Five Days at Memorial

Life and Death in a Storm-Ravaged Hospital

By: Sheri Fink

Narrated by: Kirsten Potter

Length: 17 hrs and 33 mins

Publisher's summary

NEW YORK TIMES BESTSELLER • The award-winning book that inspired an Apple Original series from Apple TV+ • A landmark investigation of patient deaths at a New Orleans hospital ravaged by Hurricane Katrina—and the suspenseful portrayal of the quest for truth and justice—from a Pulitzer Prize–winning physician and reporter

“An amazing tale, as inexorable as a Greek tragedy and as gripping as a whodunit.”—Dallas Morning News

After Hurricane Katrina struck and power failed, amid rising floodwaters and heat, exhausted staff at Memorial Medical Center designated certain patients last for rescue. Months later, a doctor and two nurses were arrested and accused of injecting some of those patients with life-ending drugs.

Five Days at Memorial, the culmination of six years of reporting by Pulitzer Prize winner Sheri Fink, unspools the mystery, bringing us inside a hospital fighting for its life and into the most charged questions in health care: which patients should be prioritized, and can health care professionals ever be excused for hastening death?

Transforming our understanding of human nature in crisis, Five Days at Memorial exposes the hidden dilemmas of end-of-life care and reveals how ill-prepared we are for large-scale disasters—and how we can do better.

ONE OF THE TEN BEST BOOKS OF THE YEAR: The New York Times Book Review • ONE OF THE BEST BOOKS OF THE YEAR: Chicago Tribune, Seattle Times, Entertainment Weekly, Christian Science Monitor, Kansas City Star

WINNER: National Book Critics Circle Award, J. Anthony Lukas Book Prize, PEN/John Kenneth Galbraith Award, Los Angeles Times Book Prize, Ridenhour Book Prize, American Medical Writers Association Medical Book Award, National Association of Science Writers Science in Society Award

©2013 Sheri Fink (P)2013 Random House Audio

Critic reviews

2014, Carnegie Medal, Short-listed

2013, Los Angeles Times Book Prizes—Current Interest—Winner

2014, National Book Critics Circle Awards, Winner

2015, PEN/John Kenneth Galbraith Award for Nonfiction, Winner

2014, Ron Ridenhour Book Award, Winner

“The journalist and doctor Sheri Fink published a meticulous investigation of these deaths in the New York Times Magazine and on the Web site of ProPublica, in 2009. Her work won a Pulitzer Prize. And now comes the book. In Five Days at Memorial, the contours of the story remain the same, yet Fink imbues them with far more narrative richness, making the doctors seem both more sympathetic and more culpable. Fink also expands on the ethical conundrums, which have festered over time and seem to gain fresh urgency.” (The New Yorker)

"“That so many people, starkly divided over the question of whether crimes had been committed, come off as decent and appealing makes this book an absorbing read. Dr. Fink brings a shimmering intelligence to its many narrative cul-de-sacs, which consider medical, legal and ethical issues. . . . By reporting the depth of those gruesome hours in Memorial before the helicopters came, and giving weight to medical ethics as grounded in the law, Sheri Fink has written an unforgettable story. Five Days at Memorial is social reporting of the first rank.” (Jason Berry, The New York Times)

Good but way too long

Great information. Good narrator. But way too long. Way too much information repeated. Could have been half as long.

is this America??

This book is a must read. It will open your eyes about how far people will go when under disaster. The book follows doctors during and after hurricane Katrina who were later charged with the euthanasia of 19 patients. The book is informative and kept my interest. What would force doctors trained to save lives get to the point on actually "putting down" helpless patients. It opens questions such as "Do doctors, under devastating circumstances, have the right to decide who lives and dies claiming to do so for the greater good?" I also found how America sadly tosses aside the elderly - viewing them as disposable. Abuse of the elderly is a hugh problem and as a result they are highly discriminated against. This book brings to light many questions as to the treatment of patients and the power of doctors under their care. To be honest, I saw this dilemma from many different sides, the doctor's, hospital's, goverment's, relatives of dead loved ones, and of course the patients who now have no say.

Harrowing events, haunting in its implications

Would you recommend this audiobook to a friend? If so, why?

All the more shocking because it could happen anywhere, 5 Days offers a moment by moment, person by person account of the disintegration of order in a New Orleans hospital in the aftermath of Hurricane Katrina over a five day period. What initially begins as a heroic undertaking by staff devolves into chaos, fear, and ultimately, life and death decisions, some of which involve involuntary euthanasia. Works both as a gripping page turner and a case study in disaster ethics, the reader constantly finds himself asking "What would I have done?" Sadly, there are no easy answers, only varying degrees of lesser evils.

What was one of the most memorable moments of Five Days at Memorial?

In a metropolitan city, in one of the richest countries in the world, how quickly the rules of society can break down, panic take over, and trust is forsaken - essentially creating an every man for himself scenario, not just during the crisis, but in the political calculations which followed. Shocking and sad indictment of moral relativism gone awry.

What’s the most interesting tidbit you’ve picked up from this book?

The relative of one of the patients who was euthanized saying that the Marines leave no man behind so why couldn't staff have done the same for its patients?

Any additional comments?

If you don't believe it could happen to you or in your city, Fink disabuses this toward the end of the book in her follow up. Wow!

Haunting

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.

more interesting than I expected

I kept putting this listen off because I really wasn't that interested in more about Katrina. But I was quickly drawn in to the well told and interesting account of this event during the storm. Fink has put together a well rounded picture of the people involved, how decisions came about, and the broader implications for our disaster recovery institutions and infrastructure.

