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
Five Days at Memorial: Life and Death in a Storm Ravaged Hospital was everything that makes nonfiction great to read: a subject worth uncovering, documented by a voice with a clear penchant for obsessive detail. Sherri Fink recounts the struggle for survival at New Orleans’ Memorial Hospital, which acted as a port in previous storms, in the days following Hurricane Katrina; she discusses at length the choices made by hospital staff (several doctors and nurses made the choice to euthanize patients they felt couldn’t be evacuated) and the investigation that followed.
I could not stop telling people about this audiobook. First off, I had no idea things got this bad at Memorial Hospital during Hurricane Katrina. The scenes described were more harrowing than any fiction could be: hospital staff stuffing preemie babies in their shirts to evacuate as there was no space for incubators, nurses ventilating patients by hand due to power outage, stifling heat with smashed windows acting as the only ventilation, while gunshots were heard outside, and rumors of martial law were spreading. Hurricane Katrina was a testament to our government’s inability to organize a response to disaster, and Five Days at Memorial illustrates the high human costs of that inability. This was at points a difficult book to get through; the descriptions are so clear I felt sick even imagining such an experience, let alone living through it. I kept asking myself, “Why doesn’t the army come to relieve these exhausted hospital staff members, and help them evacuate these dying patients?” It was so frustrating to know this happened in America and there was nothing I could do about it now.
The questions of justice presented here are some of the most difficult questions that exist about human life, and at points reminded me of the perplexing moral issues presented in Michael Sandel’s epic Justice class at Harvard, free on iTunes U. Is it right to evacuate the most able-bodied people, who need the least help and will be the quickest to get into helicopters? Or is the more moral choice to evacuate the most sickly to safety first, as they are the most in pain and most in need of help? The questions presented at Memorial Hospital in that hellish time after the storm speak to historical ethical dilemmas, and Fink does a great job of explaining the dangers with and benefits of each choice.
Kirsten Potter narrated the audiobook, and did an incredible job. This story could have easily been overdone by a different narrator. Potter managed to stay neutral but interested, the voice of a reporter bearing witness to history rather than a character actor.
Although the second part of the book (covering the aftermath of choices made at the hospital) may not be as gripping as the harrowing account of survival in the storm, I think this is the portion that makes this book so important. We can all guffaw at the tragedy, but examining it with a critical eye is the only thing that will keep it from happening again. Perhaps the most terrifying part of Five Days at Memorial is its end, when Fink embeds with American medical disaster teams after the earthquake in Haiti. Seemingly logical decisions to preserve oxygen for those who need it most almost cost a young woman her life. It seems like in a disaster, the luck lies with those who have the most innovative, creative doctors who are able to see beyond the complicated machines of modern medicine.
Sheri Fink, MD, PhD, published "The Deadly Choices at Memorial" in the New York Times on August 30, 2009. I read it on line, and, when I found an abandoned copy at a Starbucks, I read it again. It was a great article, and I wished for more details - why did the hospitals generators fail? - why didn't the hospital's emergency plan have procedures in place for a catastrophic failure? - why didn't the doctors who administered fatal injections wait for rescue that, in hindsight, was just hours away? That article won a Pulitzer Prize for investigative reporting; and this lengthy book (576 pages on paper) answers those questions, and more.
Fink has the rare gift of understanding how complex systems work and fail, and the ability to explain them in a lively, intriguing narrative that weaves history, culture, engineering, medicine, medical ethics and people and companies together into a compelling story. She doesn't draw conclusions: she gives the conclusions reached by the government; the American Medical Association; the people that survived Memorial and the family members of those who didn't; law enforcement; expert witnesses; criminal attorneys and civil attorneys; and ethicists.
As a reader/listener, I reached my own conclusions about why Memorial failed as a physical building, and how and why Dr. Anna Pou, did what she did - she apparently euthanized patients, and was arrested for second degree murder. A grand jury declined to indict Dr. Pou or the two nurses that helped her, years after Katrina.
Would I have made the same kind of decision in an analogous situation? It's easy to pass moral judgment sitting in my comfortable backyard, well rested, enjoying a Sunday croissant and strong, black coffee. I don't think I would have, especially as to patient Emmett Everett, Sr., but I really don't know.
Fink's epilogue makes a strong recommendation: guidelines need to be in place for medical priorities when medical resources are short, and those decisions need to be made well before natural or man made mass casualty events happen, not in the middle of a catastrophe.
The book was so well narrated, I realized I was up at 1 a.m., after repeatedly setting the Audible sleep timer, listening. I had to switch to a book I'd already heard so I could sleep.
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I really debated whether I should purchase this book. I think I've been on disaster overload. But, I thought the book sounded interesting and the author is a Pulitzer Prize winning journalist. So, I used one of my credits and I'm glad I did. This book made me mad, it made me sad, but most of all it made me think. While it is an account of what happened at Memorial Hospital during hurricane Katrina, it raises moral and ethical questions that are further reaching than that moment in time. Frankly, I had to stop listening several times. I just had to walk away.
The narrator did a great job. The Author did not try to sway your opinion, she just told the story in a straight forward manner. I will be thinking about this one for a while.
