Evacuation of Memorial Medical Center during Hurricane Katrina

The evacuation of Memorial Medical Center during Hurricane Katrina was a prolonged, improvised effort to move patients, staff, and relatives from a flood-isolated hospital. It shifted between boats and helicopters as leaders disagreed over priorities, rescue capacity, and how to move people who could not walk. The operation eventually cleared nearly all patients and visitors, but the changing plans, delayed transport, and fear surrounding the rescue left the most vulnerable people waiting amid broader failures in New Orleans’s emergency response.

The evacuation problem before the hospital

At around ten in the morning, New Orleans mayor Ray Nagin issued a mandatory evacuation order, after delays while officials considered logistical and legal questions. Many residents could not leave independently because they had no cars or other means of transport; those who could drive were already caught in traffic. The New Orleans Superdome was designated a shelter of last resort, and Nagin urged people with medical conditions to move there, without specifying what assistance would be available. Hospitals and their workers were exempted from the order because officials feared that closing hospitals would leave people injured in the storm without care.

That exemption met a practical problem the emergency plans had not solved: how to move the patients who remained in New Orleans. Officials had discussed a catastrophic hurricane scenario in the Hurricane Pam exercise, which assumed that more than two thousand hospital patients would be in the city, but no workable plan had been established to transport so many people out of a flood. Preparations also had not ensured that every hospital’s generators and electrical switching equipment were above ground-floor level. Memorial was among those without that protection.

Transport outside the hospital was already strained. Dispatchers at Acadian, the region’s largest ambulance company, were overwhelmed by requests from hospitals, nursing homes, and private homes. Many of the roughly two dozen ambulances it made available were immobilized in interstate traffic; some began taking patients to the Superdome rather than attempting the clogged roads out of town. The city’s shortage of buses and drivers, uncoordinated rescue efforts, and weak communications would later be identified among the factors that compounded deaths and suffering.

Boats, changing priorities, and crowded exits

At Memorial, the evacuation strategy changed as the available routes and judgments about who could travel shifted. Initially, boats took patients considered well enough to be discharged. Doctors moved to the emergency-room ambulance ramp to supervise loading, and staff members and patients’ relatives were also allowed to leave. The line extended from the ramp through the emergency room and into reception. People asked where the boats were taking them, but staff did not always know. Some people hesitated when asked to leave possessions behind, and one woman refused to board without her purse, despite an offer to take responsibility for it.

The stream of people toward the boats could itself disrupt decision-making. When a uniformed man shouted that women and children should come forward, people moved toward the ambulance ramp as though the opportunity to leave might be ending. Meanwhile, LifeCare staff on the seventh floor reported dwindling supplies and asked what would happen to nine patients still there, including a large paraplegic patient. Susan Mulderick told them that no living patients were to be left behind and directed them to consult Anna Pou. The exchange made clear that LifeCare’s remaining patients, the hospital’s evacuation capacity, and the decisions being made on other floors were not easily coordinated.

Boat access was not the only point of disagreement. Hospital leaders and state police differed over how to evacuate wheelchair-bound patients who had spent the night on the first floor. Most were carried up to the second floor and through an opening in the wall for helicopter evacuation; others were taken by boat, without the police’s approval, from the sloping parking-garage ramp. Police said they would leave by five in the afternoon and would not remain to protect the hospital. Their warnings about civil unrest increased the pressure to clear the building, while the airboat they had brought was not used to transport patients.

Helicopters and improvised transfers

The helicopter operation also required clarification and adaptation. Curtis Dosch used a satellite phone to update Tenet officials in Dallas every half hour on how many people remained. After one crew member said that only patients able to walk could fly, Dosch checked with Tenet and learned that the helicopters were meant to take patients regardless of whether they could walk. A pilot’s log recorded three early lifts by aviation services and five Coast Guard lifts using three aircraft; it also listed a total hospital population of 450 as of 10 a.m. on September 1, including about 120 patients from Memorial and an associated hospital.

Some pilots nevertheless refused to take bed-bound patients. Doctors adapted by moving certain patients into wheelchairs and securing sheets around their waists and chests so they could be carried as seated passengers. Other transfers were physically demanding: patients were moved through the opening in the machine-room wall and across the parking garage toward the helipad. Wynn and other female nurses helped lift the last few patients through that opening as the day’s boat and helicopter trips removed nearly all patients and visitors.

The route through the emergency-room ramp continued as well. A surgery chief, an anesthesiologist, and the plant-operations chief returned with another boat they had found, which maintenance workers started by hotwiring it. Staff were eventually permitted to leave with their pets, but the change came too late for some. The contrast between the animals’ earlier fate and the later permission to take them underscored how fast instructions and available options were changing.

Patients left waiting and the meaning of rescue

As the evacuation proceeded, Karen Wynn cared for patients from Memorial and LifeCare who had been brought down to the first floor in anticipation of rescue. She also encountered a neighborhood resident who had waded to the hospital because he was overdue for dialysis. Earlier, an outpatient had reached Memorial through floodwater for a scheduled chemotherapy appointment; Wynn told her that treatment would not be given that day. These episodes linked the hospital’s internal emergency to the surrounding community: people outside Memorial were also seeking care, while the hospital itself struggled to move its own patients.

The book places the evacuation within a wider account of systemic failure. More than a thousand people died immediately in New Orleans, many in medical facilities, while others suffered or died later amid disrupted health care. The causes included delayed evacuation, inadequate transport for people without cars, poor coordination and communications, and hospitals and nursing homes that had not evacuated before the storm or secured sufficiently robust backup power and water. At Memorial, the evacuation’s changing routes and improvised methods were not simply logistical details; they showed how rescue depended on who could be moved, which instructions held, and whether transport arrived in time. The operation cleared most of the hospital, but its course exposed the gap between an order to evacuate and the means required to carry it out.