by Sheri Fink
I’m profoundly grateful for the way Crown has gone about putting Five Days at Memorial into the world. The house is filled with talented individuals who prove the value of traditional publishing in supporting the creation of books and helping readers discover them. Molly Stern, publisher, force of nature, makes the impossible happen. Thank you to Maya Mavjee, David Drake, Jacob Lewis, Christine Edwards, Candice Chaplin, and the outstanding sales force; the powerhouse publicity and marketing teams of Jay Sones, Jessica Prudhomme, Carisa Hays, Annsley Rosner, Michael Gentile, Leila Lee, and colleagues; Chris Brand for the water-stained brilliance of the cover; Elizabeth Rendfleisch for interior design perfection; Rachel Meier, Amy Boorstein, and Luisa Francavilla for managing the near unmanageable; Terry Deal and Rachelle Mandik for their utmost patience and precision; and the great support of Wade Lucas, Kelly Gildea, Kirsten Potter, Linda Kaplan, Diane Salvatore, and Tina Constable. Special thanks to Rachel Rokicki, this book’s inimitable publicist, for her hard work and authentic zeal; Matthew Martin for careful and numerous legal reads; and to Claire Potter, for expertly liaising as editorial assistant, following on the excellent work of Miriam Chotiner-Gardner, who continued to contribute after becoming an assistant editor. Jeffrey Ward created beautiful maps that orient readers to a most disorienting situation.
Finally, all the adjectives in the world wouldn’t be enough to express my gratitude to Vanessa Mobley, perhaps the only editor who would leave the comforts of the big city behind to venture without a car in snowy, icy winter to the New Hampshire wilds to help her author bring her book home. Vanessa, thank you for your generous gifts of time, attention and editorial insight, your tremendous backing, and your unflagging trust in me and my work. Thank you for understanding why the story of these people, this place, matters. Thank you for making this a better book in every way.
NOTES
These notes are meant to clarify sourcing when it may not be apparent in the text, to offer finer detail on important points, and to guide the reader seeking additional information. Interviews with the author that informed the narrative are grouped by chapter and not typically referred to by page number.
Information concerning Dr. Anna Pou comes from a range of sources, as detailed here. Over the course of the reporting, this included attendance at several events involving Dr. Pou, among them two fund-raisers on her behalf, two conferences, and several of her appearances before the Louisiana legislature. Pou also sat for a long interview, but she repeatedly declined to discuss most details related to patient deaths, citing wrongful-death suits and the need for sensitivity in relation to those who did not sue her.
PROLOGUE
Interviews
Dr. Horace Baltz; Essie Cavalier family (John Hazard, grandson); Donna Cotham family (Rosemary Pizzuto Cotham, mother); L. René Goux; Carrie Hall family (including Kimberly Rivers Roberts, granddaughter); Martha Hart family (James Harris “Judson” Hardy, Stephen Chalaron Hardy, and Jane Molony, cousins); Dr. Faith Joubert; Dr. John Kokemor; Dr. Daniel G. Rupley; Dr. John Thiele, Patricia Thiele; Karen Wynn.
Published Literature
Meitrodt, Jeffrey, “Katrina Nurses Called Victims of Justice; ‘Their Performance Has Always Been Exemplary,’” Times-Picayune, July 23, 2006.
Unpublished Documents
Letter from Dr. John Thiele to Dr. Horace Baltz, December 22, 2006; Memorial Medical Center Disaster Critique Mass Casualty Drill (sarin gas scenario) surveys, April 8, 2005; copy of Tenet Healthcare Corporation helicopter lease contracts and e-mails with Aviation Services, Inc.; photocopy of pilot log book; New Orleans Civil District Court records: petition to probate will of Martha Hart, case no. 2007-06959; Hall, Kevin, et al v. Memorial Medical Center, et al, case no. 2006-00127.
Miscellaneous
Photographs of second-floor lobby and doctors’ offices; video of airboat departures; e-mail correspondence between author and attorney for Susan Mulderick in August 2009.
