I am from the New Orleans area and was one of the many thousands who evacuated for Hurricane Katrina. I was also one of the large population of locals who were offended and dismayed when then-Attorney General Charles Foti arrested a doctor and two nurses who had been at the flooded Memorial hospital during the disaster. Public opinion at the time was squarely behind the hospital staff, largely because we thought that the opportunistic former sheriff was blaming the very people, who saved so many lives, of not being even more heroic. This was my opinion, and that of everyone I talked to - until I read the ProPublica article about conditions at Memorial, published in 2009. That article convinced me that perhaps something very unsavory had happened at the hospital during the disaster.
And so it was with great interest that I read the reporter's more thorough examination of those days in this book. This book deserves a Pulitzer; it is an unbiased, well balanced and extremely thorough examination of the events at Memorial and the consequences of those events. I also have a Ph.D. in philosophy, and so I was hoping to see a studied examination of the ethical issues surrounding the events, and I was not disappointed. Ms. Fink clearly and accurately explained some of the most basic principles of ethics, and how they were (or were not) applied in this case.
The overall impression that I had of the medical professionals at Memorial was that they were so over-taxed, over-worked and under-prepared that they were not in a position to make truly rational choices about their sickest patients. To prevent this kind of tragedy in the future, our institutions must determine ahead of time how they will react in a disaster, and the people in those institutions need to cling to their moral principles, rather than abandon them in such a moment of crisis. The contrast of Memorial hospital with Charity hospital is most striking in this regard. Both hospitals were stranded in flood waters and lost power. But at Charity they were prepared and had practiced for just such an event. They evacuated the sickest patients first, not last, and they didn't give any patients lethal injections. Three people died at Charity, compared with forty-five deaths at Memorial, many of those in the last few hours, even as helicopters were arriving en masse to evacuate the hospital. Please read this book.
This is a book that could have been so much more had the author had any talent beyond headline grabbing. This book's greatest failure is the author's inability to move the story past the immediacy of tabloid journalism. It reports without any critical analysis leaving the reader, who lacks expertise, with the authorial responsibility to fill in the missing gaps and determine which voices are correct or the most accurate. It's raison d'etre is not how medical institutions function in a crisis but with the accusation that euthanasia was committed. It is an important story. This book might have been important. What happened in New Orleans also happened in New York City after Sandy and may happen again in other cities.
The book does not cover so many important issues that bubble up from the story being told. It leaves out of its purview the role of privately owned, for profit hospitals in preparing for and responding to these crises. It gives almost no coverage to what happened beyond this hospital on a local, state, Federal level that left medical personal incommunicado, literally in darkness, with no idea when rescue would happen, and in fear of attack either from residents from the surrounding area or from those in equally squalid conditions. She leaves unanswered why the individual most thought was coordinating relief was a private nurse with only a few hours of disaster courses, not a FEMA employee or even in contact with FEMA. Yet the myopia is only a part of the frustration one will experience with this book.
The only reason this book was written is because allocations that euthanasia occurred at this hospital were made. The author skews the story in order to assign blame when the story she tells is that people in isolation, in desperate straights, without electricity, without, air conditioning, in fear for their safety, suffering from sleep deprivation and hope of rescue as low as could be imagined, were doing their best to deal with the overwhelming challenges they faced. It might be argued that some of these issues are dealt with in the second section of the book. This would be false. The author does write of how medical personal behaved in Haiti after the earthquake. She brings up, briefly, how NYC hospitals managed when Hurricane Sandy struck. But her analysis is always superficial and is essentially useless. In both cases, individuals did not fear isolated. They did not fear for their personal safety. They were in contact with the outside world. They did not feel hopeless and helpless. They remained in control and in communication with the outside world. They were not part of for profit health corporations who had no plan with how to deal with a disaster of this magnitude nor did they feel any urgency to provide support to these beleaguered medical personnel. There is not analysis of health care provided by for-profit hospitals versus publically supported hospitals.
