How do we cope with a disaster on the scale of Hurricane Katrina? Do we learn the necessary lessons and adjust accordingly, or do we simply slip back into a state of denial? How prepared are we for the next major storm?
Questions like these have been on my mind this week during my stay in New Orleans. Today I saw Living with Hurricanes: Katrina and Beyond, an exhibit at the Presbytere, part of the Louisiana State Museum. The interactive exhibit weaves together first-person narratives, storm relics, news media coverage, and the voices of experts attempting to make sense of the disaster from an environmental, community, and political perspective.
There are messages of hope, as well—stories from storm survivors, art works by children, Tommie Elton Mabry‘s fascinating storm diary written on the walls of an empty apartment in the B.W. Cooper Housing Development, and in the entrance of the museum, Mitchell Gaudet‘s installation of etched glass bottles titled Message of Remembrances.
But Katrina was just one hurricane among many to hit New Orleans. There was also Betsy, Camille, Bertha, Gustav, and 43 other major storms. The inhabitants of Louisiana’s coastline have been fighting back the water since 1722. There has been a lot of wreckage and lost lives along the way. Seeing those notorious spray-painted Xs again, along with photos and videos of people trapped on roofs and in squalid conditions at the SuperDome is still disturbing and infuriating, even after all of these years. It’s even more alarming to discover that it was a perfect storm of environmental recklessness, bad engineering, lack of preparedness, bureaucratic mismanagement, and sheer natural force made Katrina such a deadly, costly disaster.
Writer Sheri Fink has spent the past several years investigating one particular thread of the Katrina story—the events at Memorial Medical Center, where 45 bodies were left behind by staff members before the facility was evacuated on the night of Thursday, Sept. 2, 2005. How these patients ended up euthanized and abandoned in the hospital chapel is the subject of Fink’s new book, Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital. Fink interviewed hundreds of nurses, doctors, patients, family members, government officials, and law enforcement officers for the story, which is a joint investigation funded by ProPublica and the New York Times. (Irene Ogrizek‘s review of the book is included below.)
Fink is a Pulitzer-Prize winning journalist. But as I learned during her residencies at The MacDowell Colony, Fink also has her M.D. and Ph.D. from Stanford University and has been a relief worker in disaster and conflict zones. This kind of in-depth investigative journalism is far too rare, but Fink’s experience, knowledge, dedication, and persistence make her the perfect writer for this sensitive and important topic.
Fink’s book was on my mind today at the Louisiana State Museum. While the Katrina show is moving and insightful and represents various viewpoints, Five Days at Memorial is a reminder that such exhibits have their limitations. At the museum, a text panel and short video called “Hospitals” both attempt to convey the horrible conditions medical workers faced post-Katrina. But the fraught ethical issues detailed by Sheri Fink are glaringly absent. Instead, the museum’s official hospital narrative emphasizes “resilience” and “bravery.” But as Sheri’s book proves, “heroism” is only part of the story.
What good is the mantra of resilience if individuals, governments, and organizations don’t make and demand changes in the wake of natural disasters? Have we learned anything from Katrina and the shocking events that unfolded at Memorial in the days following? If Hurricane Sandy is any measure, the answer looks grim. During the storm, nearly 300 patients had to be evacuated in flashlight-lit stairwells at New York University’s Langone Medical Center when generators failed due to flooding. Sandy also forced Bellevue Hospital to close when their generators ran out of fuel and diesel fuel pumps flooded in the basement.
Disaster preparedness costs time and money, but without viable backup plans, there could be more incidents like the one at Memorial. Five Days at Memorial is an urgent plea to remember disasters of the past.
A Review of Sheri Fink’s Five Days at Memorial
by Irene OgrizekOn Sunday August 28, 2005, Hurricane Katrina was whorling its way toward New Orleans. At 10 o’clock that morning, mayor Ray Nagin gave evacuation orders. All routes of egress became clogged and those left in the city battened down the hatches in anticipation of a category five assault. Residents were told to bring axes with them to their attics so they could hack their way to their rooftops. Hurricane Betsy, in 1965, had taught them not to underestimate the perils of coastal flood waters.
At Memorial Hospital, situated in the city’s basin, working staff brought along their families and pets. The hospital building was considered a safe refuge and many residents in attendance had sought shelter there before. Hampers of food, changes of clothes and other supplies were safely stowed while staff got on with the job of caring for patients and family members hunkered down for what was expected to be one of the worst storms of the century.
Sheri Fink’s account of everything that went wrong at Memorial, is densely layered and elaborate. At the centre is the story of Dr. Anna Pou, a head and neck surgeon who, along with two nurses, hastened the deaths of at least 18 critically ill patients just as helicopters were arriving and hospital staff were undertaking a final evacuation.
Ten days later, when relief workers entered the empty hospital, a total of 45 corpses were discovered, a number that got the attention of the state attorney’s office. Thus began the arduous task of recreating events leading up to the gruesome discovery.
