by Sheri Fink
8 In fact, Baptist was one of the last: Southern Baptist Hospital administrator Raymond C. Wilson, in his “Thinking Out Loud” column in the May 1967, The Triangle, said a US Government official told him that fewer than three hundred hospitals in the US had chosen to operate without government aid, and “the opinion was expressed that Southern Baptist is the largest of the group to ‘go it alone.’” Wilson wrote that New Orleans hospitals that participated in Medicare were being asked to give the government’s office of Equal Health Opportunity a list of patients referred by each doctor to each hospital (presumably to help ferret out ongoing segregation). “Such a measure could seriously hamper a doctor’s privilege of deciding which hospital is best suited for each particular patient,” Wilson wrote.
9 New Orleanians sent supportive letters: Wilson included these quotes in his “Thinking Out Loud” column, September 1966, The Triangle. He also applauded San Leandro, California, for turning down “millions of dollars available through antipoverty programs, federal urban renewal, housing and beautification programs” to resist “control of their community affairs.” The 1966 statement was reprinted in Wilson’s column in the July 1966, The Triangle.
10 The hospital began quietly: Wilson wrote in his June 1969 “Thinking Out Loud” column: “It is the creed and practice of our hospital to make available our services to all people, regardless of race, creed, color, national origin or ability to pay.” The same month, the Southern Baptist Convention, meeting in New Orleans, adopted a “Resolution on New Orleans Hospital Integration” requesting that the trustees of the hospital commission “pursue this matter without delay in order to bring actual practice in line with stated policy”; http://www.sbc.net/resolutions/amResolution.asp?ID=888. The integration policy had been adopted a year earlier, at the Convention’s annual session in June 1968, which met the week Sen. Robert F. Kennedy was fatally shot. At that meeting, the new program statement of the Southern Baptist Hospitals had replaced this phrase, adopted in 1962: “Makes available the full resources of the hospital to those people least able to pay in such ways as to preserve human dignity and worth.” According to Greene, Glen Lee. The History of Southern Baptist Hospital (New Orleans: Southern Baptist Hospital, 1976, and original 1969 edition), the hospital implemented the Convention’s revised program statement by beginning to admit black patients; an article in the June 13, 1968, Baptist Message said, according to the hospital’s annual report to the Convention: “the New Orleans hospital admitted its first Negro patients this year.” Dr. Horace Baltz, a white physician who had worked at the hospital beginning in the mid-1960s, told me “it was very quietly done,” and Dr. Windsor Dennis, a black surgeon of Dr. Baltz’s generation who did not work at the hospital, said he knew of only one black person, a prominent school principal, who was treated there before this time (“It was kept quiet.”). Dr. Baltz noted that Dr. Emmett Lee Irwin, one of the most active segregationists in New Orleans, had been a leading staff physician whose views may have influenced hospital policy (he died in a car accident in 1965). Greene’s book lists Irwin as a founding member of the Southern Baptist Hospital medical staff in 1926, and McMillen, Neil R. The Citizens’ Council: Organized Resistance to the Second Reconstruction 1954–64 (Champaign, IL: Illini Books, 1994) describes Irwin as a founder and early leader of the Greater New Orleans Citizens’ Council. The organization worked to oppose school integration and, with Irwin as its chairman in the mid-1950s, “packed thousands of Confederate-flag-waving spectators into New Orleans’s Municipal Auditorium to hear speakers denounce integration as a Communist plot and make dire predictions of an impending race war,” according to Mohr, Clarence L. and Joseph E. Gordon. Tulane: The Emergency of a Modern University, 1945–1980 (Baton Rouge, LA: Louisiana State University Press, 2001). Mohr and Gordon’s book discusses Irwin’s earlier role founding and leading the Louisiana Coalition of Patriotic Societies. Irwin’s tactics in opposing school integration included bringing white children, some in blackface, onstage at a rally and signaling them to begin kissing each other; he told the crowd, “That’s just a little demonstration of what integration means.” (Bush v. Orleans Parish School Board and the Desegregation of New Orleans Schools. Federal Judicial Center; http://www.fjc.gov/history/home.nsf/page/tu_bush_narrative.html.) A statement from earlier in Southern Baptist Hospital’s history suggested a more inclusive attitude, at least on paper. A hospital report from 1935 stated: “Our policy, consistently followed through the years has been to care for the sick who came to us, regardless of race or creed or position in life, giving such care as we have been capable of rendering.” Perhaps significantly, while “race” is mentioned, “color” is not.
