Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital (44 page)

In one letter, Marirose Bernard, the nursing director for women’s and infants’ services who had appeared on Fox News, accused Fetter of having said on cable television that Tenet had the situation at its hospitals under control on Wednesday, August 31; all the most severe patients had been evacuated; and replacement workers from throughout the country were prepared to go into New Orleans:

Where did those “replacement workers” go to? […] Virtually ALL of these patients were “severe” and deserved to have been evacuated long before Thursday night when the last of the patients were finally evacuated. I recall as we picked up one patient to move him along the line to the helicopters and told him that he would be leaving soon he screamed out “Oh God—are you throwing me away??!!!” He said he had been told for so long that he was going to get out that he just knew we were throwing him away. This memory will be with me forever. Another patient called out “Mama, Mama, Mama” constantly, others were in terrible pain and agony—how dare you give this nation the impression that you were providing for these patients and for your employees.

Some workers recalled the sense of abandonment they had felt during the disaster both before and after leaving the hospital. Upon being airlifted or boated from Memorial, many had been left to fend for themselves on threatening street corners, highway intersections, and at the teeming Ernest N. Morial Convention Center, which Mayor Nagin had opened as a second mass shelter after the storm but
had not supplied with food, water, or adequate staffing.

“Frankly, I believe Tenet had a duty during Hurricane Katrina to protect employees such as me and failed to fulfill its obligation,” one ICU nurse, Dawn Marie Gieck, wrote to Fetter. “When I consider how others and I put ourselves in harm’s way for Tenet, I feel a sense of indigo-that
the company wasn’t there to take care of those taking care of its patients.” She added that she had served in the military during Operation Desert Storm and agreed with comparisons between post-Katrina Memorial and a war zone. She argued that it was easy for individuals and organizations to point to the floundering of local and federal governments after a natural disaster as a way of excusing their own failures.

One of Memorial’s administrators did blame the government, copying company officials on an aggrieved letter to US president George W. Bush. “I want to express how deeply proud I am to have been associated with such a courageous and compassionate group of caregivers at Memorial Medical Center, and how disappointed and ashamed I am in my government that failed each and every one of us.”

Three nurses from the medical and surgical unit on the fifth floor also wrote to Tenet. They had been accused of abandonment and fired. One was the nurse whose husband was the Coast Guard junior grade lieutenant who had helped organize the evacuation of Memorial’s neonates and ICU patients. Another was her close friend Michelle Pitre-Ryals, the nurse who had repeatedly carried a cell phone downstairs on Tuesday night when Coast Guard officials called trying to continue Memorial’s evacuation overnight.

The commander of the New Orleans Coast Guard sector had
authorized the lieutenant to land on Memorial’s helipad late on Wednesday afternoon and rescue his wife. The nurse and her two close friends made a split-second decision to go against their manager’s instructions. Although all except one of the patients were off the floor and the nurses had not been assigned to care for others, some of their coworkers were furious at them for leaving. For their part, the three nurses wondered how Tenet could fire them after all their hard work, when the hospital itself was pitifully unprepared for the disaster. They were reinstated and their relief pay was restored, but another nurse who had left her post as soon as the water began rising, saying “I’m getting out of here,” and telling colleagues she was concerned about her pets, was permanently fired.

ON OCTOBER 12, 2005, Rider and Schafer came to New Orleans from Baton Rouge to reinterview the main LifeCare witnesses in person and go over photographs with them. After they finished their work, they found a bar where they could watch CNN.

“Good evening,” anchor
Anderson Cooper said to hundreds of thousands of viewers. “We begin tonight at a moment when Hurricane Katrina went from being a disaster to a tragedy, when people began making choices that leave a mark on the soul. Now, as the water and the mud recede, secrets are coming to light, whispers of life-and-death decisions and talk, heard here for the first time anywhere, of more, of mercy killing. Authorities in Louisiana are investigating. Tonight, we know this for certain: at a bare minimum, the question was on the table inside a hospital.”

Reporter Jonathan Freed described the horrific conditions at Memorial and introduced Dr. Bryant King. “Most people know that something—something happened that shouldn’t have happened.” Without naming names, King described what he had heard and seen, much as he had told Virginia Rider and Butch Schafer the previous week. He said he had spoken with one doctor about putting patients out of their misery and saw another one holding syringes.

“The only thing I heard her say is, ‘I’m going to give you something to make you feel better.’ ”

The network took care to protect Pou’s name. Airing accusations of murder with little evidence could have put the news organization in danger of a libel suit, and Pou now had an aggressive defense attorney. If nothing else, exposing Pou’s identity would have alienated her, and producers at the channel still hoped to convince her to tell her side of the story on camera. Reporter Freed said that, when told of King’s allegations, the doctor in question would not comment either way. Freed quoted Pou anonymously from what he described as several phone conversations:

“We did everything humanly possible to save these patients. The government totally abandoned us to die, in the houses, in the streets, in the hospitals. Maybe a lot of us made mistakes, but we made the best decisions we could at the time.”

