The Great Deluge

by Douglas Brinkley

  “Wow!,” “Holy cow!,” and “Look at that!” were the kinds of greetings Clark received when he started passing out home-cooked food first to his family, then to the others camping out in Harrah’s parking lot. “We ate well,” Clark said. “Friday morning, I went back up to One River Place, climbed the stairs, and made a huge batch of grits. We had it goin’ on.”

  At the Convention Center the authorities were obsessed with the chairs. They viewed the bringing of them outside as looting. “I’d have Grandma in a wheelchair and Auntie lying down on the cart, and we’d stand in them buses’ lines for hours,” Clark recalled. “Friday night we were told 100 percent, absolutely they were coming. They never did. We ended up sleeping at Harrah’s garage again. But come Saturday morning the National Guard arrived by the hundreds, full of evacuation orders. They acted like we were the Vietcong or something, maybe Indians in a damn concentration camp. They kept shouting for everybody to give up their weapons. Problem was, nobody really had weapons, although a few guys coughed up penknives.”61 That was the Convention Center: something bordering on a prison camp.

  VII

  New Orleans had nine major hospitals. Six of them—Lindy Boggs Medical Center, the Ochsner Foundation Hospital, Memorial Medical Center, Tulane University Hospital, Methodist Hospital, and Children’s Hospital—were privately owned. The federal government operated the Veterans Administration hospital in Bywater. Louisiana State University Hospital was also a government operation. And so was the largest of them all—Charity Hospital, a nonprofit institution created to provide care for poor people.

  Children’s Hospital and the Ochsner Clinic, which were on the relatively high ground of Uptown, near the Mississippi, remained safe from flooding. The other hospitals were much more vulnerable. Memorial Medical Center was located toward central New Orleans. Lindy Boggs was in Mid-City. Methodist Hospital was on Read Boulevard in Lakeland, only a couple of blocks from Lake Pontchartrain. The other four—the VA, Charity Hospital, University Hospital, and Tulane Hospital—were all located in the medical district, about six blocks north of the Superdome, and under the shadow of Interstate 10.

  As Katrina approached, a hospital seemed to be a smart place to spend a hurricane. The buildings were securely constructed, with auxiliary generators and plenty of supplies. Nonetheless, Charity Hospital evacuated its stronger patients during the weekend before the storm.62 That left only the critical cases, those least able to sustain any stress. During Katrina, the wind damage at the hospitals was by and large light. Even after the power failed in New Orleans on Monday, the hospitals were still viable, relying on generators to power the lights and lifesaving or life-sustaining equipment, such as kidney dialysis machines, respirators, ventilators, and defibrillators. With the flooding on Monday and Tuesday, however, the hospitals lost most of their power: generators had been placed in the basements, which filled with water early on. Portable generators could operate machines for the critically ill, but not indefinitely. By Tuesday night, helicopters were evacuating the most serious cases from Tulane Hospital, using a parking garage as a landing area. Such evacuations were not in and of themselves chaotic; hospitals practice for emergencies regularly, honing the art of triage and planning for the type of equipment that would have to be transported with each particular type of patient.63

  No hospital, though, was prepared for the conditions that met New Orleans as Tuesday turned to Wednesday. The staff at Memorial Medical Center, which was surrounded by six feet of water, couldn’t properly care for its 260 patients. When people swam or paddled to the hospital seeking help, they were turned away. Memorial was in fact trying to evacuate its own patients, even though, as CEO Rene Goux would later write, “there was no sign of any organized rescue effort, just these people who came from out of nowhere.”64 Remarkably, no government agency made any effort to canvass the hospitals or coordinate an evacuation effort. Memorial staff members were reduced to hot-wiring a boat parked in a nearby garage, so that they could evacuate a critically ill 400-pound woman. About one hundred patients were sent to safety by Wednesday night, largely through the efforts of Acadian Ambulance Services. The Memorial staff tried to care for those who were left, but the level of care was primitive. As the death rate rose, bodies were placed in the chapel. With temperatures high, the stench from the decay was overwhelming. Angela McManus, who had weathered the storm in a bed next to her mother, Wilda Faye Sims-McManus, a cancer patient on the seventh floor, said, “The sewer lines had all backed up, and we were down there in all that stifling heat and this odor was horrendous. People were trying to get into the hospital just to get to higher ground, and they weren’t allowing that…so they boarded the doors up, and we were just in there smothering all night long.”65

