Beyond Survival: Katrina's Wake Turns into a Life's Work
CBN.com When Stephanie Dutton headed to Biloxi on the Mississippi coast late in the summer of 2005 for her psychology residency, she was thinking of patient care, not hurricanes. But while Dutton was still unpacking, one of the most devastating hurricanes in the history of this country began forming over the Bahamas on August 23. Its name then was simply Tropical Depression Twelve. Within 48 hours, this tropical depression was upgraded to a hurricane, given a name — Katrina — and made landfall in Florida. Hurricane Katrina gained strength over the Gulf of Mexico, and on August 28, the first storm surge reached the Mississippi/Louisiana coastline. On August 29, Hurricane Katrina became the third strongest hurricane on record to make landfall in the United States when it came ashore near Buras, La. Levees in nearby New Orleans broke, flooding the city. The hurricane then tore through Mississippi where Biloxi, Dutton’s new home, was among the areas worst hit. Nearly 2,000 people lost their lives in the storm and resulting floods. At least 230 of the dead were on Mississippi’s Gulf Coast where hurricane winds, 28-foot storm surges and 55-foot sea waves leveled entire neighborhoods. Many people were rescued from trees and rooftops, including those who cut through attics to escape the rising water inside. In all, Hurricane Katrina was estimated to have caused more than $100 billion in damage.
For most students, an internship is a chance to put book knowledge to work in the field under expert mentoring. Stephanie Dutton’s clinical psychology residency was all that and more. There is nothing like a devastating hurricane to find out who truly has grace under pressure. Dutton passed the test.
In her last year of the clinical psychology doctoral program at Regent University’s School of Psychology & Counseling, Dutton picked the Veterans Administration Gulf Coast Health Care System in Biloxi, Miss., as her first choice for her residency. When she arrived in late summer 2005, she began the first of four rotations in employee assistance, Post-Traumatic Stress Disorder (PTSD), health psychology and administration.
Then Hurricane Katrina made landfall near Biloxi just three weeks after Dutton had arrived at the hospital. Dutton remained at the hospital during the storm. “Like everyone else, I didn’t think it was going to be as bad as it was,” she says. “I had been through Hurricane Isabel in Virginia Beach. I had been through Hurricane Opal in Florida. I had thought this would be kind of a fun experience, exciting and different, getting to use my skills in a different way, bonding with staff and faculty who were staying there. I really didn’t have any idea what I was getting into. Nothing had been as bad as Hurricane Katrina.”
All of a sudden, everyone, not just the patients, was in crisis mode. Many staff members lost their homes — down to the slab. Suddenly, it was a world of high winds and rising waters as the hurricane’s center passed near the hospital. The new reality was reminding people to eat and sleep, filing paperwork for disaster checks and pulling staff aside both to comfort them and to make sure they were okay to keep working. Those five-minute quick checks came instead of the hour-long therapy session or group therapy meetings that Dutton and others in her field train for.
“She did the work of a lifetime,” says Gustave F. Sison Jr., Ph.D., chief of the psychology service at the VA Medical Center in Biloxi. “Imagine you’re in the second week of your internship. You don’t even know where the buildings are and you’re faced with the greatest disaster in United States history. We were faced with unprecedented mental challenges. She did a masterful job. She did a fantastic job in her professionalism, her intelligence and her judgment — and all of this in her second week of residency training. Despite the difficulties inherent in such a major disaster, one thing it allows us to do, especially in Stephanie’s case, is to see and have hope that there are exceptionally well-trained professionals who are ready to step up in the most dire circumstances. I applaud Regent for this.”
Dutton was given the option to find another residency program but opted to stay and minister where she had been called. At a time when others in her position might have run, Dutton instead put her Regent training into action quickly and hit the ground running, says Judy Johnson, Ph.D., professor and director of clinical training in Regent’s School of Psychology & Counseling.
“She experienced a certain amount of trauma as well just by being there in that hurricane, yet she maintained her cool,” Johnson says. “Unlike a lot of internships where the interns very much remain as trainees, she had to immediately practice her skills. Although she still had clinical supervisors and mentors, she was basically surrounded by traumatized people — not only patients, but also other staff. It’s amazing that she maintained her inner peace and calm and was able to function competently. I wasn’t surprised at all. She’s a very steady, very strong person.”
Since many of the patients had already transferred to other facilities, the focus changed from patient care to staff care. “A lot of our staff members were traumatized from the hurricane,” she says. “We wanted to be able to be there for the staff so they could care for the patients. We were making sure people’s basic needs were being met: ‘Are you sleeping? Have you been eating? Do you have shelter?’ A lot of our staff had lost their houses and had nothing but a slab left. We were helping people fill out paperwork to get Red Cross checks. When you see people in a crisis mode, they forget about taking care of themselves in the most basic ways.”
