Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital (59 page)

The clinical language of the petition only heightened its pathos. “At that time, decedent yelled out that she could not breathe,” it said. Both Merle Lagasse and her daughter pleaded for the mask to be replaced, “but Jane Doe refused such a directive.”

Karen Lagasse had made it out of Memorial by boat only to end up at the overcrowded New Orleans Convention Center where, in fear for her life, she slept outside on the street.

Someone told her there that her mother had died at the hospital, but she refused to believe it. She recruited friends to call emergency rooms from Louisiana to Texas, searching for ten frantic days before she finally received a call from a Tenet official who told her that her mother was on a list of people thought to have died during the evacuation. Months later, she was allowed to return to the hospital garage to sift through debris for her mother’s personal effects, surviving artifacts of the life they had shared in a Lakeview neighborhood now lost to flooding.

She buried her mother on Valentine’s Day, in a metal coffin the funeral home workers sealed with a rubber gasket to confine the odor of decomposition. Lagasse argued with them to remove the body bag before placing her in the coffin. They refused. The indignity of this upset her, as did the thought that her mother had not, at the very least, become the “beautiful corpse” of Ewing Cook’s morbid imagination.

A full year later, Karen Lagasse had still not been told what had happened to her mother after their traumatic separation. The interview the attorney general’s investigators had conducted with her mother’s doctor, Roy Culotta, was not shared with her. She believed her mother to have died from his negligence and that of the hospital that had failed to prepare properly for a disaster. She wondered how long her mother had suffered in the heat and whether she had continued to receive oxygen and pain medicines.

Karen Lagasse sued Culotta; the hospital; its CEO, René Goux; “Jane Doe”; and internal medicine department director Dr. Richard Deichmann, who her lawyer found had written and self-published a book,
Code Blue: A Katrina Physician’s Memoir
, revealing his key role in the evacuations. Deichmann was Karen Lagasse’s own internist and she was at first surprised to learn her attorney had sued him in her name.

The family of stroke patient Essie Cavalier also sued the hospital. Her daughter, who had worked as a medical malpractice attorney, became depressed after obtaining Cavalier’s toxicology results. She wondered aloud how someone could have decided for her mother that she wasn’t going to make it. Where were the checks and balances?

Families of three of the four LifeCare patients mentioned in the arrest affidavit—including Emmett Everett and Rose Savoie—filed civil suits not only against Memorial and LifeCare but also against Pou, Budo, and Landry and, in two cases, Susan Mulderick and Steven Harris, the LifeCare pharmacist. The suits variously alleged euthanasia, inadequate backup power supply, failed evacuation policies, and abandonment.

Emmett Everett’s wife, son, and daughter also named Pou’s employer, Louisiana State University. “
He was awake, alert and oriented throughout the relevant time period,” the suit said.

“Who gave them the right to play God?” Carrie Everett asked on a CNN Katrina anniversary broadcast. “Who gave them the right?”

The Everetts had not learned of Emmett’s death until fifteen days after it occurred. They asked for a trial by jury. Kathryn Nelson’s mother, Elaine, was not one of the four patients whose deaths were attributed to the injections in the arrest affidavit. However, her family knew from interactions with the attorney general’s office, and from having viewed the toxicology reports, that the laboratory had found a large concentration of morphine in her tissues. They were outraged that after living an upstanding life and doing so much to help others, she had apparently died as if her remaining moments had no value. Kathryn’s brother Craig was an experienced white-collar and health-care attorney nearing retirement who had the knowhow, resources, time, and motivation to find out exactly what had happened to his mother—and make someone pay.

Angela McManus, Wilda’s daughter, felt differently. The prospect of
having to talk to a lawyer on a regular basis about her experiences at Memorial was too upsetting, and she left it to a sibling to file a lawsuit. She needed to focus on getting well. She had little energy. Anhedonic, she found it difficult to escape the narcosis of her television screen.

Instead of suing, she had done what felt more important to her, though it nearly destroyed her—she spoke publicly about what had happened to her seventy-year-old mother, became again her mother’s voice. She was outraged at suggestions that the health workers were relieving suffering in the last moments of life—who told them it was the patients’ last moments, patients they had never even treated?

She felt her family and her mother had been violated even though her mother might not have had much time left. Family members had been deprived of the chance to be with her when she died, to see her body and sit vigil over it at a wake—it was so badly decayed, the family had decided to have it cremated. As a result, Wilda McManus could not have the kind of funeral she merited, at the church, St. Raymond’s Catholic on Paris Avenue, around the corner from their house, where she had sung in the choir and everybody knew her. It would have been, Angela knew, a standing-room-only crowd.

After the arrests, Angela believed that having listed her phone number made her the only LifeCare family member the media could readily find in Baton Rouge.

“I gotta tell this,” Angela said to herself, and took calls from radio reporters on the phone. She allowed television reporters to troop in and out and aim their bright lights on her framed family photographs. She posed, gazing off the patio balcony, for them to record their background B roll.

“
I don’t believe that a person with a sane mind could make this decision,” she told an ABC reporter for
Good Morning America
.

“At least now I’ll be able to get some answers,” McManus said to an Associated Press reporter after the arrests. “For months, I haven’t known
what happened to my mom. I need some answers just to be able to function.

“
Euthanasia is something you do to a horse, or to an animal. When you do it to people, it’s called murder.”

Reporters engaged her from morning until night the day after the arrests, working her last nerve. They lined up in the parking lot of the Baton Rouge apartment where she was staying; the two-story New Orleans duplex where she had grown up was destroyed. The wind had blown the roof down into the bedrooms, and floodwaters had come up from below. She had stopped paying insurance on it after she left her job to become her ill mother’s caretaker.