What Fink’s account doesn’t reveal is the sheer enormity of the task she must have faced piecing together witness accounts to form a narrative so rich in detail. Hints are there in Pou’s prevarications in the aftermath of the crisis. In a way that will be familiar to those who have experienced medical malfeasance, information, via Pou’s lawyer, was fed to investigators and the media via the drip method, leaving onlookers and those seeking justice to fill in substantial gaps.
Fink fills those gaps and does so superbly. Her diligence has produced a backstory that casts doubt not only on the preparedness of the hospital and state and federal governments, but also on a legal system pliable enough to convince jurors and even prosecutors to ignore overwhelming evidence pointing to a defendant’s guilt. That evidence included high concentrations of morphine and the sedative midazolam found in the organs of many of the dead, including the organs of one victim who was not critically ill. He had enjoyed his breakfast the morning of his death and had poignantly asked a nurse to make sure he was not left behind. He was Emmett Everett, a 61 year-old paraplegic and doting grandfather.
To date Pou has never openly admitted she had a hand in the four deaths that were eventually deemed homicides. Instead she has conspicuously relied on her supporters, her silence and her religious faith to shape the public’s perception of her. Since this is Louisiana, and Pou is known as a “southern lady,” her strategy has worked and she has never been indicted.
Infrastructure problems aside, the choices made by Pou and her two nurse assistants are hard to understand, particularly when adequate stores of drugs, food and water were found in the hospital by relief workers. Moreover, one wing of the hospital — the cancer ward — was still operational; its generator had not quit. No patients were moved to that wing during the crisis, but staff took breaks there, watching television, heating meals and reclining in armchairs designed for chemo patients. If there were enough supplies and part of the building had back-up power, why were these patients killed? And it’s obvious they were because as one investigator points out, having numerous patients die in a span of three and a half hours points to something other than coincidence.
That there were no legal consequences speaks to the prevailing forces that were at work in New Orleans after the crisis, forces that deflected blame away from the centre and toward the margins of a larger controversy that, like Katrina itself, seemed shaped by unpredictable gusts of power. Those powers were the American Medical Association, which stood behind Pou, the anger of Louisiana’s citizens, who felt abandoned by their governments, and the spectre of corporate greed manifest in the poor response times of both Lifecare and Tenet, the healthcare giants that ran Memorial.
Combined, these forces upended fundamental notions of justice itself: a grand jury that dismissed charges, despite knowing “a crime had been committed,” is an aberration and deserves our attention, particularly at a time when offing the elderly, via legalized euthanasia, seems to be the answer to many politicians’ budgetary prayers.
Five Days at Memorial is a cautionary tale about the dangers of uncontested authority and the vulnerabilities of the weakest and most needful among us.
Gwarlingo also recommends Jeff Sharlet‘s in-depth review of Fink’s Five Days at Memorial titled “First, Do No Harm,” which was published in the most recent issue of Bookforum magazine. You can read Jeff’s entire article here. Here is an excerpt:
The storm strikes, windows shatter, but everyone survives. Then relief gives way to flooding. Rescue is intermittent. Tenet doesn’t have a plan, or, apparently, a clue: One top executive mistakes a volunteer on the phone for FEMA; another concerns himself with granting Fox News the access to produce a story on Memorial, “a huge PR play for Tenet.” The “cavalry” arrives: police and other unidentified armed officials who force a daughter at gunpoint to abandon her mother and otherwise seem to stand around with shotguns, helping no one and warning of gangs. There is talk of looters—a lot of talk—even though, at Memorial, there appears to be no looting. Doctors arm themselves. Boats come and go. There are tear-inducing rescues, there are prayers—a lot of prayers—and there are bodies piling up before the altar of the hospital chapel, now converted into a morgue. Later, a disaster mortuary team would find fifty-two rotting corpses in the empty hospital. Many of them—how many we’ll never know—had been euthanized.
What begins, in Fink’s telling, as standard you-are-there stuff—the daughter of a gravely ill mother “flew to her bedside”; a heroic doctor “worked and played with gusto”—grows more fascinating, and horrifying, as the water rises then stagnates, as the power fails and even the walls sweat, as “heroism” becomes an entirely relative question. And yet Fink does nothing so simple as switch from life-affirming courage to muckraking scandal. Her questions are always harder. We know what to think of the Memorial doctor who hand-pumps oxygen into the lungs of premature babies—but what, crucially, do we make of those who, with the best of intentions, invert the code of triage, evacuating the able-bodied first on the principle that they have the likeliest chance of survival? Or of the doctor who, disgusted by what he believes to be unethical—maybe even murderous—choices, abandons the hospital? Or of the nurse who sedates—and inadvertently endangers—patients “to the point they would no longer care that they were smelling the feces they were lying in”?
To learn more about Sheri Fink and her work, please visit her website.
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About Irene OgrizekIrene Ogrizek teaches English at Dawson College in Montreal, Canada. Previously, she was cross-appointed in both English and Humanities at Vanier College, also in Montreal.
In her 20s, she worked in the airline industry, both in Canada and abroad, spending two years living and working in countries in the Persian Gulf. Later, she worked on contract for both the Canadian Environmental Law Association and Canada’s International Centre for Human Rights and Democratic Development, led by Ed Broadbent. She is the creator of irenespage.com.
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