Angela McManus—Wilda McManus

Angela McManus—Wilda McManus is a mother-daughter relationship tested by illness and by the decisions made during Hurricane Katrina at LifeCare Hospitals of New Orleans. Angela had spent more than a year caring for Wilda and understood herself as responsible for her mother’s dignity and well-being. At the hospital, that responsibility meant speaking for a mother whose stroke and medication sometimes made communication difficult, providing hands-on care when help was scarce, and trying to ensure that a do-not-resuscitate order would not be mistaken for permission to leave Wilda behind.

A Daughter as Advocate

Before the storm, Wilda had been the longtime patient information manager at Charity Hospital. Visitors encountered her at the entrance: she was among the first people they saw. After a stroke and the effects of some medicines, however, she could still smile but could not always make herself understood. Her admission paperwork specified that Angela should stay with her at all times. The shift from welcoming and guiding hospital visitors to depending on her daughter to speak for her gives their relationship a striking reversal: Angela became the person who conveyed Wilda’s needs to the institution.

Angela had quit her job and spent more than a year as Wilda’s caregiver. Her commitment was not presented as a narrow medical task. She had not set limits on what she would do for her mother, and caring for Wilda and protecting her dignity had become the purpose of her life at that time. At LifeCare, that established role continued under conditions in which ordinary support was difficult to secure and the family could not be sure what would happen next.

The Meaning of the DNR Order

When Wilda’s infection worsened on the day Hurricane Katrina struck, Angela was counseled by the infectious diseases specialist on duty. She agreed against surgery in an operating room relying on backup power. She also agreed that if Wilda’s heart or lungs stopped, attempts to revive her with breathing tubes, electric shocks, or chest compressions would not address her chronic underlying health problems. These decisions reflected Angela’s understanding of the likely limits of treatment; they did not mean that she had stopped valuing her mother’s life or care.

The distinction became urgent when staff prepared to leave the floor and Wilda had not been taken away. Angela had approved the DNR order, but now understood the circumstances differently: she had not intended for it to mean that her mother would be excluded from rescue. She asked for a doctor to rescind the order, seeking to prevent a medical instruction about resuscitation from determining whether Wilda would be evacuated. The account emphasizes that Angela’s position was not inconsistent. She could accept that certain invasive procedures would be futile while still insisting that Wilda should be cared for and not abandoned.

Care Under Evacuation Conditions

On Wednesday, Angela watched other LifeCare patients being carried toward the stairwells before Wilda. Nurses returned in tears after patients had died during transit. The repeated departures made the order of evacuation visible to the family: other patients were moving, while Wilda remained. Angela waited beside her mother through the day and asked in vain for a doctor to reverse the DNR order. A chart note recorded that Wilda was en route to the heliport, but she never made it off the floor.

Angela continued to care for Wilda herself while exhausted and anxious about a sibling living near the levees. She gave her mother nourishment through a feeding tube, managed routine personal care, and eventually recruited a nurse to help clean and change her dressing when no running water was available. For hours, the practical work of care depended on Angela’s persistence in finding assistance. She also talked, sang, and prayed with Wilda. Before the storm, LifeCare staff had gathered for what they called church when Wilda recited the Lord’s Prayer and the Twenty-Third and Ninety-First Psalms. In the crisis, prayer remained part of the care Angela could offer, alongside the physical work and advocacy.

Separation and the Attempt to Preserve Contact

Angela had taken comfort from hearing staff say they could not leave until every patient was gone. She understood this to mean that no one would be left behind. Late Wednesday afternoon, however, she was told that the remaining patients would soon be moved and that she should leave by boat. Before going, she asked where Wilda would be taken. The LifeCare nurse executive, Therese Mendez, could not tell her. Instead, she suggested putting a contact number on Wilda so that Angela could be reached.

The attempt to write directly on Wilda’s skin failed because it was too wet. Staff wrote Angela’s phone number and a brief request for urgent contact on pieces of gauze and wrapped them around Wilda’s arm and leg beneath her gown. The makeshift labels were a fragile substitute for the daughter who had been told to leave: they carried her name and the demand that she be found, even though no destination was known. The episode leaves the separation unresolved at the moment it describes. Angela was sent away without knowing where her mother would end up, while the staff tried to keep their connection legible to whoever might receive Wilda.

Comfort, Absence, and the Relationship’s Significance

Just before midnight, a nurse judged that Wilda might need something to calm her and gave her a small dose of Ativan. Angela was not there to alert the nurse to the drug’s previous paradoxical effect. The passage does not present medication as a replacement for the care Angela had provided: no drug could supply the reassurance of her daughter, who had been made to leave. The contrast is central to the relationship’s portrayal. Angela’s presence had consisted not only of formal decisions about treatment but also of feeding, tending, speaking, singing, praying, and remaining beside Wilda.

Their story also shows how a DNR designation could acquire consequences beyond the decision it was meant to record. Angela had agreed to limits on resuscitation after receiving medical advice; when evacuation became the immediate question, she tried to make clear that those limits did not cancel her mother’s claim to rescue or continued care. The account preserves both parts of her position: she did not demand interventions she believed could not help Wilda, and she resisted a process that left her unable to protect or even locate her. Their bond is therefore rendered through action under pressure, as a daughter repeatedly translates love into advocacy and practical care, even when the hospital’s evacuation leaves her separated from the person she had spent more than a year caring for.