Summary

Five Days at Memorial by investigative journalist Sheri Fink details the harrowing events that unfolded at Memorial Medical Center in New Orleans during the aftermath of Hurricane Katrina. This 2013 work of nonfiction expands on Fink’s Pulitzer Prize-winning 2009 article. For the book, Fink conducted exhaustive research, including 500 interviews, to capture the ethical dilemmas and life-or-death decisions faced by healthcare professionals with severely limited resources in the wake of an unprecedented disaster. Widely praised for both its meticulous examination of disaster preparedness and its gripping account of healthcare providers under extreme duress, the book won the National Book Critics Circle Award for Nonfiction in 2014. In 2022, Five Days at Memorial was adapted into a limited series for Apple TV+. 

Plot

Five Days at Memorial chronicles the harrowing events that unfolded at Memorial Medical Center in New Orleans during Hurricane Katrina in August 2005. As floodwaters rose and the hospital lost power, thousands of people found themselves trapped inside without electricity, air conditioning, or working medical equipment. The book details how, over five grueling days, exhausted staff struggled to care for patients and evacuate the facility under increasingly dire conditions.

As the situation deteriorated, medical personnel were forced to make difficult triage decisions about which patients to prioritize for rescue. The hospital adopted an unconventional system that placed ambulatory patients first in line for evacuation, while critically ill patients and those with “do not resuscitate” orders were designated last. By the third day, patient evacuations finally began but progressed slowly as resources were limited.

On the fifth day, faced with dozens of patients they believed would not survive, some staff members allegedly made the wrenching choice to hasten deaths through lethal injections of morphine and other drugs. In total, 45 patients died before the hospital was fully evacuated. The bodies of 23 patients were later found to have elevated levels of morphine and other medications in their systems.

In the aftermath, authorities launched an investigation into the deaths at Memorial. This led to second-degree murder charges being brought against Dr. Anna Pou and two intensive care nurses, though these charges were eventually dropped. The book explores the complex legal and ethical questions surrounding end-of-life decisions made under extreme circumstances, as well as issues of disaster preparedness and health care rationing during crises.

Themes

• Ethical dilemmas in disaster response

• Failure of disaster preparedness

• Power dynamics in crisis situations

• Moral ambiguity in medical decision-making

• Impact of systemic inequalities on disaster outcomes

• Legal and ethical implications of euthanasia

• Resilience and heroism in the face of catastrophe

Setting

Five Days at Memorial takes place in late August and early September 2005, during the immediate aftermath of Hurricane Katrina. The story unfolds against the backdrop of one of the worst natural disasters in US history, as the powerful storm devastated the Gulf Coast and overwhelmed the area's flood protection systems.

The primary setting is Memorial Medical Center in New Orleans, Louisiana. As floodwaters rose around it, the hospital became an island of desperation. Without power, running water, or sufficient supplies, the facility transformed from a place of healing into a sweltering, chaotic environment where life-and-death decisions were made under extreme duress.

Beyond the hospital walls, the book provides glimpses of a city in crisis. New Orleans, a vibrant cultural hub known for its music and cuisine, had become a flooded disaster zone. The broader setting encompasses the political and social landscape of post-Katrina America, as the tragedy exposed deep-rooted issues of inequality, disaster preparedness, and healthcare ethics on a national scale.

Key Figures

• Dr. Anna Pou: A head and neck surgeon at Memorial Medical Center. One of the key physicians present during the crisis, she was later accused of euthanizing patients. Pou faced criminal charges but was ultimately not indicted. Her case sparked debate about medical ethics in disaster situations.

• Susan Mulderick: The nursing director who became the incident commander at Memorial during the crisis. She played a crucial role in decision-making and coordination efforts as conditions deteriorated. Mulderick had to navigate complex ethical dilemmas with limited resources.

• Dr. Ewing Cook: A senior physician at Memorial who was involved in triage decisions. He openly admitted to hastening the deaths of some patients, believing it was the most humane option given the circumstances.

• Karen Wynn: The head of the intensive care unit at Memorial. She struggled with difficult choices regarding patient care and evacuation priorities during the crisis.

• Cheri Landry: An intensive care nurse who, along with Dr. Pou, was arrested and accused of euthanizing patients. The charges against her were later dropped.

• Lori Budo: Another intensive care nurse arrested alongside Dr. Pou and Cheri Landry. The charges against Budo were eventually dropped.

• Arthur “Butch” Schafer: A Memorial staff member who assisted with evacuations and witnessed some of the controversial events that unfolded.

• Dr. John Thiele: A pulmonologist who worked alongside Dr. Pou during the crisis. He was involved in some of the end-of-life decisions made for critically ill patients.

Quick facts

• Five Days at Memorial expands on an article Sheri Fink wrote for The New York Times Magazine in 2009, which earned her a Pulitzer Prize.

• For the book, Fink conducted more than 500 interviews.

• Fink devoted six years to researching and writing Five Days at Memorial, which was published in 2013.

• Fink is a physician as well as a journalist, which gave her unique insight into the medical aspects of the story.

• As indicated in its title, Five Days at Memorial examines events that took place over just five days at Memorial Medical Center after Hurricane Katrina.

• 45 patients died at Memorial before the hospital was fully evacuated.

• The book discusses allegations that some patients were euthanized by medical staff during the crisis.

• In 2022, Five Days at Memorial was adapted into a limited series for Apple TV+, developed, written, and directed by John Ridley and Carlton Cuse. 

• The book was initially considered for the third season of FX's American Crime Story before being made into its own series.

• Five Days at Memorial won the National Book Critics Circle Award for Nonfiction and the PEN/John Kenneth Galbraith Award.

About the Author

Sheri Fink is a renowned American journalist and author. Holding an MD as well as a PhD from Stanford, she brings her expertise as a trained physician to her groundbreaking work in health and medical reporting, shedding light on critical issues in healthcare, particularly during crises and disasters.

Fink is widely known for her 2013 book, Five Days at Memorial, which explores the harrowing decisions made by medical professionals in a New Orleans hospital in the aftermath of Hurricane Katrina. This book, which expanded on her Pulitzer Prize-winning 2009 article for The New York Times Magazine, won the National Book Critics Circle Award for Nonfiction and the PEN/John Kenneth Galbraith Award.

As a correspondent for The New York Times, Fink has emerged as a leading voice in health and science journalism. Her coverage of the West Africa Ebola crisis, alongside her colleagues, earned the 2015 Pulitzer Prize for international reporting. Fink also has extensive experience as a relief worker in disaster and conflict zones.