Days Leading Up to the Storm... A Catastrophe Waiting to Happen

In the book Five Days at Memorial, the author dives into the moral and ethical ramifications that began at Memorial Hospital in New Orleans after the catastrophe of Hurricane Katrina. The prologue jumps into the theme of the book immediately, following along with Dr. John Thiele (pictured left). The book starts a few days after the storm has ended, and at this point, there has been very little relief. Nobody has come to give the staff a break, many patients had not yet been evacuated, the power was out, and they were running incredibly low on supplies. After triaging the patients left, the medical staff had come to the conclusion that the healthiest patients should be evacuated first, because those were the ones who had the best chance of recovery and survival after the disaster was over. The conditions within the hospital were worsened by the state of the city outside as well. The area was put under martial law, and the staff within the hospital had heard that “in the days since the storm, New Orleans had become an irrational and uncivil environment’ (Fink, 9). The physicians were worried that criminals would break into the hospital searching for substances they were addicted to. In Thiele’s mind, medicine no longer had the rationality and the civility that it possessed just a few days prior. Because of this “He could rationalize what he was about to do as merely abbreviating a normal process of comfort care,”(Fink, 9). Him, along with a few other medical staff, were planning on injecting the sickest of the patients left with morphine and Versed, which is a lethal cocktail that would, in Thiele’s mind, put these patients out of their misery. The remainder of this book would be spent exploring the events that lead up to this decision, the court case after, and the ethical ramifications of the crime in itself.

After the brief prologue, chapter one gives an overview of the history of the hospital and the history of the flooding within the city. Being right on the Gulf of Mexico, New Orleans is an incredibly hurricane-prone city. This was definitely something that the residents were used to, and Memorial Medical Center (which had gone through many name changes and was affectionately still referred to as Baptist), had weathered almost 80 years of storms since its opening in 1926. Memorial was located in one of the valleys of the city, and was technically located below sea level. Throughout several different hurricanes and floods, there had been many different attempts to improve drainage throughout the city. There were multiple levees installed in the waters around New Orleans (read more about levees here: https://education.nationalgeographic.org/resource/levee/). After a particularly bad storm in 1927, New Orleans hired an engineer to design and implement the largest drainage pump, and the drainage capacity quadrupled after the installation. Unfortunately, even with the improvements, the area around Memorial still suffered some of the worst flooding within the area. Staff at Memorial became accustomed to the flooding, and they began to take measurements to prepare for incoming storms. Some would park a few blocks away so their cars remained above sea levels, the maintenance team would keep waders in their lockers, and the staff even kept a metal fishing boat suspended from the ceiling of the parking garage. This was a part of the job and “many Memorial employees had long ago stopped seeing water as a significant threat,” (Fink, 23). The staff at Memorial would not be prepared for the catastrophe that would hit them on August 29th in 2005.

After the brief history in chapter one, Fink began to categorize the following chapters by each day leading up to the hurricane, during the hurricane, and after the hurricane. Chapter two was an incredibly short passage from the day before Katrina, following Gina Isabell, RN while she helped move elderly patients from a small one story clinic to a unit that they had leased at Memorial. Isabell worked at LifeCare, which was an elderly rehabilitation facility with the goal of returning the patients to nursing homes or with their families. They had debated whether or not the risk of the hurricane flood waters was worth the taxing ambulance transfer for the patients (many of whom were still dependent on ventilators). Ultimately, they made the decision to move to Memorial when the waters were predicted to rise above the roof of the facility. One of the patients died in the transfer. 

Chapter three accounts for the day of Hurricane Katrina. The National Weather Service warned that the area would be inhabitable for weeks. (To learn more about the hurricane, visit https://www.weather.gov/mob/katrina). The mayor sent out an evacuation order for the city and the surrounding areas, but he gave an exemption for the hospitals. The traffic around the city was bumper to bumper with evacuees, making it almost impossible for medical evacs to happen in the first place. One ambulance company came and picked up a few patients, but the ambulances never returned after the first round. All of this to say, Hurricane Katrina was an intense problem that Memorial Health Center would be facing in the very near future.

Pictures courtesy of:

https://antoniaatkinsonaplang.wordpress.com/2015/11/03/the-truth-starts-to-emerge/

https://earthobservatory.nasa.gov/images/15395/hurricane-katrina