Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital (70 page)

It was a warm day, with thunderclouds chasing sunshine. Cicadas droned and red-faced ducks paddled in a pond behind the pillars of City Park’s peristyle, where hundreds of people gathered, spilling outside and opening umbrellas against the intermittent rain. The downpours stayed just light enough to avoid forcing a cancellation of the sort that scuttled the 1926 May Day fête in the very same spot, where moss-draped live oaks had stood rooted for hundreds of years.

Several supporters of Buddy Caldwell, one of Attorney General Foti’s opponents in the upcoming election, stood to the side wearing campaign stickers. Other attendees held cardboard signs:
THEY STAYED
. And:
FOTI IS ANOTHER NIFONG
.

ICU nurse Cathy Green walked up to the podium in blue scrubs and looked down at her prepared remarks. “Many of you worked at Baptist during the storm with Dr. Pou. I know you thought our rescue work was done. The storm was almost two years ago. But we are not done. We are called to another mission. We must seek justice and exoneration for the one person who is carrying a burden for our whole hospital, Dr. Anna Pou.”

Speakers included a nurse, a clergyman, one of Pou’s brothers, and Dr. Dan Nuss. Some of them aimed their comments directly at the grand jury members, who had not been sequestered and could freely watch news
coverage. The speakers warned that medical professionals, whose ranks had already been depleted by Katrina, would flee Louisiana in droves if a doctor was indicted after serving in a disaster. They read aloud a joint statement from the American Medical Association and American Nursing Association urging “that strong consideration be given to the harmful repercussions of continuing the prosecution of this case.”

DR. JOHN THIELE stood in the crowd, well aware of those repercussions. He had endured an even more punishing year than Pou, although few people had learned about his role in the Memorial deaths, namely that he had injected patients beside her.

After the arrests of the three women, Thiele’s attorney had told him, “If someone rings the doorbell, be ready.” Sitting across from Thiele in a small office, the lawyer had outlined four possible charges: first-degree murder, second-degree murder, manslaughter, and negligent homicide. All were felonies. A conviction on any one of them would mean the loss of his medical license. “Prepare what you’re going to do,” the lawyer advised.

“I’ll fight it,” Thiele said at first, but if the jury found him guilty, he would go to jail, losing his freedom and his family. He knew he could not live in jail. He was too family oriented and had too many friends and relatives. The lawyer asked what he thought about a plea bargain that might get the charges reduced to negligent homicide. That would still mean losing his medical license. If that happens, Thiele wondered, how can I do what I was born to do? His vocation was to care for people, help people, make a difference in their lives.

All year whenever his doorbell rang, he seized up with the thought, I’m going to jail. In his gut he felt he should fight the charges, but if his attorney could plead him down to a lesser charge with no prison time, he
would grab that. He could live without his medical license, he decided, but not without his freedom. He would find something to substitute for doctoring.

He’d been able at times to laugh about the storm, once gathering with a few other Memorial kin for a night of drinking and reminiscing. Sitting out on a colleague’s dock on a canal just off of Lake Pontchartrain, Thiele read aloud a top-ten list of memories he had drawn up in the style of David Letterman’s late-night television comedy show. Number six: eating peanut-butter-and-jelly sandwiches by candlelight, serenaded by a nurse on violin. Another was coaxing a friend’s dog to pee in the parking garage by peeing there himself, and lying on the carpet of a medical office, petting the dog, looking into her eyes, “both of us thinking, ‘I don’t need this shit.’ ”

Thiele recalled taking turns with friends sitting in his car to cool off, listen to classical music, and recharge their cell phones from the car battery with the motor running, while they wondered if they were in a good spot not to get shot by snipers … then discovering at the gas station after the storm that from the Saturday before the hurricane to the Thursday after it, the car had averaged 0.7 miles per gallon.

Number one on his top-ten list was an expression of gratitude. “Thanking God over and over again for surrounding me with such great and special people facing this hellacious ordeal.”

Thiele’s life had remained stressful. As his lawyer fought to keep his statements to Tenet from being released to the attorney general’s office, his legal bills mounted, far exceeding the total in the medical staff slush fund, normally used for banquets, that had been set aside to help several doctors after Thiele’s appeal for support at the medical staff meeting the previous December. Tenet higher-ups balked at paying to defend him, arguing that he wasn’t an employee and hadn’t been required to stay for the storm. How absurd, when he had been called upon to care for Memorial patients whose doctors were unreachable after the storm hit.
He worried he would have to mortgage his home, and it was not clear whether threatening to tell his story might convince the company to pay.

Thiele had recovered from the stroke he experienced days after leaving Memorial, but over the course of the year, he lost a great deal of weight. He chalked it up to the stress of the investigation. He skipped a colonoscopy, recommended for men his age.

In February, the month the grand jury was selected, he’d experienced a few days of pain in the lower left side of his abdomen. He thought it might be a hernia or diverticulitis, a painful infection in an outpouching of the intestinal lining. He was admitted to a hospital.

“Suppose you had cancer?” his wife, Patricia, asked.

“Whatever it is, we’ll handle it,” he told her before being wheeled to the operating theater.

