Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital (37 page)

Throughout the day, boats and helicopters drained the hospital of nearly all of its patients and visitors. Wynn and a group of other female
nurses helped lift the last few patients through the hole in the machine-room wall.

From: Denise Beltran on Behalf of Earl Reed [LifeCare CEO]

Sent: Thursday, September 1, 2005 4:02 PM

To: All LifeCare Locations’ Employees

Subject: New Orleans Update – Sept 1

[…] Our patients in the Tenet hospital are still being evacuated. We are exploring private means of evacuating those patients. […]

AS THE LAST patients were brought to the top of the garage in the waning daylight, Merle Lagasse continued to await rescue there. A day had passed since the wrenching separation from her daughter as Lagasse was conveyed through the machine-room hole. Lying for days in the heat, suffering from advanced cancer and emphysema, Lagasse was far from the glamorous lady she had once been. A nurse noticed her gasping for air, breathing in a pattern that often heralds death. The nurse asked Lagasse’s physician, Roy Culotta, to give her something to ease her respirations.

Culotta saw Lagasse was in respiratory distress and believed she was actively dying. He took her out of the evacuation line. He asked an ICU nurse to retrieve painkillers and sedatives from the hospital.

A shortcut led from the garage back into the seventh floor of the main hospital over the rooftop of an intervening building. A wooden pallet bridged the gap between the garage and rooftop, with a hose to grip for balance, allowing those staffing the helipad to go back and forth easily to retrieve supplies. The ICU nurse returned with a mix of painkillers
and sedatives Culotta assumed came from a lockbox in the ICU; they included morphine, Versed, and Ativan.

Culotta had been treating Lagasse with narcotics for weeks because she had pain and anxiety from her spreading cancer, so he knew her tolerance was high. It would take a large amount of morphine, he felt, to relieve her gasping and suffering. It would also, he believed, undoubtedly hasten her death. While she and her daughter had not agreed to a DNR order, he, as her doctor, had felt during her hospitalization that her therapeutic options were limited, and a central goal of his care was keeping her pain and anxiety in check.

The nurse gave the drugs Culotta ordered. They put Lagasse in the back of the truck, and Culotta drove back down with her and brought her into the hospital. He was with her when she died.

SUSAN MULDERICK surveyed the emergency room. She had been told hours earlier that the two patients lying in its waiting room—one of them the elderly lady who had arrived with her husband and was cared for by Karen Wynn—were not being moved because they were dying. The two were still present and alive. “What are we doing with these people?” she asked the ER doctor. Mulderick told him they needed to make a decision about the two. Were they expected to die soon, or was it time to move them upstairs? The doctor said, “OK,” that he’d take care of it.

IT HAD BEEN a long day on the helipad. Some helicopter pilots refused to take bed-bound patients. To get around this, doctors lifted some of these patients into wheelchairs and tied sheets around their midsection and chest to convert them to “sitting patients.”

At around nine p.m., the obese ICU patient Rodney Scott was hoisted
up the open metal steps to the helipad. He was apprehensive about being carried up a narrow passageway by inexperienced volunteers but relieved to be outside of the dark, airless hospital. Sudeep Reddy, a reporter from Tenet’s hometown newspaper, the
Dallas Morning News
, tracked Scott’s progress toward rescue. Reddy had begged a ride from the aviation services company supplying leased helicopters to Tenet and flown in with a photographer, Brad Loper, late that afternoon. Reddy had counted eighteen people, many of them women, helping slide Scott through the machine-room wall on a count of three. Six others received him on the garage side, discussed how much oxygen he needed, and loaded him onto the back of a Ford F-150 pickup truck for a ride to the top. As Reddy ascended to the upper level of the parking garage, he was surprised to see patients in obviously terrible condition still lying in the heat on the ground. Some looked so bad that Reddy took doctors and nurses aside and asked in a low voice whether the patients were alive. The medical staff said they were, but that others had died on the ground in the horrific conditions. Reddy could not piece together why these very sickest patients had not yet been airlifted.

Reddy watched clusters of volunteers hoist stretchers on their shoulders and carry patients up the narrow metal steps to the helipad. He scribbled in his notepad. “Urine and feces rolled off the beds and onto the workers, forcing them all to wipe down with sanitizing liquid every time,” his story would say.

Now four men surrounding Rodney Scott shouted, “Push! Push!” and rolled his heavy wheelchair into a Coast Guard helicopter. When this was done, one of the male ICU nurses collapsed to the ground. He’d been pinned against the helicopter by the wheelchair and his colleagues hadn’t heard him yell for them to stop.

The ICU nurse seemed to be having trouble breathing and it looked like he would need to be evacuated, too, perhaps in place of Scott. Dr. Roy Culotta bent to examine his chest and other workers screamed for ICU nurse manager Karen Wynn, who had helped lift Scott through
the machine-room wall and then grabbed her purse and hiked to the top of the eight-story garage. What can I do? she wondered. She was like a mother to her nurses, even as they scattered from Baptist and New Orleans, perhaps forever.

Another helicopter hovered overhead. It could take the injured nurse and Culotta, who would accompany him, ready to insert a chest tube in midair if necessary to help him breathe.

As they devised this plan, the helicopter carrying Rodney Scott lifted away. Weighing more than three hundred pounds, recovering from surgery and heart trouble, and unable to walk, Scott had been designated the last to go through the hole in the wall because of his weight. Ewing Cook had mistaken him for dead the previous day. And yet he had been successfully airlifted, alive. Scott was the last living patient to leave Memorial.

PART 2
RECKONING

Yesterday we could see, today we can’t, tomorrow we shall see again.…

—José Saramago,
Blindness

C
HAPTER
8

THE CAMERA WENT LIVE, showing some of the thousands of people trapped on the stinking, trash-filled Interstate 10 cloverleaf on Thursday night. The reporter estimated that 90 percent of them came from inner-city housing projects. “But then there are the others,” she said. She introduced two Memorial Medical Center employees, describing them as very scared.

“You could have gotten out. You could be in a nice, warm bed tonight, but instead, you’re out here,” the reporter said. Her made-up face looked, to the tattered survivors, out of place in the disaster.

Memorial’s director of maternal-child nursing, Marirose Bernard, had agreed to go on camera
in exchange for what she thought was a promise from the news crew to help rescue her children, husband, and mother, who had left Memorial on Wednesday only to end up hungry, thirsty, and terrified at the New Orleans Convention Center.

Bernard described the five days at Memorial. She said doctors and nurses had worked with, at most, an hour of sleep a night. She spoke of learning to triage and explained how employees and visitors carried each patient down the stairwell in the dark.

The reporter asked whether she had any regrets for having stayed at Memorial for the hurricane. “No regrets whatsoever,” the nursing director
replied. “I don’t regret it at all because I’m a nurse, and that’s what nurses do.”