At the time of then-hospital director Wilson’s 1969 message, Southern Baptist Hospital was still not participating in Medicare. “It does concern me that our position on Medicare has been confused in some people’s minds with civil rights issues,” Wilson wrote. “From a very practical point of view, I’d like to remind our critics that in order to support our hospital in its worthy endeavors… if we favored only the needy, we’d be unable to function in short order.” He pointed out that the federal government had announced a 2 percent reduction in Medicare reimbursements. “Our policy on Medicare has been one of ‘wait and see’ and it seems the longer we wait, the more problems are becoming evident.”
11 the hospital set aside its opposition to Medicare: “SBH Joins Medicare,” The Triangle. The hospital joined on November 1, 1969. Wilson noted that the census of seniors was thirty-one on November 3, fifty-two on November 10, and eighty-six on November 18. By January 1970 there were 123, according to Greene, p. 209.
12 Tensions persisted: Johnie Montgomery v. Southern Baptist Hospital, EEOC charge no. 062-79-1208; Sheila Bass v. Southern Baptist Hospital, EEOC charge no. 062-79-1282; Issac Frezel v. Southern Baptist Hospital, EEOC charge no. 062-79-1905 and 062-80-0316; Tyronne Smith v. Southern Baptist Hospital, EEOC charge no. 062-80-0819; Rita Robertson v. Southern Baptist Hospital, EEOC charge no. 062-80-0845; Dorothy Nelson v. Southern Baptist Hospital, EEOC charge no. 062-80-1464. The hospital sued the EEOC and its chairman, Eleanor Holmes Norton, among other officials, in 1980 (Southern Baptist Hospital v. Equal Employment Opportunity Commission, et al, US District Court, Eastern District of Louisiana, 80-3972) for copies of investigative files in the seven cases. EEOC attorneys argued that releasing them “would permit the employer to intimidate, harass, and retaliate against employees” and interfere with ongoing proceedings against the hospital. The hospital lost the case on the latter grounds. For a brief essay on continuing challenges related to implementing integration in health care, see Smith, David Barton, “Racial and Ethnic Health Disparities and the Unfinished Civil Rights Agenda,” HealthAffairs, 24, 2 (2005): 317-324. http://content.healthaffairs.org/content/24/2/317.full.
13 sued Southern Baptist Hospitals: Issac E. Frezel v. Southern Baptist Hospitals, Inc., US District Court, Eastern District of Louisiana, 80-4603 (1980).
14 Flint-Goodridge Hospital: See, for example, “The History of Flint-Goodridge Hospital of Dillard University,” Journal of the National Medical Association, 61, no. 6 (November 1969): 533–536; “Medicine: Negro Health,” Time, April 8, 1940; http://www.time.com/time/magazine/article/0,9171,763801,00.html (requires subscription).
15 Surgery and chemotherapy had stalled: Jannie Burgess’s family kindly facilitated access to her medical history and records.
16 First African American Bunny: According to Linette Burgess Guidi.
17 All staff members: Memorial Medical Center unpublished memo entitled “HURRICANE KATRINA—AUGUST 28, 2005.”
18 Unlike many others, Dr. Anna Maria Pou: The section on Dr. Anna Pou’s history is drawn from interviews with Pou and others listed above, as well as from information provided by additional family members, medical colleagues, and friends of Pou who attended the “Friends of Anna” disaster-preparedness seminar and dinner/fund-raiser held in Houston, Texas, in May 2007. Pou’s attorney, Rick Simmons, inf
ormed me about the event when I first met with him to express an interest in writing about Pou. I attended with the permission of the organizers and paid for my own meal in accordance with journalism ethics standards. Many of Pou’s supporters were eager to share stories about her and expressed the hope that I would write something that went beyond the quick hit television pieces that focused exclusively on the acts that she was accused of without giving a deeper sense of who she was as a physician and person.
19 even her elementary-school: Comment on nola.com weblog from “Tim Ballein of Westwego,” July 31, 2006 who identified himself as a St. Rita’s school classmate.
20 He treated patients: See Kolb, Carolyn, “Life Along St. Claude Avenue,” New Orleans Magazine (August 2008); http://www.myneworleans.com/New-Orleans-Magazine/August-2008/Life-Along-St-Claude-Avenue.
