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

by Sheri Fink

In the United States at the time of Katrina, at least nine well-recognized triage systems existed to prioritize patients in the case of mass casualties. Because of the difficulty of investigating outcomes, including deaths, in emergencies—and perhaps because of the potential for political embarrassment or due to a lack of financial incentives—almost no research had been done to see whether any of the commonly used triage systems achieved their intended goals or even that they didn’t paradoxically worsen overall survival. Most systems called for people with relatively minor injuries to wait while medical personnel attended to patients in the worst shape. This was Baron Larrey’s original concept of triage as described in his memoirs of an October 1806 battle in Jena, Prussia, between Napoleon’s forces and the Fourth Coalition.