Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital

Simplistically, this is a story of how a hospital full of doctors, family and patients dealt with and sustained through Hurricane Katrina. However, the story that focuses mainly on Dr. Anna Pou is a moral conundrum that is as divisive a subject as I can imagine.Sherri Fink treads through public files, personal testimonies and witness accounts to bring us a wide look at what took place at a New Orleans hospital as chaos ensued and governmental and corporate response languished. This lack of emergency response seems to be caused by a deadly combination of negligence and incompetence by the staff of the hospital and everyone they seemed to reach out to. Consequently, important decisions had to be made under stress , exhaustion and unbearable heat: Who among us gets to leave/receive critical care first? The oldest? The sickest? The ones with the best chance to survive? The ones with best quality of life chance? Triage was set up and days passed by slowly as people's lives hung in the balance.Thus enters Dr. Anna Pou. Fink goes into incredible detail of her background and character and gives us a sympathetic/ hard working, no-nonsense type of doctor who delegates authority amongst the nurses and charges at Memorial. Ultimately, it seems according to the book, that Dr.Pou would make important decisions to euthanize certain patients in what seems like a badly-kept secret that morally divided the staff. This is the central focus of the book and how you feel about Dr. Pou's actions will polarize the reader and have you second-guessing your original feelings.I must say, immediately I felt that euthanasia was completely acceptable. I believe that if somebody is to the point where pain and suffering renders somebody to the point that they are alive in the most basic definition only, I feel it acceptable for them to want to end their life. And, I did indeed feel this way throughout the book about Dr. Pou until you realize that these particular patients never consented. And there in lies the rub: euthanasia should never be put in the hands of the doctor without consent of the patient or family. Furthermore, in the case of Mrs. Burgess and Emmett Everett, not only did they not wish to die, they very much wanted to live. The fact that they were killed on the same day the mass evacuation was taking place only makes it more the tragedy.The second half of the book focuses on gathering evidence , the politics of prosecuting staff that risked their lives and otherwise behaved heroically during a disaster that most , including myself, got to watch from a distance. It's riveting and I think Fink presents every possible ethical possibility on what happened and what COULD have happened. I feel like she was objective and fair and if anything, only really painted LA attorney general in a negative light.It's no doubt controversial and there seems to be two camps: those that think that Dr. Pou is an amazing doctor who appears to have killed (with help of other staff, mind you) patients, even if ending their suffering was paramount in her mind. The other half is those that take Fink's reporting as factual. Perhaps the truth lies somewhere in between , but to those who deride Fink as trying to make a buck by sensationalizing , you have to consider both sides. Dr. Pou obviously has a lot to lose, including her freedom, if these accounts are accurate. She would literally have gotten away with murder. I don't, however, think she meant to kill with malice but rather with compassion. What does make me lose respect for her , though, is her continuing to lie about small details to exaggerate the conditions of the hospital ( lack of water, food, helicopters not being able to fly at night). If there was more of a consensus, or even if there was a moral consensus taken before she made the injections, I'd sleep better. Unfortunately for the victims, it seems like their deaths were carried out clandestinely. Meanwhile, their was an equal conspiracy of disapprovers who did nothing but express outrage over the possible euthanasia amongst themselves while not lifting a finger to stop it.I could go on and on about this with points both for and against all parties involved and not come within a mile of satisfaction.It's an astounding read that will test your preconceived notions of right and wrong and I'm not quite sure I'm qualified to judge anybody during a situation as hellish as this.

Fink, S. (2013). Five days at Memorial: Life and death in a storm-ravaged hospital . Crown Publishers.Dr. Sheri Fink’s work explores the impact of crises on health care and is informed by her background as an MD and former relief worker in disaster and conflict zones. Fink received a PhD in Neuroscience and an MD from Stanford University.Part 1 describes what happened during Hurricane Katrina at Memorial Medical Center. Although there were lessons learned from prior hurricanes, flooding events, and scenario planning, necessary expenditures were not allocated to make changes or to create scenario specific response plans pertinent to preparedness, coordination, and evacuation. Reading the five days described by Fink is like watching a train wreck as conditions worsened and doctors and nurses strived to take care of seriously ill patients. When do normal hospital operations cease replaced by emergency conditions where standard rules and protocols simply are not feasible? This is a story about a hospital filled with doctors, nurses, patients, family members, and pets with no power, rising waters, deteriorating conditions, and poor evacuation protocols. Tenet Healthcare, portrayed as a corporate owner with no real incident command system in place for emergencies, no preexisting contracts with medical transporters, etc., relied on government resources to respond to the emergency. Doctors met to establish a protocol for prioritizing patients with those with DNR order prioritized last for evacuation.According to Fink, "Concepts of triage and medical rationing are a barometer of how those in power in society value human life." (p. 136) But what happens in an emergency when choices may be necessary? What triage systems exist to help responders make decisions? Fink noted, "[Dr. Anna] Pou and her colleagues had little if any training in triage systems and were not guided by any particular protocol" (p. 139). 45 deceased were found in the hospital following Hurricane Katrina. Toxicology reports indicated high concentrations of morphine and other drugs in some patients suggesting that some patients were euthanized.Part 2 describes the aftermath including investigations, arrests, and accusations of Dr. Anna Pou and nurses who were asserted to have committed euthanasia.

