Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital (80 page)

  
3
upgraded its hurricane watch
: Hurricane warning including the New Orleans area was issued at ten p.m. local time on Saturday (0300 UTC Sunday), Knabb, et al.

  
4
archaic Teletype
: Oremus, Will, “TORNADO POSSIBLE. MIGHT KILL YOU … MIGHT NOT,”
Slate
, April 2, 2012;
http://www.slate.com/articles/health_and_science/explainer/2012/04/new_tornado_warnings_why_national_weather_service_storm_alerts_weren_t_scary_enough_.html
.

  
5
THE BOTTOM LINE IS THAT KATRINA:
“Hurricane Katrina Discussion Number 19” NWS TPC/National Hurricane Center, Miami, FL, eleven p.m. EDT, Saturday, August 27, 2005.

CHAPTER 3

Interviews

Dr. Horace Baltz; Joanne Cardaro; Dr. Ewing Cook; Minnie Cook; Dr. Richard Deichmann; Dr. Barry Faust; Faye Garvey, family of Jannie Burgess (Linette Burgess Guidi, Bertha Mitchell, Gladys Smith, Johnny Clark); Gina Isbell; Dr. John Kokemor; Gov. Richard Lamm; Grayson Lovick; Dr. Jeffrey N. Myers; Dr. Daniel W. Nuss; Dr. Anna Pou; Karen Wynn; John Zimmerman.

Archives

“NOAA Hurricane Katrina Advisory Archive,” National Hurricane Center, 2005;
http://www.nhc.noaa.gov/archive/2005/KATRINA.shtml?
.

Documents

Johnson, Brig. Gen. David L. “Service Assessment: Hurricane Katrina August 23–31, 2005” (Silver Spring, MD: NOAA’s National Weather Service, 2006);
http://www.weather.gov/os/assessments/pdfs/Katrina.pdf
; New Orleans evacuation order; copy of Dr. Anna Pou’s signed relocation agreement, acceptance of offer, and employment offer cover letter from April 2, 2004.

Notes

  
1
MOST OF THE AREA WILL BE UNINHABITABLE
: “URGENT-WEATHER MESSAGE,” NWS, New Orleans, LA, eleven a.m. CDT, Sunday August 28, 2005;
http://celebrating200years.noaa.gov/events/katrina/side_katrina.html
. Also roughly twenty-four hours before the storm made landfall, NHC public advisories began predicting a storm surge (water height above normal astronomical tide level) in the range of eighteen to twenty-two feet (and as high as twenty-eight feet wherever the center of the hurricane hit land).

  
2
“remember the old ways”
: Press conference, Aaron Broussard, president, Jefferson Parish, LA, WDSU eleven a.m. CDT;
http://www.youtube.com/watch?v=Mk64s3xT8W8
.

  
3
confusion over whether he had the legal authority to issue it
: US Congress, Senate Committee on Homeland Security and Governmental Affairs,
Hurricane Katrina
:
A Nation Still Unprepared
. Chapter 16, “Pre-Storm Evacuations,” footnotes 59–60, pp. 264–265. (Washington, DC: 109th Congress, 2nd session, S. Rept. 109–322 GPO, 2006.i);
http://www.gpo.gov/fdsys/pkg/CRPT-109srpt322/pdf/CRPT-109srpt322.pdf
.

