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A New York Times Bestseller Culminating six years of Pulitzer Prize–winning reporting, physician Sheri Fink reconstructs five days at Memorial Medical Center and draws the reader into the lives of those who struggled amid the chaos of Hurricane Katrina. In a voice at once involving and fair, masterful and intimate, Fink exposes the dilemmas of end-of-life care and reveals just how ill-prepared we are in America for the impact of large-scale disasters.
- Sales Rank: #3589691 in Books
- Published on: 2014-02-19
- Format: Large Print
- Original language: English
- Number of items: 1
- Dimensions: 8.50" h x 1.00" w x 5.50" l, .0 pounds
- Binding: Hardcover
- 856 pages
From Booklist
*Starred Review* As the floodwaters rose after Hurricane Katrina, patients, staff, and families who sheltered in New Orleans’ Memorial Hospital faced a crisis far worse than the storm itself. Without power, an evacuation plan, or strong leadership, caregiving became chaotic, and exhausted doctors and nurses found it difficult to make even the simplest decisions. And, when it came to making the hardest decisions, some of them seem to have failed. A number of the patients deemed least likely to survive were injected with lethal combinations of drugs—even as the evacuation finally began in earnest. Fink, a Pulitzer Prize winner for her reporting on Memorial in the New York Times Magazine, offers a stunning re-creation of the storm, its aftermath, and the investigation that followed (one doctor and two nurses were charged with second-degree murder but acquitted by a grand jury). 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. --Keir Graff
From Bookforum
Five Days at Memorial is Sheri Fink’s elaborately researched chronicle of life, death, and the choices in between at a New Orleans hospital immediately following Hurricane Katrina. What’s important, it slowly emerges, is that despite Fink’s painstaking re-creation based on five hundred interviews and mountains of documents—we weren’t there. We cannot know. Fink, under the guise of third-person journalistic objectivity, drives us towards a kind of uncertainty so great that it’s revelatory. There are conclusions to be drawn from Fink’s collection of dilemmas. She seems to indicate that she believes “a crime had occurred.” The scope of that crime—not just a legal trespass but a moral and ethical one as well—is the true subject of this book. 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. —Jeff Sharlet
Review
"New York Times "Bestseller
MSNBC's "Morning Joe" Book Club
"Wall Street Journal "Bestseller
"NPR "Bestseller
"New York Times Book Review" Editor's Choice
"A" - "Entertainment Weekly"
#1 September Book - "Christian Science Monitor"
One of "USA Today"'s "Coolest Books" for Fall
One of "People "magazine's "Great Reads" in New Nonfiction
"What we have here is masterly reporting and the glow of fine writing." - Sherwin B. Nuland, """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"
"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 ga
Most helpful customer reviews
152 of 166 people found the following review helpful.
Five Days You Won't Forget
By Ferdy
The first half of this book reads like an apocalyptic thriller while the second half is like a legal drama and in fact was dramatized on the television show, Boston Legal.
The tragedy that occurred at Memorial Hospital in the aftermath of Hurricane Katrina is unflinchingly detailed by the author. The horrors that the staff and patients had to face will haunt you. The actions that were taken to save lives was heroic. There were also decisions made, however, that led to at least 7 deaths. Were these unavoidable casualties of the disaster or were these people murdered to effect a long overdue rescue of the remaining patients and staff?
The questions surrounding the deaths led to an investigation of one doctor and a couple of nurses. This legal investigation is what comprises the second half of the book.
The author, a Pulitzer Prize winning journalist, gives a fair and complete assessment of the five day ordeal in the storm ravaged hospital. There is also background information for many of the staff and some patients who were stranded in the flood. There were points that actually had me near tears as I read of their struggles.
The investigation after the incident and the legal battles which ensued are equally as compelling. The political machine that took over so much of the Katrina recovery is a big part of the story. The reader is left to come to his own conclusion based on the information given. Through the stellar reporting of this author, it is easy to empathize with both sides in some respects. Was euthanasia necessary? I'm not going to go into my own personal beliefs but I will say that you will look at the whole situation differently after reading this book.
You will also be forced to take a look at the choices available to us as the end of life approaches.
Five Days at Memorial is a compelling book that documents a particularly horrible natural disaster and the mess that our government and some corporations made of the rescue process. You can't read this and not be changed. It isn't a story that has a happy ending but it's the kind of thing that needs a light shown on it so that, hopefully, we learn a valuable lesson from the mistakes that were made.
91 of 99 people found the following review helpful.
For those prepared to grapple with major ethical issues
By Trudie Barreras
This is not the type of book that anyone should pick up if they are not prepared to deal with some extremely grim realities. Although certainly all of us have heard, and some of us have experienced personally, the horrors resulting from "natural disasters", Sheri Fink's exhaustively detailed description of events at Memorial Hospital in New Orleans after Hurricane Katrina is uniquely powerful.
This is a book that SHOULD make one angry as well as profoundly and deeply distressed. It is also a fascinating investigation of the evolution of human perspective as "technical medicine" has become ever more complex and infrastructure-dependent. It includes an extraordinarily focused discussion of the historical issues - the fact that this hospital was flooded previously, but the necessary upgrades to provide better protection for the backup generators as recommended was never accomplished, being the most cogent.
