“Blindness was spreading…”

“Blindness was spreading…” is the epigraph from José Saramago’s Blindness that opens Part I, “Deadly Choices.” Its decisive image is not of a sudden calamity but of an insidious spread: small rivulets gradually soak the ground until they submerge it. In the book’s account of Hurricane Katrina, the metaphor offers a way to see how accumulated institutional histories, emergency rules, and individual decisions could converge in a disaster without being reducible to one dramatic moment.

The Image of Gradual Inundation

The epigraph describes blindness as a process whose scale becomes clear only after its separate currents have joined. That structure echoes the book’s movement between the immediate crisis at Memorial Medical Center and the histories and decisions that preceded it. The flood is literal in the narrative; blindness is figurative, a failure to perceive the consequences of practices and categories that may appear ordinary when considered one at a time.

The metaphor’s force lies in its delayed recognition. A decision can seem administratively manageable in isolation, while its effects accumulate across people already exposed to danger. By placing Saramago’s sentence before the account of the hospital crisis, the book invites readers to attend to that accumulation rather than treating catastrophe as an entirely sudden rupture.

A History of Unequal Care

Jannie Burgess’s history gives the image a long institutional timescale. She entered nursing to support her children and worked for decades in New Orleans hospitals and nursing homes. Yet, because she was a light-brown-skinned Black woman, she could care for patients in private hospitals where she herself could not receive care. Born just months after Memorial opened in 1926 as Southern Baptist Hospital, she waited more than four decades before she could be a patient there.

The hospital was among the last Southern hospitals to integrate. In the mid-1960s, when federal hospital programs including Medicare made reimbursement conditional on nondiscrimination, Baptist refused to participate, arguing that it should remain free of governmental direction. The epigraph’s slow infiltration resonates with this history not because the book equates every later decision with the earlier discrimination, but because it places the emergency within institutions whose practices had long shaped who could enter, receive care, or be recognized as vulnerable.

When a Classification Becomes a Barrier

During the evacuation, Memorial’s doctors made an exception to prioritizing the sickest patients and those dependent on machines: patients with Do Not Resuscitate orders would go last. The four DNR patients in the intensive care unit included Helen Breckenridge and Jannie Burgess. The distinction between a DNR order and a living will mattered: a DNR directed clinicians not to revive a patient whose breathing or heartbeat had stopped; it did not itself mean that the patient was terminal or should be excluded from rescue. Richard Deichmann later explained that he had understood the law to require a certified terminal or irreversible condition and believed DNR patients had the least to lose if disaster struck.

The consequences of treating the label as an evacuation judgment became unmistakable when staff stopped moving a bed-bound patient after seeing her DNR order. Her daughter had agreed that her ninety-three-year-old mother should not be resuscitated after cardiac arrest, but had not understood that the order could leave her behind. Once the daughter asked to cancel it, staff found a doctor to remove it; the patient was taken downstairs toward the helipad and survived that immediate ordeal. The episode makes the metaphor concrete: the failure was not simply a lack of information, but a failure to see that a medical instruction with a limited purpose had acquired a different, life-altering meaning in the emergency.

Perception, Disagreement, and Counterexample

The book also presents disagreement over what the crisis revealed. When a family with small children arrived by boat, Memorial turned them away. Bryant King protested to L. René Goux that the hospital had to help people. Karen Wynn saw a hospital already at capacity and did not perceive racism in the refusals; King, the only African American doctor on duty, was especially troubled that those turned away were nearly all African American. He avoided making race explicit in his argument because he expected it would make others defensive. The book preserves this difference in perception rather than resolving it into a single account, even as it emphasizes the contrast between animals sheltered inside and babies afloat on polluted water outside.

Charity Hospital supplies a further counterpoint. It faced flooding, loss of power and basic services, no helipad, severe evacuation obstacles, and more patients with fewer staff than Memorial. Its transfer of patients took until September 2, a day after Memorial’s, yet fewer than ten patients died. Staff accounts described continued care in patients’ rooms and efforts to sustain morale through frequent meetings and a flashlight talent show. This contrast prevents the epigraph from functioning as a blanket verdict on everyone caught in the disaster. Instead, its image of spreading blindness directs attention to failures that accumulated in particular settings—and to the different choices and forms of care that remained possible within catastrophe.