Michael Arvin

Michael Arvin was Tenet Healthcare’s regional business-development director for the Gulf Coast, a role he described in commercial terms as responsibility for the market. During Hurricane Katrina, that ordinary portfolio abruptly became a point of contact for hospitals in danger. The change exposed both his limited preparation for emergency operations and the corporate structures within which he was trying to respond: Tenet had no established incident-command system and no preexisting contracts with medical-transport companies.

From Business Development to Emergency Contact

Two days before the crisis reached its peak, Arvin interrupted a tennis match with his children at a Dallas country club to join a conference call with the chief executives of Tenet hospitals along the Gulf Coast. Katrina was bearing down on the region, and three of Tenet’s six affected hospitals would need evacuation. The shift from business development to disaster coordination was rapid; the account emphasizes that Arvin had no background in emergency management, even as messages from the hospitals began to require decisions about transport, supplies, and outside assistance.

The company’s preparations were thin. Tenet had not secured standing agreements with medical-transport providers, and its headquarters had no emergency incident-command structure. An executive with National Guard experience who might have offered crisis-management knowledge was on vacation, advising by cell phone from a beach retreat in Oregon. Arvin was therefore operating amid an organizational gap rather than within a practiced corporate emergency system. His actions mattered, but so did the absence of established channels and plans that could have made those actions more coordinated.

Memorial’s Appeals and the National Guard

As Memorial Medical Center sought help, Arvin replied to messages from Sandra Cordray, the hospital’s community-relations manager. He said that he had been told entry into the city would not be possible and asked whether Memorial had contacted the National Guard. Cordray had already told him that Guard members were at the hospital; their presence, however, was not enough to solve the evacuation problem. The exchange shows how information about resources could circulate without producing a workable transport plan.

Arvin told Cordray that Tenet was working to obtain medicines and blood for Memorial, but he was unsure how those supplies could be delivered. He also pointed to Lindy Boggs Medical Center, Tenet’s sister hospital, where troops were expected. His guidance to Memorial was to begin planning on the understanding that the National Guard was coordinating evacuation. That advice placed considerable weight on military coordination, although the local Guard contingent at Memorial could not by itself evacuate the hospital’s patients.

At 12:28 p.m., Memorial’s director of case management sent a company-wide appeal to colleagues at other Tenet hospitals, describing the expectation of fifteen feet of water and asking them to find destinations for the hospital’s 187 patients. Arvin was quickly inundated with offers of space and, in at least one case, relief staff. He had also been contacting Tenet hospitals in Houston and Nacogdoches to arrange assistance. In response to the broad appeal, he asked that requests be routed through him and Bob Smith, explaining that the company was being overwhelmed by the messages. The episode conveys both the real volume of help being offered and the strain of trying to direct it through an improvised process.

Atlanta Medical Center, another Tenet-owned former Baptist hospital, offered support by email and phone, including aeromedical helicopters for Memorial’s evacuation. Arvin urged the Atlanta executives to hold back because, in his understanding, the National Guard was coordinating relief. The Atlanta chief executive agreed to wait for further direction from Arvin or the Dallas office. This decision left an offer of private helicopter assistance on hold while Memorial continued to depend on a coordination system that was not clearly delivering the help it needed.

The LifeCare Patients and Growing Delay

The difficulty of coordinating support also extended to LifeCare, which operated a hospital unit inside Memorial. LifeCare’s patients had not been included in the evacuation underway at Memorial, and the plan being discussed required Tenet corporate approval for them to travel with the Coast Guard. From Memorial’s command center, Cordray asked Arvin to work directly with LifeCare’s corporate office. The proposed arrangement was for Memorial to move LifeCare’s fifty-two patients to a staging area outside the city, where LifeCare could meet them with ambulances and take them to Baton Rouge.

The process stretched into the evening. Cordray sent Arvin the contact information for LifeCare’s Robbye Dubois and reported that no more National Guard trucks would be available that day because the water had risen too high. Dubois later said she was waiting for approval to send ambulances and expected that approval could take hours. After speaking with Arvin, she reported that ambulances would be sent to the staging area, but the rising water might prevent trucks from reaching the hospital until morning. Critical patients would go first, with staff accompanying them. LifeCare staff prepared to proceed if the hospital lost its backup power and computer connection, anticipating that movement might begin between three and eight in the morning.

The account does not identify a clear reason that corporate permission was needed for LifeCare to use federal rescue assets, nor does it describe Arvin personally making the final transport decisions. It does show him as a required link in a chain of calls and approvals: LifeCare awaited contact and authorization while the available routes narrowed. Meanwhile, Memorial incident commander Susan Mulderick recognized that helicopter size and the time needed to move patients meant that not everyone would be evacuated alive. The urgency of the patient-transfer arrangements was therefore inseparable from delays in coordinating them.

State Requests and Private Airlift

On Tuesday evening, Arvin called the emergency medical services bureau in Baton Rouge and left a message for its director. He reported that floodwater was rising around Memorial and Lindy Boggs Medical Center, said one of the hospitals had lost electricity, and asked the state for assistance. Within an hour, state logs designated the hospitals a high-priority evacuation mission. A volunteer was dispatched toward New Orleans to meet fifty-five boats, but the boats had stopped because of darkness and reports of snipers; the volunteer instead joined emergency medical workers at the Causeway Boulevard interchange. The sequence reveals the distance between a recorded priority and an evacuation resource that could actually reach the hospitals.

Arvin also passed along a late-Tuesday offer from a private air-logistics company in a Dallas suburb. When Bob Smith, another Tenet executive, asked how to begin arranging an airlift, Arvin told him about the company’s message, and Smith directed him to contact the firm. The contact proved fruitful: the company began lining up helicopters to arrive in New Orleans on Thursday morning. Tenet executives called the aircraft air ambulances, although they were regular helicopters generally used for firefighting and other purposes. Arvin’s role here was to connect the corporate response to an outside offer; the account presents the resulting airlift as a later development, not as an immediate solution to Memorial’s first urgent appeals.

Corporate Limits and Narrative Role

Tenet executives also tried to persuade government agencies to prioritize the evacuation of Memorial and the company’s other stranded hospitals. Their requests passed among congressional offices, state officials, federal agencies, hospital associations, and emergency-management bodies, with each often directing the company to contact another. Arvin’s calls and messages belong to this broader pattern of fragmented coordination. He was neither the sole decision-maker nor an emergency specialist, but his position made him a conduit between Memorial, Tenet headquarters, other hospitals, state responders, LifeCare, and a private air-logistics firm.

The book’s portrayal holds individual effort beside institutional failure. Arvin tried to secure supplies, solicit state assistance, respond to offers, and surface a private airlift option; at the same time, Tenet lacked prearranged transport contracts and an incident-command system, while proposals could be delayed by unclear authority or reliance on coordination that had not produced enough help. The contrast with Charity Hospital, a public institution without corporate overseers, further places Memorial’s evacuation within a wider crisis rather than treating corporate involvement as a complete answer. Arvin’s significance lies in that tension: he was a busy and consequential intermediary inside a response whose communications multiplied faster than reliable evacuation capacity.