Dr. Sheri fink, what is the timeline of your book . What are you talking about . Casco im talking about this fire days in 2005 when the levees failed in new orleans after Hurricane Katrina and water just round one of americas most beloved kitties. Looking specifically about what happened after those five days at the hospital. Memorial Medical Center was one of those scary longstanding Community Hospitals that have been built in 1926. It was the place people went for storms. The staff would go there even if they didnt have to work. They brought along their pets sometimes because of coors you need somewhere for the past. They brought Family Members and they sometimes even to a coup detat may not be safe at home. This is a place everyone thought was safe in the storm. Host so they would ride out hurricanes . Guest yes. What happened was that this has several vulnerabilities that ive since learned Many American hospitals do. One of them was that element of the electrical power system. So when the waters dirtied approach in the hospital, they knew they had to evacuate because city power was gone. They were relying on this backup generator. Data within hours, all powers could fail. The first real dilemma was when helicopters landing on the route to take people, there were 250 patient, 2000 people. Talk is, nurses, staff, Family Members. Purdue rescue first thing i got our stuff to pow members. Purdue rescue first thing i got our stuff to power . That was the first dilemma. It also started getting hot inside the hospital. Another vulnerability hospitals have come im sorry to say, is they are not required for their backup Power Systems to keep the air conditioning or the heating, depending where you are in the country, functioning. Even before all power was lost, it was august, it was new orleans. It was hotter than it is here in miami and is it getting hot in the hospital, making it difficult for patients and people working there. Host where is memorial in new orleans . Guest it is uptown in new orleans. It is two feet below sea level. New orleans is like a bull in the dips below sea level. Many of the hospitals there were in a similar situation. Host what is memorials reputation . Guest the reputation was excellent. This is a place where people were proud to work. The giants in new orleans had walked the halls. People were proud to work. It was a place where a nurse would work and have a child and the child would grow up and work in the same unit. Theyre a Multigenerational Families who had worked at this hospital here at a real family, a Real Community and very wellregarded. Wellregarded. It had been a baptist hospital, originally known as southern baptists. But the changes in medicine we saw in the 90s, it was bought by forprofit company. Host is memorial opened today . Guest it is under new ownership and back with a baptist name. Same building. I was just at the other day and theyve just reopen the neonatal icu in a place for people to go have their babies, which is many, many people were born at doctors hospital. They have made the improvements in their electrical system that unfortunately, hospitals and the for example, in my city where i live now, new york, do not have to make improvements until the year 2030 because we discovered with Hurricane Sandy that we at the same vulnerabilities in as many places in flood prone areas that do not have their Power Systems protect it. This hospital now does. They felt secure enough to bring their babies back. Eight years later, it took a very long time for this to occur. Host sheri fink, walk us through the five days. What is the date we are talking about . What happened on the first day . Guest basically the first everybody arrives. The next morning the storm hits. It was scary. Thats not what they remember. They remember the next day, the third day that the levees failed near the hospital that the water started coming up. Thats when things became very, very critical. You can imagine we rely as doctors and nurses rely on power to do just about everything, whether it is running an iv that is run by gravity. Now there are electrical pumps, which are not digital. That doesnt work when when the power fails. Think about ventilators. People who rely on machines to help them breathe. Those failed. The doc is had decided to get the neonatal outcome of the little babies, as well as the intensive care unit patients. They also designated a group of patients to go last. Some of the sickest patients with do not resuscitate orders. We have since learned that this may not be the best way to do triage, trying to figure out how you get the resources that people need to people in a crisis. Sometimes you need to allocate those resources or ration them. You do not resuscitate order does not mean that somebody can benefit or would want to be saved at the expense of others, which is what doctors assumed. Bad to make this on the fly. So these patients it was decided they would go last. And you imagine all power fails. They moved patients out of their brooms come into staging areas, think and helicopters would be coming. At some point, everybody was up on the rooftops. Many people did not evacuate the cities. People waving anything they could to get helicopters to come rescue them. The pilot had to decide, do i rescue someone off a rooftop that may not even have water . Or do i go to this hospital where presumably they have a helicopter drop of medicine that they needed. Sometimes the helicopters came very slowly. The patients grew sicker and sicker. Some of the staff grew very afraid. Host sheri fink, 2000 the hospital when hurricane hit. How many people were evacuated . Guest so, what happened was purchased incredible work, creative thinking, they were bitterly doctors and Staff Members who win out a new faribault semitrailers in the neighborhood. They went and hotwired one of them, brought it back to the hospital and started getting sent ablebodied people out because dry ground was only about eight blocks away. That would be a way. They got people out that way. Originally, they started euthanizing pets because they felt, no, we cant set