1. Sheri Fink conducted over 500 interviews to construct this work of narrative journalism. What challenges must she have faced in order to craft this book? What dilemmas of her own do you think she wrestled with while researching and writing?

Sheri Fink faced many challenges when researching and then writing this book. She had to portray the people – the doctors, hospital administrators, nurses, patients, staff, history, and city folk of New Orleans with proper facts and details from true stories that happened before, during and after Hurricane Katarina in her book. She had trouble locating staff and some staff would decline to comment on what happened during Hurricane Katarina. Some staff had trouble recalling memories of certain events that happened at the hospital during Hurricane Katarina. If the story was not told the best way possible, Fink would have legal issues – people happy to sue her for not telling and writing the story right. She also had to keep her emotions in check while writing the book so she would not come across biased but objective to what happened at Memorial Medical Center.

2. The prologue opens with the crux of the life-or-death issues doctors faced at Memorial Hospital. What questions does the prologue raise for you about Hurricane Katrina? Why do you think doctors like Dr. Pou were ultimately placed in the predicament to prematurely extinguish the lives of their patients? What would you have done given the circumstances? Note: We will engage this “Big Question” again after reading the book.

The prologue introduced me to what happened at the hospital during Hurricane Katarina and the crux of the problem that Dr. Pou faced while taking care of end-of-life patients at Memorial Medical Center. The prologue gives you a feeling of how horrible it was in the Memorial Medical Center and that Hurricane Katarina was an all-around natural disaster which led to horrible devastation in New Orleans (and other areas). Another picture created in the prologue was that people stranded for days in the hospital when the hurricane hit. The doctors in the hospital had to euthanize family pets just to be evacuated because the pilots of airboats would not allow pets on them. There was no back up power for the failed hospital generators, no air conditioning, no running water, and no transportation. Everyone was stuck there and had to find higher ground because the first floors of the hospital were under water.

Dr. Pou had patients to care for – days on end – at the end of life and she euthanized them – she had this decision not to do any harm to these patients and let life run its course and she did not do that. The doctors were told to be the last ones to leave the hospital. Regardless of it being Dr. Pou’s first natural disaster as a surgeon at the hospital- she took an oath to care for all patients and she should not have harmed those 12 patients who died in her care.

No, I would not have harmed a patient at the end-of-life. It was wrong what Pou did. Even though these patients were not to be evacuated because of their health and end-of-life status – they should not have been killed. I would have kept the patients comfortable as best as I could but did no harm to them. I would not have done what Pou did even if it meant losing my own life.

3. Who was given exemptions from the mandatory evacuation? Why? What other orders given were significant? What “old knowledge” and customs were presented in the book as Hurricane Katrina drew closer?

The exemptions from the mandatory evacuation were the end-of-life patients and doctors. Doctors were to be the last to leave the hospital after the hurricane. The parish of St. Bernard, Louisiana knew what happened when Hurricane Betsy hit in 1965. They remembered levees breaking, businesses and homes being destroyed by flooding, and pumping stations failing to pump water. This parish moved patients via Life Care to somewhere safer which was Memorial Medical Center before Hurricane Katarina hit. Memorial Medical Center was seen as the place to go to when these big storms occurred for the city. It was a “Godlike” fortress to protect the patients and their families & pets while they rode out a bad storm.

We are also given a history (or old knowledge) of what happens in New Orleans after a bad rainstorm. That the city was growing in population in 1920’s when Memorial Medical Center was created and build by the Southern Baptists. That it was a mission from God to have this huge hospital built in a city that sat below sea level and had trouble pumping out water in its streets after rainstorms. It was a “Godlike” fortress to protect the patients and their families & pets while they rode out a bad storm. Without the financial support and backing of the city budget at that time, the pumping stations (run by the city sewer and water works) would not be able to expand and support the city in pumping out flood water in the streets after the rains in 1920’s. That this whole situation proved that New Orleans was not ready for any hurricane – and it would eventually lead to an ill-fated disaster. It just happened to be Hurricane Katarina in 2005.