"Five Days at Memorial" by Sheri Fink

The first half of Five Days at Memorial is one of the most compelling reads I've read all year. Fink recounts five days at New Orleans' Memorial Hospital immediately following Hurricane Katrina, detailing the events that ultimately led, on the last day, to several doctors and nurses administering lethal doses of drugs to a number of the hospital's sickest unevacuated patients.

Fink does an excellent job of putting the reader in the hospital staff's shoes as they fight mounting panic and uncertainty of rescue. Though rescue helicopters began to arrive early, they arrived without a central coordinated effort, making future return trips always uncertain. And the staff received no relief in caring for its many patients or in the simple yet backbreaking work of carrying patients up the stairs in order to be evacuated. If Hurricane Katrina revealed anything, it revealed a complete lack of disaster preparedness, from the individual hospital level all the way to the federal government.

Of course, why Five Days at Memorial has been made into a book is because of the staff's decision to euthanize a select number of patients whom they deemed would be unable to be evacuated from the hospital. For that reason, the second--and much drier--section of the book concerns the investigation into what happened and the later attempts at prosecution. I don't blame Fink, but there's just no way to make recounting interviews especially interesting, even if the subject matter is.

Though the book is written from a third-person objective point of view, it's clear that Fink ultimately believes that the doctors acted inappropriately and should be subject to criminal punishment. Yet, despite Fink's bias, I just couldn't agree (and neither could many others--none of the doctors and nurses were ever prosecuted). We expect individuals to be superhumanly heroic in times of disaster, but, even though they performed extraordinary services to the patients, the doctors and nurses are, ultimately, human. They were under stress, concerned for their lives, and had little outside support. They did not act maliciously or negligently--they did what they legitimately believed had to be done at the time. And, perhaps equally important, what is to be gained by prosecuting the staff? You deprive their patients of their services. You deprive their families of the presence. And you make them a jailed burden on the tax payers. What does that achieve? The doctors and nurses are unlikely to act similarly again, and the idea "justice" for the deceased families seems somewhat hollow. Their loved ones were very sick, and even if they had been evacuated, many or most probably would have died. After all, even after evacuation, the majority--sick and healthy--were left uncared for for days on roadsides or in the airport.

That's not to say that there were no poor judgments. That's made especially clear in the case of Emmett Everett, an obese man who was chosen for final evacuations because of his weight and other health conditions. He too was euthanized despite being conscious and alert the final morning. His case, more than any of the others, caused me to reconsider the doctors' actions.

Despite Fink's clear point of view, the book is excellently researched and compelling. Though the content should provide much for discussion, perhaps its most important contribution can be its emphasis on the need for clearly defined emergency procedures. When the insane occurs, people perform best with structure, order, and a sense of purpose.