1. The author likely faced many challenges in writing this book. She interviewed over 500 people from the hospital staff to patients and their family members. Organizing accurate accounts and timelines from so many individuals must have been very challenging as I am sure there were many conflicting stories.

Sheri Fink must have faced her own dilemmas while researching and writing this book. I believe she may have wrestled with her own ethics and opinions of what happened. I would imagine it was difficult not to cast judgement on certain individuals and to remain neutral while crafting this book.

2. The prologue of the book raised questions for me. It makes me think of the facility where I work and how prepared are we for a disaster. I believe Dr. Pou was ultimately placed in the predicament to prematurely extinguish the lives of patients due to a combination of lack of communication, direction and disaster preparedness along with feelings of abandonment and loss of hope. I would like to think that under the same circumstances I would do everything in my power to save lives.

3. Hospitals were exempt from the mandatory evacuation. Memorial Hospital had long been a place of safety during past storms. It was customary for staff working a hurricane to bring along their pets, family members, coolers and chips and dip even staff that were not on duty may show up to ride out a hurricane. I believe the order to evacuate the DNR’s last was significant because I feel it changed the mindset of saving lives to ending lives. Memorial Hospital had experienced extreme flooding, loss of power, loss of elevators and communication on other occasions. The city’s drainage issues had been improved but flooding was still an issue in the Memorial Hospital area. The staff was aware of the flooding issues and had developed their own mechanisms for dealing with moderate flooding and warnings such as parking several blocks away on “neutral ground” maintenance workers at the hospital would put on waiters and pull colleagues to work in a battered metal fishing boat they kept suspended in a parking garage basement. Most had stopped seeing the water as a significant threat. The hospital did not make changes regarding their medical supplies and continued to store them in the basement.