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

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Overview

One of the New York Times’s Best Ten Books of the Year

Winner of the National Book Critics Circle Award for Nonfiction


Winner of the 2014 J. Anthony Lukas Book Prize, the Los Angeles Times Book Prize, the Ridenhour Book Prize, the 2014 American Medical Writers Association Medical Book Award ...

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

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Overview

One of the New York Times’s Best Ten Books of the Year

Winner of the National Book Critics Circle Award for Nonfiction


Winner of the 2014 J. Anthony Lukas Book Prize, the Los Angeles Times Book Prize, the Ridenhour Book Prize, the 2014 American Medical Writers Association Medical Book Award (Public/Healthcare Consumers), a 2014 Science in Society Journalism Award, and the SIBA 2014 Book Award for Nonfiction


An ALA Notable Book, finalist for the NYPL 2014 Helen Bernstein Award, and shortlisted for the PEN/E.O. Wilson Award and the ALA Andrew Carnegie Medal


An NPR “Great Reads” Book, a Chicago Tribune Best Book, a Seattle Times Best Book, a Time Magazine Best Book, Entertainment Weekly’s #1 Nonfiction Book, a Christian Science Monitor Best Book, and a Kansas City Star Best Book

Pulitzer Prize winner Sheri Fink’s landmark investigation of patient deaths at a New Orleans hospital ravaged by Hurricane Katrina – and her suspenseful portrayal of the quest for truth and justice.

In the tradition of the best investigative journalism, physician and reporter Sheri Fink reconstructs 5 days at Memorial Medical Center and draws the reader into the lives of those who struggled mightily to survive and to maintain life amid chaos.

After Katrina struck and the floodwaters rose, the power failed, and the heat climbed, exhausted caregivers chose to designate certain patients last for rescue. Months later, several health professionals faced criminal allegations that they deliberately injected numerous patients with drugs to hasten their deaths.

Five Days at Memorial, the culmination of six years of reporting, unspools the mystery of what happened in those days, bringing the reader into a hospital fighting for its life and into a conversation about the most terrifying form of health care rationing.

In a voice at once involving and fair, masterful and intimate, Fink exposes the hidden dilemmas of end-of-life care and reveals just how ill-prepared we are in America for the impact of large-scale disasters—and how we can do better. A remarkable book, engrossing from start to finish, Five Days at Memorial radically transforms your understanding of human nature in crisis.
 

Winner of the 2013 National Book Critics Circle Award for Nonfiction
Winner of the 2014 Ridenhour Book Prize
Winner of the 2013 Los Angeles Times Book Prize for Current Interest
One of the New York Times Book Review's 10 Best Books of 2013

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Editorial Reviews

From Barnes & Noble

The winds and floods of 2005's Hurricane Katrina induced thousands of dramatic stories of rescue, survival, or tragedy, but perhaps none more resonant than those at New Orlean's Memorial Medical Center. For author Sheri Fink and other critics, what the venerated hospital had offered those grim days was far different than shelter from the storm. Indeed, the forty-five corpses found after the calm suggested to several observers that Memorial's physicians had sometimes functioned more as angels of death than as life-givers. In Five Days at Memorial, Fink adds depth and breadth to an article that won her a Pulitzer and a National Magazine Award.

The New York Times - Jason Berry
Although she had the material for a gripping disaster story, Dr. Fink has slowed the narrative pulse to investigate situational ethics: what happens when caregivers steeped in medicine's supreme value, preserving life, face traumatic choices as the standards of civilization collapse. This approach is a literary gamble, demanding more of readers than a standard-issue medical thriller would. But Dr. Fink…more than delivers. She writes with a seasoned sense of how doctors and nurses improvise in emergencies, and about the ethical realms in which they work…Sheri Fink has written an unforgettable story. Five Days at Memorial is social reporting of the first rank.
The New York Times Book Review - Sherwin B. Nuland
Though not present during the disastrous days, [Fink] interviewed more than 500 participants, from hospital executives to family members, prosecutors and ethicists, recording their comments and descriptions so meticulously that her gripping narrative captures not only the facts of the situation, but the thoughts of her witnesses and the feverishly unfolding disorder, confusion and tragedy. Her choice of sentence structure, the almost staccato voice, and the starkness of style and language reflect the circumstances so well that the reader cannot help being pulled into the discordant rhythms of those chaotic hours…The tone is…visceral and very appropriate to the atmosphere created by the storm and its consequences. What we have here is masterly reporting and the glow of fine writing.
Publishers Weekly
“They were in a war zone,” Fink (War Hospital: A True Story of Surgery and Survival) writes of those stranded inside New Orleans’ Memorial Medical Center in the calamitous wake of Hurricane Katrina. In this astonishing blend of Pulitzer Prize–winning journalism (Fink, who also has an M.D. and Ph.D., won the award for the investigative reporting on which this book is based) and breathtaking narration, she chronicles the chaotic evacuation of the hospital and the agonizing ethical, physical, and emotional quandaries facing Memorial nurses and doctors, including a nightmarish triage process that led to the controversial decision to inject critically ill patients with fatal doses of morphine in order to refocus attention on those with a chance of surviving. An alarming 45 bodies were recovered from the crippled hospital, nine of which were deemed suspected victims of euthanasia. Yet investigators realized that unraveling the tragedies was “as impossible as collecting fragments of a fractured mirror and then, somehow, inferring what image had once appeared there.” Some members of the medical staff were charged with murder, but a grand jury acquitted them. Plenty of hard-earned lessons were learned from the stunningly mismanaged response to the disaster, yet Fink acknowledges that for the families of those who never made it out of Memorial, the “war against nature” could only be considered a loss. (Sept. 10)
From the Publisher
New York Times Bestseller

