Friday, February 21, 2014

Five Days At Memorial: Life and Death in a Storm Ravaged Hospital by Sheri Fink

 Reviewed by William Wade

This is not a fun book to read.  Not by a long shot.  But it’s important, and a great many of us need to know this story and to consider the consequences of the events unfolded here.  Five Days at Memorial is the graphic account of what happened to a major hospital in New Orleans during the Katrina hurricane in September and October, 2005.

The first part of the book deals with the immediate aftermath of Katrina.  Initially the staff of Memorial Hospital thought they had survived the hurricane reasonably well – some blown-out windows, but they could be repaired.  City electricity was off because of downed power lines, but their own auxiliary generators were working well.  Then came the ominous news that a far worse disaster was upon them. The streets of downtown New Orleans were filling with water!  The main levees protecting the city had been breached!  City services such as water, sewerage, and electricity would all be disrupted for an indeterminable time.  Unfortunately, the auxiliary generators at Memorial were located on the first floor, and the rising water would put them out of operation.  The entire building would become dark, life-giving machines for patients would cease to work, elevators would be out of operation, and the water supply would be contaminated.  Clearly, Memorial Hospital had to be evacuated and the sooner the better.

Telephone service was also non-existent, and the staff had to communicate through internet and cell phones.   Emergency messages went out immediately, but all New Orleans was in a crisis no one could have imagined.  City and state authorities had no contingency plans for such a catastrophic emergency.  A call went out to the parent company in Texas which owned Memorial, but they had little to offer, and the hospital seemed to be on its own.  Memorial did have a helipad on the roof, but this rusted structure had not been used for a decade, and no one knew whether it was safe.  And so the staff acted on their own, triaging the patients and deciding to try to evacuate the least desperate cases first.  Over the next several days the National Guard sent some helicopters, and the landing pad did hold.  But it was an onerous task carrying each patient  through narrow dark stairwells to the roof, and the process was exceedingly slow.  Pilots complained that they could work much more efficiently by plucking  individuals from rooftops all over the city.  Finally a fleet of small boats was sent to take away those who were walking patients and could be deposited on a roadside beyond the flooded area.  This left the sickest patients, generally elderly and on life support.  Many were in a vegetative state and near death; they could probably not survive any kind of transportation.  Could the medical staff remain behind, waiting until they died?  And so a decision was apparently made, led by Dr. Anna Maria Pou, a prominent physician on the staff, that these last patients would be administered a lethal dose of morphine.  Was it an act of mercy, or was it murder?  One of the doctors asked the question: “Should we be doing this?”  Those words would come back later to be remembered again and again.  Finally all of the staff departed, and Memorial Hospital was left vacant and empty.

Part Two of Five Days at Memorial is a full and detailed account of the tangled aftermath that would ensue for weeks, months, and even years.  As the waters gradually abated, curious persons, chiefly the news media, approached Memorial Hospital and ventured inside.  The structure was unbelievably fetid from days of accumulating human waste and decaying bodies.  Some individuals fainted.  Others took pictures, and the grisly scenes were soon displayed on local television.  Authorities entered and carried away forty-five human bodies.  Questions soon arose: what happened at Memorial Hospital?  How did this come about?  Accusations were made; it became a major theme of the local news media, and before long questions were being asked nationally.  It was a feature on “Sixty Minutes.”  Relatives of the deceased wanted explanations.  Inevitably the authorities were brought into the picture and an official investigations was underway. The leading members of the staff, including Dr. Anna Marie Pou, were subpoenaed and their testimony taken.  Local citizens began to take sides.  In general Dr. Pou and her colleagues gave a similar response to questions: “ you were not there and cannot believe how horrible the situation was.  We acted in what we thought was best for our patients.”  But was it murder?  Finally it came down to the decision of a grand jury which had to decide whether Dr. Pou and others should be formally charged and tried for a criminal act.  By then most of the public was sympathetic to Dr. Pou, and the jury refused to indict.  Ultimately the whole matter was dropped, although fears lingered that it might resurface.

One of the most valuable parts of the book is a concluding Epilogue in which author Sheri Fink asks what lessons are to be learned from this episode.  After Katrina, did authorities throughout the United States take steps to prevent the repetition of Memorial.  For her answer she considers the actions of authorities when superstorm Sandy struck major Northeastern metropolitan areas and also the response to the 2010 earthquake in Haiti.  Much has been done, but Fink finds our governmental authorities, our institutions, and our people in general remain unprepared for any kind of major catastrophe, whether caused by nature or through human design.  This is a book for all of us to read and to consider: how can we best prepare for the unthinkable?

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