  Most of the New Orleans hospitals ultimately bypassed the government and its inadequacy and hired their own medevac helicopters. The going was slow, but at least something was being accomplished. At Charity Hospital and University Hospital, though, there was no money for private evacuation services. They would have to await government help, but there was no sign of it as Wednesday came to a close. At Charity, the staff operated ventilators by hand, pumping steadily to keep patients alive, for two days.

  On Thursday, the situation was desperate: no one was coming to evacuate Charity and many patients who ought to have lived were about to die for lack of proper care. The situation at Tulane Hospital was slightly better. CEO Jim Montgomery and his colleagues at the Hospital Corporation of America (which owned the hospital) had arranged for small helicopters to remove the last patients. Once that was accomplished, Montgomery lined up his staff and their families—and their pets. “Then a situation developed,” he wrote. “A frantic Medical Director of Critical Care showed up by boat from Charity Hospital. Major problem. Charity was in a meltdown. He had 21 critical care patients, many being hand ventilated for two days and he couldn’t get any help from the state. Can you help me, he asked? This was a tough question, but it had only one answer.”66 Montgomery assigned the small helicopters to help Charity. His staff, exhausted as each member was, would wait for another helicopter.

  One doctor who wouldn’t leave New Orleans was Dr. Christopher Wormuth of Ochsner Clinic. Flood victims were arriving at Ochsner’s emergency doors in a steady stream. Wormuth lived on South Carrollton Avenue with his wife, Laura, and their two kids. Early on they made a “family decision” to stay. They were going to protect their property with a shotgun. At dawn on Wednesday they drove to Lafayette, purchased six generators and seven gallons of gasoline, and felt fortified as they returned home. But Thursday the looting intensified and gunshots echoed throughout the night. “Then on Friday a policeman came up to me and said, ‘What are you doing in town?’” Wormuth recalled. “I explained my job at Ochsner and how I had a gun and was protecting my family. He said, ‘You think you’re protecting your family? Really? I could have just shot you dead, you didn’t know I was a cop. If you care about your family, get them the hell out of here.’” Wormuth was rattled enough by this NOPD officer that he loaded his SUV and had his wife drive the kids out of town. “I stayed at Ochsner,” Wormuth said, “but I gave up on that whole ‘community watch, protect my property’ thing. New Orleans had descended past that.”67

  For a day or two, difficult to accept as it was, the general feeling was that the hurricane had landed a powerful punch and they would all have to help overcome it. By the fourth day, Thursday, people in the hospitals couldn’t understand why the government had forsaken them. At Memorial, there was a palpable feeling of hopelessness when word ran through the ranks that the institution was low on a list of state priorities for evacuation. Hospitals weren’t used to being dead last on anybody’s priority list, nor should they be. Awful things happened to patients as a result. “Yesterday was the first day I think that I only cried once,” Dr. Randy Roig, director of a rehabilitation hospital on the north shore of Lake Pontchartrain, said ten days after the hurricane struck. “You don’t really have much choice, an
d every now and then, I just get into a corner and get to myself and let my emotions run rampant. But then, I have to get right back to work.”68

  Oscar Zavala was a patient in a New Orleans hospital on Thursday, suffering from a bacterial infection. “What hurts in my soul,” he said later, “is that we waited for the government response and it never came. My government is the first one there whenever something happens in a foreign country…and here they failed from the very beginning.”69

  AT CHARITY Hospital—or Big Charity, as it was popularly known—food had run out that Thursday and no assistance was forthcoming. The busiest trauma center in New Orleans was itself in critical condition. Founded in 1736, Big Charity, according to New York Times reporter Adam Nossiter, was “a symbol of a social commitment to the poor.” When Charity celebrated its 250th anniversary in 1986, Allen Toussaint wrote about the legendary hospital in a song titled “Charity’s Always There.” But Katrina turned Toussaint’s lyrics upside down. The hospital was in lockdown, forced to turn people away.70 Dr. Norman McSwain, the chief of trauma surgery, waded from Charity to his office at Tulane Medical School, where he was a professor. He called the Associated Press. “We have been trying to call the mayor’s office,” he explained, “we have been trying to call the governor’s office…and have tried to use any inside pressure we can. We are turning to you. Please help us.”71 His hope was that the media would become the cavalry. Every time they reported a heart-wrenching post-Katrina story, some private sector mogul stepped up to help out.