She brooked no challenge, no skepticism or disrespect. She knew exactly what story she wanted to tell, the story she had lived with from the day she had been forced to leave her mother’s bedside, the story the world finally wanted to hear. “I’m going to play the devil’s advocate,” a male reporter said.

“No, you’re not,” McManus told him. She threw him out. “Neither the devil or his advocates are welcome here.”

The families’ suits stalled pending the outcome of a challenge to
a similar lawsuit at another hospital, Pendleton Memorial Methodist in New Orleans East. The suit alleged that the hospital had been negligent in preparing for and responding to the storm, a premises liability claim that one uninvolved insurance attorney described as
“a new theory of liability against health-care institutions—lack of emergency preparedness.” The hospital’s lawyers were arguing that the case should proceed instead as a medical malpractice claim. That would advantage the hospital: Louisiana medical malpractice law required a panel of three doctors to review each case before it could proceed, and it capped compensation at $500,000 per hospital or other health-care provider—most of which was typically covered by a patient compensation fund.

Patients and their families weren’t the only ones seeking legal recourse.
While Louisiana workers’ compensation law protected employers from claims by their employees, some Memorial workers, including a group of neonatal ICU nurses, nevertheless sued, variously attempting to hold parent company Tenet responsible or to exploit the law’s exception for intentional tort. LifeCare staff and their families at the hospital also sued Memorial, as they were not its employees.

The ICU nurse who had previously written a critical letter to Tenet’s CEO, Dawn Marie Gieck, claimed in her suit that Memorial and Tenet had failed “to see to the care and safety of the people stranded at the Hospital” and failed to evacuate properly: “Since Katrina I have experienced emotional distress, which makes it impossible for me to work as an ICU nurse or [in] any other kind of nursing. I have been diagnosed with post-traumatic stress disorder. Although I have attempted to work nursing jobs, I could not stay on.”

However, some Memorial evacuees were grateful, not bitter. The premature neonate whom Dr. Juan Gershanik, earning the nickname “the Argentinian Kangaroo,” had held against his body and ventilated by hand in a rescue helicopter, had thrived over the year at his new home in Houston. Baby Boy S’s mother returned with him to New Orleans to reunite with the doctors and staff who had saved him, on the first anniversary of the storm, initiating a yearly tradition.

THE NBC TELEVISION news magazine
Dateline
carried an anniversary report about Memorial’s sister hospital, Tenet-owned Lindy Boggs Medical Center. The conditions had been similar to those at Memorial—no power, almost no communications, delayed rescue. Water had poured over the hospital’s floodgates with the drama and variegation of a natural waterfall.

With no helipad and no assurance of ambulances a boat ride away on dry ground, hospital staff at first ferried only able-bodied non-patients
from Lindy Boggs. On Wednesday, firefighters arrived and began directing drivers of the small dinghies and pleasure boats to take patients to a berm by a nearby post office to be picked up by helicopters. The roughly 150 patients were divided into categories: A, B, and C. Some doctors and nurses thought the C’s, the most critical patients, should be rescued first. But the doctors and firefighters in charge decided to leave them for last. The concern might have been that there would not be medical care for them at the drop points. For the
Dateline
story, reporter Hoda Kotb asked firefighter Chris Shamburger the reason for the triage protocol. He offered little explanation: “That’s the way things are done.”

Dr. Glenn Johnson, acting chief of staff, described drawing letters on people’s foreheads with a permanent marker. “I’m just having horrible thoughts, like, ‘Is this what happened, like, at Auschwitz or something?’ You know, where people were just marked like cattle.”

Johnson took pity on a paralyzed patient whose husband offered to carry her—Johnson turned her C into an A, “my one act of mercy for the day.” Lindy Boggs staff helped carry patients down multiple flights of stairs in sheets. The firemen were instructed to retreat before sundown due to safety concerns. They left critically ill, hospice, and long-term acute care patients behind and never returned. A handful of medical staff and other rescuers came back on Thursday, September 1, and began taking survivors out on a small, stolen flatboat. Other patients went out on Friday.

The story focused on Dr. Johnson’s agony over the decision making, his outrage at the dearth of outside help, his ingenuity in replenishing medicines, and the intensity of his work in the deadly, sapping heat. When he flew out on Wednesday, August 31, rather than being delivered to safety, he was dropped off with his patients on the I-10 freeway cloverleaf.

Anna Pou thought the
Dateline
program was phenomenal. It gave the public a sense of what it felt like to be trapped as a doctor and face such difficult decisions. Many people, including one of her sisters, called her to say they had not appreciated what she had gone through until watching
it. The report painted a sympathetic picture of the medical professionals. The flooding itself was the enemy.

The story mentioned that the attorney general’s office was looking into events at Lindy Boggs. Virginia Rider had originally helped out on the investigation, which uncovered
an even more troubling story than what
Dateline
had portrayed.

The criminal inquiry centered on what had happened after nearly all of the 175 staff members escaped. At the fire officials’ suggestion, they had put on gowns and drawn the triage symbol “C” on themselves to look like patients so they could be evacuated by military helicopter. Some took pictures of one another grinning, patient gowns tied loosely over their scrubs, bright-red triage letters marking their chests, hands, and foreheads.

A respiratory therapist asked what would happen to the patients being left behind. She was told: “At some point, someone will have to euthanize them.” An anesthesiologist, James Riopelle, was approached about euthanizing patients and said the idea was crazy. This isn’t the
Titanic
, he thought, Lindy Boggs isn’t going down. We’re only a mile from dry ground, with plenty of drinking water. Rescue efforts had been slow, but he knew they would eventually gain traction, despite rumors that officials were turning away civilian volunteers and their boats at the border of the city out of security concerns.