Truly unforgettable piece of investigative journalism at its best; the emotions in the reviews attest to the haunting staying power of the horrific events being recounted. Meticulously researched and presented in a way that has you feel the impending storm approaching with each page, compounded by the prescience of tragedy. Fink gives a brief explanation of the geography and history of the land and the levees, and some insight as to the worse case scenario prior to the storm. The land so dependent on the infrastructure of the system -- the citizens also dependent on the systems. What follows is a domino effect-like breakdown of those systems that had provided such a false sense of security, from the personal morals and responsibilities, to the corporate policies, to the government. Fink shows a top-rate journalist's ability to accurately report the events unattached to opinion, having each person responsible for their actions without labeling them good guy/bad guy; and there are times, in certain situations that you flip back and forth with your own judgements, but always keep the weight of decision in your own mind.
The account does get long as it goes over the legal process and how it was perceived by the media, but the details helped -- like a necessary stretch after a long hard workout, stress relief; and it is an interesting look at the machinations of the legal system and corporate power. Still, a fact to consider for some readers. Kristen Potter gives a flawless and pragmatic performance, always concise and neutral, piling onto the reader the responsibility of their own conclusion. I remembered a disaster preparedness drill we went through at our hospital to pass the JCAHO guidelines... The drill-coordinator gave us the ol' *who would you throw out of the boat if the boat was going to sink* dilemma. The supervisors in the boats started rationalizing whom and why, as the drill-coordinator listened straight faced. When everyone had decided on whom to toss overboard to lighten their boat, the coordinator said, "but, you have to get everyone safely to shore." We, the Hospital Administrative Directors, had not counted on that possibility.
I found the book fascinating and heartbreaking. One of the few times I have felt truly like I was walking in the shoes of another, from an obese paralyzed black man, to an old beloved mother, to a frantic nurse with children at home, to a doctor juggling whom to put on the rescue helicopter, to a daughter hundreds of miles away. I certainly have made some moral adjustments. Excellent, informative, very haunting.
Yes, and I have already done so. I had no idea of the suffering those patients, staff, and family members at Memorial Hospital endured for those 5 days after Hurricane Katrina. Like everyone else, I was transfixed by the post apocalyptic scenes seen on television, but until you read this book, which is so well written, you feel like you could almost be there, then there is no way of knowing what it was Like to be in such horrific circumstances and to be faced with decisions no doctors or nurses should have to face.
The events of the final two days, as conditions deteriorated, and the ethical dilemma the doctors and nurses had to face.
The narrator does an efficient job. She kept me interested.
As a registered nurse, and having worked in the ER and ICU, I could understand both sides of the ethical dilemma. One thing I do know is that unless I actually walked in those shoes and was faced with those conditions, I have no right to judge or condem anyone's actions or decisions. I do believe that in the event of an extreme disaster, that the normal standards of medical,practice should not apply.
As an Australian, far removed in distance from the horrors of 'Katrina', but close because of television and news media, I wanted to hear this story. Especially because I'm a Registered Nurse, the fact that the scene reported what happened in a hospital, stirred my interest further.
The propensity to litigate is something that I have been sad to see grow in Australia over the past few decades. It is something I've always regarded as 'American' and I found it difficult to listen to the hours of dialogue that related the seemingly infinite ways individuals, companies and corporations sue, counter sue, wriggle and squirm to avoid basic responsibilities and accept the vagaries of life without the need to feed media and lawyers vast sums of money stretching and distorting facts, omitting details, and generally bludgeoning society with half truths and more.
The detail in this book is magnificently detailed. The balanced view cannot be faulted. The horror for those involved is clear. That wrongs were committed - well - I'm not sure. How can any of us judge how we might behave in such a situation. Not only during 'Katrina' but in the life we would then have to lead afterwards.
My husband died 13 years ago, of an aggressive cancer, that removed his quality of life from the day he was diagnosed until the day he died 9 months later. In his last month of life, he woke up every morning crying, begging me to kill him. He would have taken his own life if he had been able. Despite the fact that his eventual death has left a hole in my life that nothing will ever replace, I would have been willing to make his journey toward his inevitable end more expedient had it been legally possible. We afford our pets such respect.
There can be no legal judgement about such matters. Compassion and kindness in the face of suffering are the only two things that really matter and if there is a god, I believe he would agree.
Corporations should not be permitted to manage health facilities. The incongruities that exist in their basic functioning a re not compatible and will inevitably lead to more situations like 'Memorial' if it is allowed to continue.
Tangential, eclectic, avid listener... favorite book is the one currently in ear.
This well research documentary is much larger than 5 days at Memorial, although the first half of the book takes place there. FYI- The prologue is irritating and can just be skipped. The story unfolds with interesting detail as Hurricane Katrina hits New Orleans and the power fails. You watch Memorial Hospital descend into chaos as systems and people fail to communicate. Then with the rescue in full swing on the 5th day the Do Not Resuscitate (DNR) patients on the 2nd and 7th floor die within a 3 hour period. Family members were forced to leave as they were euthanized. The 2nd half of the book looks at what happened and why, the court cases, what happened at other hospitals in New Orleans at the time and then forwards to recent problems in Haiti and Hurricane Sandy in New York to see if anything was learned. It is an eye opener and I couldn't stop listening.
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.
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.
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.
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?
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!
"Five Days at Memorial" is balanced, thought provoking and unexpectedly shocking. I still wonder "what would I have done" under the same horrific circumstances. Was the outcome just? Was truth and justice really served? Why wasn't the situation different? I'm still haunted.
It's an excellent piece of investigative journalism.
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