Five Days at Memorial by Sheri Fink: Book review

In August 2005, a doctor with two newborn babies struggling for survival stood on a run-down helipad. Below him, floodwaters were lapping at the walls of New Orleans’ historic Memorial Hospital. A chopper came to his aide, but its pilot only had room for the babies—not their incubators. The doctor had to make a critical decision. He could keep the babies at the foundering hospital, which had lost power and would soon reek of sweat and feces, or he could disconnect them from life support and evacuate them, throwing their young lives into peril.

Such gripping accounts form the contours of author Sheri Fink’s Pulitzer Prize-winning Five Days at Memorial, an illuminating investigation into the moral and physical chaos that consumed a hospital during Hurricane Katrina. Memorial Hospital, like much of New Orleans, was woefully underprepared for Katrina. As the building flooded, electrical systems malfunctioned, and so did back-up generators. Bathrooms overflowed and temperatures skyrocketed, and yet workers acted valiantly, boiling water in microwaves to perform dialysis while citizens ransacked a nearby pharmacy.

When help from government agencies and the hospital’s corporate owners was slow to come, doctors and nurses grew nervous. False rumors about murderous mobs and a declaration of martial law only intensified their panic and anxiety. Certain staffers, among them Dr. Anna Pou, allegedly created a hierarchy of patients. Medical professionals prioritized patients that seemed likely to survive for evacuation, and they placed the terminally ill or those with do-not-resuscitate orders at the bottom of the evacuation list, breaking with conventional protocol. After being holed up in the dying hospital for four days straight, Pou and others went into “survival mode,” ostensibly administering a lethal dose of sedatives to patients who they deemed unlikely to survive the evacuation process.

Were these medical professionals being “humane” in a situation that had turned into a “war zone”, or were they a “renegade team roaming the hospital bumping people off” in order to save themselves? Fink allows the doctors and nurses who were present to offer a fascinating array of responses, and she also interviews the family members of deceased patients and the investigators who would later try Pou for murder. These individuals are all depicted with care and complexity, like characters in an extraordinary novel. Dr. Pou, for example, is a resilient, ambitious surgical genius, and yet her view of what occurred during the storm grows appallingly distorted with the passage of time.

Fink, a physician who has previously written about doctors during the Bosnian genocide, shines a spotlight on government negligence and mismanagement during Katrina, and she makes an urgent plea to society at large about the need to establish humane guidelines for denying “lifesaving resources” during disasters. But at the core of this book lays a subtle, cogent critique of corporatized healthcare, whose business motives have skewed essential conversations about end-of-life care.

A decentralized corporate structure in which key decision makers were business managers rather than medical professionals certainly contributed to the strife at Memorial, as did the fact that these managers were located outside of Louisiana, removed from on-the-ground realities. Accordingly, Fink’s meticulous reportage provides vital correctives to American readers who mistakenly equate public healthcare with the “death panels” of rightwing ideologues. It reminds an international audience that literature can soar to artistic and intellectual heights undreamed of in other realms of media.

Hirsh Sawhney, the editor of Delhi Noir, is the Interim Director of Drew University’s undergraduate creative writing program.