by Sheri Fink
10 until they drained their batteries: The nursing notes in Ms. Burgess’s chart discuss the effects of the power failure on her care.
11 Sometimes ten to fifteen seconds: This was noted by Ms. Burgess’s nurse at around eight that morning.
12 “She has lung cancer…”: Cathy Green did not know her name, but it is possible she was Merle Lagasse. The Memorial patient census (which did not include LifeCare patients) shows only one other patient whose admitting diagnosis was lung cancer (there was also a mesothelioma patient, but she apparently died on the second floor); she was eventually airlifted from Memorial and was only fifty years old, so it is doubtful that Green would have thought her “elderly.” Green shared this story with the author in an interview in 2007, and she recounted part of it (under the pseudonym “Kate”) in Budo, Lori. Katrina Through Our Eyes: Stories from Inside Baptist Hospital (Lexington, KY: CreateSpace, 2010), pp. 115–116.
13 said she was a Holocaust survivor: Budo, Katrina. Other nurses had a vague memory of this.
14 danger in the coming darkness: It would have been quite dark outside regardless of the weather. The new moon was September 3, according to NASA moon phase chart; http://eclipse.gsfc.nasa.gov/phase/phases2001.html.
15 jotted “Katrina”: Copy of document entitled “MHCNO: Disaster Preparedness Committee,” Friday, August 26, 2005, 12–2 p.m.
16 “Which patients should be extracted”: Copy of page entitled “Subcommittee: Region 1—Affected Area,” part of document entitled “Louisiana Catastrophic Planning, 2005 Workshop,” dated August 23–24, 2005. The planning was focused on the idea of setting up temporary medical staging points outside of the hurricane-affected areas where patients collected at the SARBOOs (like the I-10 cloverleaf) would be transferred for care.
17 “to save life and limb”: Copy of “Concept Paper,” part of “Louisiana Catastrophic Planning, 2005 Workshop.”
18 setting their own priorities: Capt. Bruce Jones, USCG commanding officer, Air Station New Orleans, interviewed by PA3 Susan Blake, Katrina Archival and Historical Record Team, October 20, 2005, for an oral history program; http://www.uscg.mil/history/katrina/oralhistories/JonesBruceoralhistory.asp. Other records in the Katrina oral history collection make a similar point, as did Coast Guard members interviewed by the author.
19 still setting up the command center: They did this Wednesday morning, according to depositions of Michael Arvin, August 26, 2010, and Bob Smith, April 14, 2008, in Preston, et al v. Tenet. Also Bob Smith e-mail to Sandra Cordray, Tuesday, August 30, 2005, at 5:55 p.m.: “We may have a command center set up by morning.”
20 jotted down notes: Bob Smith, April 14, 2008, deposition exhibit in Preston, et al v. Tenet.
21 air logistics company: Aviation Services, Inc., in Frisco, Texas.
22 in her four months on the job: US Senate. A Nation Unprepared, p. 423.
23 LifeCare’s corporate chief financial officer: E-mail from Jim Shelton to Robbye Dubois, Wednesday, August 31, 2005, at 1:45 p.m. These paragraphs summarize events described in e-mails sent throughout the day by LifeCare officials.
24 HF radio: Smith wrote in an e-mail to colleagues at 9:30 p.m. local time that he had “just established HF communication with Memorial.” It is unclear what kind of system was used to establish this link. The Hospital Emergency Area Radio (HEAR) Network System that was supposed to be operating in New Orleans “simply did not work,” according to the US Congress’s February 2006 report, A Failure of Initiative, p. 291.
CHAPTER 7
Interviews
Aster Abraham (daughter of Tesfalidet Ewale); Dr. Bill Armington; Dr. Horace Baltz; Kamel Boughrara; Fran Butler; Joanne Cardaro; Catherine Chatelain; Dr. Karen Cockerham; Dr. Ewing Cook; Minnie Cook; Rosemary Pizzuto Cotham (mother of Donna Cotham); Julie Couvillon; Dr. Richard Deichmann; Curtis Dosch; John Ferrero; L. René Goux; Andre Gremillion; Gina Isbell; Charles Jarreau; Janice Jenkins; Dr. Faith Joubert; Dr. Bryant King; Dr. John Kokemor; Karen Lagasse; Wayne Leche; Father John Marse; Angela McManus; Therese Mendez; Alfred Lee Moses; Kathryn Nelson; Dr. Anna Pou; Dr. Paul Primeaux; Sudeep Reddy; Karen Sanford; Rodney Scott; Dr. John Thiele; Dr. John Walsh; Capt. Mark Willow; Stella Wright; Karen Wynn; Eric Yancovich.
