Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital (33 page)

Fournier had decided to stay and had worked harder than most, often alongside Anna Pou. That morning, Fournier had sprawled on the
second-floor lobby carpet amid the patients in front of a box fan with blades, powered by the overloaded generator, that moved in slow motion. The long extension cords and high loads kept tripping the generator’s breaker, and someone had to run to the parking garage repeatedly to reset it. The doctors who met in the radiology room had decided to try to convince Fournier to leave the hospital as soon as transportation arrived. One was dispatched to encourage her to do so, but he thought she seemed fine and hadn’t pressed the issue.

Fournier grappled with the implications of Mulderick’s request as she interpreted it. She did what she typically did when she had concerns—shared them freely. Fournier asked a nurse manager, Fran Butler, what she thought of the talk going around about putting people to sleep or out of their misery. “
That is not an option,” Butler said. She’d held that view for a quarter century—personally, professionally, and spiritually—since becoming a nurse. She didn’t turn up the morphine unless a patient looked uncomfortable. She’d trained at Charity, knew how to work in the trenches, and while Memorial “wasn’t the Taj Mahal,” she’d say, she didn’t think the conditions were unbearable. Back upstairs there had been a breeze through the broken-out windows, she’d cut her uniform pants into shorts, put on her flip-flops, slung a tied-together pair of ice-filled gloves around her neck—and worked; she was heavyset, sweat-slicked, flushed, and not the youngest of nurses, but she thought everyone should have stayed on their wards and “maintained” until the water went down around them.

Kathleen
Fournier solicited another opinion later, as she and pulmonologist John Thiele struggled to euthanize two Siamese cats around a corner from where the patients lay on the second floor. The cats belonged to a pharmacist who lived alone and considered them her children. She had asked Fournier to euthanize them, convinced she would have to abandon them.

Fournier held one of the cats as Thiele trained a needle toward its heart. While they worked, Fournier told Thiele she did not want to participate
in putting patients out of their misery. Thiele told her he understood, and that he and others would handle it. She wasn’t sure what that meant.

Before Thiele could inject the heart-stopping medicine, potassium chloride, the cat struggled out of Fournier’s hands. It clawed at Thiele, ripping his sweaty scrub shirt. Someone else injected another cat and threw it out a broken window into the floodwaters.

Fournier polled another of the doctors, Bryant King, whom she knew from Tulane Medical School. She pulled him aside on the second floor. “This is between me, you, and the fence post,” she told him.

The words tumbled out. Her concerns about her cat. Her concerns about the patients. The patients were suffering miserably, she said, and she asked King what he thought about helping to end their suffering.

He said if they could find some way to turn on the air-conditioning or more fans, that might help.

“No,” Fournier said. That wasn’t what she meant. She told him about her conversation with Susan Mulderick and Anna Pou.

“I can’t be a part of anything like that,” King said. “I disagree one hundred percent.” The idea was stupidity itself. They had only been there two days since the floodwaters rose, and they were dry and had food and water.

He told her that hastening death was not a doctor’s job. He knew the situation was grave. He’d carried the man’s body to the chapel before sunrise. But he, unlike Pou, Fournier, and Mulderick, had gone upstairs and visited every patient on the seventh floor to assign a triage category. The remaining patients were hot and uncomfortable, and a few might be terminally ill, but he didn’t think they were in the kind of pain that called for sedation, let alone mercy killing.

In normal times, doctors occasionally sedated very sick patients to unconsciousness in cases of intractable anxiety, breathlessness, and pain, and sometimes even to make caring for certain patients less taxing on nurses who would otherwise constantly need to monitor patients’ suffering or guard against the possibility that their movements would disrupt a spaghetti-like mass of tubes and lines. But taking away patients’ ability
to monitor their own well-being and express themselves could render them even more helpless than a baby or an animal to communicate when something was wrong. And they might seem less alive, less worth saving.

“
I’m a Catholic,” Fournier said, “but not a great Catholic.”

“Well that’s between you and your God,” King replied.

The conversation deepened King’s desperation to escape Memorial. He was nearly ready to swim out, despite having watched nurses foul the murky water with the contents of bedpans. He sent text messages to his sister and his best friend telling them that “evil entities” were discussing euthanizing patients. He begged them to send someone to get him out of there. Contact CNN, the National Guard, anyone, he wrote.

Handwritten note by Aviation Services, Inc., on-site flight manager, Memorial helipad

Pilot’s log book with leatherette cover

Please pass to Aviation Services in Dallas

1) AVS 3 lifts so far 2 Slidell & 1 to Kenner

2) Coast Guard shuttling 3 HH65 aircraft. 5 lifts so far moving amb, children, women to (about 5-6 per lift) ambulance ground site near Superdome

3) Per Admin-total population as of 1000 CT/1 Sep is at 450. Repeat 450

4) Total pop includes ∼120 patients from this hospital (Memorial) & associated hospital

5) Population was ∼1500 but surface water craft moved many yesterday

6) Criticals were moved Mon & Tue […]

7) CG shuttling about every 15 minutes w/ 5-6 pax per lift.

