Tuesday, July 30, 2013

Nonfiction Book Review: 'Five Days at Memorial' Recounts a Harrowing Hurricane Katrina Tale

Five Days at Memorial: Life and Death in a Storm-Ravaged HospitalFive Days at Memorial: Life and Death in a Storm-Ravaged Hospital by Sheri Fink

My rating: 3 of 5 stars

Three and a half stars, really: four stars for the first part, and three stars for the second part. The first part is well-written, but upsetting and hard to read because of the facts in this case. It involves a lot of human misery. Memorial Medical Center, originally founded as Southern Baptist Hospital in New Orleans and conceived of as a charity hospital, was ordered not to evacuate when Hurricane Katrina threatened in late August 2005. It was assumed that the hospital had plenty of food, water, and medicine and that, with its back-up generators, the hospital would not only be able to keep operating during the hurricane, but could also serve as a storm shelter.

Memorial Medical Center, post-Katrina
Many employees and family members of patients took shelter there, bringing their relatives and pets for safety. As per usual in NOLA, they expected the hurricane to be an almost tail gate party-like atmosphere. No one really expected the devastation of Katrina; windows in the hospital burst, water poured in and it was surrounded by floodwaters, accessible only by helicopter and boat. People heard gunshots outside the hospital, feared looting, and mistakenly believed that martial law had been declared.

Worst of all was the fact that the disaster plan for the hospital, drilled only a few weeks earlier, proved to be of no use whatsoever. No one appeared to be in charge; the corporation that owned the hospital, states away from the disaster, was ineffectual; the government was giving no clear instructions; hospital administrators who were on-site didn't seem to have a cohesive plan. As a result, when it became clear that the hospital would have to evacuate after all, there was no clear plan of what order patients, employees and family members should leave in. At some point, it was decided that the ambulatory patients would be evacuated before the sickest patients.

The evacuation took the five days of the title. By the fifth day, the generators had failed. Machines stopped working, the toilets had long stopped flushing (leading to horrendously unsanitary conditions), and the heat was unbearable. Because the sickest patients had not been evacuated first, nine mostly elderly, ill people lay in hospital beds on the seventh floor, many of them with high fevers. Their overworked, stressed-out caretakers feared they would have permanent brain damage because they were having breathing problems and because of their extremely high body temperatures. Someone decided they people could not be rescued, and ten people were given a combination of drugs, including morphine, that led to their deaths.

The tenth person, Emmett Everett, was only 61 years old. Although he was quadriplegic and had a very large body size, he was very much conscious and in no immediate danger of dying from the conditions inside the hospital. Although it would have been difficult to move Mr. Everett out the window, through the tunnel that led to the garage, and up onto the roof where he could be rescued by helicopter, it was possible, but for some reason no one tried. His story is among the most haunting of this book.

View from the parking garage roof of Memorial - then Southern Baptist - in 1991
The second part of the book deals with the legal proceedings that followed the evacuation of the hospital. No one was ever tried or convicted of anything from this incident, although there were both local and federal investigations, including the convening of a grand jury. The writing style in the second part isn't very compelling in parts, and it could stand to be more logically organized. (Keep in mind I read an advance reader's copy, so the final version may differ.)

I'll give an example: the very last section of the last chapter starts with the words, "'Does anyone feel that they're making a mistake?' a man on the special grand jury had asked his fellow jurors before they took their final vote." Since the previous section was about things that happened after a press conference Dr. Anna Pou held after charges against her were dismissed, mention of the grand jury is clearly out of chronological order. Unless there was a second grand jury? If that's the case, this is a lousy way to end the book, just leaving the reader hanging.

I hope a lot of hospital administrators will read this book and take this away from it: have a good evacuation plan and an emergency plan in place in case the evacuation takes much longer than expected. Make sure your generators can run for a week or more, and prepare your employees to keep giving care even in less-than-ideal conditions in case rescue is delayed.

Clearly, people died in Memorial Medical Center who didn't need to die. Some of them were very sick, but still, the were deprived of dying with dignity and their relatives and personal wishes were left out of the decision. Hurricane Katrina was a catastrophe, no doubt, but in this hospital, some of the misery was entirely preventable. People have to be willing to learn from a terrible situation - like in the 1940s when the terrible Cocoanut Grove fire led to better fire codes, better treatment for burn victims, and more widespread use of antibiotics. Hopefully, this book will help make hospitals safer in natural disasters.

In this clip, you can hear Sheri Fink talk a little bit about it in her own words.

Disclosure: I received this book for free through the Amazon Vine program. This represents my honest opinion. I did not receive any compensation other than the free Advance Readers Edition of the book, in paperback.

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