Last Tuesday evening, as the news reports of flooding rolled in and it started to become clear to me what the human scope of the tragedy would be, I thought of the one person I knew in New Orleans.

She's an acquaintance I met exactly once some years ago, going out to dinner with a coworker who knew her from an online group. She's a survivor, an incredibly cheerful and bushy-tailed person who had long outlived every prognosis she'd been given for her lymphoma. Of course, her cheefulness may have had to do with having just been transfused the morning of the day I saw her. She was, however, pretty close to the margins of health and society in perhaps the poorest state of the union. Her treatment had exhausted her resources and whatever insurance she may have started out with. Transferred into the indigent health system, she racked up debts to the State of Lousiana for an amount larger than most people earn in a lifetime. Contrary to the beliefs of most Canadians, there is coverage of last resort in the US, but they are sure not happy about keeping you alive. One problem was the very length of her survival: some of the programs paying for her care capped the total amounts at levels based on prognosis -- live too long, and the money runs out, you've overstayed your welcome, go find somebody else to pay. Another is that the programs you end up in are more concerned with cost control than excellence of care. Kidney failure required her to have dialysis once a week -- skip it, and you start dying pretty quick. Some bright administrator had determined that "once a week" meant the same as "no more than four times per month". Those with an excellent command of arithmetic may notice that four times per month times twelve months equals forty-eight, somewhat less than the fifty-two weeks which actually occur in a year. (Perhaps said administrator went to a Louisiana public school, which tend to rank even lower than post-Proposition 13 public schools in California, as far as academic excellence goes.) So every time there came a five-week month she and her caregivers were left with an awful scramble, trying to find a facility to adminster treatment. (Hm, "finding". If she were black, these days we'd say "looting". And it's not so different: I doubt the places that served her in those fifth-weeks ever received a dime for it.) Sometimes she'd have to give up, and go without.

Money was tough. The state demanded the vast majority of whatever she could earn, to pay back the medical debts, see, although at her rate, she would have to live for centuries to catch up. The cabfare to come meet us consumed most of a month's disposable income, so we bought dinner and the cab home. (Why didn't she declare bankruptcy? I don't know -- perhaps she already had, perhaps she couldn't afford the filings, perhaps the State, in its infinite wisdom, chose to disallow cancellation of debts to itself. Or perhaps it simply wouldn't have helped.) It was also quite difficult for her to work, given transportation difficulties, the amount of medical care she required, and her health's effects on her ability to produce. She was perky the day I saw her, but anemia, induced in almost all chemo recipients, can be an incredible drain on your ability to function, much less accomplish anything. Erythropoeitin helps some, but is fantastically expensive. She had an office job for awhile, but she lost it, due to frequent absences. Later she had a job at a pizza place, but got mugged on the way to work one evening. She arrived, but late, and so beat up looking that she was fired on the spot. She lived the life of Job, as my coworker says.

So I thought of her Tuesday night, as I looked at the pictures of water flowing over levees, and read of the difficulties evacuating the sick and the poor, and thought that it was exactly people in her kind of situation who might not make it. And then I realized that, in fact, she was unlikely to have survived until now anyway. She was too sick, her existence too marginal. And I felt sad.

Wednesday, my coworker told me she was okay. (O ye of little faith!) A friend drove her out to someplace higher and drier. The lymphoma is in remission, dialysis is twice a week now, but she's okay. And you know, despite my tenuous connection to her, I felt truly grateful. Being an atheist, I don't know who to thank (though the person driving the car comes to mind). A Christian might say that God spreads his love on the faithful and faithless alike. It doesn't matter why, I will take it, and be thankful.

An AP poll has 80% saying don't rebuild New Orleans below sea level. This sounds like a rough consensus, but it doesn't include everyone, obviously. Here's one alternative voice:

Joyce Jones, a retiree from Modesto, Calif., said: "If the levees were built stronger, they should put it back the way it is. We're a nation of lots of smarts. Those Corps of Engineers can do just about anything."

I find the language here interesting. I absolutely agree that the nation has lots of smarts, and, given those smarts and sufficient time, money, and effort, great feats of engineering are possible. However this statement contains an implicit limitation on what we are allowed to use those smarts for: can we apply the smarts only to the engineering, or are we also allowed to be smart about what goals we choose to engineer?

The other obvious question, not posed by AP, is "which sea level?" Do we pick a value from the 19th century, the 20th, or what reasonable expectations are for the 21st? And who gets to define "reasonable expectations"? This one could get very sticky and political, but get it wrong, and the same problem could repeat far sooner than necessary.