Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital (68 page)

A FOURTH MEMORIAL nurse received word from her lawyer that she, too, would be asked to testify. It was Budo and Landry’s supervisor at Memorial, nurse manager Karen Wynn. One of Wynn’s colleagues had told the attorney general’s investigators that Wynn had spoken to her about people being euthanized on the seventh floor. Wynn wouldn’t deny it. “Even if it had been euthanasia,” she would say, “it’s not something we don’t really do every day—
it just goes under a different name.”

After having helped inject patients on the second floor, Wynn had emerged from the disaster confident in what they had done for the patients. “We did the best we could do,” she would say. “It was the right thing to do under the circumstances.”

The only decision she questioned was having put her sixteen-year-old daughter on a helicopter out of Memorial without her. The child had experienced a difficult journey to safety, and Wynn heard her tell others it made her question her belief in God. That broke Wynn’s heart.

Wynn was also concerned about her two arrested nurses. Their lawyers had told the women under scrutiny not to talk to one another—they could be accused of colluding—but Wynn and others ignored that advice, checking in to see how the others were doing.

In advance of Wynn’s possible grand jury date, her attorney prepared her to testify. She told her what types of questions to expect and made sure Wynn’s message was clear and consistent. The lawyer was patient and kept her up to date on the legal proceedings. She was fierce and protective, and Wynn came to love her, but talking about the events felt like reliving them. Sometimes after their meetings, it took weeks to find her way back to feeling OK, to move forward in a different direction and get beyond what had happened.

Wynn supposed it was post-traumatic stress disorder. She recognized its symptoms in herself and in her colleagues, figured they were there for life.

For the moment, the dedicated nurse didn’t want to be one anymore. She made light of this, joking that she wanted to grow up and sell shoes at Saks Fifth Avenue instead, but she felt she had given up a part of her soul at the hospital, sacrificed it. She thought of the many times in her quarter century of work there that she had put patients and her career as a manager ahead of time with family. She recalled the fifty- or sixty-hour work weeks and the fact that it was she who had called Cheri Landry and Lori Budo to tell them they were on the schedule for the storm. She no longer wanted that kind of responsibility; that feeling had been building even before Katrina. She felt worn.

After everything they had been through in those five days, to have their integrity questioned, to be facing the possibility of going before a criminal grand jury investigating a colleague for murder, was unbearable. Wynn awaited the call to testify, but for her, unlike the others, it didn’t come.

THE SAME DAY the other nurses were scheduled to testify, Anna Pou’s patient James O’Bryant was given a choice. A scan showed that his cancer had advanced through the bones of his face and reached his brain. Pou was still practicing only at the public hospital, not the private hospital where O’Bryant was being treated, and her colleague Dan Nuss, who had recently performed another extensive operation on O’Bryant, told her about it. Nuss had cried when he gave the news to O’Bryant, only fifty-three years old, who touched him on the shoulder and told him he knew Nuss had done everything he could. It was the day before the O’Bryants’ thirty-second wedding anniversary. The choice was between chemotherapy, which Nuss felt would only make him sick, or stopping anti-cancer treatment altogether and going into hospice, meaning O’Bryant would receive care focused on controlling his symptoms and keeping him as comfortable as possible until he died. O’Bryant chose hospice.

Pou called his wife, Brenda. “How did he take it?” she asked. Brenda said they weren’t happy but were kind of OK. Pou invited Brenda to call her morning or night, any day of the week, twenty-four hours a day. Pou phoned repeatedly to check on them. She told Brenda she would try to visit.

AS THE ANNIVERSARY of the arrests approached, the American Medical Association
published the first issue of a new journal on disaster medicine, with a photograph of a post-Katrina shelter on its cover and a preliminary report suggesting the death rate in New Orleans had risen dramatically after the storm. Several articles cited Pou’s case as an argument for new disaster-medicine policies.

In late June, prominent doctors from across the country converged in Chicago for the AMA’s annual meeting. Inspired by Anna Pou’s case, the AMA’s ethics council, whose appointed members served as custodians of the organization’s code of ethics for the medical profession, held an open forum to consider whether and how normal medical standards should be altered in disasters. AMA policymakers also planned to vote on a proposed campaign for state laws that would make doctors automatically immune from liability in disasters unless they acted maliciously, even if their care was grossly negligent. Only
a minority of American physicians were said to claim membership in the AMA, and many opposed its policies, but the professional organization exerted considerable legislative influence through richly funded lobbying and political donation wings.