  
4
on a conference call
: Knox Andress’s notes on the ten a.m. conference call are included as exhibits in
Elmira Preston, et al v. Tenet Health System Memorial Medical Center, Inc. D/B/A, Memorial Medical Center, et al
. 2:06-cv-03179-EEEF-KWR document 74-6 filed October 24, 2006, US District Court Eastern District of Louisiana, civil action no. 06-3179, available on PACER, Public Access to Court Electronic Records,
http://www.pacer.gov
. (The case was later remanded to civil district court and certified as a class action; therefore, later motions and judgments in the case, referenced elsewhere, are not available on PACER.) A conference call participant said only Children’s and Methodist hospitals had both generators and switches above the ground floor. However, Methodist, too, lost power when the city flooded, and its former administrator had informed the New Orleans health director three years before Katrina that one of the hospital’s main generators and elements of the fuel supply system sat below flood level and would cost $7.5 million to protect (see Fink, Sheri, “The New Katrina Flood: Hospital Liability,”
New York Times
, January 1, 2010). Deposed in a lawsuit brought by the family of a critically ill patient who died at Methodist, CEO Larry Morgan Graham explained that while one of the generators was well above flood level, the pump that fed diesel power to it was flooded. The hospital was without power for about eighteen hours before staff restarted the generators by “hand carrying diesel fuel to the roof” (
Stephen B. Lacoste, et al v. Pendleton Methodist Hospital, LLC
, Civil District Court for the Parish of Orleans, case no. 2006-2347, deposition taken May 2, 2008). Vulnerable fuel pumps have remained a problem for other hospitals in flood zones. Superstorm Sandy in October 2012 knocked out basement fuel pumps at New York City’s Bellevue Hospital, where fuel was also hand-carried upstairs to keep generators running.
more than $17 million
: Louisiana Hospital Association, data on Hospital Preparedness Program grants from the US Department of Health and Human Services to the Louisiana Department of Health and Hospitals, 2002-2005;
http://www.lhaonline.org/displaycommon.cfm?an=1&subarticlenbr=138

  
5
“It is assumed that many”
: US Senate.
Hurricane Katrina
:
A Nation Still Unprepared
. Chapter 24, “Medical Assistance,” p. 399, p. 427 (reference 7): Philip Navin, e-mail to EOC Report, August 29, 2005, 6:58 a.m., provided to Committee; filed as Bates nos. CDC 747–749.

  
6
lost her only son in Vietnam
: Ruben Anthony Burgess, private first class, United States Marine Corps, December 9, 1948–February 23, 1968. See “The Virtual Wall: Vietnam Veterans Memorial,”
http://www.virtualwall.org/db/BurgessRA03a.htm
.

  
7
could not receive care at them
: See, for example, Baker, Robert B., Harriet A. Washington, et al, “African American Physicians and Organized Medicine, 1846–1968,”
JAMA
, vol. 300, no. 3 (July 16, 2008): 306–314. Racial segregation in Southern hospitals had its legal basis in decisions such as the “separate but equal” 1896 Supreme Court ruling in
Plessy v. Ferguson
, as well as statutes in Southern states mandating segregation of white and black patients. The Hill-Burton Act of 1946 allowed federal funds to be used for construction and improvements to segregated hospitals. The practice continued after
Brown v. Board of Education
struck down the principle of “separate but equal” in education. (Quadagno, Jill and Steve McDonald. “Racial Segregation in Southern Hospitals: How Medicare ‘Broke the Back of Segregated Health Services’ ” in Green, Elna C., ed.,
The New Deal and Beyond
:
Social Welfare in the South Since 1930
. [Athens, GA: University of Georgia Press, 2003]). The Civil Rights Act of 1964, Title VI, forbade discrimination in any private organization receiving federal financial assistance. However, only hospitals that received federal funds were seen to be bound by the nondiscrimination provisions. When Medicare was passed in 1965, a hospital could not receive its funds unless it could certify it did not discriminate.

  
8
In fact, Baptist was one of the last
: Southern Baptist Hospital administrator Raymond C. Wilson, in his “Thinking Out Loud” column in the May 1967,
The Triangle
, said a US Government official told him that fewer than three hundred hospitals in the US had chosen to operate without government aid, and “the opinion was expressed that Southern Baptist is the largest of the group to ‘go it alone.’ ” Wilson wrote that New Orleans hospitals that participated in Medicare were being asked to give the government’s office of Equal Health Opportunity a list of patients referred by each doctor to each hospital (presumably to help ferret out ongoing segregation). “Such a measure could seriously hamper a doctor’s privilege of deciding which hospital is best suited for each particular patient,” Wilson wrote.

  
9
New Orleanians sent supportive letters
: Wilson included these quotes in his “Thinking Out Loud” column, September 1966,
The Triangle
. He also applauded San Leandro, California, for turning down “millions of dollars available through antipoverty programs, federal urban renewal, housing and beautification programs” to resist “control of their community affairs.” The 1966 statement was reprinted in Wilson’s column in the July 1966,
The Triangle
.

