by Sheri Fink
Kathryn had, after the boat ride to dry ground, been picked up by a brother. Then, with tunnel vision, she had walked to her home in polluted, chest-high water to save her cats. She, and one of them, spent a night sleeping atop her flooded car—there was nothing dry to lie on inside her toxic-smelling home. Kathryn ended up in a Shreveport hospital with suicidal thoughts and a bout of depression. When Rider, Schafer, and another special agent interviewed her by speakerphone on October 3, her family had only recently located her mother’s body at a massive temporary morgue set up in a town named for Saint Gabriel, the “archangel of death,” between New Orleans and Baton Rouge. A volunteer coroner from Wisconsin had told Nelson an autopsy had been performed on her mother. Nelson asked why. The coroner said euthanasia was suspected.
“I don’t think that any circumstance justifies euthanasia,” she told Rider and Schafer, even though her mother had been close to death. Killing someone was breaking God’s law. Kathryn, her mother’s longtime caregiver, would have known more than anyone what Elaine would have wanted and whether she was suffering. Nobody had asked her opinion. Her mother was extremely strong and believed in always doing right, the kind of lady who slipped a dollar into each purse she donated to Goodwill so that whoever ended up with it would have a little something extra. Kathryn had no doubt her mother would want the truth to emerge.
She offered to write down everything she remembered from the time of the storm until she was forced to leave the seventh floor on Thursday, September 1, and provide it to the investigators. “I appreciate what you are doing,” she said. “I think this is extremely important.”
Butch Schafer sympathized with Nelson, even given her mother’s short life expectancy. Weeks earlier, looking down at his daughter’s coffin, speaking at her funeral, he’d said he would give everything that he owned, everything that he would ever have, everything that he was, for five minutes more with her right then.
He could not allow his personal grief to influence the investigation, but that grief always accompanied him, always awaited him as he filled his time and his mind with work. In Nelson’s loss, he recognized his own, and he experienced it again. This occurred each time he spoke with a bereaved family member. It was like a knife, death. Always waiting to cut.
The Wisconsin coroner Nelson had spoken with had been right about the autopsy. At first, Orleans Parish coroner Frank Minyard told Special Agent Virginia Rider it would be useless to examine the bodies from Memorial, which had decomposed in the heat for more than a week before being recovered. There was no way to take a blood sample, for example, to check for lethal levels of drugs.
The news was upsetting. Rider and Schafer would need more than eyewitness testimony and empty morphine vials to prove a crime. But a volunteer pathologist told Rider that drugs could leave traces in other, hardier, tissues, such as liver, brain, and muscle, or in the fluid that pooled in the abdomen after death. At the attorney general’s request, overburdened coroner Minyard grudgingly agreed to ask a federal disaster mortuary team to perform autopsies and take tissue samples from all the hospital and nursing-home patients who had died in Orleans Parish after Katrina—about one hundred in total, it first appeared. The attorney general’s office had received allegations of wrongdoing at several of the facilities.
On September 22, state and federal investigators flew north with sets of tissue samples from eighteen of the Memorial Medical Center bodies and delivered them to National Medical Services, Inc., a forensic toxicology laboratory in Willow Grove, Pennsylvania. In an acidic-smelling corner of a long, open room with scuffed walls, technicians extracted the samples into tiny, metal-capped containers shaped like medicine vials and sent them through gas chromatography/mass spectrometry machines bearing nicknames, including “Morticia” and “Gomez.”
Two weeks later, on October 6, the head of the laboratory, Dr. Robert Middleberg, called the attorney general’s office with preliminary results. Virginia Rider put him on speakerphone so prosecutor Butch Schafer and another special agent could hear. The strength of their case depended on the news the forensic toxicologist was about to deliver, the answer to whether the LifeCare patients had died with detectable levels of morphine and other sedative drugs in their bodies.
Middleberg began by qualifying his findings in the language of a careful scientist. He said the samples the laboratory had received were less than ideal because of decomposition.
