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Sociology. True Crime. Nonfiction. HTML: The award-winning book that inspired an Apple Original series from Apple TV+ ? 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 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 of those caregivers 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 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. One of The New York Times' Best Ten Books of the Y… (more)
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In the aftermath, after everyone had left and the flood waters receded, there were found to have been too many deaths, especially when compared to the similarly struck Charity Hospital. There were rumors that some of the medical personnel had taken matters into their own hands, believing that certain patients were too ill to be rescued, if indeed rescue was even coming. Several patients had all died during the same time frame and all had high levels of morphine and sedatives in their bodies.
An investigation is opened, spurred along by intense media interest, and focusses on two nurses and the physician Anna Pou. Five Days at Memorial follows the investigation and the lives of those who were affected closely as lines are drawn between those who think this is a politically motivated witch hunt and those concerned that people got away with murder.
This is a gut-wrenching story. I changed my mind about what went wrong, who was to blame and what the motivations were for those medical personnel several times throughout. It was interesting to note how adeptly the corporations involved sidestepped any real accountability. The hospital CEO and a few other executive officers were present during the debacle, but stayed largely in the one wing of the hospital that retained power and air conditioning, relaxing and watching TV and eating chicken noodle soup while across the way patients died in 110 degrees heat and without respirators. The CEO failed to lead, although he did graciously bring nurses some coffee. It seemed to have occurred to no one to move the patients into the one place where their suffering could have been alleviated. And after rescue, while those same patients lay on the floor of an airport with inadequate care, those same executive officers were flown away in the corporate jet.
Meanwhile, the medical and support personnel were given no or conflicting information. There was no plan of rescue. Those patients flown out had to be carried down several flights of stairs, pushed through a maintenance shaft, driven through a car park, then carried up several flights of rickety stairs to a decaying heliport. Helicopters left without passengers when they were delivered too slowly. Seriously ill patients had to lay outside in the sun for hours waiting for the next helicopter to fly in. And there were constant rumors and fears that the hospital would be overrun at any time by gangs of looters.
Five Days at Memorial brings those days to vivid light. It was compelling and uncomfortable reading. The book has been nominated for the National Book Critics Circle Award. It would be a worthy winner.
After the floodwaters rise around the hospital, the power fails, the heat is suffocating and the staff must arduously determine which patients can be safely evacuated by either boat or helicopter. The conditions in the hospital are ghastly, the staff is exhausted and questionable decisions are made. Should the sickest patients go first or last? Should elderly patients with DNRs be considered expendable just because they have a Do Not Resuscitate order? At the end of five days, those patients who are still alive are finally evacuated. But months after the event, some staff members are arrested and charged with deliberately injecting patients with drugs that would hasten their deaths.
As the facts are weighed and the evidence is collected, the author drives the conversation towards the inevitable questions: how can we be better prepared for disaster? What do we need to address about end of life care? How much do we value human life?
Absolutely riveting and oh so thought provoking. Very highly recommended.
Fink introduces the reader to so many participants in this tragedy, helping the reader to understand multiple perspectives, telling the story in part narrative, but supported with facts and sources all the way through. The first half tells the story of Katrina at Memorial Hospital, the second half tells about the reaction of the community to the choices made by medical personnel. I didn't expect the second half to be as good of a read, but Fink repeatedly introduced intriguing ideas and concepts that were new to me and I could hardly put the book down till the last page. When I did put it down, it was to go to google and youtube and see and hear these people.
My initial thoughts before reading the book were that I was in no position to make any judgements about this story and would never know all of the facts. I still feel the same way, but appreciate the knowledge, emergency procedures and protocols developed due to the information given by the participants and others. As Margaret Mead was quoted in the book, "It is the duty of society to protect the physician from such requests." She is speaking of euthanasia and saying that we as a society must take the responsibility for making these decisions rather than putting it on one person. I don't think anyone has said it better.
So many questions were raised:
Who gets evacuated first?
Who is responsible for evacuation?
Who decides when to evacuate?
Who receives resources when they are limited?
In what situation does a DNR apply?
Is there a loss if we speed up death, a loss of interaction with family and/or God that we often put off until forced to face it?
Is there value in suffering?
