Warning: this book is deeply disturbing. After reading it, I became even more distrustful of doctors and of the medical profession than I was before I read the book. I also lost some confidence in the government and in the justice system (already low). I decided to buy a small generator as soon as possible if I can afford to since we live on the Gulf coast in hurricane country. I thought about end-of-life decisions and hospitals and who to depend on in an emergency. I was reminded of how thankful I am for my sister who came to Texas and spent many weeks caring for my mother last year when she had to go to the hospital and then into a rehab facility. I’m not sure anymore that it is safe to be in a hospital without a family member nearby who will spend time at the hospital with you daily—and at night.
So, Five Days at Memorial is the story of the five days after Hurricane Katrina as they were experienced at Memorial Medical Center (formerly Baptist Hospital) in New Orleans. As you might imagine, or you may have seen or heard news reports, conditions at the hospital went from bad to worse in the wake of the storm. Hospital employees, doctors, nurses, and patients who were stranded at the hospital, surrounded by flood waters and rumors of riots and violence outside, began to think that they had been abandoned. Rescue was slow to come. Information going in and out of the hospital was confused and intermittent. Patients died. The question woven throughout the book is: did they die because of Hurricane Katrina and the lack of government or corporate response to emergency conditions, or did some of the patients die because doctors and nurses gave up hope and decided to euthanize them, “put them out of their misery”?
I’ve thought about what I might do to care for myself and my family in the event of a major crisis such as a hurricane. I’ve thought about the hard end-of-life decisions that health care professionals and families have to make together and about how those decisions could be made easier and more loving and kind to all involved. I’ve thought about how doctors and nurses can sway patients and family members to make decisions that meet with the professionals’ ethics but perhaps not the family’s. And I’ve thought about journalistic ethics, and how a writer of true-life stories can show us a story as the journalist sees it, but not necessarily give full credence and weight to all sides of the story. I think Ms. Fink tried to see all of the possibilities and complications of this particular event and present them fairly, but then again, I wasn’t there.
As I said, it’s a difficult book to read. There are stories of great courage and perseverance, but there are also questions, many disturbing questions. When evacuating a hospital with a range of patients from ambulatory to critically ill with probably very little time to live, who goes first? What is the purpose of triage, and who decides which people will be given the best chance to survive? What is the ethical basis for those decisions? What is a health professional’s responsibility in a crisis? Are doctors and nurses obligated to sacrifice their own well-being, perhaps their lives, for their patients? How can hospitals be better prepared for a crisis? How much should hospitals and other public service agencies spend on preparing for a crisis that may never materialize? What is the government’s role in protecting the public and preparing for an emergency? What is the responsibility of the health care corporation that owns the hospital or nursing home? Many, many more questions, and some answers, are embedded in this very personal story about what happened in a hospital in New Orleans after Hurricane Katrina.
I would recommend that all people involved in health care professions, especially in hospitals, read this book. You may or may not agree with the author’s conclusions, but you will be given lots of food for thought—and even prayer.