Internet
John Thiele obituaries (Daily Comet; Times-Picayune) and associated online comments, family Facebook pages, and tribute sites (Lake Lawn Metairie Funeral Home website, http://lakelawn.tributes.com/our_obituaries/John-Stephen-Thiele-M.D.-90423470 and www.legacy.com); www.vitals.com page on John Thiele; Harry Tompson Center website, www.harrytompsoncenter.org; www.FDA.gov for documents on midazolam (Versed), including labeling/boxed warning history.
Notes
1 pantomimed giving an injection: Thiele recalled in interviews with the author and a fact-checker in 2008 and 2009 that Kokemor made this sign to him, However, Kokemor said in an interview in 2009: “Unequivocally, that never took place.” Kokemor did recall being on the ER ramp with Thiele (“He gave me his last two or three cigars”) and said in 2013 that he felt doctors had to stay until the end, because “it’s like the captain of the ship; they don’t go first, they go last.”
PART 1: DEADLY CHOICES
CHAPTER 1
Interviews
Dr. Ewing Cook; Minnie Cook; Curtis Dosch; Cathy Green; Dr. Faith Joubert; Eric Yancovich.
Published Literature
Greene, Glen Lee. The History of Southern Baptist Hospital, revised edition (New Orleans: Southern Baptist Hospital, 1976, and original 1969 edition).
Coverage of Hurricane Betsy in The Triangle, Southern Baptist Hospital, September 1965, including Raymond C. Wilson, “Thinking Out Loud”; J. Doak Marler, “How We Rode Betsy Out”; “Baptist Bears Betsy’s Brunt.”
“Ivan Knocked, Memorial Stood Ready,” Connections, September 2004.
“Baptist Hospital Admits First Patient, Mrs. Cotey,” Item-Tribune, March 9, 1926.
“Baptist Hospital Gives Treatment to First Patient,” Times-Picayune, March 9, 1926.
Articles and advertisements from the Item-Tribune, March 14, 1926, including: “Hospital Is Ready for Use”; “Facts About Baptist Hospital”; “Hospital Head Directs Work”; “Hospital Staff Comprises 127”; “Baptist Hospital Will Not Differ in Charity Cases.”
“Ideal of Christian Healing Voiced at Formal Opening of New Baptist Hospital,” Times-Picayune, March 14, 1926.
“Report of General Superintendent” and other sections of the Semi-Annual Report of the Sewerage and Water Board of New Orleans, La., December 31, 1908, and period of 1926–1930.
“City Park Is Gaily Garbed for Great Festival Sunday,” New Orleans States, May 2, 1926.
Coverage of the May 2, 1926, storm and aftermath: the Times-Picayune (May 3, 4, 7, 9; August 26; September 12); New Orleans Item (May 3–5, 8, 11, 14); Item-Tribune (May 9); New Orleans States (May 3).
Coverage of the April 15–16, 1927, storm and aftermath: New Orleans Item (April 16 and 23) and Times-Picayune (April 16–21, 23–24, 26–29).
Barry, John M. Rising Tide: The Great Mississippi Flood of 1927 and How It Changed America (New York: Simon & Schuster, 1997).
Documents
“The 1927 Great Mississippi Flood: 80-Year Retrospective” (Newark, CA: Risk Management Solutions, Inc., 2007).
Pamphlets and reports from the Southern Baptist Historical Library and Archives, including: Marvin W. Johnson, “Report of the Baptist Hospital at New Orleans,” 1925; Louis J. Bristow, “Southern Baptist Hospital,” 1926; “Proposed Program Structure, Southern Baptist Hospitals,” undated; Louis J. Bristow, “The Heart of Healing, Unto the Least,” ca. 1930s; Louis J. Bristow, “Hospital Stories: Indicating How the Southern Baptist Hospital Is Fulfilling Its Task of Healing Humanity’s Hurt,” ca. 1930s. Issues of the Annual of the Southern Baptist Convention (1928, ’29, ’36, ’42, ’43, ’62, and ’68) for reports of the hospital’s work, philosophy, and finances.
