Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital

by Sheri Fink

Floodwaters unleashed by Hurricane Katrina had marooned hundreds of people at the hospital, where they had now spent four days. Doctors and nurses milled in the foul-smelling second-floor lobby. Since the storm, they had barely slept, surviving on catnaps, bottled water, and rumors. Before them lay a dozen or so mostly elderly patients on soiled, sweat-soaked stretchers.

men and women had been lifted by their hospital sheets, carried down flights of stairs from their rooms, and placed in a corner near an ATM and a planter with wilting greenery. Now staff and volunteers—mostly children and spouses of medical workers who had sought shelter at the hospital—hunched over the infirm, dispensing sips of water and fanning the miasma with bits of cardboard.

Louisiana State University medical student in 1977. A classmate would later say that Johnny Thiele had turned into the sort of doctor they all wished to be: kind, gentle, and understanding, perhaps all the more so for having struggled over the years with alcohol and his moods.

where he learned, when several paramedics burst into the emergency room in close succession, to attend to the most critical patients first. It was strange to see the sickest here at Memorial prioritized last for rescue.

ensure that those with a greater chance of long-term survival were saved. The doctors at Memorial had drilled for disasters, but for scenarios like a sarin gas attack, where multiple pretend patients arrived at the hospital at once. Not in all his years of practice had Thiele drilled for the loss of backup power, running water, and transportation.

There was little in his personal history or education that had prepared him for what he was seeing and doing now.

The hurricane cut off city power. The hospital’s backup generators did not support air-conditioning, and the temperature climbed. The well-insulated hospital turned dank and humid; Thiele noticed water dripping down its walls. On Tuesday, the floodwaters rose.

Thiele felt abandoned. You pay your taxes and you assume the government will take care of you in a disaster, he thought. He also wondered why Tenet, the giant Texas-based hospital chain that owned Memorial, had not yet sent any means of rescue.

Thiele knew nothing about the dozen or so patients who remained, but they made an impression on him. Before the storm, the poor souls would have had a chance. Now, after days in the inferno with little to no medications or fluids, they had deteriorated.

The first thing, he thought, was the Golden Rule, do unto others as you would have them do unto to you.

Thiele had also adopted a motto he had learned in medical school: “Heal Frequently, Cure Sometimes, Comfort Always.” It seemed obvious what he had to do, robbed of control over almost everything except the ability to offer comfort.

In the days since the storm, New Orleans had become an irrational and uncivil environment. It seemed to Thiele the laws of man and the normal standards of medicine no longer applied. He had no time to provide what he considered appropriate end-of-life care. He accepted the premise that the patients could not be moved and the staff had to go.

If you were a doctor and had outpatients who were unwell, you might check them in too, believing Baptist a safer refuge than their homes. Then you’d settle down on a cot or an air mattress, and the hurricane, which always seemed to arrive at night, would rage against the hospital and leave. The next day, the sun would rise and you would help clean up the debris and go home.

The hospital opened its doors to serve its stated, three-pronged mission: the alleviation of pain, the prolongation of life, and the relief of suffering.

The new hospital sat in one of the lower parts of a city that dipped below sea level like a basement below the water table. Runoff had to be caught, channeled, and pumped skyward to expel it into surrounding lakes.

Around the turn of the twentieth century, $15.3 million had been spent on drains, canals, and pumps to help transform the soggy, typhoid- and malaria-ridden basin between the Mississippi River and Lake Pontchartrain into a modern city.

An upgrade in the area’s pumping and canaling capacity had been envisioned to go along with the development, but while buildings went up, the work below ground lay undone. With no storms of great magnitude, the improvements had not been prioritized.

The city’s drainage system had extruded more than six billion gallons of water into Lakes Pontchartrain and Borgne, the grandest performance in its history. Yet it had failed to keep pace with the storm, and recriminations followed. Thousands of flood-affected residents phoned complaints to authorities.

The board’s longtime general superintendent, George G. Earl, had warned for a decade that the system simply wasn’t capable of handling that much rain. Without funding to complete a planned expansion, flooding in the lower parts of the city was inevitable, yet residents professed shock when this occurred.

Many Memorial employees had long ago stopped seeing water as a significant threat.

Katrina’s strength was rated Category Three on the Saffir-Simpson Hurricane Wind Scale, projected to grow to a fearsome Four or even a catastrophic Five.

St. Bernard had been slowly rebuilt after its surrender to spare New Orleans from the 1927 floods, but a series of subsequent calamities kept residents uneasy whenever weather disasters threatened. Many remembered the levee breaks, devastating flooding, and pumping-system failure that followed the Category Three Hurricane Betsy in 1965. St. Bernard residents had little faith that their officials or their levees would protect them.