them on a helicopter. We are trying to take patients and Family Members out. It turned out through creative thinking they were able to extend resources to the hospital. I always say one of the big lessons is that you, me, any of us could be in a disaster for official hop doesnt come quickly enough. Its really that creative thinking, the preparedness of you and me to care for ourselves, Family Members, community is really crucial. You saw in the philippines, too. The help comes a little too late. There is a Family Member of a patient who is outside of new orleans, who fought her way past the check point, found some guys in a small boat and got an directed them to the hospital. Saved not only her and her husbands mother, but also many, many people at the hospital. Overall, there was an incredible effort to coast guard skin. No air Traffic Control risk in their lives to an anonymous helipad that hasnt been used in years. What was found after were 45 bodies. About 40 patients had died during or after the disaster. Thats when this question began, why did so many more patients die at this hospital than many hospitals in a similar situation . Very soon after, some of the staff at this hospital came and spoke with the media, spoke also with investigators for the state and said, we think something happened here that wasnt right. Just imagine you are in mrs. Them. You feel patients are starting to die. You think you may not save everyone. You categorize a whole group of people, but you think they may not survive at all. The question began circulating in the hospital. Shouldnt we be thinking about putting the patients out of their misery . Host who started the circulation question . If youd like to participate in our conversation with sheri fink, the author of five days at memorial, also a poet or winner and medical doctor. Were talking about Hurricane Katrina, medical ethics. 202 5853880 the Central Eastern time zone. By the high 3881 and a knot in pacific and further west to time zones. You can also send comments or questions via twitter. booktv is our twitter handle. So back to my question. Guest yes, several people started talking about this when i investigated and looked into how this all played out. It was interesting because even at the time there was great tension over this, there were staff who thought like this was the right thing to do. Some of them bravely spoke to me. I say briefly because ultimately there were arrests involved. There were people who thought they should give these patients in madison and help them to their death essentially. One of the authors that he was so fright and he literally called his wife and that i dont entail going to see you again. He had to get out of the hospital and what would happen to the patient. Host who is he . Guest he passed away recently, that he is a Critical Care doctor at memorial. Host he was there for the five days . Guest he certainly was. Postcode can you say doctors at memorial were euthanizing patients . Guest it kind of takes you back into the definition of euthanasia. I typically say to doctors told me that should be called according to the attorney general of louisiana, murder, seconddegree murder is what he called it. He arrested several Health Professionals because, a yearlong investigation took place. According to medical ethics, the laws of the land, the will of the Family Members who were present and some cases, that we dont do this. There is a tradition in madison that goes back to hippocrates, that doctors should not be in a role. That is something medical codes in the United States is not about. There are few places in the world now where euthanasia is allowed, but only with a can and then under certain very strict rules for the end of life, if wishes that to be hastened. Host sheri fink, who is dr. Anna poe . Guest dr. Anna poe is a head and neck surgeon. She was one of the doctors who is now said to give some benefits to patients. The investigation shows that 20 patients receive a combination of morphine and a powerful sedative, one of the other oath and died in a very short time. Im not fit day, but thursday, september 1st. Many physicians and nurses were involved in this. She was one of them. There were two nurses who are off the arrested. The three of them arrested and accused by the attorney general of seconddegree murder in the deaths of several patients. They were arrested because the prosecutors had the most evidence. There were witnesses who had seen them, who had heard them, had spoken with them about giving medicines. Unlike the doctors who spoke with me openly about what they did, dr. Poe, while she spoke with me, will not address the issues around those deaths. Not surprisingly, if you are arrested and accused of murder, settled or dismissed now. I think, on the advice of her attorney, she has not really address the issues that the court, except to say she was innocent and not guilty of murder. Host still practicing medicine . Guest dr. Poe is still practicing medicine at Louisiana State university. In fact, she was promoted after these events because, i should say that there was coming in now, while the evidence was there that these deaths were hastened, certainly the drugs were given. What the motivation was was that the case hinged on. If you intentionally cause death, you can see that might fit into murder according to the attorney general. However, if the medicines were given for comfort, that is something we do allow in the United States, certainly to treat patients for comfort truth the endoflife. But you know, the experts who were called in to look at these cases were pretty convinced. There was one that just a pattern of so many deaths in such a short time led them to believe that this was more than just an effort to provide comfort. But these Health Professionals and louisiana, because of the larger context, that the decisions were made in and fail to respond quickly enough on a governmental level, corp. Model. So given that context, and if so, how we arrest three professionals give incoming and no, all that sort of failed around them. Host sheri fink, when did news reports