Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital (20 page)

On the seventh floor below them, the LifeCare notepad computer lost its text-messaging connection. The special mattress supporting Emmett Everett’s massive body deflated. Mechanical breaths still hissed rhythmically in the rooms of patients on life support. They would cease when the battery backupus on the ventilators were exhausted.

MEMORIAL’S FIFTH FLOOR was bathed only in the dim, bluish light from Toshiba Satellite laptop monitors. A night shift nurse, Michelle Pitre-Ryals, quickly typed notes into her patients’ electronic charts before the computer batteries died, despite the fact that once that happened, the electronic medical records system would be useless. Paper
was high technology in a disaster. The electronic medication dispensing cart, new to Pitre-Ryals’s unit, would also shut down, its stock of medicines locked securely inside it.

Pitre-Ryals was carrying a cell phone belonging to the nurse whose husband was at the Coast Guard station. It rang. “
We have sent three helicopters and someone is waving them away,” a Coast Guard auxiliary member said. Pitre-Ryals took the phone downstairs in the dark to the command team. “Is that that guy again from the Coast Guard?” a nursing director asked, and she disappeared with the phone to speak with him. On return she instructed Pitre-Ryals not to bring it down again. The man, she said, was “not part of our evacuation plan.”

Pitre-Ryals made her way back upstairs, but then a Louisiana health department official and a Coast Guard lieutenant called. The latter commanded her to disregard her instructions and bring the phone immediately to someone in charge. Pitre-Ryals descended the unlit staircase again, and the nursing director berated her before taking the phone. A male doctor said no more patients were being evacuated because it was too hard to see. Pitre-Ryals suggested waking people up and putting flashlights in the stairwell, but she was ignored. After she returned to the fifth floor, the phone rang again. A more senior Coast Guard lieutenant insisted on speaking with a hospital leader. Pitre-Ryals gave the phone to a nurse’s husband to carry back downstairs while she went to care for her patients. She couldn’t believe hospital leaders were yelling at the Coast Guard for trying to send rescuers. “With these people in charge,” she told a fellow nurse, “we may very well die here.”

UP ON THE eighth floor in the ICU, it wasn’t easy to sleep. Battery-powered fans agitating the hot air lost their will and sighed into silence.

Nurse Manager Karen Wynn lay awake on an air mattress that her
ICU staff had prepared for her. Her daughter, lying beside her, seemed to be the only one asleep.

After a time, Wynn stood up in the darkened room.

“
Where are you going?” one of the nurses from the medical ICU, Thao Lam, asked.

“I’m just gonna go see what’s going on,” Wynn told her. “I’m not asleep, might as well get up and do something, be productive.”

“Can I come with you?”

“Sure. Come join the party.”

Wynn shined her flashlight, and the two nurses walked to a staircase near the elevator lobby on the eighth floor. They didn’t have to descend more than one story to find action. On the seventh floor, LifeCare staff members were carrying ventilator-dependent patients into the stairwell as nurses dispensed huffs of oxygen from football-shaped Ambu-bags compressed like bellows between their fingers. Word had come that the Coast Guard was on the pad again and could evacuate patients if they were brought there immediately.

Wynn and Lam offered their help. They and the other workers helped roll patients onto their sides in bed and then roll them back atop stiff spine boards. They slid the spine boards onto waiting stretchers and wheeled the patients down the corridors toward the staircase by the elevator bank. They lifted the spine boards off the stretchers and began carrying the patients downstairs.

Lam held on to the front end of a spine board and lit the way with a flashlight. Wynn carried the back end and managed to shine hers. Two or three other volunteers stood at each side. Every few steps, they reached a landing that marked a turn in the narrow staircase. They lifted the patient above the handrails and rotated the board into position to continue down to the next flight. All the while someone continued to pump oxygen into the patient’s lungs and tried to ensure that the breathing tube didn’t get dislodged from the airway. Down five stories they went, to
the second-floor lobby and through a hallway to the power plant, with its now silenced generators.

No doorway existed between the hospital and the parking garage beneath the helipad. Without the elevators working, Wynn assumed they would have had to go outside to access the garage—clearly impossible now with the flooding. Plant operations director Eric Yancovich had talked about busting a hole in a hospital wall to create a direct conduit. In fact, they could have carried the patients down to the first floor, through two doorways into a separate stairwell and up to its second-floor landing, which opened into the garage, a taxing journey. But one of Yancovich’s workers recalled a hidden passage. Inside the machine room, halfway up the wall to the right of the entrance beneath a large water pipe, stood a rectangular three-by-three-and-a-quarter-foot opening lined by rough concrete. It was normally covered by a piece of hinged metal. Yancovich thought the opening might have been created to allow equipment to be serviced directly from the garage.

Wynn and Lam passed the patient through the opening and into the hands of other volunteers stationed in the parking garage. A welcome breeze tunneled through the passageway. Wynn had no idea why it existed. Perhaps God had said there needed to be a hole there.

