In New Orleans, Memorial Medical Center was known as a safe place to ride out a hurricane.
Since its opening as Southern Baptist Hospital in 1926, "Baptist" had provided refuge during even the worst storms, not only for patients and staff, but also for their families and pets. In August of 2005 it was no different when, in advance of Hurricane Katrina, Mayor Nagin ordered the city's inhabitants to evacuate. Hospitals and their workers were exempted from this order. On Sunday, as Katrina approached, there were 238 patients, 600 staff members, and several hundred family and community members in the hospital complex, as well as dozens of family pets.
Early Monday morning, with the storm in full fury, windows began breaking. At 4:55 a.m. the power failed and the hospital's generators kicked in to provide power for emergency lighting, critical equipment and a few outlets, but not for air conditioning. The streets were flooded and the basement began filling with water. By Monday afternoon the storm had lost strength and the water outside receded. However, by Tuesday morning the water from breached levees started rising around the hospital and this time it would not quickly recede. Some patients, including infants, had been evacuated, but staff realized they had to get everyone out, yet they lacked a plan or resources for this to happen. They were exhausted, frightened, confused and feeling abandoned. Help was coming only sporadically. The hospital was unbearably hot and there was no running water or functional toilets. Early Wednesday morning the last backup generator died.
Confronted by conditions for which they were both practically and emotionally unprepared, doctors and nurses had to make impossible decisions about the care of their patients.
Sheri Fink is more than qualified to write this story. She is an MD, a PhD and a Pulitzer Prize winning journalist. In the first part of this meticulously researched book, Fink tells the story of the hospital, of the patients and of their caregivers, and of their struggles to survive the ravages of the storm. In the last part she details the aftermath. When the last living person was evacuated from Memorial on Thursday, 45 patients were dead and the coroner ruled that 20 of those deaths were homicides. One doctor and two nurses were arrested and charged with second degree murder.
This is a disturbing story on many levels, including: how truly unprepared we are for large-scale disaster, how the worst suffering falls on the most vulnerable, how slow we are to implement necessary change, and how ethical decision-making can be severely compromised by physical and emotional exhaustion.