The staff still called the location “LifeCare Baptist” even though Tenet Healthcare Corporation had bought Baptist Hospital and changed its name to Memorial ten years earlier. Most of the St. Bernard patients, LifeCare’s leaders decided, would be moved there, and the remaining few to another nearby hospital.

She passed a reassuring message to Hutzler’s daughter: “Tell her she’s here, and I’m going to take very good care of her.”

It took until nightfall to transfer nineteen of the patients to the Baptist campus. A twentieth died en route.

The grim-faced president of a parish near New Orleans warned those who intended to stay to buy an ax, pick, or hammer so they could hack their way to their rooftops and not die in their attics like many Hurricane Betsy unfortunates had. He told them to “remember the old ways” and fill their upstairs bathtubs with water; after the storm that would be the only source for drinking, bathing, and flushing toilets.

no previous New Orleans mayor had mandated an evacuation, although state law allowed the governor, parish presidents, and, by extension, him to do so.

“The storm surge most likely will topple our levee system,” Nagin warned. “We are facing a storm that most of us have feared.” Flooding, Blanco added, could reach fifteen to twenty feet.

While the mayor commanded everyone to leave, many didn’t have cars or other means to do so, and officials knew that the city’s plans to help transport them had significant holes, including a lack of sufficient drivers.

Jannie Burgess had always been a lady who knew her lipstick, powder, and paint. She was seventy-nine years old now and obese, but in her youthful prime she had been tall with an hourglass figure and unlimited access to the beauty parlor owned by her older sister Gladys. She had fled an abusive husband as a young mother and lost her only son in Vietnam, but she knew joy, too, loved putting on the perfume and grabbing her daughter, Linette. “Let’s dance, let’s dance!”

Baptist was one of the last Southern hospitals to submit to integration.

cancer in her liver. The tumor couldn’t be

She told her mother she loved her and thanked her for all she had done to raise her and make her the woman she was. “Release, let it go,” Burgess Guidi said to her mother. She told her she’d be back to see her on Wednesday.

As Pou grew older, it became her turn to help mother the younger ones, driving them to after-school activities and helping prepare meals. Taking care of others was a family value, taught and modeled by her parents, a way of doing good.

Anna Pou rushed to the young man’s side, rolled him over, and bent to his lips. She blew breaths into his mouth and quickly revived him. Pou suggested he go to a hospital.

But Anna Maria had also seen how children can break a mother’s heart.

As the storm approached, there were about 183 patients at Memorial—a little more than usual due to last-minute storm admittances—and nearly as many staff members’ pets.

Administrators tallied the census of humans in the medical center buildings at between 1,800 and 2,000.

The National Guard estimated that more than 25,000 people who wouldn’t or couldn’t leave New Orleans were packed into the Superdome.

The National Guardsman told him the levees protecting New Orleans had been breached. “You need to prepare for fifteen feet of water,”

The neonatologist, Dr. Juan Jorge Gershanik, looked down at the water surrounding Memorial and imagined what it would be like if all power went out. The children would be goners. It would be a death sentence. He felt like he was in a movie.

They plugged her pumps and drips back into the emergency wall outlets and restored her mechanical ventilator, but she soon died, a death perhaps imminent but nonetheless seemingly the first in the hospital to be hastened by Katrina.

make the right decision? Practically the only way to know whether the baby was still alive was to use his free hand to pinch the baby’s foot and feel whether he withdrew it. Gershanik’s other hand was getting cramped from rapidly squeezing the oxygen bag. He made a silent promise: If this baby lives, I’ll never complain about anything again.

For a moment, Gershanik considered the larger reality, the competing priorities that had emerged as waters suffocated an entire city. He was only doing what is ingrained in a doctor—advocating for his own patients—but now he saw that the struggle to save lives extended far beyond the two critically ill neonates in the helicopter, or Memorial’s entire population of sick babies, or even the whole hospital, much as it had seemed like the universe when he was back there. He used the delay to switch oxygen tanks with some difficulty. He apologized for his impatience.

from practicing medicine to, at least in one case, arguing with a Coast Guard pilot about how many patients could fit in his helicopter. The pilot flew away to rescue people elsewhere.

A text message arrived a few hours later from Baton Rouge. All the babies had made it, including Gershanik’s. Baby Boy S’s oxygen level on arrival matched what it had been on the high-tech machines, thanks to the doctor’s life-support improvisations. The babies were more resilient than the doctor had imagined.

“We’ve had to secure all egress,” one Memorial employee wrote to Tenet colleagues in the evening, “as the community is trudging through three feet of water to try to find shelter here.”

An Indian-born respiratory therapist and his wife had secreted a pair of golden retrievers in the hospital where they weren’t allowed. At home, the cossetted pets slept like children in their own room on individual recliner beds and were never permitted to trot outside without a quartet of boots placed over their paws. What was to become of them now?

Paper was high technology in a disaster.

She couldn’t believe hospital leaders were yelling at the Coast Guard for trying to send rescuers.