Memorial Medical Center Crisis and Evacuation During Hurricane Katrina was not simply a rescue operation under extreme conditions: it was a disaster whose risks had been identified in advance, but whose infrastructure and evacuation systems proved unequal to the emergency. As floodwater reached the hospital, its backup power failed; meanwhile, patients, staff, and families faced limited transport and changing evacuation priorities. The episode became part of a broader reckoning with failures that extended from hospital planning to the city’s transportation and rescue response.

Evacuation orders and limited routes to safety

At around ten in the morning, New Orleans mayor Ray Nagin issued a mandatory, immediate evacuation order. The warning came after hours of delay, and its force exceeded the practical means many residents had to obey it. People without cars depended on transport arrangements that officials knew had serious gaps, including too few drivers; residents who could leave on their own were already caught in traffic. The New Orleans Superdome was designated a shelter of last resort, and shuttle buses were meant to bring people there. Nagin specifically urged people with medical conditions, including those on dialysis, to go, but did not explain what assistance they would find at the shelter.

Hospitals and their workers were exempted from the order so that injured people would have somewhere to seek care. That decision also left patients and staff inside facilities exposed to the very conditions the evacuation was meant to escape. Acadian Ambulance dispatchers were overwhelmed by requests from hospitals, nursing homes, and private homes. Many of the roughly two dozen ambulances made available were immobilized in traffic, and some redirected patients to the Superdome rather than attempting to take them out of the city. Elsewhere in the region, the first group of critically ill patients left Chalmette Medical Center, but ambulances did not return. The movement of medically vulnerable people thus depended on a transport system already congested and short of vehicles and drivers.

A known weakness in the hospital’s power system

The danger to Memorial’s electrical system had been documented before the storm. After Hurricane Ivan narrowly missed the city in 2004, plant operations director Eric Yancovich reviewed storm-surge projections. The hospital stood three feet below sea level; a severe storm could bring twelve to fifteen feet of water around it. Yancovich’s hand-drawn calculations showed that less than four feet of flooding on Magnolia Street could send water over the loading dock and into the hospital. Although the backup generators themselves were on the second floor, parts of the emergency power distribution system—including switches and other critical equipment—were below ground or only inches to a few feet above it.

Yancovich warned his supervisor that relatively little water could disable most of the medical center. He expected the main hospital to lose power and believed patients would need to be moved to the newer Clara Wing, where the electrical circuitry seemed better protected. The hospital had added floodgates and raised the vent for its underground diesel tanks, but broader improvements remained undone. Yancovich recommended raising emergency power transfer switches and pumps supplying medical air and vacuum suction, both essential to patient care. A partial bid for electrical work exceeded a quarter of a million dollars; he concluded that the work was unlikely to be approved because of limited capital. The vulnerability, in other words, was not only that the hospital had generators, but that the system connecting emergency power to patient care depended on components exposed to flooding.

The generators fail

By the time the crisis reached its second night, Memorial’s three generators had been running for two days. Each was rated at 750 kilowatts, but the units were designed and tested for short-term emergency use, while the hospital’s disaster plan expected them to support operations for at least three days. The maintenance staff on site were not generator mechanics. When one engine stopped, workers suspected overheating, added water to its radiator, and restarted it. Later, low oil pressure and other problems prompted further attempts to prime the motors with diesel and recover power across the hospital’s complicated electrical network.

As outages spread, workers in rubber boots entered the basement and found knee-deep water. About a third of the automatic transfer switches appeared to be at a low enough level to be submerged, confirming the importance of the vulnerability Yancovich had identified. The workers tried to connect circuits from a failed generator to one that was still running, using a bypass handle above their heads. The working generator then drew too much current, raising the risk of a short circuit and fire at a time when the sprinkler pumps were underwater. Staff shut off circuits serving unused equipment to reduce the load, but another generator failed, and attempts to salvage parts did not restore it. At about two in the morning on Wednesday, August 31—nearly forty-eight hours after Hurricane Katrina made landfall—the last backup generator surged and died. Alarms sounded; Karen Wynn climbed onto a chair and struck an alarm panel with her shoe to silence it.

Rescue, difficult choices, and the wider aftermath

The evacuation continued amid uncertainty about who could be moved and where they would go. At one point, only patients well enough to be discharged were being placed on boats, while doctors and hospital workers supervised loading from the emergency-room ramp. Staff and family members also joined the line. Some people hesitated when they learned they could not bring belongings; one woman refused to leave without her purse, despite offers to take responsibility for it. Wynn also encountered an outpatient who had made her way through the floodwater for a scheduled chemotherapy appointment. Wynn told her that chemotherapy was not being given. Such moments showed how difficult it was for people outside the hospital’s immediate care crisis to grasp the severity of conditions inside it, and how the evacuation’s practical rules could become personal obstacles to leaving.

A further opportunity for helicopter evacuation arose overnight. Accounts differ in their timing and in whether the offer reached the hospital command team in the same way: Paul Primeaux recalled receiving a call from the United States Coast Guard and carrying an enthusiastic message about continuing the operation to Richard Deichmann on the helipad. Deichmann did not remember that exchange, although his memoir described deciding later that night that continuing was inadvisable. The account therefore records both the possibility of more rescue flights and the uncertainty surrounding the decision to suspend them. Separately, two nurses cared overnight for the two surviving patients with do-not-resuscitate orders.

The evacuation crisis belonged to a much larger pattern of failures. In the eleven months after the storm, investigations and reporting identified the delayed city order, inadequate transportation, uncoordinated rescue operations, poor communications, and hospitals and nursing homes that had not evacuated ahead of landfall or invested in sufficiently robust backup power and water systems. More than a thousand people died immediately in New Orleans, many in medical facilities and many others among the poor and elderly; others suffered or died later amid disrupted health care and stress. Fear of lawlessness further interrupted rescue efforts, although many of the worst crimes reported at the time proved not to have occurred. In 2010, a disaster medical team treating earthquake survivors in Port-au-Prince again faced shortages of oxygen and fuel, a later episode that echoed the book’s concern with how fragile supply chains can constrain care. Together, these events frame Memorial’s crisis as both a hospital emergency and a consequence of wider systems that failed to move, power, and protect people when they depended on them most.