“So that’s just one of the reasons why there has been a slight delay in us getting back to you. In fact, we’re still working on these cases; we are not complete. We wanted to give you an update as to where we are.”
“OK,” Rider said.
“Thank you, Doctor,” Schafer said.
“Ah… of the eighteen cases today, nine of them are positive for morphine and a number of them, I guess about another five or six, are positive for midazolam.”
“Doctor, you’re going to have to forgive me,” Schafer interrupted. “I don’t know what that is.”
“OK, I’ll be happy to tell you. Morphine obviously you’ve heard of?”
“Yes sir.”
“Midazolam is, the brand name is Versed, V-E-R-S-E-D. And it belongs to what’s known as the class of compounds called benzo, B-E-N-Z-O diazepines, D-I-A-Z-E-P-I-N-E-S. And the one you are most familiar with in that family would be Valium, but the difference here is that midazolam is not a compound that people are routinely put on. It’s a compound generally used in operating suites or when someone is going to be intubated; someone may be given midazolam, but it’s not one of these compounds that you’ll find somebody getting a prescription for at home.”
“Yes sir,” Schafer said.
Middleberg explained that the lab had also detected a number of common medicines in the bodies, as expected, including antidepressants and drugs for gastric reflux. “Certainly the midazolam I’m finding is a little bit disconcerting,” he continued, “and I understand the difficulty, but medical records are going to be very, very important now.”
“Doctor, are these drugs such that they could have accumulated in a person?” Schafer asked.
Middleberg said midazolam shouldn’t be given on a repetitive basis. “Unless somebody is consistently being intubated and extubated or consistently going into the operating suite, there would be no reason for somebody to accumulate midazolam over periods of time.”
“Yes sir,” Schafer said.
“Morphine, certainly you can accumulate over time. But the concentrations we’re finding—and you have to understand that the specimens we have, again, were not ideal—some of the concentrations with morphine that we’re finding are, are pretty darn high.”
“If you were here,” Schafer said, “I’ll give you a kiss.”
“Ah… well, I’ll have to see you first.” Middleberg joked.
“OK,” Rider chimed in. “I would give you a kiss if you were here.”
“That would be more pleasurable,” Schafer said.
“All right,” Middleberg agreed.
“Thank you very much, Dr. Middleberg,” Rider said.
“Ah… you said, there were nine positive for morphine,” Schafer said. “Would you have the body numbers or some identifying number that we could go by and check out?”
“Yes, we can. Yes, we do. We will give you names of people, how about that?”
“Wonderful, oh great!” Schafer said.
“First one where morphine is found is a Harold Dupas, D-U-P-A-S.”
“Yes sir,” Schafer said. Dupas was one of the nine patients the LifeCare staff had believed were injected by Dr. Pou or the two Memorial nurses who came up to the seventh floor on Thursday, September 1.
“Next is a Hollis Ford [Hollis Alford]; Wilda McManus; Elaine Nelson; Emmett Everett; Alice Hutzler, H-U-T-Z-L-E-R; Rose Savoie, S-A-V-O-I-E; Ireatha, I-R-E-T-H-A [sic], Watson; and George Huard, H-U-A-R-D. I apologize for the pronunciation.”
It was stunning. Of the eighteen samples tested, those positive for the two drugs coincided
exactly with the names on the attorney’s list of suspicious deaths. And the laboratory hadn’t been told which names were on the list.
They said good-bye and Middleberg wished them a good afternoon. It certainly was. It was rare that everything lined up so neatly. Middleberg had called the morphine concentrations “pretty darn high.” Rider and Schafer would remember those words.
AS UPLIFTING as it was to gather the evidence needed to pursue justice, much remained ahead of them, and Butch Schafer knew from experience that even the most promising new case usually doesn’t end up the way you think it might. “Don’t. Get. Emotionally. Involved,” he warned Virginia Rider.