21 One warm day in the late 1970s: The shallow water drowning episode is depicted as retold to the author by John Zimmerman, the fully recovered drownee, on July 23, 2007.
22 a federal fugitive: US Drug Enforcement Administration New Orleans Most Wanted Fugitives listing for Frederick Anthony Pou Jr., NCIC# W603770132; http://www.justice.gov/dea/fugitives/no/24B099BA-E9B1-4EDA-982C-C01C8C83D102.shtml. Frederick Pou Jr., was indicted by federal grand juries in Alabama and Louisiana; the Alabama indictment concerns the alleged importation of approximately 12,000 kilograms of cocaine from Colombia. See also: USA v. Pou, et al 1:89-cr-00072-BH, US District Court Southern District of Alabama, May 9, 1989; USA, et al, v. Land Baton Rouge, 2:89-cv-02289-MLCF, US District Court Eastern District of LA (New Orleans), May 22, 1989; United States v. Ricou Deshaw, 974 F.2d 667 (5th cir.), no. 91-3131, October 14, 1992.
23 the hospital began to ration care: Wysocki Jr., Bernard, “Hospital Sets Strict Rules to Limit Costs,” Wall Street Journal, January 12, 2004; Kinonen, Judie, “A Tale of ‘Rational Rationing,’” UTMB Magazine (Spring 2005); http://www.utmb.edu/utmbmagazine/archive/05_spring/pog.
24 “Dr. Pou, we regard this” […] “without additional pay”: Copy of Pou’s signed relocation agreement, acceptance of offer, and employment offer cover letter, April 2, 2004.
25 Panepinto purchased: Real property history record retrieved from nexis.com.
26 first hospital in the Southeast to purchase a “crash cart”: According to hospital administrator Wilson, quoted in “Hospital Adds New Lifesaver,” The Triangle (March 1967), a reprint of a February 16, 1967 Times-Picayune article. Also Wilson, Raymond C., “Thinking Out Loud,” The Triangle (June 1967) discusses a hospital expansion and adoption of high-tech aspects of “The Hospital of Tomorrow,” including piped-in oxygen and backup power.
27 “Many of us have trouble accepting the business motive”: “Dr. Baltz: Excellence Is Our Strength,” The Triangle (February 1984).
28 Clarence Herbert: See, for example, Lo, Bernard, “The Death of Clarence Herbert: Withdrawing Care Is Not Murder,” Annals of Internal Medicine, no. 101 (1984): 248–251.
29 “The ways and means of dying”: “The Ethics of Life and Death,” Spectrum (Spring 1985): 23.
30 “We’ve got a duty to die”: Excerpted remarks, Colorado Health Lawyers Association, March 27, 1984, transcribed from a tape provided by the Denver Post; transcript given to the author by Gov. Richard D. Lamm. See also: Kass, Leon R., “The Case for Mortality,” The American Scholar vol. 52, no. 2 (Spring 1983): 173–191. The then-largest circulation daily, the New York Daily News, carried Lamm’s comments with the headline: “Aged Are Told to Drop Dead: Colo. Gov Says It’s Their Duty,” March 29, 1984. Gov. Lamm received hateful telegrams, the e-mail flames of the day. The original Denver Post article substituted “you” for “we,” and its headline implied incorrectly that Lamm had asserted specifically that elderly or terminally ill patients should die. Gov. Lamm later won a correction from the New York Times (“Correction,” November 23, 1993), which said that Lamm’s quote had been distorted in eight articles over the years. Lamm used the national attention to advance his argument that people who needed health care were being robbed of it because too much money was being spent on “high-tech procedures and machines” that too often led to “a living death” for patients with poor prognoses (Lamm, Richard D., “Long Time Dying: When ‘Miracle Cures’ Don’t Cure,” New Republic [August 27, 1984]). At a conference in 2010, I asked Lamm if he still held the same views, now that he had hit the three-quarter-century mark himself. He said with a smile that he’d go crawling and scratching his way to the hospital if he needed care. “I would, I think,” he agreed in a more formal, follow-up interview on October 7, 2011. He said it was natural for sick people to be desperate for treatment. “All the more reason a health care system has to assert sanity over that very human need.”
31 With the appearance of crash carts: See Benjamin Weiser’s remarkable and still-fresh, five-part Washington Post series on end-of-life care dilemmas, including “‘Orchestration’ of a Death,” April 19, 1983; and “A Final Judgment on Quality of Life,” April 20, 1983. See also Kleiman, Dena, “Uncertainty Clouds Care of the Dying,” New York Times, January 18, 1985.