 
10
The hospital began quietly
: Wilson wrote in his June 1969 “Thinking Out Loud” column: “It is the creed and practice of our hospital to make available our services to all people, regardless of race, creed, color, national origin or ability to pay.” The same month, the Southern Baptist Convention, meeting in New Orleans, adopted a “Resolution on New Orleans Hospital Integration” requesting that the trustees of the hospital commission “pursue this matter without delay in order to bring actual practice in line with stated policy”;
http://www.sbc.net/resolutions/amResolution.asp?ID=888
. The integration policy had been adopted a year earlier, at the Convention’s annual session in June 1968, which met the week Sen. Robert F. Kennedy was fatally shot. At that meeting, the new program statement of the Southern Baptist Hospitals had replaced this phrase, adopted in 1962: “Makes available the full resources of the hospital to those people least able to pay in such ways as to preserve human dignity and worth.” According to Greene, Glen Lee.
The History of Southern Baptist Hospital
(New Orleans: Southern Baptist Hospital, 1976, and original 1969 edition), the hospital implemented the Convention’s revised program statement by beginning to admit black patients; an article in the June 13, 1968,
Baptist Message
said, according to the hospital’s annual report to the Convention: “the New Orleans hospital admitted its first Negro patients this year.” Dr. Horace Baltz, a white physician who had worked at the hospital beginning in the mid-1960s, told me “it was very quietly done,” and Dr. Windsor Dennis, a black surgeon of Dr. Baltz’s generation who did not work at the hospital, said he knew of only one black person, a prominent school principal, who was treated there before this time (“It was kept quiet.”). Dr. Baltz noted that Dr. Emmett Lee Irwin, one of the most active segregationists in New Orleans, had been a leading staff physician whose views may have influenced hospital policy (he died in a car accident in 1965). Greene’s book lists Irwin as a founding member of the Southern Baptist Hospital medical staff in 1926, and McMillen, Neil R.
The Citizens’ Council
:
Organized Resistance to the Second Reconstruction 1954–64
(Champaign, IL: Illini Books, 1994) describes Irwin as a founder and early leader of the Greater New Orleans Citizens’ Council. The organization worked to oppose school integration and, with Irwin as its chairman in the mid-1950s, “packed thousands of Confederate-flag-waving spectators into New Orleans’s Municipal Auditorium to hear speakers denounce integration as a Communist plot and make dire predictions of an impending race war,” according to Mohr, Clarence L. and Joseph E. Gordon.
Tulane
:
The Emergency of a Modern University, 1945–1980
(Baton Rouge, LA: Louisiana State University Press, 2001). Mohr and Gordon’s book discusses Irwin’s earlier role founding and leading the Louisiana Coalition of Patriotic Societies. Irwin’s tactics in opposing school integration included bringing white children, some in blackface, onstage at a rally and signaling them to begin kissing each other; he told the crowd, “That’s just a little demonstration of what integration means.” (
Bush v. Orleans Parish School Board and the Desegregation of New Orleans Schools
. Federal Judicial Center;
http://www.fjc.gov/history/home.nsf/page/tu_bush_narrative.html
.) A statement from earlier in Southern Baptist Hospital’s history suggested a more inclusive attitude, at least on paper. A hospital report from 1935 stated: “Our policy, consistently followed through the years has been to care for the sick who came to us, regardless of race or creed or position in life, giving such care as we have been capable of rendering.” Perhaps significantly, while “race” is mentioned, “color” is not.
   At the time of then-hospital director Wilson’s 1969 message, Southern Baptist Hospital was still not participating in Medicare. “It does concern me that our position on Medicare has been confused in some people’s minds with civil rights issues,” Wilson wrote. “From a very practical point of view, I’d like to remind our critics that in order to support our hospital in its worthy endeavors … if we favored only the needy, we’d be unable to function in short order.” He pointed out that the federal government had announced a 2 percent reduction in Medicare reimbursements. “Our policy on Medicare has been one of ‘wait and see’ and it seems the longer we wait, the more problems are becoming evident.”