After seeing the recent TV series based on this book, I decided to buy and read it. On the plus side, the author Sherri Fink writes very well, and gives readers a compelling account of the "Five Days" as hospital staff struggled to deal with an impossible situation during Hurricane Katrina. Largely abandoned by City, State, and Federal officials, as well as by Tenet (owner of the hospital), the staff had to make agonizing decisions about survival, including which patients could be saved. Fink focuses much of her attention on one doctor, Anna Pou, who euthanized a number of seriously ill patients (at least according to this book). Although I admire this book, I do have some criticisms:1) About half of the book is devoted to the aftermath of the "Five Days," with extensive reporting about the efforts of the local DA to investigate and later prosecute Dr. Pou. I wanted to see a shorter section on this, but additional discussion (to what is given) at the end of the book about the ethical issues and implications for future disasters.2) Although Fink does provide at the beginning o the book some historical context, there should have been more information provided about the multiple failures in planning and decision-making by officials at all levels of government in the last 10 or so years prior to Katrina.3) I found it difficult to understand how the hospital could have been given such low priority for evacuation. I wanted to see more information about the Governmental response during Katrina.Overall, I still learned much of value from reading this book, which offers powerful lessons for disaster planning and response.

Divides into three stages. First is the story of the five days up to Sept 1st 2005 after Katrina at Memorial hospital in New Orleans. The full horror and danger of the circumstances are conveyed along with the sheer heroism and devotion to duty which the medical staff showed. Without this knowledge what happened next cannot be understood so it is worth sticking with its confusions and complexities. Second is the account of how the authorities tried to bring one doctor and two nurses to trial for second degree murder on allegations of 'euthanising' patients who could not be rescued from the hospital. I found myself repeatedly pulled in contrary directions and the writer skilfully takes the reader through all the ethical ambivalence of the case with both the medical and non-medical communities divided in their views on what happened and the ultimate grand jury verdict. Third is an interesting and disturbing consideration of the lessons of Katrina and other disasters for our preparedness in the future to meet natural and health crises where medical resources will be limited.

I found this book compelling. As a Registered Nurse practising on the Gulf Coast for forty years I know the system and the terrain and the weather risks. As a Nursing Administrator I had to make decisions about evacuation of patients, transportation and the care of staff during these conditions. I must say I cried and found the situation harrowing. I thank God that I never had to make the ultimate decision these Nurses and Doctors had to contemplate.I have thought long and hard about this and I seriously believe, that in this world of severe weather issues, infectious epidemics and terrorism all over the world, we the healthcare providers must have urgent dialogue about the final triage. Don't leave it to the desperate people left on site to make these decisions.God Bless the patients and staff involved. God help those people at the corporation who failed to act!!

A straight reporting of what went on at Memorial, during and immediately after Hurricane Katrina.The reader is left to come to his or her own conclusions.Who knows how we would act under such stress? One would like to think that one would act with more compassion, who knows?This is a horrifying account - how often is this scenario acted out in our hospitals, when there is no hurricane?

This is the story of the Memorial Hospital during Hurricane Katrina. I think it is an important document of public record of what can go wrong during a crisis with poor management however the writing style didn’t appeal to me. I felt it was neither presented as a factual report or written in a story like fashion. The book covers the most dramatic circumstances yet manages to be boring and really hard work.

A well researched and thorough account of events. The loss of one star was purely because, whilst the aftermath of Hurricane Katrina was riveting, the legal aspect, for me, was not so. For those who like investigative and legal procedures it would be a five start book.