Five Days at Memorial

Life and Death in a Storm-ravaged Hospital

Sheri Fink

• Publisher: Atlantic Books
• Year: 2013
• Print ISBN:
  9781782393757
• eBook ISBN:
  9781782393764
• Topic: History
• Subtopic: 21st Century History
• Index: History

In the tradition of the best writing on human behaviour and moral choices in the face of disaster, physician and reporter Sheri Fink reconstructs five days at New Orleans' Memorial Medical Center during Hurricane Katrina and draws the reader into the lives of those who struggled mightily to survive and to maintain life amidst chaos. After Katrina struck and the floodwaters rose, the power failed, and the heat climbed, exhausted caregivers chose to designate certain patients last for rescue. Months later, several health professionals faced criminal allegations that they deliberately injected numerous patients with drugs to hasten their deaths. Five Days at Memorial, the culmination of six years of reporting, unspools the mystery of what happened in those days, bringing the reader into a hospital fighting for its life and into a conversation about the most terrifying form of health care rationing. In a voice at once involving and fair, masterful and intimate, Fink exposes the hidden dilemmas of end-of-life care and reveals just how ill-prepared we are for the impact of large-scale disasters - and how we can do better. A remarkable book, engrossing from start to finish, Five Days at Memorial radically transforms our understanding of human nature in crisis.

CONTENTS

	MAP
	SELECTED INDIVIDUALS
	NOTE TO THE READER
PART 1: DEADLY CHOICES
	Prologue
	Chapter 1
	Chapter 2
	Chapter 3
	Chapter 4
	Chapter 5
	Chapter 6
	Chapter 7
PART 2: RECKONING
	Chapter 8
	Chapter 9
	Epilogue
	ACKNOWLEDGMENTS
	NOTES
	INDEX

SELECTED INDIVIDUALS

Affiliations listed as at the time of the events in the book.
Relatives listed only if they appear in the book.

Doctors (many on staff at both Memorial and LifeCare)

Dr. Bill Armington—Neuroradiologist

Dr. Horace Baltz—Internal medicine specialist, one of the longest-serving medical staff members present for storm

Dr. Reuben Chrestman—Medical staff president; on vacation

Dr. Ewing Cook—Chief medical officer, retired pulmonologist experienced in critical care medicine

Minnie Cook, wife, former surgical intensive care unit nurse

Stephanie Meibaum, daughter, current surgical intensive care unit nurse

Dr. Roy Culotta—Pulmonologist and critical care specialist; grandmother sheltering at LifeCare

Dr. Richard E. Deichmann—Chairman, Department of Medical Services

Dr. Kathleen Fournier—Internal medicine specialist

Dr. Juan Jorge Gershanik—Neonatologist

Dr. Bryant King—Internal medicine specialist

Dr. John Kokemor—Internal medicine specialist; former coroner assistant under Dr. Frank Minyard

Dr. Anna Maria Pou—Otolaryngologist; head and neck surgeon, specialist in cancer surgery

Vincent Panepinto, husband

Peggy Perino, sister

Dr. Frederick Pou, father

Frederick Pou Jr., brother

Jeanette Pou, mother

Jeannie Pou, sister

Michael Pou, brother

Dr. Paul Primeaux—Anesthesiologist

Dr. John Skinner—Pathologist

Dr. John Thiele—Pulmonologist experienced in critical care medicine

Dr. John J. Walsh Jr.—Chairman, Department of Surgical Services

Memorial Medical Center

Nurses

Lori Budo—Surgical intensive care unit nurse

Cathy Green—Surgical intensive care unit nurse

Thao Lam—Medical intensive care unit nurse

Cheri Landry—Surgical intensive care unit nurse

Patients and Their Family Members (ages and locations as of time of storm)

Helen Breckenridge—77, intensive care unit, eighth floor

Jannie Burgess—79, intensive care unit, eighth floor

Linette Burgess Guidi, daughter

Johnny Clark, brother

Gladys Clark Smith, sister

Bertha Mitchell, niece

Essie Cavalier—79, fourth-floor medical ward

Donna Cotham—41, fourth-floor medical ward

Tesfalidet Ewale—66, intensive care unit, eighth floor

Merle Lagasse—76, fourth-floor medical ward

Karen Lagasse, daughter

Rodney Scott—63, intensive care unit, eighth floor

Hospital Administrators, Managers, and Nonclinical Staff

Fran Butler—Nurse manager of fourth-floor west and south medical and surgical units

