordegren. They’re the Sentimental Team of the Century; if Dick Enberg were calling the NFC championship game, he’d need a trailer truck of Kleenex. Even if you forget everything that New Orleans endured during Hurricane Katrina—and how could you?—they’re the Saints, the former Aints, one of the most hard-luck franchises in the history of hard luck. Not long ago, newborns came into the world in New Orleans hospitals with tiny grocery bags on their heads.

If the Saints win this weekend, we expect the Louisiana Superdome to levitate off the ground, stop at Parkway Bakery & Tavern for a roast beef po’boy and fly straight to Miami for the Super Bowl.

Around here?  We’re preparing for take-off.



Wanna come along?  This will help out.



Or, if you need to ease into it, go with the U.S. Marine Corps Band.

Geaux Saints!

Welcome to the lastest Just Posts roundtable, the monthly list of blogger writing on topics of social justice and activism compiled and hosted by Alejna and me.

It’s taken me 5 days to get this post up.  Does that say enough about life in Cold Spaghetti land?

Some of the delay in posting is due to a conference presentation I gave over the weekend about health and infrastructure in New Orleans.  Using a lot of maps, charts, and pictures, I gave the context for Louisiana, one of the poorest, least developed, States in our United States.  (Enter joke.  Our State motto: “Thank goodness for Mississippi,” lest we be last on ALL measures.)  The level of vulnerability among those in the Gret Stet is extreme by any measure and when further defined by race, becomes unthinkable.  But as far as we are down the hierarchy of outcomes, we are not so different than the rest of the country and indeed, not so different than the rest of the world.  The images of inequality and despair burned into our minds after Katrina are not indicative of New Orleans.  Those memories do not define or create a distinction for the rest of the country to use to separate themselves from our reality.  Every place is just waiting for that moment when it all falls apart, when our inequalities, vulnerabilities, and differences can no longer be invisible.

And now, the all important list: The September Just Posts.

• BipolarLawyerCook with My best friend’s wedding…
• dmariemart of Argot with Minds of Our Own
• Emily of Wheels on the Bus with No More Hall Passes
• Erika at Be gay about it. with and Iowa: a proposal. and Iowa: mawwiage, that dweam within a dweam.
• flying tomato of Flying Tomato Farms with Quit the Bullsh*t–Public Option Now!
• girlgriot of if you want kin… with Street walking and Danger, Will Robinson! Don’t Go “Down There”!
• jen at one plus two with bob marley has definitely left the building
• Jenn at breed ’em and weep with Hi, I’m somebody
• laloca of baggage carousel 4 with the politics of counting and thinking about miscarriage
• Magpie of Magpie Musing with From the Rain Comes Hope
• Neil of Citizen of the Month with Tales of Health Insurance
• Painted of Painted Maypole with Why isn’t this a non-issue?
• Tami of What Tami Said with I’m saving my cheers over new, “authentic” black Barbie line
• wreke of wrekehavoc with guilty pleasure monday: millworker (james taylor)
• Zach Ford at Zach Ford blogs with Coming Out Might Be Easier, But It’s Still Hard

The posts of this month’s roundtable were submitted by:

Slouchy
girlgriot
Holly
alejna

Thanks so much for reading! We really appreciate your support. And not just appreciate it. We need your support to keep the Just Posts going. Please drop by Alejna’s to see what she has to say this month. If you have a post in the list above, or would just like to support the Just Posts, we invite you to display a button on your blog with a link back here, or to the Just Posts at Collecting Tokens. If you are unfamiliar with the Just Posts, please visit the information page.

For about two years, I’ve had a video clip of an ABC Nightline News broadcast on youtube.  It’s a segment from a show discussing violence in NOLA, and heavily features stories related to the murders of Helen Hill and Dinneral Shavers.  It’s personal, this event, and for New Orleans, it symbolized a larger political movement that continues now.  (I’ve written about these things here, here, here, here, and here.)