Maygarden, Benjamin D., Jill-Karen Yakubik, Ellen Weiss, Chester Peyronnin, Kenneth R. Jones. National Register Evaluation of New Orleans Drainage System, Orleans Parish, Louisiana, 1999. Chapter 4, “History of the New Orleans Drainage System, 1893–1996.”
Notes
1 317-bed: Tenet Healthcare Corporation, “Tenet to Create New Health Network in New Orlean
s,” October 24, 2005.
2 wrote in a letter: Greene, G. The History of Southern Baptist Hospital, p. 60.
3 “The crying need”: Ibid., p. 29–30.
4 with initial estimates: These were cited in local newspapers and may have been high. A ten-year report of the hospital commission in Annual of the Southern Baptist Convention, May 1936, mentions “property losses in flood damages in 1926 and 1927 which cost us $43,220 to repair and replace.”
5 between $525,000 and $800,000: Minneapolisfed.org. “What’s a Dollar Worth” calculator—$528,000 to $792,000, retrieved May 13, 2013.
6 Only once in the eight decades that followed: Robert Ricks of the National Oceanic and Atmospheric Administration searched NOAA’s database for the top ten rainiest days in New Orleans (Audubon station 166664) since 1871 for the author in September 2010. A storm on October 2, 1937, resulted in 13.08 inches, compared with the official 13.00 inches on April 16, 1927.
7 35 percent limit in effect at the time of Katrina: According to City of New Orleans, Louisiana: Basic Financial Statements December 31, 2011, “The Louisiana Legislature, in Act 1 of 1994, increased the City’s general obligation bond debt limit to an amount equal to the greater of (i) $500,000,000 or (ii) 35% of total assessed valuation of the City.”
8 The Mississippi River floods of 1927 led to: 1928 Flood Control Act. Seventieth Congress, session I, chapter 596; 1928, chapter 569, “An Act for the Control of Floods on the Mississippi River and Its Tributaries, and for Other Purposes”; http://www.mvd.usace.army.mil/Portals/52/docs/MRC/Appendix_E._1928_Flood_Control_Act.pdf.
CHAPTER 2
Interviews
Gina Isbell; Robbye Dubois.
Published literature
Landphair, Juliette, “‘The Forgotten People of New Orleans’: Community, Vulnerability, and the Lower Ninth Ward,” Journal of American History, no. 94 (December 2007): 837–45.
Unpublished documents
“Tenet Healthcare Corporation to Acquire Mercy†Baptist Medical Center,” May 17, 1995, Mercy†Baptist Medical Center (press release); hospital floor plans; LifeCare e-mails August 28, 2005, reporting that all patients were moved from Chalmette.
Notes
1 A hurricane watch covered a wide swath: Hurricane watch including the New Orleans area was issued at ten a.m. local time on Saturday (1500 UTC). “Hurricane Katrina Advisory Number 17,” NWS/TCP National Hurricane Center, Miami, FL, ten a.m. CDT Saturday, August 27, 2005; http://www.nhc.noaa.gov/archive/2005/pub/al122005.public.017.shtml. See also: Richard D. Knabb, Jamie R. Rhome, and Daniel P. Brown, “Tropical Cyclone Report—Hurricane Katrina.” NWS TPC/National Hurricane Center, 2005; http://www.nhc.noaa.gov/pdf/TCR-AL122005_Katrina.pdf.
A watch meant that hurricane conditions were possible in the watch area, “generally within 36 hours… Katrina could become a Category Four Hurricane.” In an expert witness report prepared for hospital defendants, including Memorial Medical Center after Katrina, meterologist Randoph J. Evans noted that the storm “rapidly intensified during the three days prior to landfall” and that the National Hurricane Center advisories and forcasts contained “omissions, uncertainties, and inaccuracies,” including a late warning that the New Orleans levees could be overtopped. Friday evening was, Evans writes, the first time that the NHC expressed confidence that the forecast tracks clustered on the New Orleans region. In advance of the 2010 hurricane season, the National Hurricane Center added twelve hours to the forecast period for watches (from thirty-six to forty-eight) and warnings (from twenty-four to thirty-six), and in 2013 further changes were made to increase the time for preparedness in advance of anticipated tropical storm force winds.
