The art of the possible: looking back and ahead 5 years after landfall.

About the author: In 2004 I opened a solo pediatric private practice in the town of Bay St Louis, Mississippi. In 2005 Hurricane Katrina produced a storm surge up to 30 ft that damaged or destroyed 90% of the buildings. I returned to practice 1month after the storm and continued there until June 2007, when I relocated to Naples, Florida, to work for a community health center. My experiences, thoughts, and advice were incorporated into the American Academy of Pediatrics “Disaster Preparedness for Pediatric Practices: An Online Tool” (available at http:// practice.aap.org/disasterpreptool.aspx). In July 2007 I was asked to testify before Congress regarding elevated formaldehyde levels in Federal Emergency Management Agency trailers. Since 2007, I have been a member of the academy’s Disaster Preparedness Advisory Council. Hurricane Katrina was the costliest disaster in US history.1 The storm mobilized an unprecedented relief effort, both official and organized (state and federal authorities including the Federal Emergency Management Agency [FEMA] and National Guard troops) and impromptu volunteer (countless churches, nonprofit organizations, and kindhearted people). Local capacity to cope was overwhelmed even before the storm came through. However, all responses must start locally, because all disasters start locally, and to understand a disaster’s true impact, you must also start locally, hearing how individual communities and neighborhoods experienced it.