“even worse is survivors who don’t trust each other”

“even worse is survivors who don’t trust each other” is a warning that disaster damage does not end with the storm or the immediate emergency: fear and mistrust can deepen the harm among people who have survived it. Father John F. Tuohey offered the phrase during a 2009 panel discussion with Dr. Anna Pou. The book places it alongside the challenge of holding people morally accountable while recognizing how disaster conditions constrain their choices. Its force lies in joining two consequences that are often treated separately: the collapse of reliable assistance during an emergency and the enduring difficulty of living with what happened.

The phrase and its setting

At the 2009 panel, Tuohey observed, “As bad as disasters are, even worse is survivors who don’t trust each other.” The remark appears in a discussion of disaster medicine, not as a claim that survivors are responsible for the failures around them, but as a warning about what those failures can leave behind. In the book’s account, trust depends on more than personal goodwill: people need dependable information, functioning systems, and confidence that help will reach them.

The phrase also sits beside an ethical argument about responsibility. In a 2009 email, bioethicist Lachlan Forrow argued that exceptional emergencies should be occasions for renewed commitment to core moral values, including compassionate but firm accountability when those values are violated. Tuohey’s remark gives the social consequence of that problem: if accountability is abandoned, or if it becomes detached from compassion, confidence among survivors can be damaged further.

How uncertainty becomes danger

The events surrounding Hurricane Katrina show how a lack of dependable information could shape people’s understanding of immediate danger. On WWL Radio, a neighboring parish president’s announcement that martial law had been declared was repeated, although martial law had not in fact been declared in the disaster zone. A caller’s unverified report of looting was amplified, and the host endorsed shooting looters while claiming the area was under martial law. The book later describes rumors of violent gangs and other threats circulating from the station to rescue pilots and the halls of Memorial Medical Center. Although lawlessness did occur, many of the worst crimes reported at the time never happened; rumors and fear nevertheless affected rescue decisions and contributed to the abandonment of posts by some first responders.

The uncertainty was not only about violence. A man named Freddy called the station from an attic in the Gentilly neighborhood, near Lake Pontchartrain, where he and four others, including a baby, were surrounded by rising water. They had made a hole through the roof and spent four hours trying to signal a helicopter. His account gives the phrase’s stakes a concrete form: people in immediate peril had to rely on communication networks that could carry both urgent testimony and unverified claims. Elsewhere, the mayor’s evacuation order sent people without their own means of transport toward the Superdome, while officials knew that transport plans had serious gaps. Acadian Ambulance’s dispatchers were overwhelmed, and many of the available ambulances were stuck in traffic; some took patients to the Superdome instead of out of the city. When information, transport, and rescue are unreliable, mutual confidence is not an abstraction but part of how people judge where safety may be found.

The unequal burden of failed systems

The book locates such uncertainty within a broader pattern of institutional failure. More than a thousand people died immediately in New Orleans, many in medical facilities and many others poor or elderly; others suffered or died later amid stress and disrupted health care. The listed causes include the delayed evacuation order, inadequate buses and drivers, uncoordinated rescue efforts, poor communications, and hospitals and nursing homes without sufficiently robust backup power and water systems. The account also distinguishes actual crimes from exaggerated fears of violence, showing how rumors could compound failures already produced by infrastructure and planning.

Inside Memorial, Karen Wynn saw how the crisis could narrow attention to one person’s predicament at a time. An outpatient reached the hospital through the floodwater for a scheduled chemotherapy appointment, unaware that treatment could not be provided. A representative of Women’s Hospital in Baton Rouge complained about a male psychiatric patient transferred there with newborns; Wynn assumed the patient could be sent elsewhere and did not grasp how widespread the crisis outside Memorial had become. These episodes show the distance between people’s partial views of an emergency. The phrase does not reduce that distance to individual indifference: the narrative places it against an overwhelmed response in which staff and patients had limited knowledge of conditions beyond their immediate surroundings.

Trust after the emergency

The book traces the aftermath not as a simple return to normal but as a period in which the events continued to surface. Gina Isbell slept poorly, had nightmares about her patients, and felt guilty about the staff she had chosen to work during the hurricane. She had left Memorial by small flat boat, then discovered that her home and community in St. Bernard Parish had been lost. Later, even after a special grand jury declined to indict Pou, Isbell remained angry about how slowly help had arrived and described herself as permanently changed by the trauma. A memory from the helipad offered some comfort: Roy Culotta’s eighty-seven-year-old grandmother told Isbell that if she were alive the next day, it would be because of her. Isbell continued to believe that she and her colleagues had done the best they could and would serve again if asked.

For Wynn, preparing to testify meant that discussions with her attorney could make the events feel newly present; after some meetings, she needed weeks to regain her footing. She recognized what she believed were symptoms of post-traumatic stress disorder in herself and colleagues. She also no longer wanted the level of responsibility she had carried through a quarter-century at the hospital, including the decision to call Cheri Landry and Lori Budo onto the hurricane schedule. These accounts give the phrase an intimate dimension: mistrust and distress are not only public reactions to rumor, but part of the difficult work of explaining decisions and continuing relationships after a catastrophe.

The book extends that aftermath through John Thiele’s later critical illness. During weeks of sedation, he experienced nightmarish visions of monsters and pods and recalled feeling underwater, struggling to surface. A nurse who had cared for him at Memorial believed from a brief conversation that he was remorseful about his role in injecting patients; Thiele later denied having felt that way and said he remained confident in what he had done. The contrast underscores how survivors may understand the same actions differently, and how difficult it can be to establish a shared account without either excusing conduct or erasing the conditions in which it occurred. In this context, Tuohey’s phrase names more than an emotional cost: it identifies trust as something disaster can damage, and as something that moral accountability and truthful understanding must try to preserve.