On the wards in the aftermath of Katrina
This impressive piece in Sunday's New York Times Magazine offers a harrowing look inside one of New Orleans' hospitals as the waters of Hurricane Katrina rose and trapped patients and staff without power, sufficient supplies and any promises of imminent rescue. (The photo above shows patients and staff being evacuated in 2005.)
The story is one of doctors forced to make life or death decisions at Memorial Medical Center as the hours became days. In many cases, the doctors hastened the deaths of critically ill patients they believed would not survive evacuation. They also injected high doses of morphine and another drug into patients who had do-not-resuscitate orders but were not close to death. In an unusual move, the staff had decided to evacuate the healthiest patients first and leave the sickest to last.
Authorities later arrested a doctor and two nurses for second-degree murder, but a grand jury refused to indict.
Many stories were shocking. One stood out, mostly because of what the doctor involved would go on to tell Sheri Fink, the reporter who wrote the NYT piece. It is the case of Jannie Burgess, a 79-year-old woman with advanced uterine cancer and kidney failure.
Before the storm hit, Burgess was already sedated by morphine to keep her comfortable and, because of all the fluids she was getiing, weighed 350 pounds.
It would have been difficult for the exhausted staff to remove her from the building, a trip that would include many flights of stairs and tight spaces to get her to the helicopter pad atop a parking garage. At some point, Fink wrote, "Ewing Cook, one of the hospital’s most senior physicians, told me he decided that in order to lessen the burden on nurses, all but the most critical treatments and care should be discontinued. ...
Being comatose and on painkillers, she wasn’t uncomfortable. But the worst thing Cook could imagine would be for the drugs to wear off and for Burgess to wake up and find herself in her ravaged condition as she was being moved. “Do you mind just increasing the morphine and giving her enough until she goes?” Cook told me he asked Burgess’s nurse.
Cook scribbled “pronounced dead at” in Burgess’s chart, left the time blank and signed the note with a large squiggle. Then he walked back downstairs, believing that he had done the right thing for Burgess. “To me, it was a no-brainer, and to this day I don’t feel bad about what I did,” he told me. “I gave her medicine so I could get rid of her faster, get the nurses off the floor.” He added, “There’s no question I hastened her demise.”
Comments
"New Orleans' hospitals as the waters of Hurricane Katrina rose and trapped patients and staff"
Those water never would have risen except our outfall canal floodwalls fell down without even being overtopped (at less than half their design loads) because of negligent engineering in the design of those floodwalls' foundations by engineers employed with the US Army Corps of Engineers as reported in the official levee failure investigation reports and reported to Congress by Corps leadership in June of 2006 and as decided by US District Judge S. Duval in 2006.
Doctors never would have been put in a position to make these kinds of decisions had federal engineers not made such huge mistakes.
I'm glad I wasn't abandoned and trapped for many days in a dark and unairconditioned hospital with the extreme heat and humidity and very little sleep and limited resources and forced to make big decisions like those that did whatever they did. What would I have done? I don't know. But until you spend a few days in those conditions, I wouldn't be too quick to judge.
Posted by: crescentCityRay | August 31, 2009 3:44 PM