What is the relationship between personal responsibility and group or government responsibility? What about corporations who now own most of our hospitals?
Are medical personnel more qualified to make some of these decisions that the rest of the community?
AND, this is after medical personnel have had to answer the question do I stay and work or go take care of my family.
I have difficulty holding anyone responsible for behavior under extremely traumatic, life-threatening situations simply on the basis of what panic does to the brain. There's not a lot of frontal lobe involvement happening during panic. Of course training can help with that, but I don't know how practical that is for civilians. I especially liked then, the idea presented by one person that justice does not necessarily require conviction, it could be achieved through retelling in the court system. I don't know that it has to be the court, but am reminded of the process of reconciliation used in South Africa.
Another idea presented, "Many ethicists felt that the conditions were so horrible that moral judgements could not be made about what happened there."
All I think for sure is that these medical workers were courageous way beyond what I would have been able to muster up and New Orleans was lucky to have them. I am also grateful that my parents made end of life arrangements for themselves very clear and taught me to do the same. Whether that makes any difference for me remains to be seen of course.
This was a five star read for me and my head is still spinning.
With gripping immediacy, [[Shari Fink]]’s [Five Days at Memorial] follows the administrators, medical personnel, patients and family members of New Orleans’ Memorial Hospital through the horrific days of Hurricane Katrina and its aftermath. Flood waters rising as the levees break, power generators lost, sanitary conditions worsening, sounds of gunfire everywhere, little support from ‘corporate’, conflicting information as to what help is coming and when. One can feel the anxiety and panic rising in tandem with the stifling temperatures inside the wards. As hours and then days pass, desperation mounts. In the days after it was evacuated, 45 bodies are found in the Hospital Chapel. Rumor and fear feed suspicion that several of these poor souls had been euthanized. Dr. Anna Pou and two nurses are singled out for prosecution.
In the ‘post mortem’ of the tragic natural disaster, coroners, doctors, investigators, lawyers and the media all enter into the discussion of what did or did not happen, and what if anything should have been done. I admire physician/investigative journalist Fink’s choice to provide ample detail from multiple perspectives without drawing final conclusions. This forces readers on their own moral gut check. I personally wavered in my opinion as I read one side then another. It is so easy as a ‘Monday morning quarterback’ to second guess those on the ground. Clearly these health care professionals had been placed in a position few had ever anticipated.
To stop there would have been a snapping good tale. Fink goes further by examining the lessons learned and the opportunities continually missed in the aftermath of the tragedy. Legislation has been filed to protect doctors. Other hospitals have placed better emergency systems in place (witness the reaction in NYC to Hurricane Sandy.) Only time and future crises will tell if enough has been done. If nothing else, after reading this book, like Fink herself, you will give serious consideration to personal health care directives and DNR orders. This was highly recommended by people I respect. They were spot on.
After
What really happened at Memorial? Author Sheri Fink presents the results of her investigation, conducted over several years. The first part of the book tells the story of August 27 - September 1, and reads like a thriller. Things go from bad to worse as conditions deteriorate and help from the parent company and the government fails to materialize. The hospital is overrun with staff, their pets, patients, and family members. Sanitary conditions go downhill very quickly. Hospital personnel are stretched to a breaking point. It's a harrowing tale, ending with the sedation and death of several patients. The second part of the book describes the legal process that followed, as investigators pieced together events to determine whether the deaths were homicides. It's not quite as fast-paced as the first part, but was equally compelling. Having had brief encounters with the theory behind disaster planning and legal compliance matters in my professional life, I found it fascinating to see how these topics played out in a real-life situation.
Fink does a great job developing key players on all sides of the story: patients, family members, doctors, nurses, lawyers, etc. The reader can't help taking sides and at the same time, it's easy to see and believe both sides of the story. And since this is a true story, the ending is far from neat and tidy and Fink leaves us with a sense of how much work we have yet to do, in the medical profession and society in general, to be able to better handle situations like these in the future.
