This is a review of Sheri Fink’s Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital. The issue of legalizing euthanasia is being debated in Canada. Opponents say less advantaged Canadians will be triaged for death the most. It’s a compelling argument, one tragically enacted at Memorial Hospital in New Orleans during Hurricane Katrina.
On 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 of that difficulty 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 that is 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 a 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 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.
Author’s bio: Irene Ogrizek teaches English at Dawson College in Montreal, Canada. Previous to that, 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.