2 rated Category Three: “Hurricane Katrina Discussion Number 17” (NWS/TCP National Hurricane Center, Miami, FL, ten a.m. CDT, Saturday August 27, 2005; http://www.nhc.noaa.gov/archive/2005/dis/al122005.discus.017.shtml) issued at the same time as the advisory said that a strengthening to Category Five before landfall “is not out of the question.” It also noted that the official forecast called for “landfall in southeastern Louisiana in 48–60 hr,” meaning Monday, August 29.
3 upgraded its hurricane watch: Hurricane warning including the New Orleans area was issued at ten p.m. local time on Saturday (0300 UTC Sunday), Knabb, et al.
4 archaic Teletype: Oremus, Will, “TORNADO POSSIBLE. MIGHT KILL YOU… MIGHT NOT,” Slate, April 2, 2012; http://www.slate.com/articles/health_and_science/explainer/2012/04/new_tornado_warnings_why_national_weather_service_storm_alerts_weren_t_scary_enough_.html.
5 THE BOTTOM LINE IS THAT KATRINA: “Hurricane Katrina Discussion Number 19” NWS TPC/National Hurricane Center, Miami, FL, eleven p.m. EDT, Saturday, August 27, 2005.
CHAPTER 3
Interviews
Dr. Horace Baltz; Joanne Cardaro; Dr. Ewing Cook; Minnie Cook; Dr. Richard Deichmann; Dr. Barry Faust; Faye Garvey, family of Jannie Burgess (Linette Burgess Guidi, Bertha Mitchell, Gladys Smith, Johnny Clark); Gina Isbell; Dr. John Kokemor; Gov. Richard Lamm; Grayson Lovick; Dr. Jeffrey N. Myers; Dr. Daniel W. Nuss; Dr. Anna Pou; Karen Wynn; John Zimmerman.
Archives
“NOAA Hurricane Katrina Advisory Archive,” National Hurricane Center, 2005; http://www.nhc.noaa.gov/archive/2005/KATRINA.shtml?.
Documents
Johnson, Brig. Gen. David L. “Service Assessment: Hurricane Katrina August 23–31, 2005” (Silver Spring, MD: NOAA’s National Weather Service, 2006); http://www.weather.gov/os/assessments/pdfs/Katrina.pdf; New Orleans evacuation order; copy of Dr. Anna Pou’s signed relocation agreement, acceptance of offer, and employment offer cover letter from April 2, 2004.
Notes
1 MOST OF THE AREA WILL BE UNINHABITABLE: “URGENT-WEATHER MESSAGE,” NWS, New Orleans, LA, eleven a.m. CDT, Sunday August 28, 2005; http://celebrating200years.noaa.gov/events/katrina/side_katrina.html. Also roughly twenty-four hours before the storm made landfall, NHC public advisories began predicting a storm surge (water height above normal astronomical tide level) in the range of eighteen to twenty-two feet (and as high as twenty-eight feet wherever the center of the hurricane hit land).
2 “remember the old ways”: Press conference, Aaron Broussard, president, Jefferson Parish, LA, WDSU eleven a.m. CDT; http://www.youtube.com/watch?v=Mk64s3xT8W8.
3 confusion over whether he had the legal authority to issue it: US Congress, Senate Committee on Homeland Security and Governmental Affairs, Hurricane Katrina: A Nation Still Unprepared. Chapter 16, “Pre-Storm Evacuations,” footnotes 59–60, pp. 264–265. (Washington, DC: 109th Congress, 2nd session, S. Rept. 109–322 GPO, 2006.i); http://www.gpo.gov/fdsys/pkg/CRPT-109srpt322/pdf/CRPT-109srpt322.pdf.
