Review: "Five Days at Memorial" by Sheri Fink

  • Posted on: 14 September 2016
  • By: TedG

Attendees were Adrian, Ed, Ted, Jack, John Hand, Ray, Chuck, Angelo, Mark, and Bill. Irv wanted to be there, but the trout were biting in Idaho and he couldn’t leave; but he sent his scores in for consideration.

First, our discussion of the book was wide ranging, but typically on point. The book recounts the events during the five days during and just after Hurricane Katrina at Memorial Hospital in New Orleans. During that period, electricity was lost to flooding, communications were spotty and confused at best, status of possible outside assistance was uncertain, and lines of authority were blurred and sometimes confused. Medical professionals had to make difficult, perhaps impossible, medical and moral choices under very difficult emergency conditions. The book also describes the subsequent legal and political aftermath, detailing prosecutions of one of the doctors and two nurses for homicide, and the role of public opinion in the justice process. And it goes into some of the planning and administrative steps that might have led to better outcomes (that is, fewer deaths).

Generally, folks were impressed with how vulnerable our critical services, in this case, medical services, are to major disruptions whether weather related, geologic, or terrorism. Forty-five people died at Memorial during those five days, many due to lack of electrical service for ventilators and other life-saving equipment––maybe better planning would involve finding some low-tech alternatives to the hi-tech equipment. Some also thought the socio-economic status of some of the patients may have led to them getting poorer care or even euthanasia. This was part of a broader discussion of euthanasia, palliative care, DNR (do not resuscitate) directives, and patient triage in such situations. Some thought the storm narrative was too much like a somewhat disconnected sequence of facts rather than a tightly written and compelling story, and that the discussion of the ethical issues was superficial; others disagreed.

Some discussion highlights: Angelo recounted his recent medical emergency in which he was unconscious and, through extraordinary measures, pulled through even though he had (he thought) an informal DNR arrangement with his wife, Virginia. He was glad (very glad) the DNR was not executed in this circumstance. Bill noted that the book Being Mortal, which discusses end-of-life issues, is part of his advance directive (a future read?). And we had a good discussion about triage––allocating scarce lifesaving resources among patients. Sickest first? Those most likely to benefit from immediate care (i.e., not die)? A lottery system where all have an equal chance to be saved (or not)? One lesson from the book was that no one––not the feds, not the state, not the city, not the owners of the hospital, and not the staff were prepared for an emergency of the scale of Katrina, and that better emergency planning could have made big improvements in the outcome. 

Average ratings for Readability and Interest were 3.7 and 4.1, respectively. Two people said they would read another book by Sheri Fink, and two said they would not. The other seven said maybe.

We settled on the two remaining books for the year:  1493 by Charles Mann and That Distant Land by Wendell Berry. We will discuss these in November and December, respectively. Other candidates, perhaps for next year, were Heart of the Lion, Hero of the Empire, Angle of Repose, Being Mortal, and some works by Ursula LeGuin such as The Left Hand of Darkness.

Plan to meet next on Thursday, October 6th, at 6:30 to discuss Grandma Gatewood's Walk. The January meeting will be reserved for our Book of the Year discussion and a discussion about how we should go about selecting books for the year.