Jannie Burgess

A Nurse in a Segregated City

Jannie Burgess was born just a few months after Memorial opened in 1926 as Southern Baptist Hospital. In mid-twentieth-century New Orleans, her light-brown skin marked a contradiction in her professional life: she could care for patients in private hospitals where she herself could not receive care. Baptist was among the last Southern hospitals to integrate. It refused to join federal hospital programs introduced in the mid-1960s, arguing that it should remain free of government requirements; participation was tied to reimbursement rules against racial discrimination and segregation. It would be more than four decades after the hospital opened before Burgess could become its patient.

She entered nursing to support her children, having worked jobs that included taxi dispatcher and secretary to a mortician. She spent thirty-five years in New Orleans hospitals and nursing homes. When patients treated her poorly, she gritted her teeth, smiled, and continued working. After retirement she moved into senior housing at Flint-Goodridge Apartments, on the former site of Flint-Goodridge Hospital, once the only private hospital in New Orleans where Black patients could receive care and their doctors could pursue residency training. She also cared for an ailing brother at home.

Burgess had endured painful losses and had a life beyond her work. As a young mother she fled an abusive husband, and her only son died in Vietnam. She also loved perfume and dancing, and had once enjoyed the beauty parlor owned by her older sister, Gladys. In old age she was seventy-nine and obese, but the memories her daughter shared conveyed someone with a strong sense of style and pleasure, not simply a patient defined by illness.

Illness, Wishes, and a Visit

Surgery and chemotherapy had stalled Burgess’s uterine cancer, and she lived well for two years. In early August 2005, weakness in her legs brought her to Memorial for evaluation. Doctors found a bowel blockage; surgery revealed cancer in her liver that could not be removed. Burgess said she did not want to live on machines, and her doctor signed a DNR order. When an infection developed and her kidneys began to fail, she also refused dialysis. After discussing her preferences with Burgess, her sister, and a niece, the doctor shifted the goal of care from treating her medical problems to maintaining her comfort. Small doses of morphine were ordered as needed for pain, and she was expected to leave intensive care for a regular medical floor when a bed became available.

Her daughter, Linette Burgess Guidi, arrived from the Netherlands after learning that the cancer had spread and was inoperable. The two spoke frequently but had rarely visited, and their meetings had often been difficult. Linette had become the first Black Bunny at the New Orleans Playboy Club in 1973, a distinction that had shamed her observant Catholic mother and contributed to years of tension. At Burgess’s bedside, however, Linette kissed her, teased her about needing a manicure, and told her she would not want to be anywhere else. Burgess opened her eyes and recognized her. The visit became a moment of reconciliation amid an unfolding emergency.

A DNR Order and the Evacuation Queue

Memorial’s doctors had made an exception to the usual evacuation priority for the sickest patients and those dependent on machines: all patients with DNR orders would go last. Burgess was one of four such patients in the intensive care unit. A DNR order meant that a patient whose heart or breathing stopped should not be revived. It was not the same as a living will authorizing the withholding or withdrawal of life-sustaining procedures. Yet medical chairman Richard Deichmann later said he believed DNR patients had to have a certified terminal or irreversible condition, and thought they had the least to lose if disaster struck. That understanding helped frame a broad evacuation decision around a directive with a narrower meaning.

For Burgess, the practical consequence was that the planned move to a general medical floor for comfort care never happened. On the morning the emergency power failed in her section of the hospital, her electronic monitors stopped working. Battery-powered pumps continued delivering fluids and medicines for about two hours, until their batteries ran down. Nurses then allowed fluid to run by gravity through her IV tubing, regulating it with a slide clamp. Her breathing was shallow and irregular; at times ten to fifteen seconds passed without a breath. In the evacuation crisis, her DNR status did not merely describe a limit on resuscitation. Combined with the hospital’s rule, it placed her among the patients left behind.

Cook’s Decision and the Forensic Review

At about two in the afternoon, pulmonologist Ewing Cook climbed to the eighth-floor intensive care unit, where he had worked for years. Most of its patients had already been airlifted; the four DNR patients had not. Burgess was the only patient then remaining in the unit. Cook examined her chart and condition. He estimated that fluid retention had raised her weight to more than three hundred pounds, and concluded that moving her down six flights of stairs would be impossible. The heat and stairs also made him doubt that he could return to the unit. He thought she probably had a day or so to live, and that the nurses with her were needed elsewhere.

Morphine was already on Burgess’s medication list for pain, but Cook knew that high doses could suppress breathing and hasten death. He also understood the difficult boundary between intending comfort and foreseeing a shortened life, a boundary he had encountered when easing the withdrawal of ventilators from dying patients. In Burgess’s case, he acknowledged that she appeared comfortable and comatose. He asked her nurse to increase the morphine enough that Burgess would not wake while being moved. He then wrote in her progress record that she had no respirations or cardiac activity, left the time of death blank, signed the note, and went back downstairs. He later said that he had hastened her death and described the decision as an easy one.

The medication record later showed seven administrations of fifteen milligrams of morphine between 2:10 and 3:35 p.m. on Wednesday, August 31: 105 milligrams in an hour and a half, more than five times the highest amount she had received in any entire day of her hospitalization. Her previous doses had been small and intermittent; the largest single dose previously documented was six milligrams. From seven that morning until Cook arrived, a nurse had given her one four-milligram injection. In the forensic review, however, Cyril Wecht considered Burgess not a clear, strong case because she had advanced cancer and had already received morphine. He marked her death undetermined and recommended excluding her from any legal case. Two other ICU patients left behind with her also tested positive for morphine, at lower concentrations, and were not considered homicides by Wecht.

The Meaning of Her Case

Burgess’s story makes the consequences of classification visible without making her wishes interchangeable with the hospital’s evacuation policy. She had declined resuscitation and dialysis and had been moved to comfort-focused care; the DNR order did not itself say that she should be denied rescue or that her life had no claim on scarce evacuation capacity. In practice, though, that order helped determine her place in line. Her accumulated vulnerability—advanced cancer, severe weakness, dependence on care, and the weight Cook believed made stair evacuation impossible—met a rule that assigned DNR patients last priority.

Her history also places the disaster within a longer institutional record. Burgess had spent decades caring for patients in a city where she could be excluded from the hospitals in which she worked. In 2005, she returned to Memorial as a patient, with a DNR order based on her expressed wishes, and remained there when the hospital’s evacuation system treated that status as a reason to defer her. Her case therefore carries both a personal ending and a broader institutional question: how a decision meant to limit resuscitation came to shape rescue, and how the evidence surrounding her death could remain grave yet, in the forensic reviewers’ judgment, legally undetermined.