The muddy waters weren’t just the result of failing levees but also arose from the medical world’s sense of their own separateness from the rest of us. Clearly, when the independent and expert reports are in, Dr. Anna Pou and the two nurses who helped her did deliberately kill those patients. It is disingenuous to claim that they didn’t. To deny that and hide behind the legal barricade as they did denies society one of the most important open debates it can and must have. Clearly justice was not served and the cases should have been tried in open court, but the attitude of those responsible for prosecuting the case was not about bringing truth to light and seeing justice done, but about riding the biggest emotional wave to shore. FIVE DAYS AT MEMORIAL is not really a disaster account, a legal puzzle or a medical mystery, but an account of people with the means and position to take lives and their completely vulnerable victims. It is an absolutely harrowing tale that even at over 400 pages is utterly compelling and impossible to turn away from.
Fink includes every possible perspective and doesn’t shy away from or flinch at the hardest of challenges. There are no easy answers, and trying to look ahead at what we learned from this or how to prevent its happening again seems beyond human capabilities. Planning ahead is good and helped spare the lives of patients at the public hospital across the city experiencing the same situation of failed power, chaos, nearby violence and slow evacuation, but pre-planning doesn’t replace independent bioethical statements on our absolute moral values. In examining the many questions that must be considered when attempting to establish disaster protocols, the reader just ends up feeling overwhelmed by them all, and that’s probably as it should be. Maybe, in the final analysis, it is a matter of attitude. As Dr. Horace Baltz observed upon hearing Dr. Pou’s remarks from the press conference after the Grand Jury decided not to prosecute the case, “Pou had genuflected to thank God that she wasn’t going to prison? He longed to hear that she had taken to her knees to do something different: beg forgiveness for having violated the commandment ‘Thou shalt not kill.’” Perhaps what is needed above all is the humility to ask God to have mercy on one’s soul when making such gargantuan decisions about the life or death of another human being.
Is this a good book? Considering, not the content or subject matter, but its structure, style, etc.? It is an exceptional book. Sheri Fink takes on an enormously difficult event, loaded with impossible dilemmas, and a vast array of resources, and crafts it all into a thorough, readable, clear, balanced and beautifully written tribute to the ones whose ability to tell their side of it all was terminated for them, both by Dr. Anna Pou and by the justice system that should have served them and their families. This is an important book, as it is likely the only way we will learn what really happened.
FIVE DAYS AT MEMORIAL is two books in one. The first relates, through the eyes of those present, the happenings at Memorial Hospital during and after Hurricane Katrina struck New Orleans, Louisiana. The nurses, doctors, visitors and patients tell their stories as
When help finally does arrive, many of the patients are dead and fingers begin to point.
The second part of the book covers the investigations into the allegations of murder or, more charitably, euthanasia, the resultant trial and the aftermath of the verdicts. FIVE DAYS is chilling reading, all the more so because of Fink’s straight forward reporting style. She makes no conclusions of her own, simply letting the participants words and actions speak.
Book groups will find many topics for discussion including euthanasia, DNR directives, patient/doctor relations, decision making in times of extreme distress, preparedness for disaster and governmental readiness.
Fink writes with an even hand and covers both sides aggressively and fairly. It is well-written and engrossing enough that it is hard to put down. Her extensive research is impressive but also overwhelming...I had to refer to her name chart prefacing the book more than once. She has written a document that serves as a testament to those involved with the Hurricane Katrina disaster and as a reminder of the ethical issues involved in a catastrophe of this magnitude.
In the midst of this crisis, questionable decisions about how to relieve pain and who should be saved were made. Fink also chronicles the investigation into patients' deaths that may have been due to lethal doses of pain relieving drugs. The questions of who should receive care when resources are low are examined in great detail. In a refreshing contrast to journalism that takes sides and broadcasts talking points designed to make decisions look simple, Fink explores the difficult ethical underpinnings of the decisions that were made in this case. She presents all angles of the case and ultimately explores what we've learned from this devastating experience. While I was fascinated by the management challenges and the ethical dilemmas represented in this situation, I think that I would read anything that Sheri Fink wrote. Ultimately, it was her careful and balanced presentation of the situation that made this book such as interesting read.
Years later, Sheri Fink has exposed details of exactly what occurred in the hospitals in New Orleans in the days following the storm, particularly Memorial Hospital.
Goodreads’ summary of her novel, Five Days at Memorial, is as follows:
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.
