Floodwaters rising and generators
failing, Memorial Medical Center in New Orleans was in dire straits in
the days after Hurricane Katrina.
Administrators,
doctors, nurses and other staff were faced with evacuating hundreds of
patients, family members and even pets using few resources.
Some patients never made it out.
 |
| Sheri Fink is the author of "Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital." (Jen Dessinger) |
Their deaths were the subject of Pulitzer Prize-winning reporting by Sheri Fink, a trained physician and journalist, in 2010.
Now Fink has
painstakingly detailed those dramatic days – and their legal and
cultural fallout -- in a compelling new book: “Five Days at Memorial:
Life and Death in a Storm-Ravaged Hospital.”
Fink draws
back the curtain on Memorial, giving readers a close-up view of the
people who sheltered at the hospital and the patients who lived and died
there. Their deaths raised questions about alleged "lethal doses" of
medications.
But it doesn't stop
there. "Five Days" also follows the investigation that targeted New
Orleans native Dr. Anna Pou and others. Pou was never indicted.
In
the book, Fink explores big questions that still demand answers today,
such as: How should the health-care industry prepare for disasters? What
criteria should determine the allocation of scarce medical resources?
Fink,
who has a M.D. and Ph.D. from Stanford University, answered questions
from AL.com about her book and the issues it addresses.
What’s the message – if there is one – in “Five Days?”
Fink:
I won’t speak for readers, because I think everyone will have their own
take-aways, but for me, now, it is the importance of investing in
disaster preparedness at your workplace and for your family. Have plans,
and be prepared to change them to fit the actual circumstances.
Be
an advocate for your loved ones in the hospital. Ask tough questions of
your local hospital and health system about preparedness for the
likeliest emergencies and express your views on how medical resources
should be allocated in case they ever fall short.
Most of all, if
you ever face a significant disaster, do your best to keep up the
spirits of those around you, act flexibly and creatively to help, try to
sort rumors from truth, and remember that the decisions you make will
have repercussions after the disaster has passed.
The moral
values, ethical codes and laws that guide our choices in normal times
are, if anything, even more important to help us navigate the confusing
and disorienting time of a disaster.
Do you believe that the people in the book "played God?”
Fink:
The Attorney General of Louisiana and some family members of the
patients who died at Memorial Medical Center after Hurricane Katrina
made that allegation. They believed that doctors and nurses decided
which patients would live and die.
On the other hand, one
of the nurse managers I interviewed said she felt medical professionals
were asked to play God all the time, not only in disasters.
What’s
clear is that the law and ethical codes of the medical profession do
not permit doctors to bring about patients’ deaths intentionally, and
that is what some doctors told me they did in this case.
How did you go about the reporting for the articles/book?
Fink:
I interviewed hundreds of people -- those at the hospital,
investigators, family members of the dead, experts -- and collected
materials, including everything from diaries and photographs to weather
reports and architectural diagrams. And, of course, I visited the sites
and looked for every article, report and book that related to these
events.
Was there one character or anecdote that stood out in your reporting?
Fink:
Dr. Pou received a great deal of media attention because colleagues at
the hospital accused her of having given "lethal doses" to patients, and
she was arrested for second degree murder in the deaths of a number of
them.
She maintained her innocence, and a grand jury refused to
indict her. I discovered that other doctors were involved with injecting
patients with morphine and the fast-acting sedative Versed, and two of
them told me they had done so to hasten the deaths of their patients.
Colleagues of theirs at the hospital told me they objected to these
actions, believing them in no way necessary or appropriate.
The
real story here is revealed in the range of voices and perspectives on
those events, and that's why “Five Days at Memorial” is a book. The
length of a book provided an opportunity to give a nuanced picture of
what happened and what it means.
What surprised you the most about this story?
Fink:
The fact that certain doctors had given patients medicine for the
purpose of bringing about death. As someone who had delivered
humanitarian aid in crisis zones and written a book about a besieged
Bosnian war hospital in just about the most dire prolonged, situation
imaginable, I don’t think I’d ever, outside of the realm of fiction,
heard of actions like this. I had a hard time believing it had
happened.
Once that was clear, it was important and urgent to
understand how things could have devolved so quickly in an American
hospital that respected physicians took part in it.
What would you still like to know? Any unanswered questions?
Fink:
The death of one of the patients, a 61-year-old man named Emmett
Everett, was particularly striking. The morning he died, he was alert,
ate his breakfast, and had asked his nurses, “Are we ready to rock and
roll?”
He weighed around 380 pounds and was paralyzed. According
to several witnesses, staff discussed his situation with Dr. Pou, and it
was decided that he was too heavy to be carried downstairs and rescued,
although others who worked in the hospital later said they would have
gladly helped carry him if they’d been told a heavyset man on the
seventh floor needed to be transported.
He was found dead that
afternoon, and toxicology tests showed morphine and a fast-acting
sedative drug, Versed, in his body, neither of which he had been
receiving or had been prescribed for him.
Dr. Pou was seen
walking into his room before he died but has not commented on his death
other than through her lawyer, who said Mr. Everett died of an enlarged
heart — several forensic pathologists concluded that his death was a
homicide, a result of the drugs that were injected into him.
His
main complaints that morning were dizziness and the desire not to be
left behind at the hospital. Why were the drugs given to him and who
gave them? There has been no explanation.
Did the reporting process change you personally. If so, how?
Fink:
It made me more passionate about the need for better disaster
preparedness on the part of our country—from government to businesses to
individuals. And the need for more research to understand how we can
improve resilience.
What has been the reaction from the medical community and from New Orleans – to reporting or the book?
Fink:
There have been some good discussions about disaster preparedness,
ethics, and end-of-life issues. I was in Louisiana last weekend, and one
hospital administrator told me she checked with her plant operations
team after she started reading “Five Days at Memorial” to make sure her
hospital’s backup generator systems were protected from flooding.
What lessons did the country learn from Katrina?
Fink:
We learned we have some major vulnerabilities, particularly in the
healthcare sector, which is a great first step, but now we have to fix
them! “Five Days at Memorial” spells that out — the final section takes
the reader from Hurricane Katrina to today, with stops in places like
Haiti and New York City after Hurricane Sandy, and what we have and
haven’t learned.
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