Every once in awhile a comment appears on the video and I get email notification of it.  The most usual comments have been from some guy who repeatedly wrote posts incriminating Paul in Helen’s murder — I have responded by deleting the comments and blocking the user.  After a few goes under two names, he stopped.  More recently, though, it’s turned into standard anti-NOLA crap.  The sort of comments you get from folks whose profile names are “LuvFOXNews”.  I’ve treated it like the others — like a nasty fly to swat away and forget.  But then another one showed up today.  And I guess I’ve started to have enough of the bullshit.  Maybe the ridiculousness around the responses to the President’s attempts at making our world better is pushing me over some edge or something, I don’t know.  But for whatever reason, I actually went to this person’s youtube page before deleting and blocking the comment, which was:

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chevyls1camaro has made a comment on ABC Nightline Jan 24th (New Orleans Violence):

You can reply to this comment by visiting the comments page.

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Typical New Orleans hate.  Here’s chevylscamaro‘s youtube page.

I visited the page and found that NOLA hate, black hate, and just about any other kind of hate one can think of seems to be this person’s reason for joining youtube.  I dunno, hating others maybe this person’s reason for living.  I couldn’t think of anything to do with the information, except for sending it here, and writing about it.  I thought you all may have some constructive thoughts or suggestions.

Cold Spaghetti is now five years old. My first post was written August 26th, 2004 — then on another site — and would move twice before ending up here in its own special domain.  I’m blushing as I admit this, but there is a lot of unfinished business on this site. One of my post-dissertation project-dreams is to re-vamp it, clean up old posts, set tags and labels, and properly archive everything in a cool kind of way (after all, it’s the closest I’m going get to cool).  That is how I’m getting through, you know… making all sorts of PLANS for what I’m allowed to do AFTER the dissertation.  Those AFTER plans?  They are BIG PLANS, let me tell you!  Life changing, earth-shaking plans!  In fact, I love to talk about the PLANS so much, that all the other stuff, like getting to AFTER, can fall to the wayside.  Oof.  If I’m going to make November, it may be time to raise the bar.  What do people do to finish a book, I wonder?  What drastic measure or extra-cool incentive helps others?  Should I deny myself chocolate or wear a chastity belt or something?   (Suggestions welcome.)

This week also marks the date of my inaugural post (granted, a cross-post, but a post nonetheless!) to NOLAFemmes — a website written by New Orleans women about New Orleans issues important to women. It’s a great site for information about local artists, events, and politics — and a good way to get an idea how the women of our city are healing our collective wounds, raising our future citizens, and carrying on life in this difficult, but beautiful place.

Most importantly, this week holds another anniversary in these parts. That of Hurricane Katrina and the Federal Flood. I don’t want to wax on about those pivotal events, only to say that we’re still here. The real work of recovery, of looking at our past and future and determining how to heal our inequalities, is just beginning. There is so much opportunity and hope; it is a really exciting time to be in New Orleans.

In honor of both events, I want to share the NOLA love. I’m hoping for comments from folks that read but haven’t commented before… just a lil’ shout out. I confess that since moving to coldspaghetti.org (two!) years ago, I haven’t been tracking traffic and I have no idea who is visiting or from where. (See, I wasn’t kidding about not being on top of the website.)

Make a comment here between now and September 1st — particularly if you’re new to coldspaghetti or never commented before — and I’ll send a NOLA-themed gift from a NOLA-based artist to one repeat commenter and one new commenter.  Selections will be made via random number and I’ll announce names on September 2nd.

Glasses raised to joie de vivre — no matter where you are!

I’m so glad Harry Shearer gets it.

He spoke compelling at today’s Rising Tide, poignantly describing the how New Orleans lost the media battle regarding the city’s story of Katrina, the Flood, and recovery.  He’s absolutely right, of course.  Read any article about New Orleans’ recovery and go to the comments; they are ripe with misinformation, sweeping falsehoods, and complete hatred towards this city and the people within it.  The reason it’s important for the people of New Orleans to continue to tell the story is because, somehow, the facts are still not understood: that this city was destroyed in a man-made disaster, a Flood that occurred when a Federally-funded agency failed to perform as it had been designed to perform because it was never built correctly.  And I can’t believe we still have to say this, again, but FOR THE LOVE, this city is NOT below sea level!  Can we move on now, please?

(See some video of Shearer’s speech here.)