When I first heard about this book, I was excited to read it. Not only because New Orleans fascinates me, but because I remember Hurricane Katrina very vividly, even living thousands of miles away. New Orleans is a very unique city, to say the least. I traveled there in 2012 for a week and I was amazed at how tightknit the community is. There are two periods of time people refer to: before the storm and after the storm. We took a tour of the city and even seven years after the storm, there are still damaged properties, an incredible amount of homeless and displaced people from the storm, and even street signs and buildings to this day have watermarks.
Reading this book, not only was I brought back to the news coverage back in 2005, but I also went back to my own experience in NOLA. Watching the news coverage in 2005 made me very sad and hopeless for many NOLA citizens. The crime, the drownings, the lack of government aid, the mass confusion, and the cleanup. But what was new to me was the incredible struggles doctors, nurses, and patients experienced after the storm. Sheri Fink does an incredible job of writing a non-fiction book that is so factual and unbiased. Not once did I hear her own opinion of the decisions the doctors made because she allows each reader to come to their own conclusions. Given the desperate times, were the decisions the doctors made correct? You decide; Fink only gives you the facts. Given the fact that the hospital had no electricity, no security, no telephones, barely any rescue resources, would you have made the same decisions? You decide; Fink only gives you the facts. Do you agree with charging any doctor or nurse with a crime, given the situation, especially after reading that in the mass miscommunication between the owner of the hospital, the Coast Guard, FEMA, and anyone else involved, they believed rescue would happen sooner than it did? Same. It’s your decision. Sheri Fink allows readers to draw their own conclusions, which is great.
I, as a reader, have an opinion after reading this book. After Hurricane Katrina hit, this hospital suffered many setbacks. Most, unfathomable, unimaginable. These doctors and nurses are incredible heroes in my opinion. Some sacrificed rescue to stay on with their patients. Some had brought their beloved pets to the hospital after being told it was a safe refuge and rescue was on the way. Most, if not all, pets were euthanized given lack of food and water and they were suffering. Some patients are also thought to have been euthanized, but in order to not give away details of the book, I beg that you read it with an open mind and put yourselves in the shoes of these heroes, the doctors and nurses of Memorial Hospital.
I can only hope Sheri Fink wins multiple awards for her research and telling of the story of the doctors and nurses and other employees at Memorial Hospital. Hurricane Katrina got a lot of coverage in 2005, and it still does, but some things are swept under the rug. Like the situation at Memorial.
Great book. Great people. Great city. I encourage you to remember the victims of this tragedy, and as a reader if you were personally affected by this storm, to take action in some way to make sure the same events never happen again during a natural disaster. Lastly, next time you plan a vacation, take NOLA into consideration. You will be amazed and inspired after visiting a city like New Orleans.
You may think you know this story of New
The first half of FIVE DAYS AT MEMORIAL is the five days at Memorial, hard to stomach but necessary to really understand what doctors and nurses were faced with and what patients, particularly the severely ill, endured. The second half involves mostly how various staff (doctors, nurses, therapists, etc.) reacted to their experience and presented their reactions to law enforcement, newspaper reporters, medical societies, etc. And we can also finally understand what went on with the intended prosecution of one of the doctors, how the media influenced the outcome.
During a book event with Sheri Fink that I attended at the Jewish Community Center in West Bloomfield, Michigan, she stated that this story all comes down to how ill-prepared our hospitals are for emergencies such as this hurricane. Of course, that's true. But it might not be enough to entice you to pick up the book.
Really, it's about so much more than that. And you want to read it; you really do. Not many books of nonfiction do more than make you smarter. FIVE DAYS AT MEMORIAL will grab you until the end. And you won't want it to end. Gees, I'm hoping the paperback will continue the Epilogue.
For the most part, Fink's writing is dispassionate and "neutral." But really, it's not that she lives and writes from the neutral zone as much as she attempts to write from the perspective of subjects who have very different opinions about what might have happened and what should have happened at Memorial Hospital. Fink can't resist an occasional snide jab at what she perceives to be outrageous decisions or outcomes (by investigators, the grand jury), but she doesn't get carried away with these and doesn't let them distract her from the story. Overall, this is an excellent work of narrative nonfiction.
