Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital (30 page)

Gangs roming the streets (as per news and contacts down there)

Fatigue, stress, anxiety, supplies—all are issues by now I

can’t stand it

Tim

MAYBE THE WORLD
was
ending. A large, dark shadow moved over the water toward the hospital at around midnight. The approaching craft was noticed by arms-bearing volunteers stationed at the hospital’s perimeter.

“Stay away!” one screamed from the main hospital.

“Stay away!” another shouted from the pedestrian bridge over Clara Street. “Don’t come close to the hospital!”

The commotion brought nurses and security personnel to windows all over Memorial. Beams lighted upon a huge boat filled with dark figures as it angled toward the hospital’s emergency ramp.

“Turn off the fucking lights!” a man shouted from the boat. Blinding beacons glared back at the hospital.

“Identify yourself!” someone at the hospital yelled. “Stay away! Don’t come to the building.”

“Turn off the fucking lights!”

“Identify yourself!”

The boat turned up the ER ramp. Machine gun–bearing figures disembarked and ran inside in a two-by-two formation, about twenty in all. They wore night-vision goggles, helmets, and dark uniforms with bulletproof jackets.

Police. The masses at Memorial met them with emotions ranging from fear to relief to anger. A nurse peeping out a second-story window as they approached ran out of her room, leaped over a doctor sleeping with a gun on his chest, and descended the staircase to see if the troops had come because of her SOS calls to well-connected family members.

The police said that they were responding to a call that thugs from the neighborhood had overrun the hospital and were trying to loot its pharmacy. “That’s what it took to get you here?” the hospital locksmith asked. He knew the looting report wasn’t true, but he was upset that the job of staying up all night to protect everyone had fallen to civilian duck hunters like him rather than trained law enforcement officials. The SWAT team soon returned to the boat and sped away from Memorial.

AROUND THE TIME the police arrived, Dr. Anna Pou excused herself from the second-floor lobby to take a nap. She returned an hour later and shooed away the infectious diseases doctor, who was anxious and having stomach problems. Pou told her to go get some rest.

Pou
found clean scrubs to change into each day, but she was drenched and dirty, and for the third night in a row, she worked on scarcely an hour’s sleep. She had assumed an attitude of blindness, navigating dark corridors with the run of fingers along humid walls and ascending invisible staircases by kicking the steps ahead as she went and counting.
With several doctors and crews of nurses, she changed patients’ diapers and dipped rags into water to make cool compresses. She said prayers with anxious nurses whose faith in their skills was shaken.

Pou still had not reached one of her sisters, a dialysis nurse who had stayed at her home in Lakeview, a picturesque neighborhood bordering Lake Pontchartrain. Pou had spoken with her soon after the storm, but the phone had cut off and she had not reached her since then. Pou and the nurses had been saying prayers for her well-being.

Pou’s husband was also presumably somewhere out in the flooded city. She took comfort in the fact that he was a big, strong outdoorsman, and she sublimated her concerns about both family members into patient care. To avoid distraction from her work, she tried not to focus on the rumored dangers that surrounded the hospital.

All around her on the second floor, dozens of LifeCare and Memorial patients lay on dirty, sweaty cots. It was so crowded there was barely enough space to walk between them. Most of the nonmedical volunteers who had fanned and offered sips of water to the patients had gone elsewhere, dismissed and
told to take a break by the doctors, who said too many people were present. Workers had included little girls, the “PBJ and cracker brigade,” who made snacks for diabetic patients.

Another doctor passed through the second floor, Memorial’s surgery
chairman John Walsh. The tableau reminded him of the Civil War–era Atlanta railway-station scene from
Gone with the Wind
, when the music swells and the camera draws back to reveal row upon row of patients in misery. “Thank heaven you’re here, I need every pair of hands,” a doctor, his face glistening with sweat, tells Scarlett O’Hara. Her eyes widen as she takes in the moaning soldiers who surround and reach for her. “Now come, child, wake up. We got work to do,” the doctor says. “Look at them, bleeding to death in front of my eyes. No chloroform, no bandages, nothing. Nothing to even ease their pain.”

Memorial’s conditions were an improvement on the Civil War, even if it didn’t feel that way. For one thing, ice had miraculously appeared. Nurses slipped chunks into exam gloves and wore them tucked under their clothes.

The more important development was almost an afterthought: the belated discovery and repair of two small generators by the director of plant operations and his staff after he returned Wednesday evening from ferrying passengers in his fishing boat. One of his electricians, who feared being shot or having to shoot someone on a security shift, busied himself instead setting up a generator in the parking garage. If the generators had been employed earlier, perhaps they could have saved some of the patients who depended on electrical equipment. Now, he ran an extension cord through the stairwell and into the lobby to power a high-speed centrifugal “squirrel cage” blower. Usually used to dry floors, here it cooled patients and staff. The new power source led to the reemergence of box fans and lamps collected from around the hospital. These supplemented the repository of cardboard fans and Coleman camping lanterns.
The generators also lit a handful of ancient incandescent bulbs on the long-unused helipad, the few bulbs with working filaments out of about thirty.