“What we have here is masterly reporting and the glow of fine writing.” – Sherwin B. Nuland, New York Times Book Review

“I’ve a tower of books by the bed, on quite a range of subjects. I’m reading Sheri Fink’s Five Days at Memorial, which is a brilliantly researched dissection of what went on at Memorial hospital in New Orleans during Hurricane Katrina. It reads like a Saramago novel.” - Colum McCann, By the Book, New York Times Book Review 

“Dr. Fink more than delivers. She writes with a seasoned sense of how doctors and nurses improvise in emergencies, and about the ethical realms in which they work. The first half of this book, which is well paced, covers the five days of the title. Then the viewfinder shifts to an entwined legal and political story in which state authorities pursue a homicide investigation. That so many people, starkly divided over the question of whether crimes had been committed, come off as decent and appealing makes this book an absorbing read. Dr. Fink brings a shimmering intelligence to its many narrative cul-de-sacs, which consider medical, legal and ethical issues…. By reporting the depth of those gruesome hours in Memorial before the helicopters came, and giving weight to medical ethics as grounded in the law, Sheri Fink has written an unforgettable story. Five Days at Memorial is social reporting of the first rank.”– Jason Berry, New York Times

“A stunning feat of journalism.”– New York Review of Books

“The journalist and doctor Sheri Fink published a meticulous investigation of these deaths in the New York Times Magazine and on the Web site of ProPublica, in 2009. Her work won a Pulitzer Prize. And now comes the book. In Five Days at Memorial, the contours of the story remain the same, yet Fink imbues them with far more narrative richness, making the doctors seem both more sympathetic and more culpable. Fink also expands on the ethical conundrums, which have festered over time and seem to gain fresh urgency.”—TheNewYorker.com

“A triumph of journalism...Fink re-creates this world with mastery and sensitivity, revealing the full humanity of each character. Unlike post-storm commentary that jumped to black and white conclusions, painting the doctors as heroes or villains, Fink’s narrative wades through the muck and finds only real people making tough choices under circumstances the rest of us, if we’re lucky, will never experience.” – Houston Chronicle

“Every page gives evidence of meticulous research, thousands of hours spent interviewing, prowling the halls at Memorial, reviewing legal documents and transcripts...[Fink] offers no easy answers, no rush to judgment. But she does deliver an amazing tale, as inexorable as a Greek tragedy and as gripping as a whodunit.”– Dallas Morning News

“Fink has done a masterful reporting job, and Five Days at Memorial is often engrossing, particularly those pages that take readers inside the hospital...Fink’s book is essential reading for anyone who cares about New Orleans, the breakdown of order in disaster zones, and medical dilemmas under crisis circumstances.” - Boston Globe

“Fink, a Pulitzer Prize-winning journalist who trained as a physician, writes powerfully of the investigation into the Memorial deaths and, in her epilogue, of subsequent disasters: the earthquake in Haiti, Hurricane Sandy in the Northeast, an influenza pandemic in India.” – Radhika Jones, TIME

“Powerful…Fink, a trained physician turned journalist, is able to re-create in minute detail the sights, smells and sounds of Memorial in the days following the storm. It’s safe to say that her medical background gave her a unique perspective, which, coupled with her fine writing, offers the reader an evocative narrative of how the hospital staff and patients struggled to cope with the lack of electricity, climbing temperatures, and a sense that they might not make it out alive.” USAToday.com

“This isn’t just a policy brief ornamented with characters. It is, like all great journalism, a document unto itself, an artifact of what we thought about ‘life and death’ issues in the early twenty-first century… Magnificent.” Bookforum

“An important book… Fink, an M.D. and Pulitzer-winning journalist, certainly knows how to craft a nonfiction page-turner.” – Laura Miller, Salon

"It’s a marvel of journalistic effort that brings an objective and sympathetic eye to the suffering and tough decisions at Memorial Medical Center.” Bloomberg

“[Fink] has shaped her research into an elegant narrative, Five Days at Memorial, with all the page-turning pull of a novel, no easy feat given the complexity of the story… riveting.” – Entertainment Weekly

“Pulitzer Prize-winning journalist Sheri Fink spells out the story of Memorial – and its consequences – in a book that is as excellent as it is alarming.” – Christian Science Monitor

“This year's most important book is also one of its most enthralling.”– East Bay Express

“Fink’s descriptions of the flooded hospital, her extensive interviews with those who were there, profiles of investigators and study of the history and ethics of triage and euthanasia come very close to a full airing of how a disaster can upset society’s usual ethical codes, and how that played out at New Orleans’ Memorial Medical Center....Fink has written a compelling and revealing account.”– Seattle Times

“Five Days At Memorial unfolds in two parts—an impeccably researched reconstruction of the events inside the hospital during the disaster, and a gripping account of the investigation and trial that followed. Pulitzer-Prize-winning Sheri Fink, who is also a physician and a former relief worker in combat zones, lays out every shred of evidence, but leaves the final judgment to the reader. Five Days at Memorial treats the chain of events at the hospital as a microcosm that raises vital and increasingly relevant questions about end-of-life care, and the ethics of euthanasia in extraordinary circumstances.”– Macleans

“Fink's reporting is stellar…[the] book is first-rate: riveting reading, morally probing, scrupulously fair. Anyone interested in Hurricane Katrina, human behavior in times of crisis, or medical ethics should read it.” – Milwaukee Journal Sentinel