—

A last minute cancellation resulted in my being a member of the Health in New Orleans panel (versus its moderator) — along with two well-known, established mental health professionals.  One is consistently named a Top Female Achiever in the City for her well-respected work with the police mental health crisis unit; the other, a psychiatrist and medical director for a large local non-profit.  I was an out-of-left-field addition to this group… I don’t have one primary affiliation with one organization, my scientific perspective is a bit different (public health), and I’ve spent nearly 4 years volunteering and researching how clients and health promoters navigate the waters of New Orleans social systems.

I wasn’t intimidated by the other panelists, but I definitely wanted to take the conversation to other places that I didn’t feel it was going (or maybe could not go).  Instead of sticking to questions and topics that had been pre-arranged, the my fellow panelists opened the talk to the floor to do a large Q&A.   What followed were a lot of discussions about local services, which I don’t find particularly useful in this type of venue: the panel wasn’t envisioned as a laundry list of mental health services for a reason, because people tend to not remember those sorts of specifics.  (If you want to list services or achievements or whatever, bring a resource guide and pass out copies.)  Panels, I feel, should build on that sort of available information.  A more productive conversation may be one that discusses how we can supplement existing programs.  As an example: what can be done to better support families to care for their loved ones transferred to facilities an hour or more away with the closure of NOAH?   Or maybe a discussion of the sorts of a strategies we all can use to handle our own stress and mental illness outside of seeking professional providers?   In my thought, the power of a group like RT is when you excite the room — after all, these are folks who write and read and write some more — so I think it’s important to try and throw out big issues.  Let people get charged up and see what types of good actions come out.

I did try to throw in a few cents — pointing out that health is so much more than access, more than doctors and medicines.  We are resource-poor in New Orleans, without a doubt, but focusing on access and getting more providers and opening more clinics and getting more people health insurance is ultimately a disservice to the people of New Orleans.  I’m not saying these things aren’t important.  I’m saying that in the end, these are not the factors that create healthy lives.  What does create healthy people are the more difficult, more sensitive, more POLITICAL realities of our lives.  Our physical living environments (FEMA trailers, polluted properties, abandoned structures, proximity to blighted areas), our work environments (are we respected? do we have benefits and fair pay? do we feel useful?), our school environments (are our children eating healthy lunches? are they learning? do they have pride in who they are?), our streets (can we exercise without fearing for our safety? are children safe walking home?), and our neighborhoods (can we buy affordable healthy foods close to our home? is there a clinic nearby to see a doctor for non-emergencies? can we get a medicine when we need it?)  All of these factors contribute to our health: they create stress, they weigh on our hearts and minds, and when not addressed in comprehensive ways, they make us sick.

And, since the feeling of having no control over your life is a key part of mental illness, (as mentioned by a panelist) perhaps involvement in some of the issues above on a community level would help individuals find more purpose and agency in their lives.  Just a thought.

But that’s not all.

And here is where I am embarrassed.  My one note, the one thing I most wanted to discuss, maybe even the most important thing to discuss within the context of health and New Orleans, did not get mentioned.  I didn’t know where to put it in without sounding like the crazy loon in the armchair throwing off the conversation… so I waited for a question from the audience that would let me bring it up.  Unfortunately, it didn’t come.  So I didn’t say anything about the issue of race and class… and neither did anybody else.

Which is a shame because we cannot consider the scope of health challenges of any kind within our city — access, stress, mental health, behavioral concerns, nutrition, whatever health issue one can think of — without discussing race and class.  Race and class shape any health experience regardless of the location.  But in New Orleans, it is a paramount issue.  For one, before 2005, New Orleans was the only city in the country that had a defined two-tier system with separate and (un)equal medical facilities for the haves and have-nots.  What has not returned post-Flood are those services for the have-nots.  So what isn’t being said is that the reason these services aren’t here, or are being taken away, is because they are for a population that many do not want here in the first place.  The rest of us work away at putting money and resources into community clinics (whose funding is not indefinite) and outreach and signing individuals up for public services — but how effective can we be in the long run if we never take a step back and look at the big picture?

In the panel that preceded ours, John Slade mentioned that the movement to re-open Charity Hospital was gaining support because Uptown whites were having to wait longer in medical facilities for treatment and were unhappy with the current desegregation of the system.  Although flip, I think his comment speaks to an important truth… at the heart of our health concerns about access, treatment, and who gets care are long-held ideas about race and class.  Until we address those base realities and histories with honesty, I’m not sure we can build a solidly healthy community — no matter how many top-of-the-line medical facilities we open.