start coming out about what may have occurred at memorial . Guest very early on there were doctors and nurses who disagreed, who had been involved in discussions over euthanasia, putting people out of their misery, whatever wording you want to use. They felt this was wrong, the patients were suffering to a degree where this is called for, even for comfort medicines. Doctors said her job is not to bring about death. He really disagree. Some of them spoke with the media. Early on their intimations of what might occur. Of course, no real evidence. A lot of people tend to dismiss the story as a sensationalist that cannot believe what happened. I had worked in disaster conflicts as an aid worker. My first spoke at the hospital under siege for three years during the bosnian genocide. Never a set of the of fiction had i heard of a situation getting so desperate that doctors and nurses really thought that some of them thought this might be to best option. It was urgent for our country to know the true story and that was the best way to really honor the sacrifices of the people who work so hard in the situation and the lives of the people who had passed away, was for us to face this head on, do not walk away from it, to look at these events. Whatever the motivation, whatever the feeling for the people who took this fact, obviously thinking it was the best name. We need to learn from that spirit we need to go forward. We dont want to see this type of thing happen again. Theres all sorts of important lessons for preparedness in our country, invest in infrastructure, areas that have vulnerabilities in certain disasters or organizations better prepared leadership and communication and individuals have been around plants, thinking through the first half is almost an hour by hour for recreation of what happened. Unlike these four. Yours and nurses who are stuck in a situation, we have the luxury of thinking about what we would want to do. Host you have a picture in here of memorial underwater. Want to show that to our viewers. 202 5853990. 5853891 in case youre interested in participating in our conversation. Please go ahead and show us what we are looking at. Guest this is taken on the fifth day. One of the tragedies here is finally the helicopters arrived to assist day. Theres a real concentrated effort. Five federal officials, just as the injections were taking place. One helicopter heading towards the hospital. You can actually see a helicopter on the top there. This is the garage ramp. Creative thinking is that saved lives here. They saved so many lives. They pushed the patient drove them up or down brand of the circling parking garage and then carried them out these rickety steps to the top of the helicopter. When the power fails, youve got no elevators. Host you see the water in the streets below. How isolated we the people of memorial on day four . Guest thera isolated. This hospital is two city blocks long, like many of our hospitals. There just was in a pattern regular meetings. People really felt like communication was good in the hospital. So there were people who have radios are in touch with rescuers and coast guard plucked a radio fare. Or for that is to get from the top of that helipad and to send staging area and the hospital, it was very difficult. The rumors just flew. As i was writing five days at memorial, i got the audio from the callin radio show that was happening. There is a Radio Station that kept going. People were calling in and supporting what was happening. People with that or he powered radios were listening. There were rumors of sharks and hotel swimming pools. They were saying that zombies were taken over new orleans. I mean, really. People at the hospital heard gunshots. The phones were cut out. They didnt have satellite phones working. You asked, where they cut off . They felt very cut off. Host what was the temperature in the hospital . Guest people have estimated that as 100 degrees. The stations were not keeping record at that time. I would say it was in the name is at least in the area around the hospital. Inside, it became human. If youve ever been in a hospital, they are sealed shut. When the power goes down, which it sometimes does, if you have no air conditioning, the walls start to sweat. It becomes slippery on the floor. It becomes so difficult to work. Host did they have water . Guest they did have water. They did not have running water. Some people feared that it would run out. Host sheri fink come youre a doctor, a medical doctor as well. Ha host sheri fink come youre a doctor, a medical doctor as well. Have you thought about putting yourself in the place for those five days at memorial . Guest ive worked in conflict and disaster zones as a worker with the nongovernmental organizations. That is what made me interested in looking at this tori. I certainly was not there when this happened and that is why it took me six years to gather documentation, to really try to piece together, moment by moment, what happened. I have a lot of empathy working for people under situations of grace rest. I felt that this lack of sleep for days can do to you when you hear gunshots going off in alms exploding. Ive been in that type of a situation. And so, that gave me some sympathy for the condition. Host were these patients euthanized in your opinion . Guest i think it is completely clear that its going to be argued 20 patients were found with drugs and their bodies. It is well documented when they died, where they died. They would take these medicines in a short period on thursday, september 1st. As to the attention knowledge of each individual person who did this act, that is sort of up to each person to say. So, two doctors said we intentionally hasten the death of her patients. Others have said i was trying to give comfort. I think when you read the book, i wanted to show the different days. I didnt want to insert myself in a manner. You know, the whole question of the legal aspect of it, the whole second half of the book is how did we adjudicate these potentially criminal acts in the context of the disaster. Host sheri fink is our guest,