32 On January 15, 2005, Pou attended: “Welcome New Members” and “Save the Date” Medical Staff Newsletter, Memorial Medical Center Tenet Louisiana Health System, November 2004. Also, photographs of Installation Banquet attendees, including Dr. Pou, January 15, 2005.
33 was in the process of selling: “Tenet Announces Major Restructuring of Operations,” press release, Tenet Healthcare Corporation, January 28, 2004. See also, Klaidman, Stephen. Coronary (New York: Scribner, 2007).
34 much to celebrate: Goux, L. R., “Memorial Achieves ‘Full Compliance’ in JCAHO Survey,” Connections (July 2004); “Memorial Shines in JCAHO Survey,” Connections (June 2005); and “You’re Tops, and We Have the Stats to Prove It!,” Connections (October 2004). Also: “Birthplace of New Orleans Cuts Ribbon on Renovation,” Connections (November 2004); “New Orleans Cancer Institute Celebrates Opening, Health Fair,” Connections (February 2004); and “New Orleans Cancer Institute Building Nears Completion,” Connections (August 2003).
35 As the storm approached: The figures are a best estimate based on copies of the patient census and e-mail communications by hospital leaders. Numbers changed during the disaster as patients were admitted, discharged, or died.
36 2:11 A.M., WWL New Orleans Radio: WWL kindly furnished digital audio of broadcasts, which were transcribed by the author and more so by the indomitable Rebecca Rabinowitz, who developed very limber fingers as a research associate at the New America Foundation in 2011. These transcripts are the basis for WWL excerpts from August 29, 2005, through September 1, 2005, quoted in the book.
37 It had fallen […] and never left: Susan Mulderick described her history with the hospital in several depositions and stipulations in the case of Elmira Preston, et al v. Tenet Health Systems Memorial Medical Center, Inc., Orleans Parish Civil District Court, 2005-11709. Memorial Medical Center Policy Number E-19, “Incident Command System,” dated June 21, 2002, describes the intended structure of the leadership system for disasters. However, interviews with staff members suggested that the plan was not followed exactly as written, and the book reflects their views on their jobs.
38 She rarely took: Diane Loupe, “5 Lucky Women Were Bumped from Plane,” Times-Picayune, July 11, 1982.
39 merged with a New Orleans Catholic hospital… sold to giant, for-profit Tenet: Harrell, Byron R. and Sister Barbara Grant, “Memorandum to: Employees of Southern Baptist Hospital and Mercy Hospital,” September 1, 1993; “Mercy and Baptist Hospitals Announce Plans to Merge,” news release, Peter A. Mayer Advertising, Inc., September 1, 1993; Pope, John, “Baptist, Mercy Joining Forces,” Times-Picayune, September 2, 1993; Rubinow, Marisa, “The Merger,” Healthcare New Orleans, October 1993; “Mercy†Baptist Joins Tenet Louisiana Health System,” Tenet Louisiana Health System (bimonthly employee newsletter), November 1995. “Another Shift Toward Tomorrow,” Collaborations (health and wellness magazine from Mercy†Baptist Medical
Center), Summer 1995.
40 Christmas decorating contests: The Triangle (January 1971). (Winners in 1970 included a Madonna made of foil and a picture decorated with “appropriately colored rug yarn.”) Faith was a consistent theme in hospital newsletters (“There are times when a prayer can be as soothing as a sedative,” The Triangle, May 1967), and was foundational. The program structure for Southern Baptist Hospitals, adopted in 1962, stated: “A Baptist hospital exists to bring men into a saving relationship with God through faith in Jesus Christ by means of direct personal witness as occasion presents, and by a positive Christian interpretation of the experiences of disease, disability, and death.” Still, concern for the bottom line existed even in that period. In providing for the medically indigent and Baptist denominational personnel, hospitals were to do so “within such limits as will not endanger the financial soundness of the institutions” (Annual of the Southern Baptist Convention, 1962, pp. 61–62). Although the Southern Baptist Convention broke ties with the hospital in June 1970 (Wilson, Raymond C. “Thinking Out Loud,” The Triangle [July 1970]), it was to continue operating “as an independent Christian institution” under a body that also governed Baptist Memorial Hospital in Jacksonville, FL.