My silence on the issue is not because of lack of interest, thought, or evidence.  Either I’ve become so apathetic that I’ve lost the ability to hold faith in anything (a distinct possibility) or I’ve smartened up — after awhile, you just have to face the fact that the dining room table is never going to respond.

Then, this past week, we were faced with situations that necessitated medical attention. The first occurred while in Pensacola, where we visited a walk-in clinic that was part of the medical center Kate was unexpectedly born in 3 years ago; the second took us to an urgent care center favored by many in our area as one of the best around.

The differences were distinct and pronounced in every respect.

At Pensacola’s Baptist Medical Center, both Kate and I were seen by a friendly, good-natured, respectful, and competent provider who gave both of us very thorough exams with no ounce of hurry.  Kate had a chest x-ray to check out some wheezing heard in her lungs.  We had several pharmacy prescriptions filled.  The kids played in a children’s area.  And, all of the above happened within a 2-hour time frame.

Then, over the weekend, one of the kids who was staying with us at the beach tested positive for Type A influenza (aka: H1N1 flu).  The testing occurred on Sunday, with Will’s first day of school Monday, the next day.  We couldn’t send him to school until we knew that he was without flu — and in the interest of due diligence, needed to show that the rest of our family were not harboring flu as well.  Both Kate and Will had some fever on Sunday afternoon, and on Monday morning, all four of us were showing fever.

Despite pre-arrival calls to the one clinic that would see all four of us, and despite filling out all paperwork before our arrival, we waited for over an hour and a half in the open waiting area.  It was not particularly busy.  When we did see a nurse, she was secretive in her assessments (if you take a measure, you share it with the client, and you most certainly do not hesitate in reporting it), and was incomplete in her evaluation.  I had good reason to believe that some of the equipment was showing measurement error and one of the machines even broke during use.  We heard the doctor insulting us from the other side of the door.  When we finally did get seen, they did not provide the service we requested, I had to correct an inaccuracy the physician made regarding influenza, and in the end, they prescribed medicines the CDC specifically advises against for H1N1 flu treatment and prevention.  From start to finish, the whole thing took about 4 hours.  Note: we did not take the extra 2 hours it would have taken to fill the prescription.  (Buying a house is faster and involves less paperwork than filling a prescription in New Orleans.)

In short, we tried to do the right thing so that Will could be cleared to attend school.  In the process, we paid a gross amount of money, lost precious work hours, were insulted, and came away with poor treatment advice.  Such is the nature of health care in New Orleans.

Yes, without question, the health care system in the United States is incredibly broken and dysfunctional.  Our country is among the worst in the developed world in virtually every indicator of health.  Without question, it’s bad.

And in New Orleans?  Whether from lack of providers, lack of resources, lack of compassion, or apathetic frustration (all of which are factors) — it’s even worse.

—

A few months ago, I was asked to help on a survey that a local agency wanted to do regarding experience with the health system.  It was being put together last minute, by well-intended people who were driven by a need to show the dysfunctions within our medical services.  Surveys in New Orleans are incredibly difficult post-Katrina (if not impossible) because we simply do not know how many people are here, particularly within marginalized, minority populations.  Still, this organization had a group of health students coming from a respected northeastern University during their spring break, and these students wanted to “help” by doing whatever “survey” this group could concoct.  Upon investigation, I discovered that the students were under no supervision from their institution, had no IRB approvals despite the sensitive nature of the questions they were wanting to ask within high-risk groups, and (most alarming) felt no ethical conflict about any of the above.  These things would be in-excusable for work done in their own city, but in New Orleans, a place known to be low on resources, it was seen as perfectly acceptable by both these students (who, frankly, should have been trained to know better) and the local organization.  In short, the idea was that it was fine for New Orleans to accommodate lower standards of research and be accepting of unethical inquiry simply because we are resource-poor.

I withdrew from the survey and advised the organization to put the students to work finding information that was needed for an area benchmarking of services.  The students protested that it wasn’t a good enough use of their time and proceeded with the survey… which grew into a monster so unethical and alarming that I pondered reporting it to their home institution.

