Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital

Memorial Medical Center, known locally by its old nickname, “Baptist,” is the place to go to ride out a hurricane in New Orleans. The building is tough and "had defended those inside it against every punch the Gulf’s weather systems had thrown” (11). 

When it first opens in 1926, the hospital contains the latest in technology and conveniences. Several weeks later, a record-setting rainstorm inundates the downtown area; the hospital grounds and basement suffer flooding. The city drainage system extrudes a record amount of flood water: “Yet it had failed to keep pace with the storm, and recriminations followed” (18). Plans to improve the drainage system are discussed, but taxpayers don’t approve the additional funding.

In 1927, fourteen inches fall on New Orleans in twenty-four hours. Flooding is much worse than the previous year, and again the hospital’s basement is inundated, this time to eight feet. Two weeks later, spring floods pour down the Mississippi River; to save the city, levees downstream are dynamited, sacrificing outlying parishes. Thereafter, the Army Corps of Engineers becomes involved in flood control. “Drainage capacity had nearly quadrupled by the end of the twentieth century” (23), but the threat of flooding persists around the hospital.

On Saturday, August 27, 2005, Hurricane Katrina roars toward New Orleans. LifeCare hospital in St. Bernard Parish decides to move most of its elderly patients to Memorial hospital’s seventh floor, where LifeCare leases space, to protect them from the oncoming storm. 

LifeCare hospital RN Gina Isbell takes charge, bringing her top staff to help with the move and the stayover: “The patients traveled in clusters, up to four to an ambulance, because ambulances were already in short supply” (25). Nineteen patients are transferred successfully to Memorial hospital, but “[a] twentieth died en route” (27).

On the first day of the crisis, Sunday, August 28, 2005, Hurricane Katrina becomes a Category 5 storm, the most intense possible: “‘MOST OF THE AREA WILL BE UNINHABITABLE FOR WEEKS…PERHAPS LONGER,’ the National Weather Service’s New Orleans office warned” (28). Much property destruction is expected, along with long-term power outages and water shortages. 

At 10:00 a.m., Mayor Ray Nagin “signed a mandatory, immediate evacuation order for the city” (29). Governor Kathleen Blanco announces that flooding “could reach fifteen to twenty feet” (29). Transportation is sketchy for poor residents, who, if they cannot escape, are urged to shelter at the Superdome stadium. Tourists stuck at hotels, sheriff’s staff, and “hospitals and their workers” (30)are exempted. 

Most hospitals, including Memorial, have ground-floor power generators that are liable to flooding during the storm. One federal official writes: “It is assumed that many of the hospital generators will lose power given the expected height of the water” (30). About 2,500 patients need evacuating from New Orleans, but the roads are jammed, and ambulances deliver some patients to the Superdome. 

At Memorial, about 600 staff arrive with “trunks full of hurricane provisions” (35), and some bring pets that they place in ground-floor rooms. Head-and-neck surgeon Dr. Anna Pou helps move equipment from the surgical annex to the sturdier main building’s old operating theaters. Pou, a New Orleans native, has practiced surgery in Pennsylvania and Texas, often on indigent patients and prisoners, and has recently returned to her home city to be an associate professor at LSU and a surgeon at Memorial. 

Dr. Horace Baltz is 71 and one of the most senior physicians at Memorial hospital. Dr. Pou first meets him with one of his patients: “[S]he took over like a commander and failed to discuss important aspects of his patient’s care with him” (48). Overall, he finds her “competent, but lacking in finesse” (48). 

“As the storm approached, there were about 183 patients at Memorial” (52), along with hundreds of family and friends of staffers. The National Guard reports that 25,000 people are “packed into the Superdome” (53).

Early on Day 2, Monday, August 29, fierce winds and rain rage against the hospital. Some windows shatter. Memorial manager Susan Mulderick, a nurse and incident commander for the Katrina crisis, directs maintenance workers to block off areas of shattered glass and board up windows in crowded areas. Mulderick also orders staff camped in the surgery wing across the street to relocate to the main building before the connecting pedestrian bridge collapses. 

Just before 5 a.m., city power fails, and hospital generators kick in to serve critical equipment. When air conditioning shuts off,“[n]urses trained box fans on their patients. There weren’t enough for everyone” (57). 

Katrina makes landfall just east of the city after 6:00 a.m. as a Category 3 hurricane. “The basement began taking water” (57), and Mulderick helps staff move food and supplies upstairs from the basement. Pets are moved from the ground floor to the eighth floor. Dr. Richard Deichmann organizes the physicians, locating them so that each of the fifteen patient units will have doctors in charge. 

In the afternoon the storm subsides, and “[b]y evening, the flooding was gone, and it was possible to walk dogs outside” (59). Although suffering some damage, the hospital “seemed to have weathered one more storm” (59).