It could easily have been a subconscious warning to himself. Only weeks had passed since he lost his daughter. She had lived with an aggressive form of rheumatoid arthritis and died in her sleep after too many doctors prescribed too many drugs to treat her pain. Toxicology results suggested that the medicines, magnifying one another’s actions, had killed her in an accidental overdose. Schafer was furious to learn that the pharmacy that had filled nearly all of her prescriptions had not cross-checked them.
The same day as the phone call with Middleberg, October 6, brought another first—an interview with a medical professional not employed by LifeCare. Rider and Schafer spoke with Dr. Bryant King briefly by phone and then drove to his undamaged home in a part of New Orleans that hadn’t flooded. King had walked there after being boated out of Memorial. “My plants were dying, so that was my biggest tragedy. Everything has actually worked out really well other than the fact that I don’t have a job,” he said.
Unlike the LifeCare witnesses, who had come to be interviewed through the company’s lawyer, King had contacted the attorney general’s office after seeing television coverage of mortuary workers recovering bodies from Memorial. He was disturbed by the number of bodies found in Memorial’s chapel. He told them about the man he had pronounced dead early Thursday morning and carried to the chapel. “That person made the sixth patient. I’m willing to go to my grave on that because I was counting in my head,” he said. “After that, nobody else died on my second-floor area before I left the hospital. I left the hospital between twelve thirty and one thirty.”
Including the bodies in the chapel, King said, the total number of deceased patients in the hospital had been twenty or twenty-one when he left. When he learned from news reports that forty-five bodies were recovered in total, “I was like, That’s way too many. That’s the first thought that came to mind. There’s no way that that many people died in the time frame in between the time I left and the following day because…” He paused. “They were sick, they were really sick, but they weren’t sick enough that, well, they weren’t sick enough collectively, that twenty of them would die in a day. I mean, come on! What hospital loses twenty patients in a day? I mean, really! If you lose twenty patients in a day, somebody is coming to investigate because there is something abnormal going on.”
The “something” he had in mind was more abnormal than the heat and loss of power that followed Katrina. King suggested Rider and Schafer speak with the person who “controlled everything” at the hospital during the storm. “I would expect that the CEO would, you know, kind of conduct what happened, but he didn’t.” Instead it was a tall woman with striking red hair. “She conducted every meeting. I mean, that was strange to me, for someone that I’d never seen before.”
He knew her only as Susan. “I didn’t know who she was, other than the fact that she rolled with a lot of clout. Everybody responded to her. She walked in a room and said, ‘OK, let’s go ahead and get started.’ Everybody shut up and started the meeting.”
On Thursday morning, September 1, King had spoken with Dr. Kathleen Fournier, his acquaintance from medical school, who told him about a conversation with Susan and Dr. Anna Pou. The conversation was about ending patients’ suffering, and King recalled that, according to Fournier, “Anna said, ‘Oh yeah, I don’t have a problem with it.’”
Fournier had asked for King’s opinion on eliminating patients’ suffering. “In my mind, I’m thinking, it’s not normal. That’s not what we’re paid to do. We’re paid to do this until either everybody dies or everybody leaves.”
The investigators pressed him later in the interview. “You knew what she meant, but you didn’t question it?”
“I kind of… we… the conversation was… It’s a little murky… But I was like, ‘What are you talking about?’ ‘Well, they’re suffering, da-da-da.’ Nothing was explicitly said other than I can’t be a part of anything like that.”
He hadn’t thought his opinion would make a difference. Whereas some people had been scared of the people outside of the hospital, King was wary of the people in it. He was a six-foot-tall, two-hundred-pound man, but all he’d brought to the hospital were apples, oranges, and some almonds. Not a weapon. The person with the weapon was the boss, the law. He’d thought this on the ER ramp when he’d seen people being turned away and had argued with the CEO. Well hell, they’ve got all the guns. They could throw me in the water and say, “You can no longer come inside.” When he saw what was happening on the second floor, he figured: There’s only so much I can do or say. There were armed security guards everywhere. Obviously they wouldn’t have shot him in front of everyone, but he was sure they would have removed him. He was the last doctor hired there. The newbie. He grew up in East Chicago. He often spoke his mind, but he knew, in the end, when to shut his mouth.