Five Days at Memorial should be required reading for any American interested in whether their hospital is ready for its disaster, and especially required reading for those who lead those hospitals — board members, administrators, leading physicians and nurses, etc. Plans need to assume help is not coming in five days, and how to decide which patients will not continue getting care if resources to care for them run out, etc.” – Bangor Daily News

“Meticulously researched… Throughout this horrifying, fascinating book, Fink, a physician, maintains the highest journalistic standards. Her reporting is detailed, nuanced and far-reaching, yet it is never biased—a stunning accomplishment in a story with this kind of moral complexity. [Fink] gives voice to all sides–the doctors, nurses, families, and patients themselves–and leaves the conclusions and judgments, none of which can or ever will be easily reached, to the reader. This is a book not to be missed. It is, quite simply, required reading.” Shelf Awareness starred

“[Fink] offers a stunning re-creation of the storm, its aftermath, and the investigation that followed…She evenhandedly compels readers to consider larger questions, not just of ethics but race, resources, history, and what constitutes the greater good, while humanizing the countless smaller tragedies that make up the whole. And, crucially, she provides context, relating how other hospitals fared in similar situations. Both a breathtaking read and an essential book for understanding how people behave in times of crisis.” – Booklist starred

“In this astonishing blend of Pulitzer Prize–winning journalism Fink, who also has an M.D. and Ph.D., won the award for the investigative reporting on which this book is based and breathtaking narration, she chronicles the chaotic evacuation of the hospital and the agonizing ethical, physical, and emotional quandaries facing Memorial nurses and doctors, including a nightmarish triage process that led to the controversial decision to inject critically ill patients with fatal doses of morphine in order to refocus attention on those with a chance of surviving.”- Publishers Weekly starred

“Pulitzer Prize–winning medical journalist/investigator Fink War Hospital, 2003 submits a sophisticated, detailed recounting of what happened at Memorial Medical Center in New Orleans during and after Hurricane Katrina. Fink draws those few days in the hospital’s life with a fine, lively pen, providing stunningly framed vignettes of activities in the hospital and sharp pocket profiles of many of the characters. She gives measured consideration to such explosive issues as class and race discrimination in medicine, end-of-life care, medical rationing and euthanasia, and she presents the injection of some patients with a cocktail of drugs to reduce their breathing in such a manner that readers will be able to fully fashion their own opinions. The book is an artful blend of drama and philosophy [and] with apparent effortlessness, Fink tells the Memorial story with cogency and atmosphere.” - Kirkus Reviews starred

“Fink’s six years of research and more than 500 interviews yield a rich narrative full of complex characters, wrenching ethical dilemmas, and mounting suspense. General readers and medical professionals alike will finish the book haunted by the question,'What would I have done?'” - Library Journal starred

“[Fink] raises important ethical questions in this fast-paced reconstruction of heart-wrenching events.” Ms. Magazine

“In a high speed world that reduces reality to black and white, Sheri Fink slows down to examine every achingly tough decision made by medical responders to Hurricane Katrina. The riveting result is nuanced and leaves you asking, 'Well, what would I have done?' Wow.” - Laurie Garrett, Pulitzer Prize-winning writer and author of I Heard the Sirens Scream

“Sheri Fink is one of the best medical journalists working in the United States today and Five Days at Memorial stands as evidence of her ability to tell a can't-put-down story, and also her ability to delve into the troubled and sometimes heart-breaking state of medical care in this country today. Read it because it's a compelling look at a hurricane-driven medical catastrophe - and read it because it matters.” -Deborah Blum, author of The Poisoner's Handbook

“Sheri Fink has once again revealed the necessity of honorable journalism: to show us, precisely, why intelligence and information are of critical use. She respects the reader by her labor—gathering the details, earning our engagement as she unfolds the complexity of this story, fact by painstaking fact. Fink invites us into a fuller understanding of five days at Memorial Hospital, the deeper dynamics of which are much in play in America, today. The stakes couldn’t be higher.” –Adrian LeBlanc, author of Random Family

Kirkus Reviews
Pulitzer Prize–winning medical journalist/investigator Fink (War Hospital, 2003) submits a sophisticated, detailed recounting of what happened at Memorial Medical Center in New Orleans during and after Hurricane Katrina. Under calamitous, lethal circumstances, the staff at Memorial did a remarkable job of saving many lives in the wake of Hurricane Katrina--though others would point out they didn't have the street smarts of the staff at Charity Hospital, whose creativeness resulted in far fewer deaths. Fink draws those few days in the hospital's life with a fine, lively pen, providing stunningly framed vignettes of activities in the hospital and sharp pocket profiles of many of the characters. She gives measured consideration to such explosive issues as class and race discrimination in medicine, end-of-life care, medical rationing and euthanasia, and she presents the injection of some patients with a cocktail of drugs to reduce their breathing in such a manner that readers will be able to fully fashion their own opinions. The book is an artful blend of drama and philosophy: When do normal standards no longer apply? what if doing something seems right but doesn't feel right? In the ensuing investigation of one doctor, who is clearly the fall guy (or woman, as it were), Fink circles all the players, successfully giving much-needed perspective to their views. The obvious villains are the usual suspects: nature, for sending Katrina forth; big business, in the guise of Memorial owner Tenet Healthcare, for its failure to act and subsequent guilty posturing; and government, feds to local, for the bungling incompetence that led to dozens of deaths. The street thugs and looters didn't help much, either. With apparent effortlessness, Fink tells the Memorial story with cogency and atmosphere.
Library Journal
★ 09/01/2013
Journalist Fink (War Hospital: A True Story of Surgery and Survival) won the 2010 Pulitzer Prize for Investigative Reporting for her work on the harrowing events at New Orleans's Memorial Hospital during and after Hurricane Katrina, reporting that became the basis for this book. Two thousand patients, staff members, and their family and friends sought safety at Memorial as Katrina approached on Monday, August 28, 2005. Without power, running water, air-conditioning, or standard high-tech medical equipment, conditions quickly deteriorated, particularly for the oldest and most critically ill patients. It wasn't until Friday, September 1, that everyone was finally rescued, and, by that time, there had been 45 patient deaths—18 of them deemed suspicious by the New Orleans coroner. A legal hurricane followed, and one doctor and three nurses were accused of second-degree murder. Fink devotes half of her book to the criminal investigations and ensuing grand jury inquiry, guiding readers through the concepts of triage, euthanasia, and end-of-life care that made the cases so controversial. VERDICT Fink's six years of research and more than 500 interviews yield a rich narrative full of complex characters, wrenching ethical dilemmas, and mounting suspense. General readers and medical professionals alike will finish the book haunted by the question, "What would I have done?" [See Prepub Alert, 6/24/13.]—Kathleen Arsenault, St. Petersburg, FL
The Barnes & Noble Review