Each time Wynn returned to LifeCare to roll a patient onto a backboard, she was surprised at how hot the patient felt to her touch. My God, she thought, someone could fry an egg on them. She knew elderly bodies had trouble regulating heat.
Certain medical conditions, such as a stroke or a head injury, as well as some commonly used drugs, interfered with the process. Dehydration, heart disease, a little extra weight—all could impair the body’s ability to rid itself of heat through sweating and other mechanisms. The extra heat, in turn, could complicate other critical illnesses.

It was likely that over the two days since the air-conditioning cut out, these patients’ core temperatures had risen. Their bodies would have failed to buffer the heat as sweat production paradoxically ceased. This
was heat stroke, widespread inflammation in the body and dysfunction of multiple organs, particularly the brain, causing a range of effects from confusion to coma. Ice baths could reverse it, or wetting the skin and fanning the patient, along with giving oxygen and sometimes fluids. Nine times out of ten the person would survive. But Karen Wynn worried about the potentially irreversible damage the heat might be causing in the cells and organs of the patients she carried. We’re going to have fried brains here, she thought.

Even those without medical training worried about the effect of the heat on the LifeCare patients.
A woman who had been hired to sit at the bedside of patient Elvira “Vera” LeBlanc reached her charge’s daughter-in-law by cell phone at around four on Wednesday morning. The sitter described how hot it was. “The nurses are starting to freak out,” she said. “People are dying. There’s no place to put them.” LeBlanc’s daughter-in-law Sandra was a paramedic. She said she was trying to get into New Orleans and back to the hospital. “When are you coming?” the sitter asked, sounding desperate.

AT THE COAST GUARD emergency command center in Alexandria, LTJG Shelley Decker, a former Army pilot who had recently joined the Guard, had been fighting to get helicopters to Memorial for LifeCare’s ventilator patients. She learned that at least three had gone to Memorial and were waved away. “No, they want them to land,” she said to a contact at the air station. “You have to go back.” The auxiliary member beside her, Michael Richard, spoke by cell phone with a nurse leader atop the helipad. She seemed to be panicking, waving her arms over her head, believing she was signaling the pilots, not turning them off. “When those helicopters come,” he told her, “stand clear!”

Each air rescue crew had only eight hours to fly within any twenty-four-hour period; thousands of people in the city needed help. Every
minute was precious. The same was true for the fragile LifeCare patients on life support. Decker kept trying to reach Susan Mulderick on the nurse’s cell phone to give a play-by-play of the helicopters’ arrivals. The rescue effort needed to proceed. She’d been told that one ventilator patient had already died waiting. Yet the pilots weren’t seeing patients on the pad. How can we keep missing these people? Decker wondered. She and two colleagues engaged in a complicated chain of communications, maintaining contact with three cell phones at Memorial, while talking to the air stations, and, via HF radio patch, to the crew of the C-130 flying over New Orleans, which then tasked the helicopter pilots.

The Jayhawk that had flown away from Memorial to Tulane Hospital hours earlier with the Acadian Ambulance coordinator was diverted again by the C-130 and directed back to Memorial to rescue the critically ill LifeCare patients. In the intervening hours, crew members had hoisted several people from the rooftops of flooded homes, depositing them at the cloverleaf highway interchange west of New Orleans. One elderly woman couldn’t walk, and the rescue swimmer on board had carried her across a field of grass to emergency workers. What he saw concerned him: thousands of people camped out on the south side of the highway, surrounded by refuse, no buses in sight.

The pilots flew to Memorial as instructed and executed a challenging maneuver at night, using a slight tailwind to position the helicopter properly on the helipad. Crew members were again told that there were no critical patients to rescue but that non-patients and staff were anxious to leave and were becoming unmanageable. One member of the flight team took to the radio again to ask what to do next. Back came the word that, according to contacts inside the hospital, the patients were indeed still there awaiting rescue.

Incident commander
Susan Mulderick had climbed up to the helipad in the dark to see what was really happening with the Coast Guard. She passed people who were clearly non-patients, perhaps extended families and community members who had taken shelter at Memorial before
the storm. They snaked up the stairwell and into the covered, enclosed walkway she had purchased years earlier when the helipad was still in use. The tunnel was designed to protect against the hurricane-force winds unleashed by helicopter rotors. Dozens and dozens of people were up here clamoring to leave, no doubt roused and alarmed by the man who had run through the hospital.

The pilot kept his rotors going to avoid stressing the pad with the full weight of the aircraft, and it was loud. Mulderick stood to the side of the helipad and discussed the situation with the Coast Guard flight mechanic, who shouted questions at her over the din. Was there food and water? Was it dry inside the hospital? Mulderick shouted back, yes. “Listen, you’ve got food, you’ve got to stay here, because where I’m going to take you, it’s not good!” the flight mechanic screamed. “We’re going to dump you off in a field!” There was no infrastructure set up at the cloverleaf. It was basically a point in the highway. It looked to him like Woodstock after the concert. The civilians were better off staying at Memorial.