AFTER A DAY and night working downstairs, LifeCare nursing director Gina Isbell returned to the seventh floor and was surprised to see “Miss Alice” Hutzler and her roommate Rose Savoie still in their shared room instead of in an evacuation line. Hutzler looked dehydrated and barely responded to her. Isbell felt guilty. She remembered she had promised Hutzler’s daughter she’d take good care of her.

Isbell took a short break in an empty room, peeling off the thick white T-shirt, blue scrub pants, and tennis shoes she had worn for days. She washed herself down as best as she could with baby wipes and put on a clean pair of jean shorts and a light gray T-shirt she had picked up from her car, where she had enjoyed another burst of air-conditioning. She sat down to have a Ding Dong and make some instant iced tea. A doctor passed the room. Isbell didn’t know her name, but she recognized the short woman with the fluffy hair, having seen her on the floor earlier in the week.

Isbell offered Anna Pou a packet of powdered iced tea for her water. “I think I will have a tea,” Pou said softly.
She wore a scrub shirt with the arms ripped off and little shoes. She looked sad as she walked away.

One of Isbell’s favorite nurses, a friend from school, Andre Gremillion, approached her looking upset. He had been down to the second floor. The other workers, he said, didn’t seem to realize there were still patients on the seventh floor. One told him they were under martial law, that “Baptist” was evacuating its employees, and anyone who could walk needed to go. “From what they telling me downstairs,” he said, “everybody’s leaving.” He was afraid LifeCare staff members would soon be the only ones there, with nine patients still to transport from the seventh floor. “If everybody leaves, who’s gonna move the patients?”

Several LifeCare leaders went down to find Susan Mulderick.

“IF YOU WANT your suitcase that badly, you’ll have to swim out with it!”

Mulderick lost her temper with a hospital employee’s family member who insisted on the right to carry a very large suitcase onto an evacuation boat. The rule was at the most one small bag, sometimes just a wallet, no suitcase, no pets.

Mulderick couldn’t take two steps without running into someone having a conniption and who felt the need to share it with her. She had walked the floors for two days, shouldering people’s tension, anxiety, and panic. Two nurses who had brought teenage children to Memorial had come to her in tears saying they had to get out. When she told them there were still patients to be cared for, they had yelled at her. Other nurses had been allowed to leave. Why not them? Mulderick defended the departed nurses—they had gone to help people at the boat drop-off point—even though she had asked them, too, to stay at the hospital.

When Mulderick passed through the second floor, people sitting with their animals and their packed bags asked her when they could leave. A therapist erupted when she told him he had to stay; there were still many patients to move. He yelled at her. He had a bad back. Carrying patients was a job for younger men. Mulderick walked away. There was too much happening to argue with every person who was upset.

After the fight over the suitcase, three senior staff members from LifeCare approached her. They said they were getting low on rubbing alcohol and a few other supplies and wanted to know what the plan was for nine patients who remained on the seventh floor—as if they expected her to tell them what to do! They said they weren’t sure they could move the patients on their own, including a large paraplegic patient. One of the LifeCare staff members had told Mulderick earlier that two of their patients were in grave condition, running extremely high temperatures of 104 and 105 degrees.

Mulderick told the LifeCare team the plan was not to leave any living patients behind. She asked them to talk to Dr. Pou. After all, the doctors
working on the second floor were the ones who had stopped LifeCare’s DNR patients from being brought down to the staging areas on Wednesday, saying it was too crowded. Were the patients dying, would they not attempt to move them; or would they proceed with getting them in the staging area for evacuation? Whatever the LifeCare leaders were going to do, Mulderick told them, they needed to decide and get it done.

During their conversation, a uniformed man began yelling, “All women and children!” More boats had arrived, and people streamed toward the ER ambulance ramp as if the man had announced the last one was leaving.

One of the LifeCare staff members, physical medicine director Kristy Johnson, excused herself to fight through the crowds. She wanted to bring the news of the family evacuations to the seventh floor, where two daughters of LifeCare patients remained.

CEO René Goux came to the ramp and asked the doctors why the hell they were loading family members onto boats. The doctors who had gone out that morning to the drop-off point had marshaled resources, including ambulances. “We’re trying to get the patients out!” he said.

“Everybody’s a patient, including us,” Dr. John Kokemor said.
He, like many others, had been concerned for his life. He kept a credit card on him to use if he made it out of the hospital and a driver’s license for others to identify him in case he did not. Patients were slow getting onto the ramp. If the boats quit at five thirty as he expected, they would all be there another night. Kokemor’s goal was to get as many people on board each boat as quickly as possible; that included two of Memorial’s oldest doctors, one of whom was Horace Baltz. Kokemor wanted to get Baltz’s older sister out too, and her daughter, an ICU nurse. They had medical problems, and Kokemor didn’t think they were doing well. “I’ll move you to the front of the line,” Kokemor told them, “and you guys get out of here.”