Rick Simmons appeared at the Hilton Chicago to speak in favor of both proposals. Wearing a dark suit with cufflinks and a sapphire tie, a matching handkerchief in his left breast pocket, he took the microphone beneath immense chandeliers in the hotel’s international ballroom. Simmons warned that when medical resources were overwhelmed, some
patients would have to go untreated and die, their lives sacrificed for the greater good based on factors including DNR orders and physicians’ fears for their own safety. Family members would inevitably sue, meaning doctors were in peril all over the country, at all times, should any number of emergencies caused by nature or terrorists occur. If doctors were to “answer the call” in such situations, they would need to be protected. Simmons reminded the crowd of the AMA’s long-standing opposition to criminalization of doctors’ medical judgment.

He argued that national guidelines on end-of-life care, which included post-Nazi protections such as seeking consent of patients or their proxies and documenting decisions and actions, weren’t appropriate for a time of catastrophe when those steps were “not available,” and it was up to doctors to exercise their own judgment in good faith.

Simmons held up the example of the World Medical Association guidelines Pou had sent him after the Houston symposium. Doctors could ethically separate “beyond emergency care” patients from others and sedate them.

Public officials, he pointed out, were immune from prosecution for certain mistakes in judgment. Why not legislate the same immunity for medical workers in disasters?

Simmons proposed a federal law to rein in state prosecutors and bereaved family members by mandating that any complaints about a doctor’s actions in a disaster be reviewed by other doctors instead of lawyers and judges. To temper the appearance of self-interest, he suggested including a victim-compensation fund to satisfy the family members of the dead.

He concluded, thanking the AMA on behalf of Dr. Pou and expressing his and her hope that no more doctors would have to endure an ordeal such as hers.

The AMA
delegates voted to create model legislation to shield disaster doctors from civil and criminal prosecution. Members would be encouraged to lobby nationwide for a new standard for conviction that would require proving a doctor set out with malice to hurt a patient. The
AMA would also strengthen existing efforts to oppose criminal prosecution of doctors by adding an emphasis on doctors in emergencies.

Without a jury or a judge having yet ruled on Pou’s case, without Pou having shared publicly what she had done, organized medicine’s main response to the alleged murders at Memorial was to close ranks and defend itself.

THE DAY BEFORE the first anniversary of Pou’s arrest, Simmons launched an attack on the attorney general, filing an invective-filled lawsuit on behalf of Pou and distributing copies to the media.

As an LSU physician, Pou was a state employee, and the suit demanded that the state pay Simmons’s legal fees for her defense in several civil cases brought by families of the dead, including Emmett Everett. “The State of Louisiana abandoned Dr. Pou and others during Hurricane Katrina and now she is being abandoned again by the State’s denial of a civil defense,” Simmons wrote, accusing the state of forcing the doctors to “save who they could save.”

Simmons’s petition circumambulated, veering from legal arguments to a personal takedown of Attorney General Foti. It called his conduct in arresting Pou and the two nurses improper and unethical, drawing parallels with a sensational case in another state.

Days earlier, Michael B. Nifong, a North Carolina district attorney who had prosecuted several Duke University lacrosse players for allegedly raping a stripper, had been disbarred for having tried his case in the media and misleading the public about evidence that was later revealed as false.

Nifong’s case “demonstrates the dangers in extra-judicial comments by prosecutors,” Pou’s suit said, suggesting that many of the charges against Nifong could be made against Foti, who had vehemently criticized
the women he arrested and whose press conference caveats had been edited out of news coverage.

Pou’s suit alleged that Foti, like Nifong, sought to capitalize on a high-profile case to bolster an upcoming reelection bid. As evidence, Simmons attached a copy of an invitation to a $500-per-head cocktail fund-raiser at the fancy Windsor Court Hotel in New Orleans, held three days after the arrests, which perhaps explained Foti’s insistence to his staff that the arrests take place when they did.

Attorney General Foti’s public information director, Kris Wartelle, didn’t need the Nifong case to put a scare in her. She already girded her tongue when speaking with the media. She often lamented to reporters that Pou’s people were free to say anything they wanted about the events at Memorial, and did, while the prosecutors were bound to say nothing about all the evidence they possessed.

CORONER FRANK
MINYARD LIKED to interact with defense attorneys, and he particularly liked Rick Simmons. The men were from the same part of New Orleans, downtown. That inspired a kinship, though Simmons was younger. Most people were younger. Minyard tried to give defense attorneys what they wanted, do what they wanted. He never wanted it to be said that he was acting as a doctor for the police or the DA. He wanted it said that he was a doctor for truth. He called his office his palace of truth. He’d told that to Mike Wallace years ago in an interview on
60 Minutes
, a tale he never tired of recounting.