Hurricane season

Hurricane season functions in the book as both a recurring planning horizon and the countdown to a disaster that overwhelms familiar routines. In New Orleans, flood risk was not abstract: even moderate storms could inundate the streets around Memorial Medical Center, while the institution’s habits of preparation sometimes left it exposed to the very water its staff expected.

A Familiar Seasonal Threat

Decades of drainage improvements had greatly increased the city’s pumping capacity, yet flooding around the Freret neighborhood remained severe. Memorial employees had developed practical adaptations: during moderate storms, they parked on the raised neutral grounds a block away, while maintenance workers in waders ferried colleagues through flooded streets in a battered metal fishing boat kept in the parking-garage basement. The hospital continued to store equipment, food, records, supplies, and linens in that basement. Repeated encounters with floodwater had made it familiar, but familiarity did not make the building safe.

The annual season also structured staffing decisions. At its start, Gina Isbell selected volunteer nurses for LifeCare Hospitals’ A team, which would work through the storm before the B team replaced it afterward. Isbell chose nurses she trusted under pressure, though the assignment meant working in an unfamiliar hospital. As patients were transferred from St. Bernard Parish, nineteen reached the LifeCare unit at Memorial by nightfall; a twentieth died on the way. The season’s advance planning had organized staff and patient movement, but it could not remove the risks created by scarce transport and vulnerable patients.

From Forecast to Evacuation

As Hurricane Katrina approached, the apparent advantage of leaving early collided with the limits of evacuation. The mayor of New Orleans ordered residents to leave, but many had no cars or other means of escape, and the city’s transport plans lacked enough drivers. The New Orleans Superdome became a shelter of last resort, including for people with medical conditions, while hospitals and their workers were exempted from the order because officials feared that closing them would leave injured residents without care.

The exemption did not resolve the danger inside hospitals. Memorial was among the many New Orleans hospitals whose generators and electrical switching equipment were not above ground level. Meanwhile, Acadian Ambulance dispatchers faced calls from hospitals, nursing homes, and homes across the region. Many of the roughly two dozen ambulances made available were stuck in interstate traffic; some began taking patients to the Superdome rather than trying to transport them out of the city. A seasonal plan to move people thus became a contest against congestion, limited vehicles, and the shrinking time available to reach safety.

Familiarity, Delay, and Unequal Exposure

The emergency also revealed how the same flood could be experienced differently inside and outside the hospital. After the water around Memorial stabilized at roughly five to six feet, an outpatient still made her way there for a scheduled chemotherapy appointment. Karen Wynn had to tell her that chemotherapy would not be given. Wynn was focused on patients waiting inside and did not realize how severe the wider crisis had become. The appointment, persisting as though ordinary routines still held, marked the distance between the familiar calendar of care and the disaster unfolding around it.

The book places these scenes within a broader chain of failures: a delayed evacuation order, insufficient buses and drivers, uncoordinated rescues, poor communications, and hospitals and nursing homes that had not evacuated before the storm or secured sufficiently robust backup power and water. Those failures did not expose everyone to danger in the same way. People without cars, patients dependent on medical care, and poor and elderly residents faced especially severe barriers to escape; at Memorial, an evacuation rule that placed patients with DNR orders last added another institutional disadvantage to physical vulnerability.

The Season as a Test of Institutions

The aftermath makes the seasonal preparation question larger than any one hospital. Memorial evacuated its patients by September 1, while New Orleans’s public Charity Hospital, with about twice as many patients across its campuses and fewer staff per patient, completed its transfer on September 2. Charity had flooded and lost power, plumbing, communications, computers, and elevators, yet fewer than ten patients died there. Staff accounts described regular morale meetings and continued care in patients’ rooms. The comparison does not erase the different conditions or establish a single explanation; it shows that exposure to the same storm did not dictate identical institutional responses.

In the book’s wider reckoning, Hurricane season is therefore more than a recurring weather interval. It is the period in which decisions about staffing, evacuation, infrastructure, and access to transport must be made before the forecast becomes an emergency. New Orleans’s accumulated flood experience had produced improvised routines and some advance planning, but Katrina showed the distance between anticipating a storm and preparing systems capable of protecting people when ordinary routes, power, and coordination fail.