Susan Mulderick

Susan Mulderick was Memorial Medical Center’s longtime nursing director and the hospital’s incident commander during its Hurricane Katrina emergency. With decades of institutional experience, she led staff through a rapidly deteriorating crisis and pressed for the evacuation of every patient. The same record, however, places her at the center of a consequential dispute: whether her discussions about relieving patients’ suffering concerned comfort care or euthanasia. Her recollections, other witnesses’ accounts, and the hospital’s medication records do not align neatly, leaving her role inseparable from the uncertainty surrounding decisions made under extreme conditions.

Identity and authority

At fifty-four, Mulderick had worked at Memorial for thirty-two years. She directed sixteen nursing departments and had served on the hospital emergency committee for more than fifteen years, eventually leading it. During the previous year’s Hurricane Ivan threat, she had also been at the helm. These years of service gave her a kind of institutional authority that the hospital’s recently arrived chief executive, L. René Goux, did not yet possess: Tenet Healthcare had sent Goux to run Memorial in 2003. The hospital’s emergency plan called for the CEO to lead, but when Katrina threatened, responsibility fell to Mulderick as the rotating manager on call.

The command role was not merely a title. Mulderick understood herself to be responsible for patients, employees, and visitors, and her duties included overseeing emergency operations, leading meetings, and making decisions with the hospital’s senior executives. The formal incident-command policy described an intended leadership structure, but staff accounts indicated that practice did not always follow the written plan exactly. In the crisis, decisions had to be made amid changing information, conflicting directions, and deteriorating conditions.

Her authority also contained a personal dimension. Karen Wynn, whom Mulderick hired as a staff nurse in the 1980s and later promoted to manager, trusted and admired her. Wynn remembered Mulderick as intelligent and creative, with clear expectations and a willingness to give staff the support and freedom to meet them. Although others could see her as intimidating and strictly professional, Wynn experienced her as warm and generous. Their relationship helps explain why Mulderick’s leadership mattered to the people carrying out the hospital’s response: she was not simply an executive issuing instructions, but a long-standing mentor whose judgment was trusted.

Command during the breakdown

The crisis’s turning point came as reports of flooding changed what staff believed the hospital could safely do. After an ambulance worker confirmed that a canal had been breached, the command team shifted hospital operations from assault mode to survival mode. Staff who had expected to hand patients over to a returning team and go home began to understand that they might remain inside for an extended period. Mulderick’s response took place against plans that left dangerous gaps: the hurricane plan did not anticipate flooding, the flooding plan did not address evacuation, and the evacuation plan did not account for losing power or communications. The hospital’s emergency preparations had identified hurricanes, floods, and power outages as major risks without adequately joining those risks into one scenario.

The danger became tangible when windows began breaking. Mulderick phoned senior intensive-care nurse Cheri Landry, who was with staff and their families in the newer surgery building across Magnolia Street. She told Landry to bring them out before the connecting bridge failed or its windows shattered. They had to cross the exposed, swaying passage to reach the main hospital. Later, when news of the water prompted another hastily assembled meeting, the room was hot and someone used a two-foot metal oxygen tank to break windows. Mulderick announced that floodwaters of up to fifteen feet were expected around the hospital. To Wynn, the meeting marked a shift from an ordinary hospital emergency toward a military-style operation, with the immediate objective of acting before the power failed.

As evacuation proceeded, the available helicopters differed in size, and moving patients to the helipad took time. Mulderick concluded that not every patient would get out alive. The prospect shaped the pressure surrounding every decision, but the evidence does not present her as having a clear, reliable picture of when rescue would come. Overnight, Coast Guard personnel favored continuing rescues, especially after learning that seven LifeCare patients were on ventilators and that water and a power cut threatened the hospital. Dr. Richard Deichmann considered it too dangerous to reopen the helipad and told an officer to send helicopters in the morning. Mulderick later went up to the darkened helipad herself to see what was happening. She encountered a long line of non-patients, including people who may have sought shelter at Memorial before the storm, as well as a patient being carried up the metal steps. Concerned that untrained staff were doing dangerous work in poor light, she told the flight crew to take that patient but not return to Memorial.

At about seven the next morning, the command team agreed to concentrate patients and resources near first- and second-floor exits. A nurse was sent to retrieve the hospital’s emergency triage armbands. Green identified patients able to walk, yellow those needing assistance, and red those wholly dependent on care from others; patients with do-not-resuscitate orders were assigned black bands. The plan offered staff a system for sorting patients, but it also made the consequences of categorization especially stark in a hospital where rescue capacity was limited and staff could not know how many people would be evacuated.

Patients, staff, and disputed decisions

Mulderick’s leadership required her to absorb not only operational decisions but also the mounting distress of the people around her. She walked the floors for two days, encountering employees in panic and trying to manage competing demands. Two nurses who had brought teenage children to the hospital came to her in tears, saying they needed to leave; when she reminded them that patients still required care, they shouted at her and pointed out that other nurses had been allowed to go. Mulderick defended the nurses who had departed to help at the boat drop-off, although she had also asked them to remain at the hospital. The exchange exposes the bind in her role: keeping care available meant asking frightened staff and family members to stay, while the evacuation itself depended on people moving resources and patients toward a way out.

