Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital (31 page)

King left the second floor for a nap and returned an hour or so before sunrise. He examined a large African American man in a green-and-blue patterned hospital gown, lying unmoving in the lobby. King pronounced him dead and documented this on a page of his medical chart.

The man, in his early sixties, had a close-cropped beard and mustache
and a history of heart disease. He had come to the hospital with symptoms of pneumonia as the storm approached. His wife had accompanied him, but like some other patients’ family members was separated and escorted away to the boat line by armed security guards after he was carried down to the second floor. Now, with the help of the family members of staff, King lifted his body and carried it into the chapel.

A nurse had earlier coaxed Father John Marse to an empty cot on the first floor, telling him it had his name on it and ordering him to rest. Standing in for him in the chapel, the nurse chanted a Hail Mary, Our Father, and Glory Be over the dead. King counted five other bodies arrayed before the altar.

EARLY IN THE MORNING on Thursday, September 1—seventy-two hours after the hurricane struck—a small group of doctors gathered in a radiology suite on the second floor. Surgery chief John Walsh described the scene he had witnessed in the lobby overnight. How rough the night had been for staff who had stayed awake to care for patients. Many were demoralized and some complained that one physician was being obnoxious and upsetting them.

The doctors at the meeting were unhappy that hospital leaders had turned down the chance to continue the helicopter rescue on Tuesday night into Wednesday morning. Few patients—unlike family members, other visitors, and staff—had departed Memorial since then. Prospects for a prompt, government-organized rescue appeared dim. The helicopters organized by Tenet, if they came, might not effect a quick rescue.

“
We need to have a little bit more of a surgeon’s attitude,” Walsh said. Surgeons were men and women of action. The group of doctors in the suite opted for insubordination over inaction. Rather than await the scheduled morning meeting to discuss options, Walsh left after first light with an anesthesiologist on the plant-operations director’s fishing boat
to try to organize a more concerted rescue effort. Another anesthesiologist went to find Drs. Anna Pou and Roy Culotta to see if they would re-triage the patients who remained. The message that day needed to be a positive one: everyone would be getting out.

SOON AFTER SUNRISE, hospital staff gathered on the emergency room ramp. Incident commander Susan Mulderick stepped up on a curb to begin the meeting, with CEO Goux beside her, and medical chairman Deichmann also present. Doctors, nursing managers, maintenance workers, and security staff jostled and shushed one another. It was difficult to hear.

Mulderick went over what remained of food, water, and people at the hospital. Few participants took special note when she mentioned the LifeCare patients who were still on the seventh floor.

The conversation moved in other directions. Food-service employees fretted over the remaining food stocks, having spent days filling Styrofoam cups with grits, sausage, and spaghetti prepared with propane stoves and Sterno, and serving juice, bagels, and mystery meat from a temporary kitchen above the flooded basement.

One doctor asked what was being done to dispose of human waste; the smell in the hospital was bestial. The hospital’s elder statesman, Horace Baltz, formally commended his colleagues for their hard work. He told them to pull together and they would all get out alive. The crowd applauded him.

Memorial’s chief financial officer, Curtis Dosch, returned to the ramp as the meeting started to disperse. He had just used a working cell phone to speak with Tenet official Bob Smith in Dallas and received confirmation that
Tenet was dispatching the fleet of privately hired helicopters and a satellite phone that morning. “Everybody shut up for a minute,” someone shouted. “We got an update.” Mulderick asked Dosch to share the good news. Some of the worn, anxious staff members seemed to disbelieve
him. They wanted to know exactly when and how they were getting out of the hospital, answers Dosch and Mulderick couldn’t provide. All the leaders could do was reinforce the idea that they were awaiting more boats and helicopters and, somehow, they were going to get everybody out of Memorial that day.

From: Bob Smith [regional senior vice president, Tenet Healthcare]

Sent: Thursday, September 1, 2005, 8:56 AM

To: Captain John Andrews, Navy Second Fleet

Subject: Tenethealth Prioities in NOLA

Since my communication yesterday we have a dire situation at Memorial Hospital in NOLA. This facility is unsecure and we need immediate assistance. We are unable to evacuate our patients and staff due to gun fire in the area. The facility is compromised and there are people dying in the building. There are people with weapons in and/or around the building. We believe lives are in immediate danger. Memorial Medical Center 2700 Napoleon Ave.

Louisiana Bureau of Emergency Medical Services phone call log, Thursday, September 1, 2005, 9:33 AM:

… 60 patients that need a move by stretcher are at Memorial Medical Center.

US Coast Guard LTJG Shelley Decker notes on Thursday, September 1, 2005:

Tenant Memorial Hospital-Presidential tasking to evac immediately

IT SMELLED WORSE on the second-floor lobby than Susan Mulderick remembered from having walked through the area on Wednesday. Despite the broken windows, the air stayed stubbornly still near the bathrooms. The fecal stench was intense.

Nobody, she thought, should have to bear such conditions, particularly not fragile patients. Some called for help, looking up from their cots along the hallway, dazed and fearful as people streamed past them.

Mulderick knelt beside an elderly woman. She peeled the pads away from her backside and began to wipe away her feces. The woman cried. The heat and a shortage of diapers and fresh linens had defeated the nursing staff’s efforts to keep patients dry and clean. Her skin was raw. Mulderick found a fresh red sore above her buttocks. It looked as if the skin had broken down as the woman lay sweating into her cot. The slightest touch caused her to yell out in pain, and as Mulderick took in the woman’s misery and extrapolated it to the dozens lying around her, the normally stoic nurse executive was profoundly shaken.

When Mulderick stood up from her work, Dr. Kathleen Fournier approached her, looking equally upset. She was worried about her cat, she told Mulderick. It was sick and suffering, no longer eating or drinking. She took Mulderick to see “Tabby.” Fournier was torn up by the prospect of putting her pet down. What did Mulderick think?

Mulderick wanted to slap her. How could the doctor express more concern for a cat than for the patients all around her? Pets were everywhere—everywhere!—in spite of Mulderick’s exhortations to keep them out of the hospital. Staff members simply ignored the rules, walking their dogs through the areas where patients were lying and telling her they wouldn’t leave their pets behind.
For Christ’s sake! Where’s your damn common sense?
she wanted to ask. It angered her to see them attending to pets around the corner from where the sickest patients lay.

A short time later, Mulderick shared these frustrations with a radiologist
on the ER ramp. “
We are talking about euthanizing the animals,” she said, “but not about what we can do to help the patients.” Mulderick asked him to communicate her concerns to the medical chief, Dr. Richard Deichmann, who was holding daily meetings with the doctors.

She would later recall that her idea was to rid the patients of their pain and dull their senses to the point they would no longer care that they were smelling the feces they were lying in, that panting dogs were weaving past and licking their hands. But the radiologist seemed to interpret her intentions differently. A physician colleague heard him ask Deichmann if they could convene a meeting to discuss euthanasia, because some of the staff were concerned about the patients and wanted to consider it. The radiologist thought it would be best to get the discussion out in the open and not have the decision made by a few people in a dark corner. Deichmann said no. The idea shouldn’t even be considered.