In the early-morning hours of August 31, 2005, at Memorial Medical Center in New Orleans, an exhausted nurse, Gina Isbell, stood over an 80-year-old patient, manually pumping oxygen into his lungs. Since Hurricane Katrina had pummeled the city on August 28th, conditions at the hospital had grown increasingly dire, but they had just taken an even more ominous turn with the failure of the last backup generator; the dark and sweltering hospital, which had been without air conditioning and running water and reeked of human and animal waste, was now without the lifesaving equipment that had been sustaining the sickest of the nearly 250 patients sheltered there when the storm hit. A doctor approached Isbell and told her that the hospital had run out of oxygen, saying, "You have to let him go." The nurse reluctantly stopped pumping and stroked the man's hair as he died, eventually wheeling his body into the makeshift morgue in the hospital chapel, where she wept in the arms of the chaplain. She later learned that the doctor had been mistaken; the hospital hadn't run out of oxygen.

This haunting story contains within it the chaos, confusion, valor, and tragedy that characterized the aftermath of Hurricane Katrina. Five Days at Memorial is Sheri Fink's masterful, disturbing account of that period at the hospital, and the fact that Isbell's story merits merely a page offers an indication of how bad things got (when a disaster mortuary team finally entered Memorial two weeks after the storm, they discovered 45 decomposing bodies, more than at any other area hospital). The book, adapted from Fink's Pulitzer Prize–winning 2009 article published jointly by The New York Times Magazine and ProPublica, focuses on an even darker episode: the apparent administration of lethal doses of narcotics to perhaps 20 patients by medical staff as the hospital was in the hectic final stages of its evacuation.

Fink, a physician-turned-journalist, devotes the first half of the book to re-creating the five desperate days, basing her narrative on interviews with hundreds of people who were there or who subsequently investigated the events that took place. There were 1,800 to 2,000 people riding out the hurricane at Memorial — patients, staffers, and their family members — and a couple of hundred pets. Initial relief that the hospital had weathered the storm was replaced by the awful realization that the levees had been breached, that the floodwaters were rising, and that help would be slow in coming. Much has already been written about the government's bungled response; Fink reprints frantic e-mails sent from staffers to Memorial's Dallas-based corporate owner, and Tenet Healthcare's ineptitude is equally appalling. As communication with the outside world became more difficult, rumors started to fly — that New Orleans was under martial law, that armed looters were on their way to Memorial to plunder its drug supply. More than one person characterized the hospital to Fink as a "war zone."

When the evacuations finally began, staffers sent the sickest patients first. Getting them to Memorial's long-unused rooftop helipad was a grueling process that involved carrying them down flights of stairs in hundred-degree heat and darkness, passing them through a hole in the machine room wall, and carrying them up the parking garage ramp to ascend a three-story metal staircase. Doctors and nurses who, Fink notes, "had little if any training in triage systems and were not guided by any particular triage protocol," eventually flipped their strategy, prioritizing not the sickest but the healthiest people for evacuation. This decision seems to have been made in part because of the difficulty of moving the gravely ill and in part because staffers weren't confident that evacuees, many of whom were being dumped on a highway interchange to await rescue, would receive adequate medical care on the other end.

One doctor, despite the wretched surroundings, remained energetic and appeared comfortable taking control. Surgeon Anna Pou assumed the lead in designating which patients would go and which would remain. There was a belief among the doctors, she later said, that they wouldn't be able to save everyone. On the fifth and final day, with police ordering that the hospital be completely emptied, Pou, along with a handful of other doctors and nurses, allegedly moved among the remaining patients, administering lethal doses of morphine and the sedative midazolam. "I'm going to give you something to make you feel better," several witnesses reported her saying.

The second half of the book is a gripping, exhaustive account of the investigation that in 2006 led to the arrests of Pou and two ICU nurses for second-degree murder in the deaths of at least four patients. (Pou herself, citing civil suits, did not discuss the charges with Fink, but two other doctors, who were never arrested, spoke to the author about hastening patients' deaths, with one of them defending his actions as "a no-brainer.") The arrests were met with outrage in New Orleans, whose citizens by and large saw medical staffers as the heroes of the storm and the government as its villain. The attorney general was eager to prosecute Pou (charges against the nurses were dropped in exchange for their testimony), but the district attorney had no appetite for a case drenched in politics that threatened to reopen the city's collective wound. Nor did the city coroner, who believed Pou was guilty of homicide but thought a trial would lead medical professionals to leave New Orleans. The grand jury never heard much of the evidence against Pou, and it ultimately refused to indict her.