  AIDS specialist Ruth Berggren was another doctor still at Big Charity on Thursday. Born in Boston, she was raised in Haiti, where her parents were public health physicians. In rural Haiti, Berggren witnessed how disease could consume entire villages, leaving rummaging shadows where people had once trod. After specializing in infectious diseases during her medical education, Berggren eventually wound up working with AIDS patients at Charity. “We had 7,000 HIV-infected individuals in New Orleans,” Berggren recalled, speaking of conditions on the eve of Katrina. “We ranked very highly in terms of the incidence of the new cases nationwide, which was a phenomenon that had been noticed in the southeastern United States. Both New Orleans and Baton Rouge had an alarming number of new cases, and it particularly appeared to be affecting adolescents and young black females.”72

  When Katrina was headed toward the Gulf Coast, Berggren’s conscience dictated that she ride out the storm with her eighteen AIDS patients. Sneaking in a quick five-mile run along the Mississippi River levee before Katrina arrived, Berggren had been the assigned teaching physician on call at Nine West for the entire month of August. “I knew that I was going to stay for the duration,” she said. “My husband and my son were going to stay at Tulane University Hospital, just across the street from Charity. My husband was the chief of oncology there. He was not on call, but he made the decision to stay because I was staying and he wanted to take care of patients, and to make sure that his research cell-lines wouldn’t be damaged in a power outage.”73

  Berggren’s patients ranged from twenty to sixty-five years of age. She was extremely worried about two patients on dialysis: one had advanced AIDS and the other was a young woman who “was responding very beautifully” to HIV therapy. “I was really desperate to get them out,” she recalled. “I was especially focused on the young girl because I felt like her life wasn’t in imminent danger and because she had a lot of life ahead of her.”

  When Katrina hit Berggren was a steel magnolia, all steady nerves and tranquil compassion. She ate a little overripe fruit and reassured all of her patients that hurricanes came and went and life went on. She caught a little sleep Monday night on an air mattress in the conference room. But when she awoke on Tuesday and looked out the window, she saw slow-moving floodwaters lapping at the front steps of Charity. “That was the moment that I knew that this wasn’t what we thought,” Berggren said, “that things were going to get very different around here. I assumed, however, that we would get evacuated within the next twenty-four hours. I never imagined we would be there as long as we were.”74

  With the flood putting the hospital in grave danger, a quick organizational meeting of doctors and nurses was called. There were over 250 patients in the building, scattered over all thirteen floors. The staff started categorizing patients according to the severity of their illness and their priority for evacuation, whether they were ambulatory or wheelchair bound. Although Berggren went along with the color code that resulted, she wasn’t very keen on it. “People got confused as to what the colors meant in terms of whether a patient could walk or not,” she recalled. “I had a guy in there who had a spinal fracture, who really wasn’t very sick; he could have been the last person out, from a medical standpoint, but he needed full support to be carried out. On the other hand, the patient I was most worried about, the girl on dialysis, could actually walk out, but her life was in the most imminent danger, because she needed dialysis. So there was a lot of confusion. I think this was a problem with the evacuations of all the hospitals and nursing homes. National Guard rescuers or police, for example, when they showed up would say that they ‘were only taking patients who can’t walk.’ They disregarded that there was another person who, if they weren’t airlifted out in twenty-four hours, would die. They just weren’t receptive to what doctors and nurses had to say. They had a fixed idea.”75

  Imbued with a deep commitment to Nine West, and an abiding passion for her eighteen patients and the loyal nursing staff, Berggren decided that they were going to stick together as a group. Quiet, respectful, and full of fear, they were now dependent on Dr. Berggren. They had all become friends because of Katrina, and they pledged to leave nobody behind. Katrina, or the blunders of Bush, Brown, Chertoff, Blanco, and Nagin, weren’t going to shatter the esprit of Nine West. Pulling for Dr. Berggren to evacuate them from the bowl became their monomaniacal cause. Somehow the chemistry gelled and Nine West adopted an us-against-them attitude.

