The book opens a few days prior to the storm as the city prepares for the forecasted hurricane. Inured to the rituals of hurricane prep, many took the warnings less than seriously and didn't heed all the warnings. At Memorial, they arranged to have staff on hand but otherwise additional precautions were not taken. In addition, many of the staff and those that lived near the hospital used it to shelter during the storm. As the storm bore down on New Orleans, the hospital was bustling but everyone felt the hospital would ride out the storm without issue. Of course, the storm was stronger than expected and the breaking of levees with the resulting flooding was not anticipated. As conditions worsened at Memorial in the days following the hurricane, the shortcomings of the city and the hospital's disaster planning became increasingly evident. With power out over the city, the hospital was dependent on back-up generator power. The generators, however, were on lower levels below the flood line; very quickly, the hospital had no power. With patients on ventilators and other equipment, the situation soon became dire. The hospital staff had to figure out how to get patients evacuated from the hospital.
At this point, the lack of coordinated effort between the hospital, its corporate ownership and government became obvious. Messages were going out from the hospital but either not being heard or responded to with inaccurate information that drove some bad decisions. Ultimately, doctors in the hospital triaged patients for evacuation by making judgement calls on the likelihood of surviving the evacuation but they were not operating with the best information about the conditions and timing of any evacuation. Based on where they were triaged, some patients were essentially sentenced to death. Faced with patients they believed were not going to be able to leave the hospital and increasingly deteriorating conditions outside, some doctors and nurses made decisions to hasten the deaths of patients with lethal injections.
My Thoughts
This story was gripping and read with the pacing of a thriller - the narrator was new to me but kept me gripped throughout without overdoing the drama. Although the outcome of the storm and the fact that some patients were euthanized was known at the start of the book, I found myself anxiously listening to hear the details and the analysis that was not well understood outside of this book. The author tells the story from a neutral viewpoint and didn't demonize the doctors, nurses or officials but let the facts speak for themselves.
One statement that really stayed with me was that the lack of planning on so many levels is actually the failure of morality in the situation - not necessarily the actions of any individual. During Hurricane Sandy in NYC, seven years after Hurricane Katrina, I watched on television as they evacuated patients from NYU Hospital because the storm waters flooded the lower levels of the hospitals which is where the generators were located - the same situation faced by Memorial. I hope our government and public health officials commit themselves to adequate disaster planning so patients never have to face what was faced at Memorial.
