Helen Breckenridge

Helen Breckenridge’s evacuation from Memorial Medical Center became an early, devastating test of a rule that treated a Do Not Resuscitate order as a reason to postpone rescue. At seventy-seven, seriously ill and dependent on a ventilator and drug pumps, she was carried from the ICU toward evacuation, then sent back upstairs when staff learned of her DNR status. Her death followed soon after the equipment sustaining her was reconnected. The account does not establish that the evacuation decision caused her death, but it presents her case as apparently the first death in the hospital to have been hastened by the catastrophe.

Illness and Transfer to Memorial

A former drapery maker and interior decorator, Breckenridge had been a patient at Memorial for about a week. She had complications involving lung and heart disease and diabetes. Before the transfer, she had received hospice care at another hospital, where treatment focused on comfort rather than extending life. She was given morphine and powerful sedatives. After she stopped eating, perhaps because of the sedation or because her disease was worsening, the hospice did not provide nutrition or fluids.

Her brother, a physician at another New Orleans hospital, could not bear to watch her decline. He believed she had been made to sign paperwork leading to her hospice admission and did not truly want to be there. He went to court to have her removed from hospice and transferred to Memorial for aggressive treatment in the ICU. That contested history matters: Breckenridge arrived not simply as a patient whose care had settled into a single, uncontested course, but after her brother had taken legal steps to replace hospice care with an attempt at more active treatment.

The Evacuation Decision

When staff tried to move Breckenridge from the eighth floor, they worked around the equipment keeping her alive. One worker squeezed air into her lungs by hand; others watched the battery-powered pumps delivering drugs into her veins to regulate her fragile circulation. The team brought her downstairs. A doctor then ordered, “Bring her back up,” explaining that she could not go in the first sweep.

The immediate reason was Memorial’s decision to place all patients with DNR orders last in the evacuation. Four ICU patients were covered by the rule, including Breckenridge and Jannie Burgess. A DNR order meant that a patient whose breathing or heartbeat stopped should not be resuscitated. It did not, by itself, mean that the patient had a terminal or irreversible condition, or that ordinary rescue should be withheld. Nor was it the same as a Louisiana living will, which could request that life-sustaining procedures be withheld or withdrawn in a terminal and irreversible condition.

The distinction was lost in the reasoning behind the priority rule. Medical chairman Richard Deichmann later said he thought DNR patients were required to have a certified terminal or irreversible condition, and believed they had “least to lose” if calamity struck. Other doctors agreed with the plan. One later explained that he thought patients unwilling to prolong life through extraordinary measures would not want to be saved at others’ expense, although neither the orders nor Memorial’s disaster plans said so. Nurses were told that “the most salvageable had to go.” A decision about which patients would be evacuated first thus turned a limit on resuscitation into a ranking of whose life warranted rescue.

Death and Significance

After Breckenridge was returned to the ICU, staff reconnected her pumps and drips to emergency wall outlets and restored her mechanical ventilator. She soon died. Her death may have been imminent, given her illness and dependence on intensive support; the narrative nevertheless identifies it cautiously as seemingly the first death in the hospital to have been hastened by Katrina. Dr. Horace Baltz was summoned to pronounce her dead and hurried up the staircase.

Breckenridge’s case makes the consequences of the DNR-last policy concrete. During evacuation, the order did not remain a narrow instruction about what to do if her heart or breathing stopped: it determined that she could not leave in the first group, despite the equipment and hands-on assistance required to move her. The danger of delay was especially consequential in a hospital whose evacuation was unfolding under crisis conditions. The account notes that the priority decision might not have been momentous if the hospital had emptied quickly; Breckenridge’s return upstairs shows what that assumption meant for a patient whose chance to be rescued depended on a rule applied before the full consequences were clear.