Tesfalidet Ewale

Tesfalidet Ewale was a sixty-six-year-old Eritrean political asylee and patient at Memorial whose death during the hospital’s evacuation crisis brought together its strained medical conditions and difficult end-of-life decisions. His course—from a possible transfer denied on financial grounds to an anticipated airlift that did not take place—shows how a patient’s prognosis, DNR status, and failing hospital systems shaped the care available to him.

Identity and Admission

Ewale was admitted to Memorial in mid-August with a presumed heart infection alongside chronic illnesses. He was considered for transfer to LifeCare, but the company did not accept Medicaid patients, and the request was politely declined. He therefore remained at Memorial, where he later became one of four ICU patients not evacuated on Tuesday.

Illness and Evacuation Plans

Several days before the evacuation, Ewale had been resuscitated when he was close to death. He subsequently came off the ventilator and stabilized with a special oxygen mask, though his medical problems remained grave. On Tuesday, an ICU nurse told his daughter by telephone that he was drowsy but arousable, could grasp hands, and would be airlifted from Memorial, possibly to a hospital in Atlanta. His DNR designation complicated that expectation; his daughter had initially resisted it.

Care During the System Failure

After the power went out, the vacuum lines failed, and medical workers could not work out how to suction Ewale’s airways effectively. His doctors, including Roy Culotta, had considered another resuscitation futile given the severity of his illness and poor prognosis. At Culotta’s direction, Ewale received Ativan and morphine for comfort. The care decisions unfolded amid deteriorating equipment and an evacuation plan that had led his daughter to expect that he would be flown out.

Death and the Question of Consciousness

Ewale was pronounced dead shortly before two o’clock on Wednesday, after hours of difficulty clearing his secretions. He had been comatose and unresponsive during that period. Karen Wynn, who was haunted by what she had been told about him, believed that a patient’s lack of outward consciousness did not necessarily mean an absence of awareness or feeling. Her belief drew on an earlier experience with a patient who had been unresponsive for weeks and later said he had heard the nurses around him. Wynn’s account places Ewale’s final hours within a wider uncertainty about what unconscious patients may experience, even when they cannot communicate.