Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital

The injured ICU nurse has suffered serious rib and internal bruises but no broken bones; he spends three days in a Baton Rouge hospital mainly for dehydration. Mulderick and other staffers are helicoptered to a nearby airport: “She and her exhausted colleagues [are] asked to care for people there” (238). 

Some staff and a few hospital executives are helicoptered directly to another Tenet hospital “and given a hot meal and a room to shower, shave, and change” (238). From there the executives are flown to Hattiesburg, Mississippi, where they leave on private jets “to their preferred destinations” (238). Tenet supplies many hospital employees with bus transport to an upscale hotel in Dallas where they receive rooms and food vouchers.

Several days after everyone has been evacuated from Memorial, disaster teams return to the hospital to find an extreme stench: “[T]hey recovered forty-five bodies from the chapel, morgues, hallways, LifeCare floor, and the emergency room” (230). A news team interviews Dr. Pou, who says: “We all did everything in our power to give the best treatment that we could to the patients in the hospital, to make them comfortable” (230). 

Other hospitals suffer casualties. At St. Rita’s nursing home, 30 residents drown; at Touro Infirmary, sixteen bodies are found, possibly euthanized. Attorney Butch Schafer and Special Agent Virginia Rider, both of the Medicaid Fraud Control Unit, begin an investigation. They hear from LifeCare that its patients at Memorial may have been euthanized. 

Two weeks after the hurricane, Tenet Healthcare begins notifying families of patients who have died at Memorial during the evacuation. Callers are instructed to explain that the notification delay is due to the destruction in New Orleans: “Your loved one was cared for throughout. Your loved one was identified and shrouded and placed in our chapel area. Your loved one was treated with dignity” (236). 

The media want to talk to the doctors involved. Dr. Pou realizes she’s under suspicion; she hires well-connected attorney Richard T. Simmons, Jr., who “had helped represent commanding officer Lt. William Calley on an appeal in the My Lai massacre case” (240) and had defended a corrupt governor’s business partner. Pou’s employer, LSU Healthcare Network, picks up the bill. 

Reports surface of deaths at nursing homes where patients aren’t evacuated during Katrina and die of heat exposure. Other reports describe deaths among evacuees during transit, which somewhat justifies the Memorial doctors’ decision to hold back their own critical patients from evacuation. 

Schafer, Rider, and federal investigator Artie Delaneuville interview LifeCare personnel who had witnessed Dr. Pou’s activities on the hospital’s seventh floor. Their stories corroborate, and “two recalled that Pou had told them directly that ‘lethal’ was her intention” (252). 

On October 1, Schafer and Rider, armed with a warrant, lead a large team to Memorial hospital to search for evidence. They grab computers, documents, drugs, and trash bags full of syringes. Rider wonders why the staff hadn’t simply moved LifeCare patients to the helipad via “the route over the rooftop directly from the seventh floor” (254). 

Tissue samples from eighteen deceased Memorial patients are sent to a lab in Pennsylvania; tests come back positive for high levels of morphine and Versed: “Of the eighteen samples tested, those positive for the two drugs coincided exactly with the names on the attorney’s list of suspicious deaths” (260). 

Dr. Bryant King, disturbed by the high number of bodies reported at Memorial, contacts the investigators. King had counted 21 fatalities, but 45 dead were found. He tells investigators he had verbally objected to the euthanasia plan, but, as the newest hire and a black man in a hospital turning away blacks seeking help, he felt he had little leverage. He saw Dr. Pou holding a handful of syringes: “King said it was highly unusual for a doctor to be handling syringes” (264). 

A sister of Susan Mulderick works at Tulane Hospital downtown, where, under similar conditions, all patients are evacuated with no fatalities. Its “parent corporation, HCA, had been proactive about arranging for private helicopters and buses to rescue patients, employees, and their families, betting correctly that government assets would prove insufficient” (266). 

Tenet abruptly lays off all Memorial staff with little beyond relief pay. Staffers are angry to learn that other hospitals nearby “continued to pay full salaries for months” (267). One nursing director chastises CEO Trevor Fetter for Tenet's failure to assist fully in the evacuation: “[H]ow dare you give this nation the impression that you were providing for these patients and for your employees” (268). 

Mulderick hires an attorney who warns her that LifeCare has accused her of euthanasia, but that the evidence is likely too weak to worry about. 

CNN breaks the Memorial story nationwide. Hospital staff have been eager to tell their stories, but soon it becomes clear to all that a criminal case is being built: “[S]uddenly the main people Rider and Schafer wanted to speak with were lawyered-up and unwilling to talk” (276). 

Dr. Thiele is concerned that he may be under suspicion. Tenet won’t represent him because he’s a contractor; now unemployed, he must scramble to pay for a lawyer. 

Dr. Culotta agrees to an interview, where he describes how one patient waiting on the helipad goes into terminal respiratory distress and “we gave him pain medicine, ah…as he was taking his last breaths” (297). A second patient on the helipad suffers a Cheyne-Stokes respiration pattern; they administer morphine, Ativan, and Versed, which Culotta knows will hasten her death: “[W]e did everything we could to make her comfortable” (298). 

A researcher learns that Cheyne-Stokes breathing also accompanies non-lethal situations, and that agonal breathing, which does precede death, occurs when so little oxygen is being absorbed that the brain is almost certainly unconscious and therefore not feeling pain. 

The investigators focus on the case surrounding Emmett Everett, one of the seventh-floor patients who had been in fairly decent shape, awake and chatting, but who was too heavy to move all the way downstairs and all the way back up to the helipad. LifeCare respiratory therapist Terence Stahelin tells them: “There’s a big flat roof next to the seventh floor. They could have knocked a window out and passed him through a window and then across to the helicopter pad” (307). 

LifeCare physical medicine director Kristy Johnson recalls seeing Dr. Pou and nurses injecting seventh-floor patients who then die, shortly after. Nurses Cheri Landry and Lori Budo, who accompanied Dr. Pou on her seventh-floor final rounds, seem likely as suspects. Other interviews produce more information but nothing definitive. Pou’s and the nurses’ actions appear suspicious, but, so far, there is no solid proof. 

Questions arise as to whether Tenet executives could have ordered euthanasia. Tenet is, after all, “a company with a trail of fraud and abuse suits and settlements” (319). Schafer and Rider want to interview them, but “it would probably be a waste of time now that the company was lawyered-up” (318). 

Major parts of the investigation are leaked to the media. Rider thinks Tenet leaked it and tries to subpoena them. Tenet is a heavy contributor to local politicians; higher-ups tell Rider to back off. The investigators want to interview Tenet lawyers who spoke with Dr. Pou before she retained her own lawyer, but a court rules against them. In June 2006, “Tenet announced intentions to sell Memorial Medical Center and its other hospitals in the region” (321). 

In July, Rider receives word that the state attorney general wants her to arrest Dr. Pou and nurses Landry and Budo. She is ordered to “get the warrant signed at six p.m. on Monday. She was to execute it the same day” (325).