Book Documents the Unthinkable Hospital Tragedy Following Hurricane Katrina

The book, Five Days at Memorial, which recently won the 2014 Ridenhour Book Prize, paints a vivid picture of seriously ill patients first left vulnerable to an ad-hoc evacuation plan, and then to a multitude of decisions made by exhausted doctors and nurses about who could be saved and who would die, in the face of limited medical care. The consequence was catastrophic: Health professionals at Memorial Medical Center injected patients with morphine and a sedative called Versed. More than 20 patients were killed by the injections.

The following is an excerpt from the book.

A battle was under way to keep the generators running. Each of the three teal-colored generators was taller than a typical adult and pumped electricity into a complex circulatory system of feed lines, riser circuits, and transfer switches. Normally an outside company serviced the 750 kW generators, each producing the power of about six engines from one of the year’s most popular cars, a Toyota Camry. The hospital’s maintenance staff did little more than change the oil and run tests once a month in the middle of the night. The tests were brief, in keeping with national codes that treated hospital generators like heart-lung bypass machines used during surgeries, meant to support vital functions for a period of only minutes to hours. Despite the fact that the generators were not built for prolonged work, Memorial’s disaster plans called for them to shore up the hospital for at least three days. They had already been running for two.

None of the Memorial electricians or engineers on-site was a generator mechanic. Earlier, when one of the generator engines had shut down, casting part of the hospital into darkness and sending staff scrambling to move patients, maintenance workers concluded it was overheated. Laboring by flashlight, they added water to the radiator and were able to restart it.

Hours later, the problems multiplied. Low oil pressure appeared to be the cause; the men brought barrels of diesel to try to prime the motors with fresh fuel and restart them. Maintenance men crossed the bridge to the surgery building to retrieve more diesel from a generator there. Some sections of the hospital were losing power. In parts where there was light, it seemed to be dimming, strangling.

Over the years, the original 1926 hospital had received additions, and the electrical system now resembled the blood supply of conjoined twins, separate but overlapping and, as a whole, unique to itself and mysterious.

One generator failed. Unable to restart it, the engineers tried to tie some of the lines it supplied to another generator. They pulled on rubber boots and ran down to the basement, splashing into knee-deep water, then climbed up a few steps to the mezzanine of the core electrical building.

They tried to determine the reason for the partial outages throughout the hospital. The depth of the water offered a clue. About a third of the automatic transfer switches, which allowed the generators to power the hospital when normal utility power was lost, were on a low level of the building, and it looked like they and their associated distribution panels might be submerged, much as plant operations director Eric Yancovich had predicted several months earlier.

Like in a scene from The Poseidon Adventure, the men waded through a narrow hallway bordered by electrical panels and a sign with two lightning bolts that read caution: hazardous voltage inside. Using a flashlight, they located a metal lever with a yellow rubber-coated handle above their heads marked “bypass handle.” Praying not to get electrocuted, one flipped it, grafting the load of the nonworking generator to a working one.

Soon a gauge showed that the working engine was drawing too much current, a sign of a short circuit. The men tried to back off and untie the two loads to avoid a fire, a terrifying possibility given that the sprinkler system’s pumps were now underwater and city fire trucks were presumably out of commission. To further adjust the load, they went around the hospital shutting off scattered branch circuits serving unused fixtures and devices.

Another generator failed. This time, the workers had an idea of what caused the problem, but no spare parts to fix it. They tried to scavenge from the failed generator, but the attempted repair was unsuccessful.

The battle for the generators raged for two hours. At about two a.m. on Wednesday, August 31, 2005—nearly forty-eight hours after Katrina made landfall near New Orleans—the last backup generator surged and then died.

The sudden silence struck Dr. Ewing Cook, lying in his office on the second floor, trying to rest, as the sickest sound of his life.

Alarms heralded the power loss. They flashed and wailed on the eighth floor, where the ICU nurses had settled for the night in the rooms of their rescued patients. Nurse manager Karen Wynn stepped up on a chair and clobbered an alarm panel with her shoe to quiet it. She told her nurses to try to get some sleep.

On the seventh floor below them, the Life Care notepad computer lost its text-messaging connection. The special mattress supporting Emmett Everett’s massive body deflated. Mechanical breaths still hissed rhythmically in the rooms of patients on life support. They would cease when the battery backups on the ventilators were exhausted.

Copyright © 2013 by Sheri Fink. Excerpted from FIVE DAYS AT MEMORIAL: Life and Death in a Storm-Ravaged Hospital, published in the United States by Crown Publishers, an imprint of the Crown Publishing Group, a division of Random House LLC, a Penguin Random House Company, New York. Reprinted with permission.