For anyone who is not aware of the background story: As well as having a complement of "regular" patients, some in Intensive Care after such things as open heart and cancer surgery, the hospital had an organization called LifeCare that leased space on the 7th floor of the main hospital complex. Their patients were mostly elderly, and were in long-term care for extremely debilitating conditions that required extensive life support and monitoring, including dialysis, tube feeding, ongoing oxygen therapy, and so on. When the hurricane first approached, on Saturday, August 27, 2005, it seemed wise to move LifeCare patients in from a less secure, smaller facility in St. Bernard Parish, to the much larger location at Memorial. In addition many others, including family members of hospital staff and patients, along with their pets, and some other community members, sought refuge at the hospital, which was deemed to be a safe location. Therefore when the hurricane actually struck on Sunday, August 28th, there were many more people in residence than the normal load.
There was considerable damage from the storm itself, but everything seemed to be on target for recovery until the flooding of Monday, as of course was the story for the entirety of New Orleans. Sadly, at this point, the failure to upgrade the generators became a very serious issue, and for the following four days, conditions went from difficult to impossible to horrific. It became obvious as power failed and violence and looting became ever more prevalent in the surrounding neighborhoods that rescue and evacuation was not going to be practical, especially for the most severely debilitated patients. Although the hospital DID have a helipad, which turned out to be marginally accessible, for some reason it never seemed possible to launch a major evacuation by air. Eventually, on the fourth day (Thursday), when rescue efforts seemed completely stalled and many of the "critical" patients were rapidly deteriorating due to the extreme heat, lack of support systems for their therapies, and so on, the decision was made that anyone who had a DNR order in place and was not easily transportable would be given an overdose of morphine. The second half of the book deals with the legal repercussions faced by the medical professionals who made these fatal decisions.
Obviously, in past eras when the "promise" of high tech medicine was not so deeply ingrained in the minds of both the medical community and the general public, these issues would not have arisen. People who were terminally ill would either not even BE in a hospital setting, or if they were, it would be clear that removing them would be inevitable, whether they died in the process or not. One of the poignant scenes in the narrative is the story of the euthanizing of some of the pets who had been brought to the hospital for shelter "because there was no room for them in the rescue vehicles". At that point, it struck me as symbolic that perfectly healthy animals, considered "family" by many of their humans, were summarily executed for lack of "space". Meanwhile, there was all the agonizing about the failure to find room in those same vehicles for admittedly terminal humans with their wheelchairs and other "paraphernalia", and the subsequent choice of the medical professionals to ease (while perhaps speeding up) the passing of those humans.
I would recommend Fink's book only to those who are prepared to be courageous in thinking about these torturous life-and-death issues, and who really want to grapple with some of the major ethical concerns of our era.
62 of 69 people found the following review helpful.
As good as The Immortal Life of Henrietta Lacks
By Diane
Fink takes on a story with moral and ethical overtones- what killed 45 patients at Memorial Hospital in New Orleans in the days following Hurricane Katrina, in her incredibly fascinating Five Days at Memorial. Fink interviewed dozens of people who were there- doctors, nurses, aides, family members, patients, hospital administrators, rescuers, police investigators, coroners and more to tell her gripping story.
Fink drops the reader right into the hospital during the hurricane and in the horrific aftermath of the storm, when the levees failed and the hospital was completely surrounded by floodwaters. The reader feels the rising panic as generators fail, toilets stop working, medicines run low, cell phones die and communication is lost with the outside world.
Close to 200 people were evacuated from the hospital by helicopter and boats, but 45 patients died, most of them either terminally or gravely ill, the most of any hospital in the city. And most of them died of an overdose of morphine and Versed, allegedly by the hands of Dr. Anna Poe, a surgeon at the hospital. She and two nurses were arrested for killing those patients after a lengthy investigation.
Fink methodically lays out what went on at the hospital during those days. The corporate owner of the hospital, TenetCare, had an emergency plan that lacked some key elements. After 9/11, hospitals had to beef up emergency plans.
"The doctors at Memorial had drilled for disasters, but for scenarios like a Sarin gas attack, modeled that April, where multiple patients arrived at the hospital at once. Not in all his years of practice had Thiele drilled for the loss of backup power, running water, and transportation."
They had no contract with helicopter companies to evacuate the hospital (as other hospitals did) during a flood in a city where hurricanes and floods can be devastating. The person left in charge in the home office of Houston had no disaster experience or training, and the lack of communication with the hospital during the crisis was unconscionable.
The staff at Memorial felt they had been abandoned by their owners, as well as by their government. There seemed to be no one in charge at a local, state or federal level who could give them information as to when and how they would evacuate. All they heard were rumors of rampant looting, and the gunfire they could hear in the neighborhood made them fear they would be overrun by criminals looking for drugs.
When the evacuations begin, with boats commandeered by an older couple looking for a family member, and helicopters fly in, the triage that took place was the opposite of most; instead of the sickest going first, the healthiest patients were evacuated first. That decision had repercussions that had to be answered for later.
The first half of the book will have you on the edge of your seat, and the people who stayed behind to help the patients were heroic in their efforts. Fink sketches them with deserved empathy and compassion. As you read, you may ask yourself, "could I have done that?"
The second half of the book deals with the efforts by investigators and the state attorney general, who was looking to make a name for himself, to bring murder charges against the three women. Most of the general public did not feel this was warranted, and support for the women was strong.
But there were people, including doctors from Memorial, who were appalled at what happened and wanted to see justice for the people who died. They felt that these women violated their oath to do no harm and took matters into their own hands.
The one overriding theme of Five Days at Memorial is that governments and healthcare facilities must have effective disaster planning. There were so many failures on the part of government and corporations that allowed this to happen when it did not have to happen.
You may think you know how you feel about this situation, but Fink skillfully shows you all sides, and you will most likely come away from this book with more questions than answers as I did. This is a must-read book.
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