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Five Days at Memorial Chapter 9 Part 3 Module 14
1. How are nurses Cheri Landry and Lori Budo faring? Karen Wynn? What did you think of their testimony before the grand jury? Whose testimony was conspicuously absent from the grand jury proceedings?
On page 402, Landry’s house was demolished after flooding after Hurricane Katrina. Landry was the sole provider and caregiver for her mother. Budo helped salvage Landry’s things from her house, took them home to clean and sanitize them. Budo was also the sole provider for her family, and she had college tuition to pay for her two kids aside from mortgage and car loans to pay. Neither nurse had a job to fall back on like Pou did. It was extremely difficult for them, and they had to rely on a support fund set up by their colleagues to pay their bills. When they were acquitted of the charges, they were reinstated as nurses at Ochsner Baptist Hospital. As for Karen Wynn, she was concerned about what was happening to her nurses (Budo and Landry) because she felt responsible for them, especially since Wynn made the nurse schedule and told Landry and Budo they were on duty for the hurricane. Wynn checked in on her nurses even though it was against legal advice. Wynn felt confident the staff did all they could for the patients during those five days at Memorial. As for Wynn’s testimony before the grand jury, Wynn was prepared by her lawyer in advance. At every meeting with her lawyer, Wynn had PTSD from the events that happened at Memorial. On page 413, Wynn decided she did not want to be a nurse anymore due to feeling worn out. She did not testify before the grand jury.
Minyard testified before the grand jury. Normally Minyard loves an audience and would be fine testifying however in this case, he did not want to go, and his family and colleagues did not want him to go either. He felt testifying went against his “religious convictions”. He is a corner and his “opinion on the matter of death is pivotal” in the case (page 418). Minyard also believed that Emmett Everett was a homicide and that telling the grand jury what he thought might get Pou convicted or might not. Even though Pou’s lawyer could easily defend her in the case of Emmett Everett’s death because of how big Emmett was and not knowing how much sedatives to use to sedate him.
There were all sorts of testimonies absent, but the most conspicuous was the families of Life Care patients as they were there right up until the end with their loved ones. John Thiele and Horace Baltz weren’t called to testify. Thiele was told not to say anything and not to bring any attention to himself by his own lawyer because of his involvement with helping Pou inject Life Care patients with the drugs. Baltz was against euthanasia of any patients The nurses who testified (Landry, Budo and D’Amico) they had immunity granted from ADA prior to testifying and they were unaware of the medical conditions of patients and disparaged Life Care nurses by saying they failed to care for their patients, and they did not evacuate them.
As for what I thought, Minyard’s testimony was the most intriguing because he knew Pou’s family, especially her father and he knew the kind of doctor she was. Minyard should have been against her according to forensic evidence. He was looking for ways to help her defend herself without putting his own job, his own thoughts about life and his love of his city, on the line.
2. Engage the questions posed on Page 440 (not page 453): “What about death in the United States? Why did it seem like Americans were so unprepared for it when it occurred?” What attitudes about death exist outside the United States?
Staff at Memorial were accused by Foti for playing God. Cathy Green, who is an ICU nurse knew that they were asked played God in the ICU every day and she did not like see patients in pain. She was very upset when “young” doctors would tell her that dying patients had less brain functioning and could not feel pain. She was disgusted with the young doctor and young nurse mind set when it came to dying patients. She told her daughter to take her to Holland when it came time for her to die.
Yes, Americans are unprepared for death and do not want to discuss death. Unless they create advanced directives with their families and plan out their deaths – it’s not seen as an important topic. Most Americans are not present when their loved ones when die. As I see this every day in the hospice unit of where I work, most families do not come in when their loved one is dying. Or they do come in when they are actively dying but they were never there, day in and day out, when the loved one lived at the nursing home. It’s very sad to see one of my residents actively pass away and they have no family to take care of them during their last hours.
As for the attitude about death outside of the United States, death is seen as a part of everyday life, and it is widely accepted where families do take care of their loved ones and are there when they die. In certain countries the elderly are seen as very important to society. Thinking of Netherlands and Cathy Green, Holland is a place where assisted suicide is accepted, and people can make their own decision on how they want to die – terminally ill or not.
3. Reflect on the differing opinions offered following the grand jury decision. In your opinion, was justice served? Why or why not?
The grand jury’s decision was already decided early by hearing the testimonies from witnesses who explained how much pressure the staff was under to evacuate the hospital and how horrible the conditions were and agreed that Pou took care of all patients as a caring doctor would. The jurors already decided on how they would vote, and they voted not to indite Pou for all the charges brought against her and that she did not have an intent to kill the patients. It was a relief for all involved who were at Life Care and Memorial during those five days because the whole ordeal was finally over. Pou and others could get back to work and heal from the events after Hurricane Katrina. Justice was served in the case of Pou, although, it allowed for families to still bring civil suits against Pou, nurses and Life Care for the death of their loved ones. Because of how much empathy Pou’s supporters felt for Pou, they were able to dethrone Foti as Attorney General and fight for immunity for medical workers if anything like this were to happen again because of natural disasters.
