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Most psychiatrists practicing in Grand Forks were forced to evacuate their flooded homes and offices. Many set up temporary practices in outlying areas where they saw evacuated patients and flood victims, according to David Peske, executive director of the North Dakota District Branch, in an interview with Psychiatric News.
By late April about 75 percent of the 50,000 people in Grand Forks were evacuated to other locations, including Fargo, which is about 75 miles south of Grand Forks. The entire population of East Grand Forks, Minn. (10,000), was evacuated about the same time to other areas, including nearby North Dakota, said Peske.
Psychiatrists in Fargo who were not forced to evacuate homes and offices, including the District Branch President Elizabeth Faust, M.D., and President-elect Stephen Setterberg, M.D., have been working long hours to help meet the mental health needs of evacuees from Grand Forks, Peske said.
The DB's official response has been hampered by the disaster's impact on members. However, Peske has met regularly since the disaster with leaders of mental health groups including psychologists, social workers, and the state's Division of Mental Health to discuss relief efforts. Psychologists have been involved in training school administrators and teachers to watch for signs of PTSD in children, he noted.
Moreover, the state was recently awarded a $700,000 grant from the Federal Emergency Management Agency to perform crisis mental health services. This effort may utilize psychiatrists in training and supervision of local workers (see related story).
Jack Kerbeshian, M.D., a child and adolescent psychiatrist and president of the state medical association, spoke with Psychiatric News from his makeshift office in Crookston, Minn., 25 miles from Grand Forks. He and the medical staff of United Hospital in Grand Forks were evacuated after helping evacuate patients. Kerbeshian is medical director of the hospital's department of psychiatry.
"As the waters encroached upon the hospital, we had to evacuate 17 psychiatric patients in four hours. This forced us to quickly assess where patients should be sent. Fortunately, psychiatrists at the state hospital for the mentally ill in Jamestown, 100 miles west of Fargo, admitted our patients with open arms.
"After the rapid hospital discharge, the medical staff was forced to evacuate due to a hazardous loss of water pressure. We were flown in helicopters to Crookston, Minn., because the bridges were closed," said Kerbeshian.
The staff of the Northwestern Mental Health Center in Crookston helped Kerbeshian establish a temporary office. Minnesota also temporarily suspended its licensing requirements for licensed physicians from other states so they could help disaster victims.
"This allowed me to see patients evacuated to Crookston and other flood victims initially," said Kerbeshian. "I notified the public health nursing unit and the human services center conducting a large outreach of my availability to see patients.
"I checked up on a daughter of a migrant worker in a shelter who has extreme hyperactivity. I was referred three people initially and then several people over the next few weeks.
"Some patients had a sustained persistent level of stress because they had fought the floods for days. When the sirens rang, they were lulled from a sense of safety to an emergency leaving. That was when the shock came."
Unlike a tornado or hurricane, this flood was not a sudden catastrophe but a gradual, unrelenting event, noted Kerbeshian. He compared it to "seeing high tide advancing on the beach."
Many people have been experiencing grief over their loss, he noted. "Now, I am seeing signs of anger, which is another stage consistent with grief. Surprisingly, very few people are angry at the river."
Kerbeshian credited the positive Midwestern social ethic with helping to sustain people. Many evacuees have extended family in Crookston and left the shelters.
Kerbeshian said he experienced the flood's devastation firsthand. The first floor of his home was flooded under three feet of water.
"As a physician, I thought about what it means to be a wounded healer," he observed. "I had a sense of mastering my own difficulties by helping patients facing similar circumstances. I am very thankful that I am a physician. I may lose material goods, but I can't lose my professional identity."
He was also gratified by other physicians' response to the disaster. The state medical association has been coordinating the physician relief effort to support emergency room and hospital activities and relieve physicians in their practices so they can repair flooded homes. Kerbeshian said offers to help have come from physicians across the nation.
He also said he appreciated the "kind, good people of Crookston who opened their homes to me and other displaced physicians and treated us well."
(Psychiatric News, June 6, 1997)