Fink is less interested in staking out a strong position on the patient deaths than in using the story to urge us to do better in the future — by patients, certainly, but also by doctors and nurses, who in this case were forced to wing it under traumatic circumstances. Compounding the original tragedy, few lessons in disaster preparedness seem to have been learned. "To the extent that protections and plans have been put in place since Katrina, recent events have often shown them to be inadequate or misguided," Fink writes in a searing epilogue that touches on calamities like 2012's Hurricane Sandy.

These waters are so murky, and Fink so evenhanded, that you're likely to put down the book feeling sympathy for everyone involved. One person in particular, however, is difficult to shake. Unlike most of the other victims, who were unresponsive, critically ill, and unlikely to survive a difficult evacuation, 61-year-old Emmett Everett, a 380-pound paralyzed man among those allegedly injected by Pou, was awake and alert on the morning of the fifth day. He'd eaten tuna fish, crackers, and relish for breakfast and asked after the other three patients he'd been rooming with, who'd already been taken out of Memorial. Pou and her exhausted colleagues couldn't figure out how they'd manage to get him down the stairs, and they worried that he wouldn't fit through the passageway to the helipad. "So are we ready to rock and roll?" Everett had asked about his own evacuation Thursday morning, later telling his nurse, "Cindy, don't let them leave me behind."

Barbara Spindel has covered books for Time Out New York, Newsweek.com, Details, and Spin. She holds a Ph.D. in American Studies.

Reviewer: Barbara Spindel

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Product Details

  • ISBN-13: 9780307718969
  • Publisher: Crown Publishing Group
  • Publication date: 9/10/2013
  • Pages: 576
  • Sales rank: 23,346
  • Product dimensions: 6.72 (w) x 9.48 (h) x 1.71 (d)

Meet the Author

SHERI FINK'S reporting has won the Pulitzer Prize, the National Magazine Award, and the Overseas Press Club Lowell Thomas Award, among other journalism prizes. Most recently, her coverage of Hurricanes Sandy and Isaac received the Mike Berger Award from Columbia University and the Beat Reporting Award from the Association of Healthcare Journalists. Fink, a former relief worker in disaster and conflict zones, received her MD and PhD from Stanford University. Her first book, War Hospital, is about medical professionals under siege during the genocide in Srebrenica, Bosnia-Herzegovina.

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Interviews & Essays

A Conversation with Sheri Fink, Author of Five Days at Memorial

How did your background in medicine and disaster relief inform the writing of Five Days at Memorial?

I'd been in situations where exhaustion and fear make it difficult to think, and when the number of patients overwhelmed a small triage station where I worked on the border of a war zone. When a previously respected doctor was arrested for allegedly having murdered her patients in the aftermath of Hurricane Katrina, I knew that this was more than an amazing, sensational story, but also an exceptionally important one. It was urgent to know the truth of what happened at Memorial Medical Center, because any of us could be caught up in a disaster and need medical care. Learning from what went wrong could help save lives in the future.

You give a very balanced view of the events at Memorial and their aftermath. Was it hard to stay objective in the face of the evidence you had?

It wasn't too hard because I don't have a personal stake in the contentious issues at the core of Five Days at Memorial. Unlike those involved in the events, who naturally have strong points of view based on what they endured, I found myself empathizing with nearly all of the doctors, nurses, patients and family members I met. Every one of us has opinions, but I saw my goal as digging for the truth and presenting it fairly and accurately to readers. That's why the book took over six years and involved interviewing hundreds of people, searching for every piece of documentation. What's important is that readers understand what happened, grapple with the dilemmas on their own terms, and emerge more prepared for an emergency and perhaps even activated to find ways to prevent what happened from happening again.I aimed to give readers that same feeling of discovery of this multi-faceted situation as I did. My role was to discover the truth and tell it.

You bring up very complicated issues of morality and justice in the face of crisis response. Is there a hero in this story?

Saying there are heroes and wrongdoers is a little too simplistic. These are real people. Some of them acted heroically yet also committed acts that many would consider deeply wrong.

You write that Memorial doctors "had established an exception to the protocol ofprioritizing the sickest patients," and that patients "in fairly good health who could sit up or walk" were evacuated before patients with "Do Not Resuscitate" orders. Why did they prioritize the evacuation of the healthier patients and even some staff and family members first?

Very early in the disaster, even before the power failed at Memorial, a small group of doctors decided that patients with Do Not Resuscitate orders (orders not to revive them if their hearts stopped) would be rescued last. One doctor told me he felt that DNR patients, who may have been closer to the end of their lives, would have the "least to lose" compared with other patients.

The hospital had large stocks of drinking water and medicine, but there were roughly 2000 people in it, and many were afraid and uncomfortable. To some extent, those who took charge tried to make the most efficient use of the rescue resources and get the majority of people out as quickly as possible. You can fit more people sitting up in a boat than lying down, and able-bodied people could wade to dry ground once a boat reached shallow water rather than having to be carried. Also, there was some uncertainty as to where patients would be taken on the other side of a boat or helicopter ride.