(Edited since the website crashed on me this weekend.)
3a. How Tenet informed the families of their love one’s deaths – aside from the strict guidelines Tenet (and their attorneys) set up for callers to follow on page 236 – it wasn’t any higher ups or Dallas employees that told the families but a team of eight callers – two callers were Karen Wynn and Susan Mulderick. They had to tell the families their love ones died especially after being through this whole ordeal.
Five Days at Memorial Chapter 8 Questions Part 2
Discuss the New York Times Magazine’s ethics columnists’ statement, “Why weren’t there plans to cope with these patients when you knew a storm was coming? Sometimes the ethical—the most important ethical question sometimes is the one you ask not at the moment of crisis, but the duty you have to anticipate certain kinds of crises and avoid them” (271).
The hospital should have been prepared for all outcomes before, during and after Katrina. Memorial had been through other hurricanes and was always the place families, patients, and staff went to wait out a hurricane. The hospitals were supposed to stand on their own for seven days after the hurricane struck according to the mock hurricane (Hurricane Pam). The staff at Memorial did not cope well with patients as the days went on and they were stranded in the hospital. They did not know how to triage the patients in an emergency (situation) – they put the end-of-life care patients last and not first to leave the hospital. They were not prepared.
Describe John Thiele’s perspective of the storm and their circumstances at Memorial. How was he able to ultimately feel it was right to smother a man?
Thiele wasn’t supposed to be at Memorial during the hurricane. He has been on “duty” at Memorial during every hurricane (by choice) the last 21 years. He spent most of the storm in the cancer center with power with other CEOs and doctors off duty. Thiele mentions that he has seen his patients commit suicide and it does not always end well for the patient. He is not opposed to euthanizing pets or humans because of this history with his patients. He justified it to himself that it was right to smother a man because he knew the man was suffering and he did not have a high chance to live. The whole situation – the evacuation after the hurricane and when the levees failed and flooded the city – plus the problems the hospital faced days after the hurricane messed with Thiele’s mind. He started off not wanting any part of the euthanasia when talking to another doctor (Kokemor) and then he changes into not being opposed to it which worried another doctor (Baltz). He had this fear of being robbed by looters and took it to an extreme in his mind thinking he was going to be robbed (by having his bracelet stolen) on a rescue airplane. And when he does get back to Atlanta and his family – he has a stoke at 53 and tells God he has his attention. It was like God told him he will be at end of life too and he was watching him to do good and not harm to others to get to heaven.
Discuss the various interpretations and nuances of end-of –life preferences in the book that take into account religion, consent and medical conditions.
The first interpretation was the hospital was to be built on strong God beliefs since it was a Baptist hospital. In the very beginning the hospital did not want to accept Medicaid or Medicare insurances and the government involved in its business. Here they are now being investigated by the Medicare Fraud Unit for the deaths of patients. All due to the doctors’ decision to make patients comfortable which ended the suffering of patients through use of morphine (and sedatives).
The second interpretation was the DNR orders of end-of-life patients and getting the DNRs rescinded for rescue from the hospital. The family of the patient normally did the DNR order with the help of the doctor (and consent of the patient). And if the patient was at end-of-life, the DNR meant the patient would not want to continue any life saving measures in the event of death. Families started to want doctors to rescind the orders so their loved ones would be rescued after the storm and flood.
The third interpretation is the hurricane, and the flooding stopped the hospital from medically treating the end-of-life patients. Even with the euthanasia laws against it in this country, doctors still felt the need to make patients comfortable with morphine (and sedatives) to help the patients be comfortable medically.
(correction to typo on question 2 response and I was unable to edit).
2. Why were pets brought to the hospital?
The pets were brought to the hospital before Hurricane Katarina hit. These pets belonged to the staff and families at the hospital. They were kept in pet crates in a hospital garage. The staff and families began to worry about how the pets were going to be rescued since the airboats won’t take pets.
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 were 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.
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.
Please ignore this discussion post by me. I was unable to edit this post. I couldn’t find it and then it popped up! 😊
Sorry all, this is my discussion post. I lost and then found my other one. Yikes! Sorry!
Carrie Anne
I like expository writing too especially when it teaches me new facts about a topic I am interested in! It happens a lot when I read newspapers and magazines as it brings a wealth of facts to store in my brain or in my journal. I love learning new things through what I read! Great thoughts!
Persuasive writing was a struggle for me in high school English classes. It took me going to college, taking English courses, to figure out how to write a persuasive essay! Here I am 28 years later and still learning how to write persuasive! Ha! I love creative writing too, especially coming up with character descriptions and plots lines in short stories! Great thoughts!
Hi Brandon! Congrats on getting into the LPN program and your starting on Tuesday! I enjoy and love being an LNA too! Carrie Anne