This book was on my radar for 2014, and was lent to me by a coworker before I left work on New Year’s Eve. I spent most of my day off yesterday reading it, and finished it up walking to work and on my lunch break today. The book is nearly 500 pages long, so
The book is broken into two parts: a description of the eponymous situation, which took place during and immediately after Hurricane Katrina at a private hospital in New Orleans, and the investigation into the actions of some of the doctors (one in particular) and the nurses involved. It also raises two separate but related questions: what is appropriate for clinicians to do when faced with disastrous circumstances in a healthcare facility, and is what the doctor and nurses are alleged to have done at Memorial in line with that? Finally, another issue of interest that gets mentioned but is not the focus of the book is the responsibility of hospitals and the state have to be prepared for foreseeable disasters such as Hurricane Katrina.
The basic situation at Memorial was similar to one facing many hospitals in 2005 (and, as shown with NYU Langione during Hurricane Sandy, was still an issue in 2012): the generator and many necessary electrical switches of the major hospital were in the basement or ground floor of the building and thus susceptible to flooding. When the levees stopped functioning the days after Hurricane Katrina came and went, the flooding reached Memorial and resulted in a generator that ultimately petered out. That, coupled with the inability to quickly evacuate patients, meant that the clinicians, patients, and other family members at the hospital faced very unpleasant circumstance. By the time everyone was evacuated, many patients had died, including many who died in a three hour period on the last day.
The writing, the research, and the story Ms. Fink weaves together is gripping. It’s heartbreaking, and as someone who works in emergency management, it is one of my worst fears. The lack of planning, the lack of preparation, the lack of support from the parent company, it all is just devastating and infuriating. And yet … the hospital never ran out of food, or water. Clinicians were, for the most part, able to do amazing things in an utterly foul situation. But the big question around why did so many patients die on that last day, and whether Dr. Pou made the decision to help death along for those patients, is the focus. And while Dr. Pou makes public statements about doing 'what she had to do,' my take-away from this book is that while there certainly are times when this might be true, this specific instance, at this hospital, was not a situation where that statement needed to be made so far as euthanasia is concerned.
Dr. Pou seems sketchy, and seemed to make HER case be about a hypothetical situation that she was never really facing (and would not reasonably have thought she was facing), but that she spoke of as if she had indeed experienced it. Based on my reading of this book, what Dr. Pou chose to do to those patients is not an example of making decisions in a no-win situation. Not to spoil it (and stop here if you plan to read the book and are not familiar with the story), but on that last day, the helicopters were there, and those patients could have been evacuated. They weren’t definitely going to die, and Dr. Pou acted as though they were. That seems to be her defense. And while it’s a defense worth interrogating for real situations where the options are death in tons of pain in a day or death easily now, those weren’t the choices facing those patients that day.
As someone interested in medical ethics, I found the discussion of these issues to be well done. The topics of rationing medical care in an emergency, of deciding who should receive treatment first, and who should wait, are issues that need to be resolved. The clinical community is aware of this and is working on it. Hopefully books like this will make the issue more salient in the rest of the community as well.
The second half of the book deals with the litigation and accusations of euthanasia and murder directed specifically at one of the doctors and two of the nurses. Ms. Fink does not make judgements here. She lays out all of the facts, interviews and recollections and lets the reader decide for themselves.
For an eye opening look at this subject I highly recommend this book.
Sheri Fink manages to portray all the players in this tableau in a sympathetic light. From the Medicaid a Fraud investigators who spend months compiling evidence, to the physicians and nurses who weigh in on both sides of the case, as well as the families of the patients, one is able to view the tragedy through a complicated prism.
Sadly, it is clear by the end of this riveting book that we are no better prepared for catastrophe, as evidenced by Superstorm Sandy. This books allows us to ponder what societal solutions are possible in these situations, as well as what directives we might choose for ourselves.
The first section of the book is engrossing as we follow the Katrina victims. While some may feel the "cast of characters" was too wide, their stories give us a cross section of experiences and a cross section of medical issues for care that a handful of personnel needed to cover. The book continues well with setting up discovery and early legal manuverings however, given the scope of the case, the engrossing read of the first section is lost. If the book could have continued at the pace of the first section, I could have awarded 4 stars.
All in all, this was a positive reading experience and one I would recommend to others to discuss the larger questions of emergency preparedness. I received this book through the Early Reviewer's program.
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