I feel sure most of us have etched in our minds those horrific scenes on t.v. during and after Hurricane Katrina hit New Orleans in 2005. The intensity of what we were viewing was unrelenting for days and the consequences and aftermath has gone on for years. Sheri Fink, a physician herself, has done extensive research into the disaster at Memorial Hospital and the subsequent charge of murder that was brought against Dr. Anna Pou and two nurses who were on duty at the hospital for the 5 days during and after the hurricane. This book is the result of Fink's research and was chosen in 1913 as one of the 10 best books of the year by the New York Times.
For 5 days the staff and patients at Memorial Hospital waited for evacuation while the city, state of Louisiana and federal authorities conducted what now looks like an unprepared and incompetent scenario of bickering and poor organized efforts of rescuing the oppressed population of New Orleans. Memorial, meanwhile operating with a skeleton crew and without electricity, was left to fend for itself, as its parent company, Tenet, was dithering without a plan or a helicopter contract. As the hurricane raged and then departed, the temperature in the hospital rose to an unbearable level coupled with heavy moisture which intensified as the days went on and worked on the emotional level of patients, staff and the families and in some cases pets who were sheltering at the hospital. Along with the rising contaminated water, the staff had to contend with roving bands of looters and addicts looking for drugs and food.
Doctors and especially nurses acted with heroism under the stress of sleep deprivation and the deteriorating condition of their patients. This is their story and Fink tells it in admirable detail. The central issue in the wake of the disaster is one of ethics and religious conviction. Overworked doctors and nurses under the direction of Dr. Pou were put in a position to make life and death decisions for a group of patients in palliative care with Do Not Resuscitate orders on their charts. When Dr. Pou made the decision to inject a number of these patients with morphine and a sedative, was she acting with mercy and euthanizing the dying or was it a question of murder? This is what the DA's office in New Orleans investigated. Forty-five corpses were found in the chapel of the hospital and many of these were not given the choice as they faced death.
Fink does a thorough examination of all sides of the moral issues involved as the city began to build its case again Dr. Pou. She writes plainly and without exaggeration as she wades through the conflicting stories and evidence in the case. Who can judge what choices people make under duress in a dreadful natural disaster such as Katrina. As Fink states toward the end of the book:
"Sometimes individual medical choices are less a question of science than they are of values. In a disaster, triage is about deciding what the goals of dividing resources should be for the larger population.......The larger community may emerge with ideas different from those held by small groups of medical professionals."
As a result of Katrina, hospitals all over the country have had to reexamine their response to catastrophic disasters. Five Days at Memorial has played its part in this reexamination. I highly recommend Sheri Fink's book to all readers. It will provoke thoughtful discussion and moral examination of our values.
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