For those of us fortunate enough to have never experienced a natural disaster, the terror and chaos of such catastrophes are left to our imaginations. Or to the sensationalism of 24-hour news networks. Or to the spectacle of Hollywood blockbusters. But for a more accurate look at just some of the medical, ethical, and legal implications of a natural disaster, look no further than Sheri Fink’s Five Days At Memorial: Life and Death in a Storm-Ravaged Hospital.
Five Days examines the case of Memorial Medical Center, a New Orleans hospital in which hundreds of people were trapped for five days as a result of Hurricane Katrina in summer 2005, and in which over twenty patients allegedly died at the hands of medical staff before the hospital could be fully evacuated. Fink focuses on Dr. Anna Maria Pou, a head and neck surgeon who was accused of killing patients through lethal injections of morphine and a drug called Versed. For Pou, these actions were taken in extreme circumstances as a means of alleviating patients’ suffering – patients who might not otherwise have been evacuated in time to save their lives. For the Attorney General, these actions were murder.
On its surface, Five Days has all the makings of a fictional thriller. The book is divided almost perfectly in two: part Poseidon Adventure, part Law & Order. The first half is set at Memorial during those eponymous five days. The second half follows the investigation of Pou by the Attorney General’s Office. However, Fink’s book is anything but neat or simplified. She goes to impressive lengths to demonstrate the complexity of Memorial’s situation during Katrina, and through detailed research prevents her readers (and her subject material) from feeling exploited. Few are better suited to tell this story than Fink. She has an M.D. and Ph.D. from Stanford University and is a former relief worker in disaster and conflict zones. But perhaps most importantly, Fink knows how to tell a story.
From six years of interviews, photographs, e-mails, news items, diary entries, and other documents, Fink meticulously paints a picture of what the hospital – and New Orleans itself – was like during the hurricane and the subsequent days after the city’s levies broke. She provides a history of Memorial Medical Center and walks readers through the entire facility. By day four in the hospital, readers can almost feel the oppressive humidity on their skin, taste the mould and decay hanging in the air as sanitary conditions began to truly break down.
The care with which Fink documents each person of interest, however, is almost too thorough. Doctors, nurses, patients, family members, hospital staff, company representatives, city and state officials – there is almost a deluge of names, a flood of information, in which readers can easily become swept up and lost. This grand scope facilitates a kind of narrative omniscience, allows Fink to be in all parts of the hospital at once, and enables a more objective presentation of events. Yet as the final evacuees are taken from Memorial, one realizes that for all she has revealed, from every possible angle, Fink has deliberately left some big questions unanswered. Questions that are investigated in part two of the book by an unlikely pair of agents from the Medicaid Fraud Control Unit.
Of course most of the questions Fink poses are not for the Attorney General’s investigative team, but rather for the medical community and society at large. The ‘right to die’ debate is obviously front and center in Five Days, but Fink also addresses the lack of emergency preparedness measures which existed at the time of Katrina and which still persists in most parts of the United States today. The book is just as much about what can happen in any crisis as it is about medical ethics and euthanasia in the wake of Katrina.
While Five Days At Memorial is the closest most readers will come to experiencing a natural disaster, the book is relevant to everyone. Fink reminds her readers that whether they live in an area prone to hurricanes, blizzards, tornadoes, or earthquakes (Vancouverites take note), the events at Memorial Medical Center could always be repeated. Unless we learn from what happened in 2005, any one of our cities could be New Orleans, and any one of us could wind up trapped at Memorial.