Book: Five Days at Memorial by Sheri Fink

Life and Death in a Storm-Ravaged Hospital

The hospital was Memorial Medical Center in New Orleans, and this story begins on Saturday, August 27, 2005. We've all seen and read about the horror of Katrina and the aftermath. Here is an account of one hospital and its staff and how they struggled, and it is also about hard decisions they made while exhausted and under extreme stress.

In addition to the patients admitted to Memorial Medical, there were also "very sick, often elderly and debilitated patients" requiring long-term care on the 7th floor, which was leased by LifeCare, a separate entity. So the story of what happened involved two separate healthcare providers at the corporate level, which complicated the turn of events.

 "Pou and her colleagues had little if any training in triage systems and were not guided by any particular protocol. Pou viewed the sorting systems they developed as heart-wrneching. To her, changing the evacuation order from sickest first to sickest last resulted from a sense among the doctors that they would not be able to save everyone."

"Pou found clean scrubs to change into each day, but she was drenched and dirty, and for the third night in a row, she worked on scarcely an hour's sleep. She had assumed an attitude of blindness, navigating dark corridors with the run of fingers along humid walls and ascending navigable staircases by kicking the steps ahead as she went and counting. With several doctors and crews of nurses, she changed patents' diapers and dipped rags into water to make cool compresses. She said prayers with anxious nurses whose faith in their skills was shaken. "

Many patients were evacuated and survived, but not all. Some died of natural causes; some died directly or indirectly due to the chaos and compromise of the physical facilities that the hurricane left after it passed (water, electricity, heat and sanitation) but others were euthanized.

The author was not in New Orleans during Katrina so everything she writes about is from sources other than a first-person experience. But it seems she researched thoroughly; she is also a Pulitzer Prize winner and has MD and PhD degrees from Stanford. Still, she was not there and so the story comes from others. As it turns out and as one would expect, there was outrage and empathy when the facts surrounding some of the deaths came to light in the months following. A grand jury was eventually convened to "decide whether the evidence they heard persuaded them that [Dr. Anna] Pou had a 'specific intent to kill' --part of Louisiana's' definition of second-degree murder."

"As the outlines of this medical tragedy sharpened, there was an urgent need to understand its causes before the next catastrophe occurred in New Orleans or elsewhere in the c country. Were deaths at hospitals and nursing homes regrettable results of an acute of nature, a chaotic government response, and poorly constructed flood protection overload on a degraded environment? Or had lax oversight allowed individual or corporate greed to play a role?"

Could this happen again? WIll this happen again? Can we be better prepared? Will we be better prepared? This is one set of questions; the other set is how we feel about euthanasia, hospice options, comfort care only, advanced directives, rationing of healthcare...

The New York Times' reviewer says, "This is not a morality tale for others, but for ourselves."