Memorial nurse manager Fran Butler also appeared in the piece. “Did they say to put people out of their misery? Yes.” She said she, too, had learned of a discussion about euthanasia. “I kind of blew it off because of the person who said it,” she said, describing, but not naming, Dr. Kathleen Fournier. Could it all have been a misunderstanding?

In the broadcast, Attorney General Foti predicted the investigation would be complete in two weeks and asked all who had information to come forward. “We’re looking at probably thirteen nursing homes and six hospitals scattered through the greater New Orleans region. So we are operating on many fronts at the same time.”

A parade of experts discussed the issues on various CNN news segments. Forensic pathologist Cyril Wecht spoke of the challenges of wresting evidence from decomposed bodies. Randy Cohen, then the
New York Times Magazine
ethics columnist, questioned the hospital’s preparedness. “
Why weren’t there plans to cope with these patients when you knew a storm was coming? Sometimes the ethical—the most important ethical question sometimes is the one you ask not at the moment of crisis, but the duty you have to anticipate certain kinds of crises and avoid them.”

Bioethicist Arthur Caplan, then at the University of Pennsylvania, said American juries rarely sent doctors to jail for hastening deaths.
“The culture that we live in does not want doctors killing, to be very clear about that. But it will listen closely and you might be able to make a defense of a mercy killing, if you will, under very, very extenuating circumstances. Whether New Orleans meets that, we’ll have to see.”

Versions of the report ran for days on the twenty-four-hour news channel. CNN’s anchors rehashed the story, verging into sensationalism.
“Did an angel of death stalk the halls of Memorial Medical there in Louisiana?”
Nancy Grace asked on her Friday-evening news show. “No one knows for sure.” When a guest began describing the loss of power, rising fears, and delayed rescue that preceded the injections, giving context to them, Grace cut him off: “Sean, Sean, Sean—I don’t want to relive Katrina. I want to find out if there was an angel of death stalking the halls of Memorial Medical! That’s what I want to find out.”

Grace seemed frustrated that Bryant King hadn’t stayed around to find out what happened, if only so he could return to report it on her show. “I find it fantastical in this case, and in many others, where witnesses can lead you up to the brink of an alleged crime, and then suddenly they turn away, they leave the room. Here they’re saying that there’s a doctor with a handful of syringes with liquid in it, saying, ‘This will make you all feel better,’ to patients. But they don’t know what happened after that? I would have been doing a backflip to see what was going on.”

The major television networks excerpted CNN’s report on their own news shows and added new details. NBC reported that a family had filed suit against the hospital for the death of a loved one. Several Memorial doctors rushed to defend their colleagues on television. “
There was no way we were going to hasten anyone’s demise,” Memorial internist John Kokemor said on NBC.

Jannie Burgess’s daughter, Linette Burgess Guidi, the former Playboy Bunny who had come from Holland to visit her mother before the storm, knew only that her mother had died during the evacuation. She had been informed of this, via e-mail, many days later. The images of Memorial on CNN looked familiar. She screamed, covered her ears, and pulled the bedcovers over her head. She heard enough to know she did not want to hear more. She refused to believe her mother was one of the patients injected. Who would want to believe that?

One network reported on an article that had appeared in the British tabloid
The Mail on Sunday
almost two weeks after the hurricane, quoting from an interview with an unnamed female doctor at an unnamed hospital.

I didn’t know if I was doing the right thing. But I did not have time. I had to make snap decisions, under the most appalling circumstances, and I did what I thought was right.

I injected morphine into those patients who were dying and in agony. If the first dose was not enough, I gave a double dose. And at night I prayed to God to have mercy on my soul.

This was not murder, this was compassion. They would have been dead within hours, if not days. We did not put people down. What we did was give comfort to the end.

On the third day of the media binge, a memo went out by e-mail addressed to all Memorial Medical Center personnel and marked “Attorney-Client Privileged and Confidential.” It said employees contacted by government or media representatives should “feel free to speak with the hospital’s lawyer at the below-listed number.”

If you decide that it is in your best interests to be interviewed by the government or the media, you have a right to request that a hospital representative appear with you. It is often prudent to have a third party present in such situations to ensure that your words are not inadvertently misconstrued or taken out of context.

Because it is not appropriate to discuss publicly these matters, the hospital asks that you refrain from talking about these issues with other employees and people outside the employ of the hospital. If you need any information or have any questions, or if the government or the media contacts you, we would appreciate it if you would call me. Please feel free to call collect: Audrey Andrews

THE SAME DAY, the Medicaid Fraud Control Unit’s chief prosecutor received a fax from Tenet attorney Harry Rosenberg. He requested that
before questioning Tenet employees, government officials inform them that they had the right to confer with him or another Tenet attorney and have an attorney or a hospital representative present. Virginia Rider and Butch Schafer complied. Ethics required this. They also wanted to ensure the information they obtained would be admissible in court. At the same time Schafer saw how strategic it was for Tenet to offer to represent its employees. What company, facing potential lawsuits, wouldn’t want to know what its workers had to say about it?