Sandra Cordray—Community relations manager; designated communication leader for Hurricane Katrina

Mary Jo D’Amico—Operating-room nurse manager

Curtis Dosch—Chief financial officer

Sean Fowler—Chief operating officer

L. René Goux—Chief executive officer

David Heikamp—Laboratory director

Father John Marse—Chaplain

Susan Mulderick—Nursing director, head of emergency preparedness committee, designated incident commander for Hurricane Katrina

Karen Wynn—Nurse manager of the intensive care units; head of hospital ethics committee

Eric Yancovich—Plant operations director and part of emergency leadership team

Tenet Corporate Officials

Michael Arvin—Business development director for Texas–Gulf Coast region

Trevor Fetter—President and chief executive officer

Bob Smith—Senior vice president for operations in the Texas–Gulf Coast region

LifeCare

Seventh Floor

Patients and Their Family Members

Hollis Alford—66

Wilmer Cooley—82

Emmett Everett—61

Carrie Everett, wife

Carrie (Ma’Dear) Hall—78

George Huard—91

Alice Hutzler—90

Elvira LeBlanc— 82

Mark and Sandra LeBlanc, son and daughter-in-law

Wilda McManus—70

Angela McManus, daughter

Elaine Nelson—90

Craig Nelson, son

Kathryn Nelson, daughter

John Russell—80

Rose Savoie—90

Doug Savoie, grandson

Lou Anne Savoie Jacob, daughter

Ireatha Watson—89

LifeCare Nurses and Therapists

Cindy Chatelain—Registered nurse

Andre Gremillion—Registered nurse

Terence Stahelin—Respiratory therapist

Hospital Administrators, Directors, and Nonclinical Staff

Tim Burke—Administrator for LifeCare Hospitals of New Orleans; not present at hospital for the storm

Steven Harris—Pharmacist

Gina Isbell—Nursing director, LifeCare Chalmette campus, relocated to Baptist (Memorial) before the storm

Kristy Johnson—Physical medicine director

Therese Mendez—Nurse executive

Diane Robichaux—Assistant administrator, incident commander

Dr. John Wise—Medical director; absent for the storm

LifeCare Corporate Officials

Robbye Dubois—Corporate senior vice president for clinical services; in Shreveport, LA

People Involved in the Investigation

Louisiana Attorney General’s Office

Attorney General Charles Foti

Julie Cullen—Assistant attorney general, head of criminal division

Virginia Rider—Special agent, Medicaid Fraud Control Unit; lead investigator, Memorial case

Arthur “Butch” Schafer—Assistant attorney general, Medicaid Fraud

Control Unit; lead prosecutor, Memorial case

Kris Wartelle—Public information director

US Department of Health and Human Services, Office of the Inspector General

Artie Delaneuville—Special agent

Orleans Parish District Attorney’s Office

Eddie J. Jordan Jr.—District attorney

Michael Morales—Assistant district attorney; lead prosecutor, Memorial case

Craig Famularo—Assistant district attorney, senior to Morales

Orleans Parish Coroner’s Office

Dr. Frank Minyard—Coroner

Forensic Consultants

Dr. Michael Baden—Forensic pathologist, New York City

Dr. Frank Brescia—Oncologist, palliative care specialist, Medical University of South Carolina

Arthur Caplan—Bioethicist; chairman, Department of Medical Ethics, and director of the Center for Bioethics at the University of Pennsylvania (until 2012; now at New York University)

Dr. Steven B. Karch—Cardiac pathologist; former assistant medical examiner, San Francisco, CA

Dr. Robert Middleberg—Laboratory director, National Medical Services, Inc.