Early on the third day, Tuesday, August 30, an elderly woman is stabbed in the chest by her daughter and is brought to Memorial hospital by the woman’s grandson: “The knife-and-gun club hadn’t taken a break, even within hours of a major hurricane” (61). A medical team treats her, attaches her to a ventilator and sends her upstairs to ICU. 

Hospital staff learn that a canal may have been breached, which “meant water could be headed toward the hospital” (63). A memo circulates, telling staffers that “assault mode” is over: “Incident Command has declared Survival Mode for Memorial Medical Center” (64). Staffers must remain at the hospital; family members are urged to stay as well. Medically stable patients are discharged. Medicines dwindle, and“[t]he head pharmacist was still scrambling to arrange for a drop-off from his supplier” (64). Equipment, supplies, and people are inventoried. 

The city’s kidney dialysis centers are closed, and dialysis patients begin to show up at the hospital. Incoming city water is too contaminated for the dialysis procedure, so staffers boil and filter it and hope for the best. Meanwhile, looters attack a nearby store; the hospital is under lockdown. 

Floodwaters from the broken canal may soon rise to 15 feet around the hospital. Eric Yancovich, director of plant operations, has taken steps in previous months to upgrade flood prevention, but he knows it’s not enough. Now he’s sure the backup generators will fail and that the hospital should be evacuated. 

The hospital’s emergency plan “did not anticipate a potential loss of power or communications” (70). The hospital’s preparedness efforts have been stymied: “[T]hey were under pressure from above to save money” (73). 

Evacuation plans are drawn up: “Nearly two hundred Memorial patients needed to be brought to safety” (74). Highest on the list are “around two dozen patients in the ICUs, a similar number in the newborn nursery, high-risk pregnant mothers, and around a half dozen dialysis patients” (74). 

Community relations manager Sandra Cordray sends a written message to Michael Arvin at Tenet Healthcare, Memorial’s owners, requesting help. Tenet is unprepared for the emergency. Three of its six hospitals in the disaster area need evacuating, and Tenet can only offer limited assistance. Cordray replies, “Are you telling us we are on our own and you cannot help?” (78). She contacts other Tenet hospitals. Several reply with offers of help, but the main Tenet office “reined them in, saying that the National Guard was coordinating all relief efforts” (79). 

Memorial staff begin to organize patients for evacuation to “an ICU, a general hospital ward, a rehabilitation facility, or a nursing home. Patients ready to be discharged could be given a week’s worth of medications and sent on to an evacuation center” (79). The hospital halts “all but the most essential treatments and care” (80). 

A fuel truck arrives but can’t make it along the flooded street to the generator tanks. The basement begins to flood, and supplies returned there earlier must be moved again. “Two carpenters raced to buttress the loading dock against flooding” (81), but water overwhelms their efforts. 

The old helipad on the roof hasn’t been used in years. Its elevator isn’t hooked into the backup generators and can’t lift patients to the pad. A military helicopter lands and takes one critically ill baby, but the loading process takes too long, and the helicopter won't return: “A hospital in Baton Rouge agreed to take all of Memorial’s babies; sixteen were critically ill” (84). The Coast Guard plans to transport them via helicopter. 

A National Guard high-water truck arrives and rescues a dozen patients. Critically ill babies are prepped for travel and taken up to the helipad. A few private helicopters arrive to take away some of the patients; one drops off needed supplies. None will accept the critical babies, however. 

Doctors decide to reverse the usual protocol: “[A]ll patients with Do Not Resuscitate orders would be prioritized last for evacuation” (90). Dr. Deichmann “believed they should go last because they would have had the ‘least to lose’ compared with other patients if calamity struck” (91). Four are in the ICU, including Jannie Burgess and 77-year-old Helen Breckenridge, who is receiving end-of-life care. Breckenridge is returned to the ICU, “but she soon died, a death perhaps imminent but nonetheless seemingly the first in the hospital to be hastened by Katrina” (91). 

Helicopters arrive to fly the critical babies to the hospital in Baton Rouge. Two incubators are too large to fit in the aircraft, so neonatologist Dr. Juan Gershanik and a nurse each take a baby in their arms and fly with them. In the end, all the babies make it alive to Baton Rouge. 

Through a miscommunication, the LifeCare patients on the seventh floor do not get priority for evacuation, and staff there must struggle to find rescue transport. Memorial workers agree to help, but then the order comes down to prioritize healthier patients and make the sickest wait till last:“Only seven of LifeCare’s surviving fifty-two patients made the list” (102). 

Hospital mechanical systems are starting to fail. People wade up to the hospital seeking shelter. Arvin at Tenet struggles to help, but rescue efforts remain chaotic. In the evening, fog sets in, making landings difficult. By day’s end, 57 of Memorial's 187 patients have been evacuated. On the seventh floor, none of the LifeCare patients have been rescued.