All people deserve ethical treatment in research, no matter how resource-poor they or their communities may be.  I do not feel that this is negotiable on any level.  What does that say about us when we decide which kind of people get respect and value in a health inquiry and which do not?

—

How we can talk about health without talking about ethics?  About what it means to be human and the ways in which our society should reflect how we define humanity?  Isn’t that the point?

I do not know how ethics have left the conversation of health care.  How, in our debate of it, we have forgotten to discuss what is right, what is the most human response.  But it isn’t there.  And in New Orleans, ethics is not only ignored but deliberately surpassed as an annoying step one can causally eliminate.  As if the people here are so desperate and pathetic that we should be thankful for any “help” we can get.

It is beneath us to compromise ourselves, no matter where our community stands in recovery, no matter where our society stands in development.

This Saturday!

The many talents of Harry Shearer are gracing this year’s event.  Panel topics include… the future of New Orleans food, music and parading culture; the state of New Orleans health care (moderated by yours truly), and politics in the Last Year of the Reign of Nagin.

Registration can be found here… and includes lunch from Cafe Reconcile!

Right after All Things Considered, just moments before the classical hour begins, our local public radio station has the owner of a consulting firm give advice in minute’s time.  They call it “The Louisiana Rebuilds Minute.”  We call it “The WWOZ Minute.”  (A friend coined the term, meaning that this is when he switches the radio to the local music station for that minute).

The idea of the Minute is that the people of Southeast Louisiana are too stupid to realize that it just takes a web search to find the answers to all problems related to an unprecedented rebuilding of an American city.  Since we’re too idiotic to figure it out, The Minute does it for us.  Paul and I have been joking for years that we would make a “Louisiana Rebuilds Minute” Generator — you just add in a common post-Katrina problem, throw in some patronizing ‘pull yerself up from yer bootstraps’ talk, and suggest that one consulting firm’s website has alllll the answers.  Insert those few tidbits, press enter, and BOOM, you’ve got your manufactured minute.

The point that The Minute doesn’t get is that JUST BECAUSE there is one organization out there with funds to build playgrounds, doesn’t mean that every school that needs one and applies will get it.  JUST BECAUSE one bus is available to a few folks who have the magic combination of ills and scripts to qualify for reduced medicines doesn’t mean that everyone who needs meds can get them.  And JUST BECAUSE The Road Home offered funds to some families doesn’t mean they have all that they need to rebuild their homes and lives.  Just because there are programs and grants and applications and dollars out there doesn’t mean that they are thought through, that they are honest, that they actual reach the people that they are meant to reach, and that they make any impact at all in the outcomes of our daily lives.

It is easy to get mislead.

It is easy to think that ideas are either good or bad.

I’m not so sure.  If I have learned anything from being a part of New Orleans’ recovery, it is that EVERYTHING is mired in thick, silty gray.

And in the middle of all that mess sits Charity Hospital.

One of the big discussions flying around Southeast Louisiana surrounds Charity Hospital.  Until Katrina, Charity was the second largest hospital in the country and one of the oldest continuously operating hospitals in the world.  It was the primary source for health care for many of New Orleans’ poor.  Actually, considering that many of Charity’s former patients have not seen a physician since Katrina, technically, Charity is still their source for health care… it’s just not open for them to receive it.

In fall 2007, Jim Aiken, the LSU University Hospital Chief of Emergency Medicine who worked the Emergency Department through Katrina and the aftermath, came to a class I was assistant teaching.  His fascinating lecture included discussion of Charity’s pre-storm emergency plans, his experience of the storm and flood from within Charity, how he helped coordinate emergency care in the extended aftermath, and finally some of the issues involved with long-term planning for health care for the city.  At every step, the issues are overwhelming at best — but what struck me was his passionate and pointed arguments for medicine, good medical care, and services to the community.  He left me convinced that we need to rebuild a top-tier medical facility in this city, one that serves the poor within it, both because it draws good doctors to gain experience within it and because providing care to those who wouldn’t otherwise receive it is as important in this community as drinkable water and drivable streets.

A little over a week ago, the Schweitzer Fellows held our second symposium.  This one was on “The State of Health in Louisiana” and Dr. Larry Hollier, chancellor of LSU health sciences center (encompassing the training programs for all allied health fields at LSU), was one of the speakers.  His presentation was about the new LSU health sciences center — a center which is desperately needed, but is incredibly controversial in how it plays out.

