Presented without comment... for now
from part 1:
[keeping in mind that i am not a transcriptionist] Dr Fink:
Now there's a field of humanitarian assistance where we look at those really extreme situations and we say How can we do better? How can we ensure that as many people survive as possible? How can we do our jobs in the best possible way? Human beings deserve that.
The real relevance here, from a journalistic standpoint, is to look at the fact that America is going to face future disasters. We're going to have more hurricanes. We have threats of pandemic diseases, including influenza this season. There are going to be times where resources are limited. There are going to be times, unfortunately, where government fails as government failed these people and health workers and patients get trapped in very difficult situations.
The whole reason to go back and look at this is to say What can we learn? What is it that this story teaches us?
Meanwhile, if you want to know what a living nightmare really is, read this story from today's NY Times Magazine about the plight of one of the hospitals during those horrible days, the awful decisions they faced and the people who made them.
Did anyone else read that NY Times piece and not come away thinking that Anna Pou should be doing a very long stint in a dark hole somewhere?
I think Pou already did her stint in a dark hole. As she and her staff chose to stay when others ran and made decisions in hellish conditions after days without sleep, I'm not going to second guess her.
Maybe her decisions weren't always the best, especially when viewed from the comfort of our air-conditioned homes. But she still stayed when others ran.
@ Will: I'm sorry, but staying and doing your job doesn't vindicate you or make you a hero. There were people in that hospital who stayed and did their jobs and refused to murder patients - maybe as many as 45 - because moving them would have been difficult and abandoning them would have looked bad.
She murdered a man who was resting comfortably because he was fat and how were they going to get him down seven flights of stairs. That kind of thing should get you life in prison, not booked on 60 Minutes.
commenter bob h:
I have heard so many people tell me that the government response to Katrina lead them to feel ashamed to be Americans.
Now this healthcare craziness is giving me the same feeling.
I'd recommend reading a little more widely on the event. The NYT's piece was definitely damning. It was written to be, with all the shading, omission and lack of context you'd find in any piece meant to lead you to a certain conclusion. I certainly have a strong suspicion that a 300+ hospitalized man sitting in 100+ degree heat and tropical humidity was not "resting comfortably."
Pou isn't in prison because a jury closely examined the evidence - presented by a very zealous prosecutor - and decided that she didn't deserve punishment. The community followed that judgment by removing the prosecutor from office in a subsequent election. The people of NOLA lived through Katrina and have a little bit more perspective on this than someone who has read a hatchet job in the New York Times.
Pou's trial by media doesn't impress me. As with the death panels and Terry Schiavo, the public at large can't deal with realistic choices when it comes to dealing with death.
commenter Sarah B.:
Will | 08.31.09 - 11:23 am | #
Well said -- and thank you for the clarity.
It was always clear to me that Dr. Anna Pou and other medical personnel were the designated scapegoats to cover up a tsunami of criminal negligence by people in much higher and more influential places than that of Dr. Pou. To say that she found herself in an impossible situation would be to understate the challenges she faced at the time.
I always appreciate large injections of light to offset the heat on any topic.
@ Will: Any suggestions on where to look?
I remember reading about it when she was initially arrested and thinking that they were railroading her based on the original stories I read.
I'm not sure if the Times' piece was a hatchet job or not but it definitely casts her and, was it Cook?, in a very bad light.
When you have a coroner go to something like nine or 10 people in two different countries to get opinions on whether or not what she did was on the level and all but one says it was clearly homicide, that's pretty damning. Moreso than being let off in a city that's notorious for sketchy justice and that re-elected a guy like Ray Nagin, who was only slightly more proactive than Brownie and Bush in the lead-up to Katrina.
The sense I got from that NY Times thing was they saw the streets flood, realized they had no usable evacuation or emergency plan and it basically turned into Lord of the Flies and the primary goal became getting out as quickly as possible and if that meant some people who were holding them back had to die, so be it.
And I'm sorry. Whoever gave that poor fat guy the lethal dose is a murderer. The guy wasn't terminal. He wasn't even that bad off. How about the old lady whose son came in the air boat to rescue people and they weren't going to let him take her out? Or the woman who was forced to leave her mother behind to be killed by lethal injection?
JT, This is being treated as if it were some sort of expose', but the author Sheri Fink in an interview is actually very sympathetic and complimentary toward Pau and the rest of the medical staff at Memorial. Her conclusion is that we don't want this to happen again and have government fail and medical professionals put in such an awful position trying to save people under such horrible conditions. For context, it's also important to realize that "euthanasia" of a sort occurs commonly in non-disasters under the principle of "double effect". It is considered ethical for a physician to give a dose of pain med that may be fatal if the intent is to relieve suffering. In practice, the doctor is sometimes fairly sure that it will be fatal, although it is hard to predict. I told a doctor who was feeling disturbed about having given "a lot of morphine" to someone who then died, that he is the kind of doctor I want to have if I'm ever in the condition that the patient was in, who was someone I knew. Now imagine having to make that choice under hellish conditions where people are suffering and dying, the water is rising every day, the hospital is dark and stinking of sewage, medical staff are helpless and can't get people out and don't even know what has happened to their own family, everyone is exhausted and traumatized, and help is not arriving. Those professionals were heroic. I'm sure some mistakes were made under such conditions, but conservatives will use this as another death panel argument because they have no imagination and can't face reality.
@ DeanOR: That's the same kind of doctor I would want taking care of me. But the question this story raises is "Was Pou that kind of doctor?" and the answer if the story is true is no. She wasn't pushing the ethical limits to ease her patient's suffering. If she'd OD'ed the ventilator patients who were going to suffocate because there was no longer a machine breathing for them, that's one thing. Or the one patient, I don't remember the exact details, but pretty much everyone agreed she might have mere hours left to live. That's fine. That's compassionate care. But when you start giving lethal doses to people who are in stable condition, alert and aware and begging you not to leave them behind cause they want to live, that's murder.
I honestly can't say that I would have had the courage to stay at my post, not knowing whether my family had made it out alive or whether I'd be able to get out alive myself. But I wouldn't murder defenseless patients in their beds. There were plenty of people who stayed in that hospital and did their jobs bravely and didn't cross that line.