  Meanwhile, mayhem had broken out in the hospital. Armed security guards were turning away storm victims at gunpoint. Locals, believing the hospital was a safe haven, had started arriving through the floodwaters en masse. While the occasional exception was made—for instance, an NOPD officer who was coughing up blood—the guards weren’t letting anyone in. To cope with the growing security menace, Charity doctors deputized three of their residents to protect the roughly 800 people in the hospital. An iron-clad rule was set: Let no new patients inside. “We couldn’t be a refuge to the public,” Dr. Peter DeBlieux, director of the emergency medicine residents, recalled. “We couldn’t even get our own patients out. We were turning people away from medical attention. You had people floating in little wading pools, you know, Grandpa’s had a stroke, being floated by his family in a wading pool to Charity Hospital, and we’re saying, ‘We’re not taking anybody. You can’t come to the hospital.’”76

  Dr. Berggren didn’t like guns. She was a Brady Bill advocate, a staunch antigun mom. Over the years, going in and out of Charity’s trauma center, she had seen too many gunshot wounds that had crumpled young men into permanent unconsciousness. So, as the flooding of Charity continued, she was less interested in National Guardsmen with long-nosed rifles pointed at looters than in rafts, flatboats, or helicopters for her marooned patients. Rumors of urban sniping, however, had turned the Guard on high alert, slowing down rescue efforts, causing choppers to abandon basket-dropping. On Wednesday there was National Guard support; on Thursday they left Charity due to snipers. Here was the rub; the Guard was not, by mandate, supposed to shoot back at fellow Americans. Posse comitatus was the law of the land. “The Guard said they couldn’t shoot,” she recalled. “That was fine by me. But we were left alone and that was particularly devastating.”

  The Posse Comitatus Act of 1878 was passed to remove the U.S. Army from engaging in law enforcement during Reconstruction. The term literally meant “the power of the county.” It was devised as a way to reassure former Confederate states that th
e federal government wouldn’t abuse them anymore. Basically, the act severely hampered the ability of the Army—and later the Navy, Air Force, and Marines—to become law enforcement officers against American citizens. But in truth, posse comitatus had evolved into a procedural issue. National Guard units—under the authority of the governor—could bypass posse comitatus in an emergency. During the Los Angeles riots of 1992, for example, U.S. troops were used to end the cycle of street violence. In addition, the Coast Guard was exempt from the act. So doctors like Peter DeBlieux and Ruth Berggren were right to be angry that the National Guard and Coast Guard refrained from evacuating Charity Hospital. Certainly the National Guard and Coast Guard had a legal right not to engage. But didn’t they have a moral obligation to save the sick? Did one or two guys with a Saturday night special really stop an entire military operation?

  When the National Guard pulled out, abandoning doctors and patients alike, on late Wednesday and early Thursday morning, Berggren had an ace up her sleeve. For some strange reason, even though the entire hospital was without phone service, one line near the Nine West ward was working. Call it blind luck or divine design, for some unknown reason, Berggren had a phone with juice. “I expressed a lot of anger about the fact that our evacuation had been stopped and that the National Guard had left,” Berggren recalled. “At one point I was berated by this guy from the media, who said, ‘What’s your problem? Can’t you see there’s 15,000 National Guard in New Orleans right now? Can’t you see them?’” Berggren couldn’t see anyone outside her window except some guys in padded fatigues. She got off the telephone, found the chief of security, and had him escort her to every door and exit in the hospital. She was right. The only protection around was a few NOPD officers or security guards. “There was no National Guard presence during the hours when the sniper shut us down and we resumed.”