“Do not rescue”

“Do not rescue” names the gulf between a patient’s DNR order and the evacuation decision made in its name at Memorial Medical Center. When a bed-bound woman was passed over for transport because she had a DNR order, her daughter realized that an instruction about resuscitation had become, in practice, a reason to leave her mother behind. The daughter’s protest forced a reversal: the order was canceled, and her mother was moved toward rescue.

The phrase in the Clara Wing

On a fifth-floor hallway in Memorial’s Clara Wing, transporters rolled a bed-bound patient toward the stairwell, noticed her DNR order, and stopped. They repeatedly maneuvered other patients around her. Nurses were told not to explain the reason to the patient’s daughter. Instead, they said her mother was not the only patient remaining on the floor, without mentioning that the only other patient was dead.

That other patient was James Lafayette, a ninety-seven-year-old man with Alzheimer’s disease. His son had brought him to Memorial Medical Center before the storm for a cough; after discharge, he spent two days lying on the hospital lobby floor before being admitted. Hours later, nurse Michelle Pitre-Ryals found him pulseless. Staff rushed into his room with flashlights and attempted resuscitation, but their efforts failed. The contrast sharpened the circumstances around the woman still waiting upstairs: extraordinary measures had been attempted for one patient, while another was being passed over for evacuation because of a DNR order.

The woman’s daughter had approved the order after her oxygen-dependent, ninety-three-year-old mother was admitted during the storm. At the time, she had reasoned that resuscitation after cardiac arrest would not make sense. Now, with staff being told to leave the floor and no one having come for her mother, she understood the situation differently. She told Pitre-Ryals, “I did not mean for her to be left up here,” and explained, “When I made my mother a DNR, I did not know it meant ‘do not rescue.’”

From DNR to evacuation priority

The daughter asked to cancel the DNR order and even appealed to the nurses’ own safety as they resisted an instruction to leave. A staff member went to find a doctor to remove the order. The patient was moved downstairs and out into the parking garage on the way to the helipad, and she survived that immediate ordeal. The phrase thus marks a consequential confusion: an order about what to do if a patient’s heart stopped was treated as a reason to defer that patient’s rescue.

The same conflict appeared on LifeCare’s seventh floor. Angela McManus overheard workers discussing the decision to defer evacuation for DNR patients and feared that her frail, seventy-year-old mother, Wilda, would not be rescued. She begged staff to rescind the order, but they said no doctors were available to do so. Wilda remained upstairs after doctors in the second-floor staging area told LifeCare staff to stop sending patients down because there was no more room. Unlike the Clara Wing patient, Wilda’s DNR order was not canceled in time to change the immediate course described here.

The phrase’s moral afterlife

The episode gives the expression force beyond a dispute over terminology. It shows how a medical designation could acquire an evacuation consequence that the family member who approved it had not intended, while decisions about patients’ categories were made by professionals and information about those decisions was withheld from the people most affected. The daughter’s words name the resulting break between a limited instruction about resuscitation and a broader judgment about who would be rescued.

Later accounts of the storm’s aftermath register the emotional burden surrounding that divide. Gina Isbell continued to see her patients’ faces in nightmares and remained angry that help had come too slowly; she nevertheless believed that she and her colleagues had done the best they could and would serve again in a storm. Karen Wynn, preparing for possible grand-jury testimony, found that discussing the events could make her feel as though she were reliving them; she came to recognize what she thought might be post-traumatic stress disorder in herself and colleagues and no longer wanted the responsibility of nursing management. John Thiele later rejected a nurse’s impression that he regretted his actions at Memorial, maintaining that his own many critical conditions were potentially reversible. These different responses do not resolve the question of responsibility. They show why the daughter’s phrase remains a pointed description of the human stakes embedded in the evacuation decision.