King said he had sent messages to his best friend telling him that “evil entities” were planning to euthanize patients.
“You were talking about ‘evil entities’?”
“Because I couldn’t call them people anymore. When you talk about killing people you’re—talk about killing people who’ve done nothing wrong—you’re not… to me that’s not really a ‘person.’ Humans don’t do that. We don’t do that to each other. So, I was like… These… these… these… the correct word would have been, ‘These motherfuckers are talking about killing people!’”
King’s best friend had taken the messages to National Public Radio, and reporter Joanne Silberner had described the texts on air on the program All Things Considered the very afternoon the injections were taking place: “King said some of the staff was starting to panic, even talking about helping some of the long-term acute care patients, those close to death, die.”
King said that after telling Fournier he disagreed with the idea and sending the texts, he helped carry patients to the parking garage for evacuation. The hospital was no longer functioning as a hospital. “The whole formal structure of it had broken down.” When he returned to the second floor, the helpers who had been invited to fan the patients were mostly gone. They had been told to leave. “A guy came in and asked, ‘Would you like to join us in prayer?’ I was like, ‘No.’ There’s no reason… we’ve never prayed before. This is Thursday at noon, I mean, what’s this?”
King said he looked around and saw Anna Pou standing on the other side of the walkway by the bathrooms and the ATM. “She had a handful of 10 cc syringes with the pink needle—which is our eighteen- to twenty-one gauges—she had a handful of them and she said verbatim to a patient, ‘I’m going to give you something to make you feel better.’” King said it was highly unusual for a doctor to be handling syringes. “I don’t know what was in the syringes; I don’t know why she had them because we don’t ever inject anybody if we don’t have to. I mean, call a nurse to do that. We don’t do it. Not to say it that way, but that’s how we function.” King wasn’t just being flippant. He saw a reason for that division of responsibility. A doctor’s order was checked by a pharmacist and checked again by a nurse. Even those trappings of medical formality and quality control hadn’t broken down at Memorial until that moment.
King hadn’t seen Pou inject a patient. He had drawn his conclusions by piecing together earlier events. “So when she had a handful of syringes, it really startled me. It’s like: prayer… la-la-la… conversa
tion this morning…. This is not a normal situation. I should probably not be here.
“As I’m leaving I’m thinking, This is crazy. Why are they praying in the middle of the day? Why does a physician have a handful of syringes? Because we haven’t been giving medicine that way.” He didn’t know what had happened after he left by boat and reached shallow water at the drop-off point. “I took all my stuff and took my bag I had upstairs and put it in one of the red contamination bags, waded through the water, took it out of the bag, changed socks, and went home. Walked from Memorial to this location right here.”
Rider and Schafer showed King photographs and he identified several people. “That’s Anna,” he said of the first one.
Before leaving, Schafer asked whether they could contact him again. “Absolutely,” King agreed. “By all means, call me, contact me, knock on my door…. My take on this is that something wrong occurred, and I don’t know how, why, or who decided it, but they need to answer to the family members, because somebody lost family members because of whatever decisions were made.”
King said the only other people he’d spoken with about events in the hospital were his girlfriend, best friend, sister, and a producer from CNN, with whom he’d had an on-camera interview several weeks earlier. It hadn’t yet aired. He said he was telling Schafer and Rider the same things he had told the producer.
“How has my information contributed?” King asked Rider. “Was it telling you things that you already knew, things you didn’t know? One direction or another?”
“Learned some things from you that I didn’t know,” Rider told him.
SUSAN MULDERICK had moved back to the city in early autumn and was cleaning out her home when she received a call from a Tenet attorney. Mulderick spoke with him at length before he told her she should get her own lawyer, and he doubted that Tenet, her employer, would pay for one. In tears, Mulderick walked to the nearby house of an attorney she trusted, who took a break from cleaning her own house to sit on the porch and talk. The attorney was furious and thought what the Tenet lawyer had done—milking Mulderick for information, then telling her to get an attorney—was unethical.