In the days following Hurricane Katrina’s landfall in New Orleans on Aug. 29, 2005, Dr. Anna Pou and 2,000 others endured “third-world” like conditions at Memorial Medical Center in Uptown New Orleans as they waited to be rescued. By the time evacuations were complete, 45 critically ill patients had died. Pou was left with painful memories, in addition to accusations of “helping” four of those patients go peacefully with a lethal cocktail of drugs. The next year, Louisiana’s former attorney general Charles C. Foti charged Pou and two other nurses with second-degree murder. Charges were dropped in 2009, and now, Pou reflects on her experience during one of the deadliest disasters in U.S. history.
Q: What does Hurricane Katrina make you think of?
A: There were people everywhere. The day Hurricane Katrina made landfall the hospital was overcrowded with patients, health care workers, family members, men, women and children from the local neighborhood who came to seek shelter – and over a hundred pets.
There were about 2,000 people, with only around 200 patients… among those patients approximately 20 were transferred to the hospital from a near-by Life Care-operated hospital, many [of] whom were very ill. Their arrival and the departure of Life Care’s medical director complicated things significantly.
The doors were locked at 5 p.m. and we all settled in for the night. Shortly after midnight, the storm made landfall. There were heavy winds and rain with some leakage of water around the windows and through the ceilings… We lost power, but the generators “kicked” on. We all waited for daylight to assess the damage.
Q: In the days after the hurricane hit, how did conditions inside Memorial Medical Center change?
A: The hospital was being powered by generators. It was hot and incredibly humid, but we had some lighting, elevator services and workable medical equipment. We had running water on Monday, but the water was not “clean” and could not be used for dialysis or for drinking. Rations of food and water were provided for patients and healthcare workers who were considered essential personnel.
It was obvious to us Tuesday morning that the levees had breached. We could see the city flooding from the hospital windows. The conditions deteriorated after the flood waters rendered the generators inoperable. We lost generator power shortly after midnight on Tuesday, August 30. The toilets overflowed, we lost all electricity, there was no running water and communication was poor. We no longer had the use of modern medical equipment… we cared for patients by flashlight, but there was a shortage of batteries to keep them operating. It was dark, the heat was relentless – many of the windows did not open – and sanitation was poor… conditions became third-world like.
Q: What was the evacuation process like?
A: Only a few ambulatory patients were evacuated on Monday with the help of the National Guard. After the city began to flood, the most critical patients and the babies in the nursery were evacuated by helicopter on Tuesday and hospital administrators tried continuously to find resources to evacuate patients… Many patients and family members were evacuated by volunteer air boats which arrived early morning and few non-ambulatory patients were evacuated by helicopters.
On Wednesday morning, all patients were carried down multiple flights of stairs from where they were being housed into a central area for evacuation. Depending upon the patient’s condition, evacuation proceeded by boat or helicopter.
Patients first had to be passed through a hole in the boiler room, into the parking garage and driven in the back of trucks to the helipad. They often waited in the hot parking garage and helipad for countless hours and were also taken, at times, to destinations unknown.
Evacuation by helicopter was scarce until Thursday afternoon. Those who were rescued by boat boarded at the Emergency Room ramp and were taken to dry land a couple of miles away and then eventually taken to safety (destinations unknown). Those who were waiting for helicopter rescue were eventually taken to the helipad by the teams which had organized the evacuation.
Q: How were those with do not resuscitate orders handled during evacuation?
A: [Patient’s with] do not resuscitate orders were cared for with dignity, compassion and respect, just as any other patient was cared for. The chief of staff and others in charge of the evacuation made a decision Tuesday night to make the DNR patients a lower order of evacuation due to the seriousness of each patient’s condition, not the DNR status alone.
Q: Does Memorial Medical Center trigger any flashbacks or bad memories for you?
A: My time spent in Memorial Hospital in the aftermath of Hurricane Katrina has left me with indelible memories… I remember patients lying on cots everywhere with every man, woman and child working tirelessly to comfort them.
Young children, the nurses’ children, held their hands, talked with them, fanned them and prayed with them. I witnessed the ultimate sacrifice that a mother could make. The nurses stayed to care for patients while they sent their own children to the rescue boats, not knowing when and if they themselves would be rescued. These are the memories that I will never forget; the many acts of love.
Q: What lessons do you take from this?
A: Having lived through a disaster first hand, I have learned that health care providers and patients are at the mercy of the hospital disaster plan and it is incumbent to us all, to know these plans and those who are in charge of executing them. In addition, hospitals should not be used as shelters, full hospital evacuation plans need to be in place, and if able, whole hospital evacuations should take place prior to the event, back up security and communication systems are essential, clean water is vital and all hospital personnel should undergo disaster training, not just those on the “disaster” team.
I have also learned that many of those who weren’t there can find it very easy to second guess and profess some special knowledge of what happened and how things should have been done differently. Unfortunately, many in the media fall into this category.
Q: How did the accusations of administering lethal doses of drugs affect you?
A: I have maintained throughout the past five years that my work and the work of the nurses was above reproach and that we were singularly focused on providing comfort and care to the very people the government at all levels abandoned.
Like any of us who lived through Hurricane Katrina and those who had family members at the hospital during the storm, my life will never be the same again. The events of the last five years have strengthened my faith and have given me the courage and resolve to do my part to ensure that nothing like this ever happens to patients and health care providers again.
Q: What is the purpose of the laws you have helped write and pass in Louisiana after Hurricane Katrina?
A: Louisiana’s model disaster legislation was written to protect the medical judgment of doctors and nurses making difficult decisions during difficult times from being second guessed. It does not, however, protect against gross negligence and intentional acts. Without healthcare providers who are willing to serve during a disaster, there will be no one to care for patients during these dire times.
While some have portrayed the legislation as designed to protect doctors and nurses, the reality is that it protects patients who depend on them. If medical professionals won’t stay and serve out of fear of future liability, there is no patient care. Patients and their families will only be the ones to suffer and pay the price. What happened in New Orleans can happen anywhere. It is not just about hurricanes.