She learned some key lessons in crisis response from her mentors on the staff. “When you’re starting off in this field and you’re a young psychologist or resident, your mindset is, ‘I want to get out there and help as much as I can.’ I was still running on adrenaline, ready to go out full speed ahead to help anyone. But one of the things I learned from being in a crisis like that is you have to keep your own energy up and save something for after the crisis. One of the faculty pulled me aside and said, ‘They will need you two weeks from now, several months from now.’ “
Once the acute needs were past, the chronic needs remained. As Dutton continued to work through her residency rotation, she continued to counsel staff because the stress didn’t end once they had roofs overhead again. Living with 13 people crammed into an apartment is a different kind of stress. “I watched how people continued to suffer emotionally,” she says. “That’s the time when you really had to have the energy to support them and work with them.”
Her work didn’t go unnoticed. She was honored with a VA Secretary’s Hero Award for her work persevering during and after the hurricane. At least as important, her colleagues at the hospital honored her with their Erwin L. Shatus Award, given every year to one of the residents in the graduating class.
Not surprisingly, after Dutton graduated from her residency program in August 2006, she was asked to stay and develop an intensive residential program to treat veterans suffering from PTSD. “When she said she was interested in being part of our psychological family — that was the easiest decision I’ve made all year,” Sison says. “She’s a keeper.”
Dutton was ready for the first group in October 2006. “I had a month and a half to get it going,” she says modestly. As a military kid herself, Dutton feels a special affinity for service members.
“My father was in the Air Force,” she says. “I grew up in a military family and lived overseas for 12 years. I’ve been around the military community my entire life, and I appreciate it a lot. I felt I had gained a lot of benefits from being in that community. I knew I wanted to work in some capacity with the military. It’s a really special population. The veterans I work with are amazing individuals. They have gone through horrific experiences. They’re survivors.”
Although she had wanted to work with those in the military, Dutton hadn’t felt a call to work with veterans suffering from PTSD until she got to Biloxi and began working first with hurricane victims and then with veterans suffering from PTSD. “I felt like God was really calling me to work in this direction,” she says.
Veterans suffering from PTSD may have trouble trusting others. They may suffer from hyperarousal, panic attacks, isolation and re-experiencing their combat trauma. “They’re always feeling on edge,” she says. “There’s a lot of anger involved. They isolate themselves a lot and try to avoid getting into situations where they’re experiencing hyperarousal.” Certain events — war news on television, or a firecracker — can cause problems. “Seeing combat situations that are occurring in the world can bring back memories of their own combat and trauma,” she says. “Those can set them off. They’re isolated from others since they don’t feel understood. They have a lot of issues, anger and anxiety.”
These emotional problems also can lead to life-shortening physical ailments such as heart trouble, high blood pressure and substance abuse. Dutton looked at different treatment programs at other VA hospitals — then combined the best elements with the biopsycho-social-spiritual model she developed for cardiac patients in a program at Sentara Virginia Beach General Hospital.
Dutton set it up so veterans stayed with the same group of eight to ten fellow vets during an eight-week residential program at the hospital. “They come in together as a group,” she says. “When you’re dealing with PTSD, there are a lot of trust issues involved. I thought it was important that they come as a group and stay as a group to build support for each other and the staff.”
The veterans come in and while they may look fine physically, they’re suffering emotionally. “We have veterans come in and say, ‘I’ve been married and divorced multiple times, and the relationships haven’t worked out,’ “ Dutton says. “We have others come in and say they’ve been married 30 or 40 years. Those families can develop secondary trauma.”
The program is set up so the veterans can help each other. Two groups are running at once, with the senior group four weeks further into the program than the junior group. “The group that has been there for four weeks can start to mentor and be available to the new group coming in,” she says. Then when the senior group graduates and a new group comes in, the junior group becomes the new senior group.
“Quite often I see a veteran come in at the beginning of the eight weeks and not trust the staff, not trust anyone,” she says.
“In the military, these veterans had been forced into survival mode, trained to be in survival mode, and that’s how they’ve functioned for the last 30 years. We start to break down these walls. They let someone in and start to tell their stories. It’s rewarding to watch someone start to build trust for the first time in 30 years. To not have to carry around these secrets by themselves — it can have an amazing healing effect. I get to watch them go through that process over eight weeks. It can be very gratifying.”
During the program, each group goes to a Vietnam memorial site in a neighboring town and holds a memorial service for fallen comrades, a service that helps the healing process. The program itself isn’t intended to be a complete cure, but the beginning of a journey. “We’re not expecting that all of their symptoms will be completely cured by the end of the program. But they begin to open up. They begin to trust us and other veterans. They realize they don’t have to isolate all the time.”
Dutton has found her calling. “I’ve been given this opportunity here that I never imagined having at this point in my career,” she says.
Sison predicts great things ahead. “She’s a trauma specialist,” he says. “In my opinion, she’ll move on to whatever level of leadership she desires.”
Years after Katrina, the world has moved on to other issues — yet those in Louisiana and Mississippi continue to feel the impact. Many residents who survived have no homes to return to. Some will never return. Private individuals, church groups, other charities as well as state and federal governments continue to help rebuild homes and lives. Mission teams still travel to the area to rebuild damaged and destroyed homes and to offer hope. And in Biloxi, Dutton continues to help war-scarred veterans fight their inner storms.