A Must Read for anyone in the medical field.

What did you love best about Five Days at Memorial?

It captured the raw happenings during and immediately after Katrina.

What was one of the most memorable moments of Five Days at Memorial?

This book painted a picture of how dependent we are on each other.

What about Kirsten Potter’s performance did you like?

Excellent reader. I felt like I was there at Memorial.

Was there a moment in the book that particularly moved you?

As retired registered nurse, this book touched my soul.

Important History for the Future

The book is Important History, for the Future.
So many layers and issues, to think about later.
We are more humane to our animals, than we are, our people.
You can be the Best, most dedicated Health Care Provider and still get drug though Court.
Have we Learned for the Future or are we repeating the same mistakes?

Pronunciation

This is a good story but the narrator should have made an effort to pronounce the names and neighborhoods correctly. I found it annoying.

Riveting and haunting

If you were to make a film of this book, what would the tag line be?

Riveting and haunting, especially for anyone who has been a hands-on caretaker of someone who was or is severely debilitated, including those who linger on the fringes of death, but yet are in life.

Any additional comments?

Sheri Fink does an outstanding job of portraying both the reality in the trenches of providing care to the sickest and most helpless patients during a disaster, without electricity, control of temperature and environment, adequate staffing, and under emotional duress. Ms. Fink also does a superb job of drawing back for an overview of the bureaucratic challenges of the institutions and government entities responsible for preparing and sustaining such care in disaster situations.

The bone-chilling choices made at Memorial by some doctors, supported by some nurses, were all the more shattering for the entirely good intentions of those who put them into action. The fragile ability to assess and evaluate, and make good decisions, under extreme conditions is only too well demonstrated in Five Days. Whether or not their choices were 'right' for individual patients, they were too often made for the 'wrong' reasons - in my opinion.

Perhaps an “emergency” is what we think it is, not an automatic knee-jerk reaction to events. Although conditions were bad, if we can nonetheless sustain the essentials, perhaps this is merely a severe trial and not a full-blown catastrophe.

The severely debilitated are not always the dying, and do not always need or long for death. Who can make decisions about what “quality of life” is for another person? Conditions that cause one person needless suffering may merely be a temporary, but bearable, trial for another, even though both are in a similar medical condition.

The doctors deliberately and wrongly cut out of the decision process the people who could have said best what the right decisions were – family members and the patients themselves, through memories of those who knew them when they were able to express themselves.

If the doctors who made end-of-life decisions for non-consenting patients did save some from needless suffering, they also cost others a life they would have wanted. As I listened, that was very clear just from my own experience.

The “Do Not” of a DNR applies to resuscitation only – not to disaster evacuation !!! A DNR does NOT measure a patient’s CURRENT quality of life. It means only that the patient understands that resuscitation is unlikely to provide quality of life AFTER the event (as well as being physically damaging, often to little purpose). By using DNR’s to cull and deny certain patients, health professionals merely pointlessly discard people with life quality, and discourage other people from pro-actively signing a DNR when they otherwise would and should. It is UNCONSCIONABLE to use a DNR (Do Not Resuscitate) order AGAINST evacuating a patient!!!

If a family member wants to stay with a patient during an evacuation – LET THEM STAY. At the destination, the family member becomes a health care aide and a scrounger of resources. They will often lighten the burden on rescue and health care professionals.

There is a huge gap between the technical medical end of care, and the emotional, comfort-focused end of care. As excellent as this book is, I thought it could have better explained that divide, and why doctors aren’t always necessary for basic care that focuses on keeping patients clean, comfortable and peaceful, regardless of their vital signs.

The one thing I would add to this book is a more detailed description of the actual physical, hands-on, process of changing the diapers of an adult who does not move on their own, to better illustrate the difficulty of ‘disaster conditions'. Of how cleaning is actually done (of even the deepest human crevices), of what it takes to prevent and treat bed sores, of the creams and ointments going onto skin, of the gloves and the garbage bags filled to overflowing for just one patient ... all of that would even more dramatically illustrate how awful the heat, humidity, poor ventilation, dark and exhaustion really were.

I think it would have clued in the readers even further with just a short explanation about the impact of Big Three in primitive conditions: “Pee, Poop and Puke”. As a caregiver told me, you must get each one of The Big Three on you, wash it off and realize that life goes on and it isn’t such a big deal, before you are truly ready to care for the severely ill and debilitated.

Seeping through this book is the lack of education and understanding about severely debilitated patients vs dying patients, and dying and death generally, that is profound among MANY doctors and nurses, as I have experienced first hand. Doctors and nurses are focused on sustaining and improving life – while laudable, many fail to grasp that there can be profound quality of life in even a short and impaired life.A tick-off list of conditions can't determine that - only patients themselves, and those who know them best, can determine that.

Even those doctors and nurses who put in a couple of years in a hospice program, thinking to fill in their gaps, tend to endure that period rather than embrace it. Too many learn the textbook and leave with relief and little true understanding of the process for the patients and their families. So much more of the process is actually about emotion and the basic comfort care of both the patient and the family, less about the medical end. Clearly that was never a greater struggle for many a health care professional than it was during the Five Days, and other disaster situations.

Full disclosure: Once I started this audiobook I realized that, as the primary caretaker of my own mother, who remained at home while bedbound, motionless and speechless as a result of late-stages Alzheimer’s until the end of her life (as she wished and I and my family wished), for my own emotional health I needed to wait until well after she had passed away.

I am recommending Five Days to at least five other people who I think will be as moved and motivated as I was by this heart-rending book.

a very long but well written account

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?