However, the decision to keep some of the sicker patients for last wasn't changed even when officials implored hospital leaders to allow Coast Guard pilots to rescue some of them the first night—patients who depended on ventilators to breathe. Family members of patients with DNR orders also protested the decision to keep them for last.

Ultimately these are questions of values as much as medicine. We have dissention in this country over how much care, at what cost, is appropriate toward the end of life. Sometimes disasters have a way of making issues that are with us all the time more apparent. We need inclusive conversations about how to distribute vital healthcare resources in an emergency. However, these issues are almost never discussed outside of small groups of disaster planners at hospitals and health departments.

In the book's epilogue, you report on conditions during Hurricane Sandy, when it seemed like hospitals were still—years after the tragic events at Memorial Medical Center—unprepared for what to do in the face of a complete loss of electrical power. Why haven't hospitals addressed these issues? Are there any formal efforts under way industry-wide to do so? What can people do to improve preparedness?

It's scary for healthcare professionals to contemplate the scenario of losing all electrical power. Just about everything in an American hospital these days relies on electricity, down to medical records and drug dispensing machines. However, just like an astronaut practices worst case scenarios in a simulator before zooming into space, we need to exercise and prepare for what can go wrong. Even when there's a backup, the backup can fail. Generators, fuel pumps, and electrical switches often aren't protected from local hazards like flooding. That's because they're generally not required to be. It's expensive to fix these problems, and hospitals and nursing home owners aren't always willing or able to make those investments in the absence of regulations or financial assistance. The U.S. Centers for Medicare and Medicaid Services, which documented "systemic gaps" in the ability of healthcare providers to plan for and respond to emergencies after Katrina, has delayed for years the release of emergency preparedness requirements. However, there is much we as individuals can do. Have a personal preparedness plan (see, e.g., www.ready.gov) and be ready to adjust that plan as needed in an emergency. Look out for family members and neighbors. Advocate for loved ones in the hospital. Ask tough questions of local hospitals and nursing homes. If you happen to be a health professional, go over emergency plans with your patients and establish multiple ways to get in touch with them. Perhaps most importantly, think through what might go wrong in your own home or workplace before you ever have to face it, and contemplate the decisions you'd want to make.

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See All Sort by: Showing 1 – 20 of 60 Customer Reviews
  • Posted September 10, 2013

    This book lives up to the hype it's getting. I received an adva

    This book lives up to the hype it's getting. I received an advance copy of this and found it fascinating reading. I remember hearing about this hospital and the people trapped there in the New Orleans flooding after Katrina, but Sherry Fink's description of the conditions in the hospital really brings home to me how awful it must have been. The author apparently researched the subject intensively and provides details about the hospital and the people who spent 5 days in the hospital during and after Katrina. She draws no conclusions about what happened, just presents the facts and lets the reader decide for him or her self.
    The book lived up to my expectations in that it was well written and almost read like a novel. Even though I knew what had happened at Memorial Hospital after the storm, I found the book compelling reading. She fleshes out the personnel so the reader gets to know the doctors, nurses and patients.
    The only objection I had to the book was the amount of time the author spent on the history of euthansia and the debates about it in the past. It was near the end of the book, and I really just skimmed those few pages. Otherwise it is a great read, and thought provoking as well. I recommend it to anyone who is interested in Katrina, disaster medicine and medical ethics.

    23 out of 25 people found this review helpful.

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  • Anonymous

    Posted September 15, 2013

    Scary, but a must read.

    We have provided certain classes of people with authority to perform acts and direct actions. What happens to these people when you turn the power off and move them out of their usual bubble? Fink has opened a door on this question in a well researched and well presented look at Memorial Hospital during Katrina. There are no heroes here, just people asked to accept an elevated level of personal discomfort and risk to care for others. The success and failures to do makes clear that "question authority" should be frontmost in times of crises.

    18 out of 19 people found this review helpful.

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  • Posted October 6, 2013

    I found this book fascinating as it told about Katrina and the h

    I found this book fascinating as it told about Katrina and the horrible "side effects" of misinformation, confusion and poor management on the part of the hospital's leaders. I have watched documentaries on TV about how so much out-and-out wrong information was given out by the news and then by the elected officials as they repeated the mistakes. I liked especially how the author did not draw conclusions, but just stated the events and let you make up your own mind about things. Obviously, there are lessons to be learned from the way that the different hospitals handled themselves. Charity simply continued their regular daily plan, and did pretty well. Memorial didn't, and ended up with euthanasia accusations. The lesson I learned is that when in an emergency situation, do not trust other people in institutional settings to do the right thing. Stay by your loved ones no matter what they tell you about how you "have" to leave. Question decisions that are made that do not seem right.

    8 out of 9 people found this review helpful.

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  • Posted October 18, 2013

    Haunting Book

    The material presented in this book was so provocative that I read it twice. Imagine being a health care provider stranded in a hospital with a full house of patients with no direction or help from the corporation who owns the hospital. During the five days depicted, the environmental conditions were worsening within the hospital - floodwaters were rushing into the streets and hospital after a 200 ft. section of the levee was breached during Hurricane Katrina - no electricity, no elevators, no air conditioning, temperatures reaching 110 degrees in the building and inadequate & poorly located emergency generators; the power available to the patient units was insufficient to support the ventilator usage. In short, there was no emergency plan in place for evacuation in the event of a disaster. To further complicate matters, the only way to evacuate patients was to hand carry them up & down dark stairways, to a helipad in the hopes of being rescued by air. This is a book that has no happy ending. It will haunt you as you wrestle with the ethics of what happened in the five days of the aftermath of Hurricane Katrina in Memorial Hospital. It begs the question of who is really responsible, who takes charge, when a massive disaster strikes?