Notes
1 tried to inscribe her: Angela McManus, interviews with author (2007, 2013); Therese Mendez, interviews with author (2013) and state investigators (2005). Angela McManus also recalled helping affix family phone numbers to other patients. The messages were found during Wilda McManus’s autopsy.
2 came up to LifeCare: Dr. Faith Joubert, the infectious diseases doctor, in interviews with the author in 2008 and with state investigators on December 9, 2005. An unsigned note in the “Physicians’ Orders” section of McManus’s chart says: “8/31/05—May have MSO4 1-4mg IV/IM Q 1° for restlessness/agitation -Ativan 1-2mg q 1° IVP/IM q 1°PRN restlessness/agitation.”
3 The Nurse, Cindy: Copy of Louisiana State Board of Nursing consent order, August 16, 2005. Copy of PreCheck employee background report on Cindy Chatelain, May 2005. Interviews with husband Alfred Lee Moses and daughter Catherine Chatelain.
4 came to receive a small dose of Ativan: McManus’s chart notes: “2340 Ativan 2mg given IVP for anxiety and yelling out.” Cindy Chatelain, when she had taken over McManus’s care at four p.m. Wednesday, wrote: “Disaster Evacuation in motion awaiting transfer to other facility—Completely [without] air, lights, water, toilet facilities.”
5 Police: The SWAT team’s appearance at Memorial was described by several interviewees, for example hospital locksmith Wayne Leche (June 2, 2013), one of the men on guard as the boat approached. Also, Capt. Mark Willow, then with the New Orleans Police Dept., told the author (July 18, 2008) that he dispatched police to Memorial during the disaster in response to concerns of a pharmacy break-in, but the officers reported back that the rumors were untrue.
6 found clean scrubs: Dr. Pou described changing into fresh scrubs and the techniques she used to maneuver around the darkened hospital, both in an interview with reporter Julie Scelfo for Newsweek in 2007.
7 With several doctors and crews of nurses: Described by Dr. Pou in an interview with author in July 2008 and by many staff members in interviews with the author and state investigators. Dr. Pou also set the scene in an interview with reporter Julie Scelfo in Newsweek, “‘Everybody May Not Make It Out,’” August 24, 2007; http://www.thedailybeast.com/newsweek/2007/08/24/everybody-may-not-make-it-out.html.
8 told to take a break: In interviews with state investigators, one nurse thought she recalled that it was Dr. Pou who dismissed the volunteers and another employee recalled it was either Dr. Pou or Dr. Kathleen Fournier who asked everyone except the nursing staff to leave.
9 The generators also lit: Noted in a photocopy of a pilot’s logbook dated Thursday, September 1, 2005. Note was made by Don Berry.
10 A battery-powered CD player: Dr. Ewing Cook and Minnie Cook recounted the scene in interviews with the author beginning in 2007, and it is also described in Budo, Lori. Katrina Through Our Eyes: Stories from Inside Baptist Hospital (Lexington, KY: CreateSpace, 2010), pp. 108–111. Budo wrote of lying down and lifting the back of her shirt to feel the coolness of the tile floor; she described a male nurse urinating on the windowsill as insurance against intruders. Women used a bucket in the room to void.
11 Pou had ordered morphine: This episode is based on several sources, including the nurse’s interview with state investigators. She did not recall the patient’s name, but her description of the patient was consistent with pharmacy records showing that individual doses of morphine between 2 mg and 10 mg were dispensed for a cancer patient of Dr. Pou’s colleague, for whom Dr. Pou would have been covering, on Wednesday and Thursday. The patient survived her ordeal at Memorial. She has since died and is not named here because the author has not reached her family.
12 “There’s not a whole lot”: Scelfo’s Newsweek interview with Dr. Pou (2007): “We kind of looked around at each other and said, ‘You
know there’s not a whole lot we can really do for those people.’”
13 Pou would later remember: Scelfo’s Newsweek interview with Pou (2007).
14 reach out to a passing nurse: Kamel Boughrara recalled suctioning Ms. Hall regularly throughout the night in his January 6, 2006, interview with investigators: “I would term her as being critical. She needed oxygen; she was not on it because there was no oxygen left at that point. She was also septic, meaning she had an ongoing infection. She just had some major, major surgery and she was definitely very, I am surprised she was fighting. She was a tough fighter, and I was giving her eye contact and telling just fight hard. If a patient is strong enough to grab you by the hand and let you know that, she is fighting.”