Then there is the larger issue of life and care of those elderly who are in a persistent vegetative state. The issue is touched upon. Indeed, it is held up as a banner to the reader and the author as a bludgeon to beat individuals she clearly feels behaved improperly. Yet it is a subject that ought to be explored in depth, particularly since it is the costs of these services that are helping to make health care so expensive--and the reasons for-profit health care exists. As important as this subject is from the perspective of policy or morality it is analyzed from the selfish perspective of individual relatives of patients in this hospital or from a moral absolutist position. Even the author seems to suggest that those she believes behaved improperly and who deserved to be held criminally accountable, did so under the best motives. Since her focus never leaves the surface we have no idea why those individuals reached the conclusion that their actions were necessary and the humane because the author's reporting occurred while they were under criminal pearl.
There is no historical analysis, there is no institutional analysis, there is little that ever does more than scratch the surface of any subject. All voices are granted equal weight and are rarely ever put in larger context. There is no authorial shaping of the story. It is the retelling of a story from the myopic and disjointed perspective of each individual, that had it some shape might have offered a valuable look at how and why people performed how they did.The reader is left screaming at the page at false conclusions made, for cheap attacks or for the superficiality of the information offered and the analysis offered. This may be an important story but it will have to be told by others as this author is lost and whose ability is unequal to the task.
It is obvious that Fink did her research and it was easy to trust her facts. I have nothing negative to say on that front. However, her writing style was far from engaging for me. This story is so incredibly intriguing, It makes you think about everything from disaster preparedness to assisted suicide to what you would do for survival... yet I felt the complexities of it were lost in this telling.
The narrator's lack of knowledge regarding the local dialect was horribly distracting throughout this entire book. PLEASE do some research and do not butcher the pronunciation of street names, sir names, common phrases, etc.
It is easy to say that those of us who were not there could never understand and should not judge. But if we are ever to learn we must try to put ourselves in these terrible places and we must be willing to judge. Fink has done an outstanding job providing a balanced and detailed account of what transpired during those hellish five days that so many of us remember watching unfold on television. She speaks for the medical workers, the families and the patients. As a pastor and a lawyer the questions she leaves me with are not related to whether the physicians did the right thing, but how we can help others the next time this happens, and the time after that.
Memorial Hospital apparently had a policy of allowing employees to bring not only their children to work but also their pets, who'd spend the day in hospital-provided kennels. The story opens with an account of two doctors struggling to inject a terrified cat in the heart with a lethal dose of chemicals, trying -- successfully, eventually, after having to chase it and catch it twice --to kill it, allegedly to prevent it's suffering in the impending chaos. They then set about preparing to also kill off the remaining patients who can't be moved.
That's the point at which I stopped listening. Too much, just too much.
This is a true story, apparently. We are told these things happened, they were done.
But for me, I came to realize -- very quickly, in this book -- that there are some true events that I just don't need to hear about. This was just too agonizing for me. Knowing that it's true makes it that much worse.
I'm trying to return the book, per Audible's return policy. I haven't been successful yet, but this is not a book I want to explore any further. What did I expect? Probably a tale of heroism, courage under impossible circumstances. I wasn't expecting a tale of mass murder of animals and sick people.
Highlighting some of the most important issues. I would love to see Sheri investigate the decisions that put the hospitals in danger to begin with, Politics and money. Politicians operate under the assumption that you are dammed if you do, damned if you don't and how would it look if we had out side help that comes to assist (happened in Katrina and then again during Sandy; how long did it take for the national guard to get to Bellevue Hospital. The other issue money, NorthShore LIJ was the only institution that evacuated not using money as a consideration. It should be mandatory that every facility has a reserve of money set aside specifically for disasters (they have all made millions over the years). health care facilities should be held accountable for any out come if they are not prepared and totally reliant on government help. Thank you Sheri.
Narration distracting from numerous mispronunciations of both common words, place names and terminology . Author likely biased but the underlying lessons of this event are necessary reading for all health professionals.
its hard to imagine what it was like in NOLA in the days after Katrina but this book gives us a small glimpse at just that. the idea of trying to practice medicine amidst chaos with misinformation and what seems like few supplies is a nightmare. if you were critically ill, would you want to suffer through this or be allowed to meet your maker?
Working in the healthcare emergency preparedness field, this is a story I wish everyone would read or listen to because the hardships and lessons learned have implications on hospitals and communities across the country. Hospital administrators and care providers are locked in an epic struggle between balancing their everyday workload, financial crisis, and emergency preparedness mandates. There simply isn't enough time or money to make it all work optimally. As a result there continues to be disaster liabilities at many hospitals that I hope and pray never come to light.