His surgeon, Dr. John Walsh, whom he knew from Memorial, discovered a tumor that had blocked off and killed a large portion of bowel and seeded his liver and spleen. It was advanced, metastatic colon cancer. Walsh marveled at how tuned out of himself Thiele had to have been not to notice how sick he was. He attributed it to the stress Thiele had been enduring as a subject of the attorney general’s investigation, his worries over becoming the next Anna Pou.

Thiele did not awaken that day. He developed a life-threatening infection in his abdomen that spread to his blood. He was taken five times to the operating room, given blood transfusions, and kept sedated and mostly unconscious for weeks with a milky, hypnotic drug called propofol.

There were awful incongruities. Thiele, a lung specialist, developed severe breathing problems and lay in the ICU on a ventilator attached to his neck through a tracheostomy.

Since well before the storm, after his mother died peacefully of lung cancer at his home on hospice, he’d had a passion for caring for patients at the end of life and counseling their families about “when to say when,”
when cure was not possible and another test or procedure made no sense. Now his own wife was being warned of his grave condition and asked about their end-of-life preferences.

By all accounts, Thiele had very little chance of surviving or, if he did, emerging without significant damage to his brain and other major organs. As his health problems mounted in the foreground of advanced cancer, it was time to consider whether to keep treating him aggressively.

His wife had no question about what she wanted for him—the most aggressive treatment possible. The doctors and nurses, many of whom knew him, concurred.

As Thiele passed weeks in a half-conscious limbo, there were certain things that even a drug known for causing amnesia could not erase. He experienced what he later described as nightmarish distortions, visions of monsters and pods. Many times he was underwater, struggling to surface, only to feel someone pushing him down.

Rarely during this period of sedation did he communicate with the people around him. Dr. Horace Baltz’s niece was a nurse who tended to Thiele in the ICU and had also served at Memorial after the storm. Thiele seemed terrified to her. When they spoke briefly during his hospitalization about the events at Memorial and his role in them, she believed he was remorseful, that he’d thought he was doing something compassionate for the patients he injected, but wished he could do things differently.

Thiele later said that was not true. He did not recall ever having felt that way. No, he was confident in what he had done. After a month in death’s shadow, he still saw a difference between himself and the people he had helped inject at Memorial. True, in twenty-five years of practicing in the intensive care unit, he had rarely if ever seen a patient go through what he did and live. He had developed nearly every sign known to predict poor survival in the ICU. Still, and this was crucial, every problem he had was potentially reversible.

If the family members of a patient in a similar condition had come to him for doctorly advice, he would have painted a hell of a bad picture for
them, letting them know, realistically, that recovery was unlikely. But he would have kept going, kept treating a patient like himself because there was nothing that happened to him that couldn’t get better with good fortune and the grace of God. Potential reversibility, that was key; it differentiated his constellation of illnesses from those of some of the patients at Memorial.

“You got special care,” someone suggested. “You’re a doctor.”

“This wasn’t in the hands of man,” Thiele replied. “This was in the hands of God. I shouldn’t be here. The fact that I came out with my kidneys intact, my brain intact, and went back to some degree of normalcy is just miraculous. There’s no other word for it.”

During the disaster, Memorial’s cancer institute, with its working lights and fans and power, and its comfortable chemotherapy recliners, had been a source of refuge. Now chemotherapy from another cancer center was keeping him alive.

As the grand jury process progressed and Thiele recovered, his well-connected attorney asked for permission to use the fact of Thiele’s illness to try to forestall any attempts to involve him. “Hell yes,” Thiele told him, “if it will keep me from being prosecuted.”

Thiele’s dedication to his medical practice was prodigious. He returned to work, making rounds to see patients wearing his chemotherapy pack.

Later he learned that one of the nurses had been asked about him at the grand jury. From what he heard, she’d simply acknowledged that she knew him and said he was a good doctor. She hadn’t spilled the beans.

His attorney had forbidden him to communicate directly with Pou and the nurses out of a fear that they could be accused of conspiring. Thiele felt for Pou and felt terribly guilty that he was not sharing her angst as the jury considered her fate. He was happy to attend the rally
to support her.

DR. HORACE BALTZ resented the thrust of what he began calling the “euthanasia rally.” By warning that an indictment would lead medical professionals to leave New Orleans, Pou’s supporters were threatening to abandon their patients if the issue wasn’t resolved to their satisfaction. It was ridiculous, irrational. It undermined the trust of society in the medical profession. How dare these educated professionals hold a gun to the head of the community and say, “You do what we want!” Never had he seen such a constructed, hysterical response to serious allegations.

Anna Pou did not appear at the rally, but it was infused with her presence. While friends speculated that the events had “really taken a toll” on Pou’s marriage, her husband, Vince Panepinto, came to support her as he had at the Houston fund-raiser. Pou was watching, in a sense, through him as he stood with a video recorder in the crowds. Pou spoke to her faithful in a statement read by her brother Michael that quoted from Isaiah: “ ‘For I am the Lord your God, who takes hold of your right hand and says to you, Do not fear, I will help you’ … and this is exactly what God has done for me.”

Pou was, that day, performing surgery at the public hospital in Baton Rouge, two complicated operations that lasted from the morning of the rally until midday the following day. She returned to the hospital that night when one patient developed a complication.