4 on a conference call: Knox Andress’s notes on the ten a.m. conference call are included as exhibits in Elmira Preston, et al v. Tenet Health System Memorial Medical Center, Inc. D/B/A, Memorial Medical Center, et al. 2:06-cv-03179-EEEF-KWR document 74-6 filed October 24, 2006, US District Court Eastern District of Louisiana, civil action no. 06-3179, available on PACER, Public Access to Court Electronic Records, http://www.pacer.gov. (The case was later remanded to civil district court and certified as a class action; therefore, later motions and judgments in the case, referenced elsewhere, are not available on PACER.) A conference call participant said only Children’s and Methodist hospitals had both generators and switches above the ground floor. However, Methodist, too, lost power when the city flooded, and its former administrator had informed the New Orleans health director three years before Katrina that one of the hospital’s main generators and elements of the fuel supply system sat below flood level and would cost $7.5 million to protect (see Fink, Sheri, “The New Katrina Flood: Hospital Liability,” New York Times, January 1, 2010). Deposed in a lawsuit brought by the family of a critically ill patient who died at Methodist, CEO Larry Morgan Graham explained that while one of the generators was well above flood level, the pump that fed diesel power to it was flooded. The hospital was without power for about eighteen hours before staff restarted the
generators by “hand carrying diesel fuel to the roof” (Stephen B. Lacoste, et al v. Pendleton Methodist Hospital, LLC, Civil District Court for the Parish of Orleans, case no. 2006-2347, deposition taken May 2, 2008). Vulnerable fuel pumps have remained a problem for other hospitals in flood zones. Superstorm Sandy in October 2012 knocked out basement fuel pumps at New York City’s Bellevue Hospital, where fuel was also hand-carried upstairs to keep generators running. more than $17 million: Louisiana Hospital Association, data on Hospital Preparedness Program grants from the US Department of Health and Human Services to the Louisiana Department of Health and Hospitals, 2002-2005; http://www.lhaonline.org/displaycommon.cfm?an=1&subarticlenbr=138
5 “It is assumed that many”: US Senate. Hurricane Katrina: A Nation Still Unprepared. Chapter 24, “Medical Assistance,” p. 399, p. 427 (reference 7): Philip Navin, e-mail to EOC Report, August 29, 2005, 6:58 a.m., provided to Committee; filed as Bates nos. CDC 747–749.
6 lost her only son in Vietnam: Ruben Anthony Burgess, private first class, United States Marine Corps, December 9, 1948–February 23, 1968. See “The Virtual Wall: Vietnam Veterans Memorial,” http://www.virtualwall.org/db/BurgessRA03a.htm.
7 could not receive care at them: See, for example, Baker, Robert B., Harriet A. Washington, et al, “African American Physicians and Organized Medicine, 1846–1968,” JAMA, vol. 300, no. 3 (July 16, 2008): 306–314. Racial segregation in Southern hospitals had its legal basis in decisions such as the “separate but equal” 1896 Supreme Court ruling in Plessy v. Ferguson, as well as statutes in Southern states mandating segregation of white and black patients. The Hill-Burton Act of 1946 allowed federal funds to be used for construction and improvements to segregated hospitals. The practice continued after Brown v. Board of Education struck down the principle of “separate but equal” in education. (Quadagno, Jill and Steve McDonald. “Racial Segregation in Southern Hospitals: How Medicare ‘Broke the Back of Segregated Health Services’” in Green, Elna C., ed., The New Deal and Beyond: Social Welfare in the South Since 1930. [Athens, GA: University of Georgia Press, 2003]). The Civil Rights Act of 1964, Title VI, forbade discrimination in any private organization receiving federal financial assistance. However, only hospitals that received federal funds were seen to be bound by the nondiscrimination provisions. When Medicare was passed in 1965, a hospital could not receive its funds unless it could certify it did not discriminate.