When LifeCare leaders sought her, Mulderick told them the plan was to leave no living patients behind and directed them to speak with Anna Pou. She asked them to decide whether they would move their patients, including those who were dying, to the evacuation staging area. This concern for getting patients out existed alongside restrictions on access to some patients. LifeCare leaders intended to check on Carrie Mae Hall and others who had been moved downstairs, but a Memorial employee blocked them at the second-floor stairwell. Staff had been told to direct people away from the area where do-not-resuscitate patients lay. The contrast between Mulderick’s stated evacuation objective and the obstacles the LifeCare team encountered is part of the record; it does not, on its own, settle who made or understood each decision.

The question of medication became more contentious. According to Mulderick’s later account to investigators, she asked Pou whether patients could be given something for suffering, anxiety, or pain. Pou agreed but was unsure what to give, so Mulderick said she would ask Dr. Ewing Cook to speak with her. Mulderick found Cook preparing to leave by boat to rescue his son, who had been trapped since the flooding, and asked him to speak to Pou before he went. Mulderick said she did not see medication being administered and did not know whether Cook followed up. She described her aim as comfort, giving a sedative such as Ativan as an example of something that might relax patients. The pharmacy prescriptions seized later showed that Ativan and other ordinary comfort medications had already been prescribed for patients by Pou and other doctors during the disaster, complicating Mulderick’s explanation of why she raised the question.

Deichmann later recalled a separate, quiet hallway conversation in which Mulderick asked whether it would be humane to euthanize the hospital’s do-not-resuscitate patients. He said euthanasia was illegal and recalled telling her there was no need to euthanize anyone. Mulderick denied through her attorney that she had discussed euthanasia with Deichmann or anyone else at Memorial. Her interview with investigators also included a direct question about whether she had discussed euthanasia; the evidence presented here does not resolve the conflict between her denial and Deichmann’s recollection. Some people close to Mulderick later suggested that remarks contrasting the treatment of animals with that of human beings may have been misunderstood or acted upon in ways she did not intend. The competing accounts make the distinction between a request for comfort medication and an intention to hasten death central to how her actions were interpreted.

Evacuation and its human aftermath

During the evacuation, Mulderick encountered confusion about how people were supposed to leave. Employees and relatives came down the stairs believing boats were ready; she told them there were no boats and left to investigate reports that helicopters were waiting. At the emergency room, she found two patients still alive who had earlier been described to her as too close to death to move. One was an elderly woman who had arrived with her husband and been cared for by Wynn. Mulderick asked the emergency-room doctor whether they were expected to die soon or should be moved upstairs, and he agreed to take responsibility for deciding what to do. These episodes show her checking earlier judgments against conditions she could see, while also relying on other clinicians to make immediate patient-care decisions.

The strain of the evacuation did not end when Mulderick left the building. After spending the night of September 1 on Memorial’s open helipad with about fifty staff and family members, she joined a call team that included Wynn. The helicopters had stopped coming after dark; the group did not reenter the hospital for fear of looters, and armed employees guarded the staircases. Mulderick later tried repeatedly to reach relatives of three deceased patients, but calls went to full voicemail boxes or recordings about network problems. After several hours she reached the son and daughter-in-law of one elderly LifeCare patient and tried to explain the circumstances of the woman’s death: the basement had flooded, electricity and air-conditioning were gone, and the patient had been very ill, though water had not reached the patient-care areas.

Investigation and contested legacy

After returning to the city in early autumn, Mulderick was cleaning her home when a Tenet attorney called and questioned her at length before advising her to obtain her own lawyer. He doubted that Tenet would pay for one. Upset, she went to a trusted local attorney, who believed it was unethical to seek information from her and then tell her to find separate representation. Her lawyer explained that a search-warrant application had to persuade a judge that a crime likely occurred and that evidence might be found at the proposed search location; allegations could include hearsay that might not be admissible at trial. LifeCare’s accusations, as her attorney described them, implicated both Tenet and Mulderick and Pou.

In January 2006, Mulderick knew investigators might ask about statements at the hospital that others had interpreted as incriminating. She had seen a copy of the secret search-warrant affidavit, which set out the allegations. In her interview, she said she had tried to reinforce that everyone, every patient, would leave, and described her medication discussion as an effort to ease suffering. She also said that she had not witnessed medication being given. These statements entered a public record already shaped by witness accounts and the seized prescriptions, rather than replacing them with a single uncontested version.

Press coverage added another layer to the dispute. One report said that Mulderick had given colleagues appallingly incorrect information by telling them no rescue would come that day, relying on sources who made that claim. The account notes that others later questioned whether it was true. Mulderick declined an interview through her attorney, and the reporter had little access to her perspective. When she read the article and allegations in the attorney general’s affidavit, she wept. The reaction was described alongside her pride in her administrative role and loyalty to Memorial, qualities that help explain why the accusations were so devastating to her.

Mulderick later declined a formal interview apart from saying that Memorial had been well prepared and that the situation had been managed well; she did not respond to a request to fact-check the book’s material, although some material from an earlier article had been checked through her attorney. Her account and the recollections of hospital colleagues therefore remain in tension. As the book presents her, she is both the experienced administrator trying to direct an evacuation and a figure whose words about medication became bound to the question of whether patients’ deaths were hastened. The gap between her stated purpose of comfort, other people’s recollections, and the conditions of a failing response is not incidental to her story; it is the unresolved center of her public legacy.