    6 out of 6 people found this review helpful.

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  • Anonymous

    Posted October 10, 2013

    As a Red Cross volunteer who helped during Hurricanes Rita, Gust

    As a Red Cross volunteer who helped during Hurricanes Rita, Gustuv, Sandy and other disasters, this book captures the chaos, feelings of desperation, and horrible conditions that exist during disasters and their aftermath. Everyone should read this book ...govt officials, those in the medical field, students, the elderly, law enforcement, public safety...I mean EVERYONE. It brought back memories for me when I worked the Red Cross shelters with no electricity, toilets clogged, no AC etc etc...Excellent journalism and hopefully this will win some awards..forces you to ask yourself what would you do in a similar situation...I will be buying more copies as gifts.

    5 out of 5 people found this review helpful.

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  • Posted December 2, 2013

    Reading it is living it. I could not put it down for the first h

    Reading it is living it.
    I could not put it down for the first half of the book, in fact I had to google some pictures of New Orleans and the hospital to understand the location and how everything was connected geographically.  This book is well researched and carefully crafted.  The reason it slows in the second half is only to do with the mind-boggling facts of the first half.  It surely gives us all pause as to what we would do in the same situation.  After being here in New Jersey after Sandy, this book really hit much closer to home than it would have before.  

    4 out of 4 people found this review helpful.

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  • Anonymous

    Posted November 15, 2013

    Compelling

    This story captured the horror of dealing with the events surrounding Katrina along with the legal and moral issues involving a medical situational crisis. The end of life issues are broader than this country seems willing to face. Most depressing is that no action has been taken to learn and take action to prevent much of what came to light in this investigation. It would cost too much money to plan and train for further disasters.

    Fink is a great journalist and the book moves right along.
    +

    4 out of 5 people found this review helpful.

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  • Posted November 1, 2013

    This is one of the best nonfiction books I have read in a long, long time.

    The details of the five days are so real that you feel you are there living in that moment. It's so full of details that you can't put the book down, and sometimes have to read over a few lines to make sure you didn't miss a single thing. Well written, well documented. It should get more than 5 stars!

    3 out of 3 people found this review helpful.

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  • Posted October 7, 2013

    Spell binding

    I've been a nurse in a variety of settings for almost 40 years. During my Master's degree program ( Holistic Spirituality and Health ) I studied medical ethics. I really wish the author had been able to get into the heads of those convicted. You definitely understand the conditions in the hospital during Katrina. I would not be so quick to condemn the actions of the staff without having walked in their shoes. Self preservation must kick in at some point regardless of your position. I also believe in the dignity of assisted suicide.

    3 out of 3 people found this review helpful.

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  • Anonymous

    Posted November 6, 2013

    Fascinating and disturbing.

    While the detail can overwhelm at times, the author is grappling with a complex and fraught subject where too little detail would be worse. As we become increasingly dependent on organizations for our care, this book is a compelling read for the questions it raises. How will care be handled in extreme circumstances? How able will people and organizations be at adapting to extreme circumstances when the system fails? Well written, and thoughtfully presented.

    2 out of 2 people found this review helpful.

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  • Anonymous

    Posted October 30, 2013

    Really well written & does a good job at not just reflecting

    Really well written & does a good job at not just reflecting the situation at Memorial but raising some VERY good questions that most of us have never had to really consider.
    I lived through Katrina, albeit on the "Northshore, with a 72 year old grandfather suffering from Alzheimers. VERY VERY difficult with no running water or electricity. How much more difficult for Doctors watching even older patients struggle with no hope?

    2 out of 2 people found this review helpful.

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  • Anonymous

    Posted October 25, 2013

    should be required reading by all - couldn't put it down

    A very even-handed approach to a disturbing story. I'm not one to praise reporting but this is a highly credible work. Very well done. Brings a great many issues to light. We should all rethink our preparedness and reexamine our personal and corporate priorities. The lack of communication at every level (from federal to state to city and even among the caregivers) was astounding. As a former caregiver I was shocked to realize that what I thought was a common vocabulary for end-of-life issues is in fact anything but common even without the overlay of a catastrophic category 5 hurricane.

    2 out of 2 people found this review helpful.

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  • Anonymous

    Posted October 12, 2013

    Hard to read and and hard to put down.

    As a medical person, I read this book with a knot in my stomach. I could sympathize with both patient and care giver. And given the situation, being merciful ,I feel , was an act of kindness.

    2 out of 2 people found this review helpful.

