Pulitzer Prize winner Sheri Fink’s landmark investigation of patient deaths at a New Orleans hospital ravaged by Hurricane Katrina - and her suspenseful portrayal of the quest for truth and justice
In the tradition of the best writing on medicine, physician and reporter Sheri Fink reconstructs five days at Memorial Medical Center and draws the listener into the lives of those who struggled mightily to survive and to maintain life amidst chaos.
After Katrina struck and the floodwaters rose, the power failed, and the heat climbed, exhausted caregivers chose to designate certain patients last for rescue. Months later, several health professionals faced criminal allegations that they deliberately injected numerous patients with drugs to hasten their deaths.
Five Days at Memorial, the culmination of six years of reporting, unspools the mystery of what happened in those days, bringing the listener into a hospital fighting for its life and into a conversation about the most terrifying form of health care rationing.
In a voice at once involving and fair, masterful and intimate, Fink exposes the hidden dilemmas of end-of-life care and reveals just how ill-prepared we are in America for the impact of large-scale disasters - and how we can do better. A remarkable book, engrossing from start to finish, Five Days at Memorial radically transforms your understanding of human nature in crisis.
©2013 Sheri Fink (P)2013 Random House Audio
Yes, because the content is so important
Very good at medical terminology
The last chapters about the legal implications
This book was assigned reading for senior students in a baccalaureate program in nursing. They were studying "health disparities." This book was very enlightening for them, and stimulated several to consider careers in crisis/emergency nursing.
This should be mandatory reading for anyone who works in a healthcare facility. It is simultaneously terrifying and thought-provoking. Even if you think you know the story, read this book. It will really make you examine how you think you might respond in a similar situation. As an audiobook, it was extremely well read, pleasant to listen to, and engaging. Made my drive go by so quickly. I would highly recommend this to anyone.
Most everyone knows where they were when Katrina hit New Orleans in 2005. We heard of many rescue successes and tragedies. Sheri Fink takes you through the hell that one particular hospital endured - and the after affects of medical decisions.
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.
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.
Very detailed story about what happened at that hospital during Hurricane Katrina. The person writing the book was very analytical.. writing every fact from every different angle that could possibly be gathered. The narrator used only one monotone voice thoughout the whole book so it was a hard listen to finish.
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?
The narrator did an excellent job with the New Orleans lingo and pronunciations. This is not an easy task. We have a lot of names that don't sound like they look. And this can be distracting from the story.
This is a tale that should never be repeated. It needs to be told.
What a horrible horrible time it was.
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