The issue is that Louisiana’s doctors come from LSU graduates… by no small amount.  The physicians practicing in the State are close to retirement age by overwhelming numbers, and the physicians coming out of LSU are not the type to stick around and take their places.  Even before Katrina, LSU was seeing a substantial increase in the numbers of foreign-trained medical students who were ‘matched’ to attend LSU for their residencies — these are students who tend to go back to their home countries after residency.  There were also increases in ‘matches’ with students for whom LSU was not a top choice… indeed, has not been a first choice for many in recent years.  In addition to bringing in students who are not necessarily going to stick around… LSU has not been attracting the best talent, who are going to get picked up by the more desirable residency programs.  Post-Katrina, these enrollment numbers have been even more dire, suggesting that the outlook for Louisiana to have competent, young physicians to support the State’s medical needs into the future is grim.  Dr. Hollier argued that plans for a new science center were in place long before Katrina, and that the need for an expanded, updated center for treatment, training, and research was critical to the survival of health care in Louisiana.

And I believe him.

Don’t get me wrong: my impression of the guy was that we’d have some seriously different views on just about any medical or social issue… but the numbers and his argument was compelling.  More than that, it completed echoed my experience as a student: my peers don’t stay.  Heck, *I* am having trouble figuring out how we’re going to stay.  Even if Paul had gainful employment, the fact is that the research dollars to study health inequalities in our city don’t go to researchers in New Orleans.  If I want to stay involved in research here, it seems like I need to move to Chapel Hill or Ann Arbor or Boston or wherever in order to do it.  (I’ll save this rant for a later date.)

I think that we need a commitment to a new, state-of-the-art facility to attract new talent, house research programs, and rebuild health infrastructure in the city.

Dr. Hollier spoke ONLY of the LSU plans — NOT the combined VA plans.  In the LSU plan, only 33 homesites are impacted over an area that encompasses more empty parking lots than businesses or homes.  (The VA plan, as outlined in a wonderful advocacy website, impacts many more people and historical properities.)  He argued rationally that the Charity hospital building could not be retrofitted to the needs of the new center and any expansion did not include parking or other supportive infrastructure necessary for that sort of facility.  He suggested the renovation of Charity as apartments for residents.

Everything that I know about New Orleans and the way things work make me question people in power — question their motives, question their reasoning, wonder about what they haven’t considered.  (In contrast, it also has shown me that New Orleanians are some of the most change-resistant people on the planet… but possibly for good reason.)  Yet, I am compelled to WANT this new center.  I WANT a place where I can collaborate and build and learn and serve.  I’m EXCITED about the possibility of this center… it makes me want to be here, stay here, work here.

Those first couple of blocks closest to I-10?  The ones that are predominantly occupied by empty parking lots?  I can’t think of a better use than to build a new science center.

But.  The rest?  Well.  I’m uncertain about this.  Because I feel that Dr. Hollier would drive through a community like lower Mid-City and not see a community worth saving.  He wouldn’t necessarily see a pattern of New Orleans rolling over yet another predominantly African-American community for the sake of progress.  Or, maybe he would — maybe he would but he would argue it was necessary for the common good.  And sometimes?  Sometimes I believe in the common good, even if it stomps all over individual rights.  Early public health efforts involved holding people down for immunizations against their will… and that is WHY we were able to control disease.  Sometimes common good is a good answer.

BUT!  Common good should come out of insight and input from the community.  That’s what it’s all about. I’m not convinced that LSU are taking alternative plans seriously.  I don’t understand why the RMJM Hillier plan isn’t feasible and while I am not convinced it is the right place to go, I do think it signals to LSU that it needs to look for compromise.

And I’m worried that this will be locked in years of debate and at the end, the people of New Orleans will continue to suffer for lack of a comprehensive medical center and a generation of medical talent will slip through our fingers.

There is no easy answer here.  And I’m sort of all knotted up inside over it because it involves my field (public health) and my passion (community-level advocating/organizing) — with one tromping on the other in the name of common good.

Got anything good for this one, Louisiana Rebuilds Minute?  What website of yours solves this??

(If anyone still reading has thoughts, comments, insight, or ideas… I’d love to hear them.)