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  • Anonymous

    Posted May 2, 2014

    The Pulitzer Prize winning non-fiction novel Five Days at Memori

    The Pulitzer Prize winning non-fiction novel Five Days at Memorial is a chronological recap of the events that occurred at Memorial Hospital during the aftermath of hurricane Katrina. The descriptions that Sheri Fink composed captivated me, making me experience an atmosphere as though I personally had been at Memorial Hospital. Her descriptive citation of the story gave me the opportunity to perceive events through the eyes of doctors, patients, investigators, and prosecutors. Although the mood of the events taking place was disheartening, I could not help but to be intrigued by the details of the event. Growing up during events such as 9/11 and Katrina, our generation’s undeveloped and innocent minds were only capable of acknowledging the event, not comprehending the details and stories of the aftermath. Personally, I felt obligated to finally take the initiative and inform myself on the true devastation that was a result of hurricane Katrina. In saying this, I would highly recommend this book for those who grew up only seeing Katrina as a storm. 
    For a quick description of the plot, Memorial Hospital was struck by hurricane Katrina and due to breaks in a nearby levee, 15 foot flood water surrounded the building. The hospital staff soon found out when evacuations were moving quickly enough that the hospital was ill prepared to take care of patients. With multiple situations such as looters, power outages, and supply shortages, questions about euthanasia arose as terminally ill patients who seemed would not be leaving the hospital in time were suffering. The novel goes on to discuss the aftermath and investigation of what truly happened inside of Memorial Hospital. A majority of the story revolves around Dr. Anna Pou, but a mix of stories from numerous sources gives the reader multiple pathways to take their opinion of the story and build a foundation of evidence to support it. Fink’s mass research of this story paid off with the quality and quantity of material that was included in the novel. Depictions of the novel were perfectly described by giving the reader a picture of how truly awful the setting was while not being overly graphic with details that could be applied to the situation. Overall, Fink’s coverage of the complete story and the investigation afterwards answers every question that the reader could have. It accomplishes the purpose of informing the reader of a piece of American history that most of us have now long forgotten, and reminds us of the complex situations that Americans overcame in life altering circumstances.

    1 out of 1 people found this review helpful.

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  • Posted February 7, 2014

    more from this reviewer

    Imagine this scenario: You¿re stuck in a hospital without electr

    Imagine this scenario: You’re stuck in a hospital without electricity, food, or proper resources to care for your patients. Some are going to die and there’s nothing you can do about it. Would you help ease their pain by euthanizing them, or hold out hope that help will arrive? And how would you decide which people to give the drugs to and which ones to rescue?




    These are, on the surface, the questions that the doctors at Memorial Hospital in New Orleans asked themselves while they waited out Hurricane Katrina. But what if there was more to the story than that? What if, in actuality, the patients weren’t about to die? These questions are exactly what author Sheri Fink set out to do when she started interviewing the hundreds of witnesses that helped recreate their five days in hell. Their choices would affect them forever, and for some would result in criminal charges.




    When I first started reading this book, I couldn’t decide what side of the ethical line I stood. On the one hand, killing someone without their consent is wrong, but on the other hand, I can’t even imagine being put in a situation that requires even thinking about such a thing, so who am I to judge? But as I started reading the book, or more accurately, as I started taking this journey, I found myself feeling every possible emotion a person can feel when reading a book. I started out sad, then turned sympathetic, followed immediately by horror, and ending with anger. As the facts unravelled, I found myself completely shocked by the utter breakdown in communication and both the hospital and government’s failure to prepare for such an event.




    Five Days At Memorial is an important and difficult read. Hurricane Katrina blew in to New Orleans and the city is still recovering, and so this book is an important part our American history. While it shines a light on our government and corporate failures, it also highlights the resiliency of the human spirit and will to survive. I highly recommend this book, but I do so with the warning that it addresses some very important and controversial issues involving end-of-life care and, in all honesty, will leave you a bit outraged.

    1 out of 1 people found this review helpful.

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  • Anonymous

    Posted December 23, 2013

    Pretty disappointing

    I was intrigued by thestory itself which is what led me to purchase this book.I am a medical person and was curious to see how everything played itself out in this type of circumstance. Besides the constant repetition I still found myself looking for more info as to what led to the decisions made. That never happened. I found the writing itself to be rather poor and lacking a good flow. It felt like someone had written pages and pages of notes, threw them up in the air and however they were picked up was how the pages were placed. Sorry to go on, but I hardly ever write reviews and am just trying to save you some money. Try Wikipedia. You'll get the answers you want much quicker.

    1 out of 3 people found this review helpful.

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  • Posted October 25, 2013

    more from this reviewer

    Five Days at Memorial by Sheri Fink tells the story of Memorial

    Five Days at Memorial by Sheri Fink tells the story of Memorial Hospital in New Orleans during and after Hurricane Katrina hit.  While many doctors and nurses did all they could to save patients as the flood waters filled the hospital and shut off the electricity, a few were accused of something horrific: euthanizing patients.

    Sheri Fink investigates and shares this amazing tale.

    I loved Five Days at Memorial, but it was a tough read.  This book is not for the casual reader or for someone who doesn't read a lot of nonfiction.

    But if you are a fan of reading nonfiction, then this book really should be added to your list.  Five Days at Memorial is a compelling read that causes you to look deep inside yourself, put yourself in the doctor's and nurses shoes, to find out what your thoughts are on the idea of euthanasia.

    What nonfiction read did you find super compelling?

    Thanks for reading, 

    Rebecca @ Love at First Book

    1 out of 1 people found this review helpful.

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  • Posted October 25, 2013

    Too administrative

    As a former resident of New Orleans, I was hoping for more detail about the city and the storm. What I got instead, was, a detailed account of all the administrative blunders at Memorial Hospital. This book has a lot of names and characters to keep up with, and almost all of them are administrators at the hospital. I would rather have read about the patients and their lives instead. if you are a hospital administrator, this is probably a great read. For the rest of us, not so much.

    1 out of 2 people found this review helpful.

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  • Posted February 21, 2014

    Very Interesting

    This is a very thought provoking book, especially for those in Healthcare. Throughout I kept thinking about the 'What if's'. I am a nurse and work in a hospital.

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  • Posted January 18, 2014

    A bit tedious to read

    I was interested in the subject and looked forward to reading about this tragedy during Hurricane Katrina. However, I felt the subject was overly detailed and would have benefited from some editing.

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