HJNO Sep/Oct 2021

HEALTHCARE JOURNAL OF NEW ORLEANS I  SEP / OCT 2021 25 2408 in 2020 and are at 1359 year-to-date for 2021. CECs also seem to have diminished from 4407 in 2019 to 3811 in 2020 and 2048 year-to-date in 2021. I think part of the rea- son for the fluctuation in numbers is my office and other agencies in St. Tammany Parish have worked very hard to educate people about the involuntary commitment process and encourage them to seek volun- tary commitment. I attribute the increase in requests for OPCs to the out of control substance use disorder issue, and that is by far and away the most common reason — there’s a family member with alcohol or drug issues. My office has been able to eas- ily absorb this increase in requests through our normal processes. Cvitanovich Yes, about a 20% increase. We have increased staffing in our mental health department to keep up with the increased volume. McKenna Yes, numbers have increased and with difficulty, mainly because our staff is overwhelmed with the high numbers and lack of facilities needed to care for the patients. Many end up in parishes outside of NewOrleans. Our office is currently short staffed. In Louisiana, the coroner’s office is charged with examining all alleged victims of a sexually oriented criminal offense. How are these handled, and how many encounters of this type does your office typically see in a year? Preston We have 2 full-time and 3 part-time sexual assault nurse examiners that cover 5 parishes. Our model is based at the coro- ner’s office, but the nurses respond to wher- ever the survivor is in the hospital. We did 123 cases in 2019, 91 cases in 2020 and have done 92 year-to-date. Cvitanovich We handle 50-70 adult rapes per year. This is relatively stable. Pediatric sexual assaults have increased about 20%. McKenna All of our cases are referred to the Medical Center of Louisiana, which handles these types of emergencies. They are a good partner with us because of their state-of- the-art facilities and outstanding staff. What has surprised you most in your position? Preston Frankly, I think the biggest surprise after being elected coroner was just how time consuming this job is. The first couple of years were like a game of whack-a-mole, responding to challenges as they popped up. Now it is time consuming trying to solid- ify our processes and expand our scope of service. And then there is the COVID-19 pan- demic ... Cvitanovich That homicides and overdoses never seem to change community behavior. McKenna Going into my second term, we see the ever-increasing volume of death inves- tigations that come through the office, both from cases of psychiatric interventions and death investigations. Has your view on death changed since being coroner? Preston My view of death is not significantly changed after becoming coroner. As an emergency physician, I encountered cases where normal people were going about their normal activities, and their lives were changed forever in the blink of an eye or lost without warning. Sometimes a patient would ask me if they were going to die of their illness, and I would reassure them that they weren’t with the caveat that God does not promise you the end of the driveway. I’ve always tried to live my life as if this will be my last day on earth, give thanks for the everyday miracles around me and tell the people I love how much they mean to me. Cvitanovich Not really. I still don’t want to die for a long time! McKenna I’m increasingly appalled by the number of young people dying from drugs and violence in our city. One would assume you compartmentalize many of the experiences you encounter in you work. How do you maintain good mental health? Preston In terms of my personal mental health, compartmentalization is certainly an effective coping mechanism. Addition- ally, I have the great privilege to be married to the most magnificent woman on earth who happens to be a physician. She is very supportive and allows me to vent with her about everything from a “cool case” to my current frustrations associated with vaccine hesitancy and the certain preventable suf- fering and death that will follow. Also, my wife is the most spiritual human being I’ve ever met, and I rely on her prayers and my prayers to reassure me that God has a plan for each of us on earth and for all of eternity. When I cannot sleep at night, I find pray- ing the rosary very calming and reassuring. What is the most personally rewarding aspect of being coroner? Preston Without a doubt, the most reward- ing aspect of my job is the team I work with at the St. Tammany Parish Coroner’s Office. It is a very diverse, eclectic group of people with a wide range of skill sets who under- stand our unified mission of “Science-Ser- vice-Compassion.”These are extraordinary people doing difficult work while respecting the dignity of the deceased or victimized and maintaining compassionate professional- ism. I have grown tremendously during this journey thanks to the relationships formed in the course of doing this job. n