Dr. Cyril Wecht—Forensic pathologist; coroner, Allegheny County, PA (until 2006)

Dr. James Young—Special advisor to the Government of Canada on emergency management; president, American Academy of Forensic Sciences (2006–2007); former chief coroner of Ontario, Canada

Others

Government Officials

Louisiana governor Kathleen Babineaux Blanco (2004–2008)

US senator Mary Landrieu (since 1997)

Mayor Ray C. Nagin, City of New Orleans (2002–2010)

Emergency Responders and Experts

Knox Andress—Health resources services administration district regional coordinator for part of northwest Louisiana, based in Shreveport; registered nurse at CHRISTUS Schumpert Health System; communicated with LifeCare corporate officials during the disaster

LTJG Shelley Decker, US Coast Guard (now LT); at emergency command center, Alexandria, Louisiana

Cynthia Matherne—Health resources services administration district regional coordinator for part of southeast Louisiana, including New Orleans; based at the emergency operations center in New Orleans City Hall; communicated with Tenet Healthcare officials during the disaster

Michael Richard, US Coast Guard Auxiliary; at emergency command center, Alexandria, Louisiana

Dr. Robert Wise—Vice president, division of standards and survey methods, Joint Commission on Accreditation of Healthcare Organizations, JCAHO (now medical advisor, division of healthcare quality evaluation at the organization, renamed the Joint Commission)

Colleagues and Patients of Dr. Anna Pou

Dr. Daniel Nuss—Chairman, Department of Otolaryngology; head and neck surgery, Louisiana State University Health Science Center

James O’Bryant—53, patient of Dr. Anna Pou

Brenda O’Bryant, wife

James Lawrence O’Bryant, son

Tabatha O’Bryant, daughter

Defense Attorneys

Eddie Castaing—Attorney for Lori Budo

Richard T. Simmons Jr.—Attorney for Dr. Anna Pou

NOTE TO THE READER

THIS BOOK RECOUNTS what happened at Memorial Medical Center during and after Hurricane Katrina in August 2005 and follows events through the aftermath of the crisis, when medical professionals were arrested and accused of having hastened the deaths of their patients. Many people held a piece of this story, and I conducted more than five hundred interviews with hundreds of them: doctors, nurses, staff members, hospital executives, patients, family members, government officials, ethicists, attorneys, researchers, and others. I was not at the hospital to witness the events. I began researching them in February 2007 and wrote an account of them in 2009, copublished on the investigative news site ProPublica and in the New York Times Magazine: “The Deadly Choices at Memorial.”

Because memories often fade and change, source materials dating from the time of the disaster and its immediate aftermath were particularly valuable, including photographs, videotapes, e-mails, notes, diaries, Internet postings, articles, and the transcripts of interviews by other reporters or investigators. The narrative was also informed by weather reports, architectural floor plans, electrical diagrams, and reports prepared by plaintiff and defense experts in the course of civil litigation; and I visited the hospital and other sites depicted in the book.

Dialogue rendered in quotation marks is reproduced exactly as it was recalled in interviews, or is taken directly from transcripts and other primary sources. If one person recounted an important conversation, I generally attempted to contact all participants, but some declined to speak, and at times memories were at odds. The main text and Notes highlight areas of significant dispute and indicate the sources of quotes when they do not derive from interviews with me. Typographical mistakes are preserved in quoted e-mails to give the reader a sense of the urgency involved in their production.

This book relates the thoughts, impressions, and opinions of the people in it, perhaps the most fraught aspect of narrative journalism. Attributed thoughts or feelings reflect those that a person shared in an interview, wrote down in notes, a diary, or a manuscript, or, less commonly, expressed to others whom I interviewed. As any book reflects the interwoven interpretations and insights of its author, I have tried to make these distinct. All errors are mine.

PART I

DEADLY CHOICES

Blindness was spreading, not like a sudden tide flooding everything and carrying all before it, but like an insidious infiltration of a thousand and one turbulent rivulets which, having slowly drenched the earth, suddenly submerge it completely.

—José Saramago, Blindness

PROLOGUE

AT LAST THROUGH the broken windows, the pulse of helicopter rotors and airboat propellers set the summer morning air throbbing with the promise of rescue. Floodwaters unleashed by Hurricane Katrina had marooned hundreds of people at the hospit...

Table of contents

• Cover
• Half-title Page
• Title Page
• Copyright
• Dedication
• Contents