A battery-powered CD player in a small room on the second floor belted out oldies to the accompaniment of a whimpering dog, caterwauling cats, and a dozen or so ICU nurses and others, who joked and sang along between fanning shifts on the second floor. They trooped in
and out to use a bucket toilet. They rested stretched across one another’s limbs and belongings. Dr. Ewing Cook’s daughter owned the CD player and the two cats, her surviving pets. The elder Cook had retreated from his office near a hospital exit, warned about possible encroachment. He dragged a cot outside the noisy room, flopped down on it, and fell into a slumber within moments, oblivious to the commotion.

The main pharmacy was fortuitously located down the hallway from the patient-filled lobby and well stocked because of the post-storm helicopter drop. A retinue of pharmacists took turns sitting on chairs outside the dark pharmacy awaiting orders, then disappearing inside with a headlamp. Even now the pharmacists documented each dose they dispensed and asked doctors to write out paper prescriptions; they were giving out medicines that could be dangerous if used improperly or put into the wrong hands. They had, unlike Scarlett O’Hara’s Civil War doctor, ample medicine to ease pain—including morphine.

Pou had ordered morphine for a fifty-year-old woman with cancer, the patient of a colleague for whom she was covering during the storm. The patient had long received the drug. A pump had pushed it continuously through her intravenous line before the power cut. But the pump relied on electricity.

She was moaning. A nurse brought this to Pou’s attention, and Pou ordered a shot of the painkiller through the patient’s blocked-off intravenous line. Pou was careful, prescribing a dose of morphine that was lower than the patient’s usual dose per hour, since she would be getting it all at once. A pharmacist filled the prescription. A nurse who knew the patient gave the injection, and it seemed to ease her pain.

Pou’s priority was to keep the patients comfortable. As for anything else,
“There’s not a whole lot we can really do for those people,” she and other staff members agreed.

Nurses were told not to give patients IV fluids, or even their usual medicines, because the hospital was in “emergency mode,” and the lighting was so dim it wouldn’t be safe.

Overnight, a patient stopped breathing and died on the floor where Pou was fanning. We live,
Pou would later remember thinking, in the greatest country in the world and yet the sick could basically be abandoned like this. As she, too, awaited rescue, she felt sad, frustrated, and helpless.

While care was limited, it was still desired. Some patients asked and even cried for the medicines they knew they needed but the doctors had decided should not be given. Carrie Mae Hall, the seventy-eight-year-old LifeCare patient with long, braided hair whose vast family called her Ma’Dear, managed to
reach out to a passing nurse and indicate that she needed him to clear out the phlegm from her tracheostomy. The nurse was surprised at how fiercely Hall was battling to stay alive, lying beside the Hibernia Bank ATM among some of the sickest patients—most of whom had been assigned to triage category 3. He suctioned Hall’s airway with a portable machine and told her to fight hard.

On the other side of the lobby, a nurse called her supervisor over to Rodney Scott, the ICU patient whose rescue had been deferred because of his immense size, and whom Ewing Cook had earlier taken for dead.
“Am I going to make it out?” Scott asked. “They said they can’t get my size out.” The nurse supervisor tried to reassure him. “We’re going to get you out, just like everyone else.” She hadn’t realized patients feared being abandoned.

While patient deaths demoralized some health workers, they inspired others to try to systemize care.
Dr. Bryant King sent a group of nurses from one end of the lobby to the other to check the blood pressures of hypertensive patients and blood-sugar levels of diabetic patients. “If we need to give them medications, we will,” he said, and he and the nurses dispensed insulin and other drugs as needed. From the beginning of the disaster, when he had tussled with Ewing Cook over discontinuing a patient’s heart monitor, King had maintained the sense that they could do more. Under King’s direction, nurses lifted photocopied medical charts out of manila envelopes and scoured them for diagnoses and issues that required urgent attention or monitoring, which they wrote on sheets of
paper and taped to the patients. This way the next shift of nurses could more easily discern medical needs.

Working overnight on the second floor of Memorial, as uncomfortable and foul-smelling as it was, was a whole lot better than sleeping in the rain and mud in South Carolina during Army Reserve boot camp in high school; King’s father, a military sergeant, had insisted that Bryant and his three younger siblings—who grew up in East Chicago, Indiana, sometimes on welfare, their parents divorced—learn military discipline. In medical school, King had cared for patients without sophisticated machinery or even an X-ray machine during a two-month rotation in Jamaica. He had learned there to make the best of what was available; to rely on his clinical skills. King had also practiced medicine in the somewhat austere environment of the public Charity Hospital in downtown New Orleans during his internal medicine residency. He had ascended to chief resident the year before Katrina, an honor indicating high achievement. King had strong opinions, and he sometimes chafed against authority and did not take well to criticism or rejection. He had quit halfway through his chief’s year over a disagreement with those in charge about how he should fulfill his administrative duties.

Here, even King recognized Katrina’s shattering of the sterile, digital, odorless, dehumidified, gloved, and gowned illusion of mastery over death and suffering doctors typically maintained. The smashed windows and lack of power left them exposed, like an army field hospital, to the elements. Knitted together for safety overnight, they felt as isolated as if they were under fire. King was as eager as anyone to get out of this motherfucker, and he said that. The task, in his mind, was figuring out the best way to keep caring for the sickest patients.