15 “Am I going to make it”: Betty Bennett, interview with author, August 14, 2009.
16 Dr. Bryant King sent a group of nurses: Two nurses and Dr. King recalled this in their interviews with state investigators.
17 The man, in his early sixties: Dr. King did not identify the man by name, but his identity was deduced from King’s description and the location of bodies noted by hospital pathologist John Skinner. His wife’s experiences are described in a handwritten note by his daughter, filed with the court as an exhibit attached to “Notice of Objection of Valencia Richards” in Preston, et al v. Tenet on October 17, 2012. Valencia Richards signed her note: “A Heart Broken Woman”; she was objecting to the class action settlement’s allocation of $41,807.43 to her for her father’s death, which she attributed to heat exhaustion: “My father was still young, only 62 years when he was snatched away from me. We still had so much to talk about and do. Instead I’m constantly imagining him suffering in that heat […] I put no faith or trust in any doctor or hospital. I don’t feel justice was served, and I don’t feel any closure concerning his death.”
18 “We need to have a little bit more of a surgeon’s attitude”: Recalled by Dr. Paul Primeaux in an interview with the author in 2007. Dr. John Walsh could not independently recall the quote when it was checked with him in 2013, but he did not dispute it.
19 Tenet was dispatching the fleet: Curtis Dosch recalled the situation as it is written here, leaving open the possibility that some staff members might not have heard the news at the meeting before it broke up. However, Susan Mulderick told state investigators that she had learned from Dosch about the helicopters before the meeting and announced that they were coming, although she did not know when they would arrive. Both Karen Wynn’s recollections in interviews with the author, and e-mails sent by Tenet officials on Wednesday night, indicate that some at the hospital knew about the helicopters the previous evening. The question of when the majority of staff members were informed became a point of contention after the disaster when some, notably Dr. John Kokemor, told reporters that staff at the meeting Thursday morning believed that the hospital was on its own in terms of rescue, and they became dejected.
20 Presidential tasking: From Decker’s after action report (AAR) notes. No further details were recorded. It is conceivable that appeals from Tenet corporate officials to Louisiana elected officials reached the President.
21 It smelled worse: Susan Mulderick declined to be formally interviewed other than to say, of the days after Katrina: “We were well prepared. We managed that situation well.” She did not respond to a request to fact check the material in this book, however a subset of the material, included in the 2009 article on which this book is based, “The Deadly Choices at Memorial” (Fink, Sheri, ProPublica, http://www.propublica.org/article/the-deadly-choices-at-memorial-826, and the New York Times, http://www.nytimes.com/2009/08/30/magazine/30doctors.html), was fact-checked through her attorney in 2009. A number of other sources were relied upon, including Mulderick’s extensive depositions in 2008 and 2010 in Preston, et al v. Tenet, and her discussion with state investigators in 2006, as well as the observations of many in the hospital who worked with her.
22 “We are talking about euthanizing the animals”: Mulderick, through her attorney, told the author in 2009 she did not use the word “euthanasia” with regard to human beings nor were any of her statements at Memorial intended as “code for” euthanizing patients. Some people close to Mulderick theorized that her comments contrasting the treatment of animals with that of humans may have been misconstrued and perhaps even acted upon by others in ways she had not intended.
23 whether it would be “humane”: Deichmann, Richard. Code Blue: A Katrina Physician’s Memoir (Bloomington, IN: AuthorHouse, 2006), p. 78.
24 Pou’s prescriptions: The pharmacist, Philip J. Duet Jr., recorded dispensing the drugs on the perpetual controlled drug inventory. In an interview with state investigators on October 25, 2005, he initially said he could not recall having been asked for any large quantities of morphine. However, once he was shown copies of the logs, he confirmed that he had filled the prescriptions. He said he thought two young female doctors came for the drugs, and the large amounts could have been to travel with the patients.
25 Dr. Kathleen Fournier had been present: In an interview with state investigators on February 27, 2006, Fournier said she thought the discussion had occurred at night. Mulderick recalled it being on Thursday morning, and that seems more likely.
26 “I just disagree with this” […] “don’t worry about it.”: Susan Mulderick’s interview with state investigators January 1, 2006. Kathleen Fournier’s recollections when she spoke with state investigators the following month were similar, as described in more detail in Chapter 8. Fournier did not respond to requests to speak with the author or offers to fact check the material in this book. The author attempted to verify the accounts through other sources, as described in these Notes.
27 Fournier didn’t have her own medical practice […] progressively more tenuous.: In her interview with state investigators, Dr. Fournier described her work arrangements with Dr. Deichmann and the fact that she arrived late on Sunday to start her rounds. The detail about the eye patch and Deichmann’s frustration are from Deichmann, Code Blue, pp. 10–12, 107, in reference to a character with a pseudonym (“Liz Foster” in the AuthorHouse 2006 edition and “Larry O’Neil” in the iUniverse Star 2008 edition). However during fact checking in 2013, Deichmann referred to the character as a “composite [that] does not represent any one individual.” He said he did recall that Fournier had an eye injury (interestingly, Anna Pou, too, suffered a minor injury and had a black eye). In correspondence with the author about Dr. Kathleen Fournier in June 2013, Deichmann wrote that he thought it important not to diminish the “incredible courage and dedication she exhibited during that ordeal. Kate worked very long hours under horrible conditions to ensure patient care when many others had abandoned them. She has my complete respect.”
28 “That is not an option”: Butler, in her interview with state investigators, thought the conversation took place somewhere between seven and nine a.m. on Thursday morning, after she finished a fanning shift, but before the morning meeting. Fournier in her interview with investigators did not mention speaking with Butler.
29 Fournier solicited another opinion: Fournier’s account of this conversation in her interview with state investigators and Thiele’s recollections in a July 26, 2009 interview with the author were consistent in terms of content. Thiele recalled Fournier said she could not or would not do it. Both recalled that the conversation took place on the second floor. Thiele said it took place while they were euthanizing the cats, which Fournier did not specifically mention.
30 Fournier polled another of the doctors, Bryant King: Bryant King interview with state investigators in October 2005. Fournier in her February 2006 interview with investigators said in general terms that King seemed upset by what she told him, and she thought that was why he left. She believed this conversation to have taken place on Wednesday evening, whereas King thought it was on Thursday morning.
31 “I’m a Catholic” and telling them that “evil entities”: Dr. Bryant King, his sister, Rachelle, his best friend, D
r. Eric Griggs, and NPR reporter Joanne Silberner, who interviewed Griggs that day, said they no longer had copies of the messages. The description of these messages is based on King’s October 2005 recollections of them in an interview with state investigators.
32 Handwritten note: The note was written by Aviation Services, Inc., coordinator Don Berry in the ten a.m. to noon time frame, he recalled in 2013.
33 She wore a scrub shirt with the arms ripped off and little shoes: According to the recollections of LifeCare staff members.
34 He, like many others, had been concerned: Smith, Stephen and Marcella Bombardieri, “Power Gone, Food Low, Doctors Focused on Life,” Boston Globe, September 14, 2005. Kokemor confirmed this with the author.
35 “Your mother is dying”: Kathryn Nelson, interview with state investigators October 3, 2005, and with the author, November 28, 2007. Therese Mendez remembered (interview July 1, 2013) that Kathryn Nelson strongly resisted leaving on Thursday, and Mendez recalled having spoken very firmly to Nelson to motivate her to go downstairs so she wouldn’t miss the chance to leave.
36 The nurse administered a small dose: Nelson’s nurse, Cynthia Chatelain, recalled in an interview with state investigators (January 6, 2006) that she gave Nelson 1 mg of morphine and 1 mg of Ativan.
37 told her that they were under martial law: This belief was commonly cited by staff at Memorial, particularly LifeCare staff, interviewed by investigators after the storm. It is not surprising, given how often this incorrect assertion was repeated on the radio, to which some people may have been listening. Therese Mendez said (July 2013) it was like a “vapor” that spread through the hospital.
38 “I’m getting out of here”: Dr. Bryant King, interview with state investigators, 2005. These first recollections are consistent with later ones, including his 2008 deposition in a case brought against the hospital by Elaine Nelson’s son, Craig, and in an interview with the author in 2007: “When I saw Anna with all those syringes in her hand, I was like Anna, that’s fucking crazy, you can’t possibly be serious.” (“You said that?”) “I’ve never been someone who keeps thoughts in my head.” Dr. Bill Armington in an interview with the author recalled seeing Dr. King leaving, upset, as did Fournier in an interview with investigators in 2006: “He was upset and angry about it, is the impression I got, so he left. I was upset and angry about it, and I stayed.” The timing of Dr. King’s departure has been a point of contention, with some at the hospital later saying they believed he left on Wednesday and could therefore not have witnessed events in the second floor lobby on Thursday. However, the specificity of Dr. King’s recollections on Thursday and the fact that numerous employees recalled seeing and working with him that day indicate that he was indeed present.