August 28, 2005

August 28, 2005, marked the shift from hurricane warnings to an urgent, uneven effort to escape New Orleans. As forecasts described catastrophic wind, flooding, and weeks without power, Mayor Ray Nagin ordered the city evacuated; at Memorial Medical Center, Anna Pou chose to stay in case patients needed specialized care. The day’s opposing imperatives—to leave immediately and to remain available to the sick—set the terms for the crisis that followed.

Forecast and Evacuation Order

On Sunday morning, television screens at Memorial showed Hurricane Katrina filling the Gulf of Mexico as a Category Five storm, the highest level on the Saffir-Simpson scale. The National Weather Service’s New Orleans office warned that much of the area could remain uninhabitable for weeks, that many homes could lose roofs and walls, and that widespread power outages and water shortages would bring severe hardship. The forecast gave the approaching storm a scale that was difficult to reconcile with ordinary preparations.

At about ten a.m., Nagin signed a mandatory, immediate evacuation order. He later acknowledged that the order had been delayed while his staff worked through logistical and legal questions, including whether he had authority to issue it. At the press conference where he read it aloud, Louisiana governor Kathleen Blanco warned that flooding could reach fifteen to twenty feet; Nagin said the storm surge might overwhelm the levee system.

The command to leave did not give every resident a practical means of doing so. Officials knew the city’s transportation plans had significant gaps, including too few drivers, while residents able to leave independently were already caught in traffic on the interstate. The New Orleans Superdome was designated a shelter of last resort, with shuttle buses intended for people who could not get out. Nagin specifically urged people with medical conditions, including those on dialysis, to go there, but did not explain what assistance they would find once they arrived.

Pou’s Decision to Stay

Pou was on duty for her department and therefore expected to remain at Memorial during the hurricane. Department chairman Dan Nuss called because he believed the storm was a serious threat. The department’s postsurgical patients, distributed among several area hospitals, were not gravely ill, so Nuss urged Pou to transfer responsibility for their care to other doctors. Her husband also advised her to leave.

Instead, Pou dismissed the two resident physicians on call with her so they could be with their families and told them to leave town. At four p.m., the National Hurricane Center warned that Katrina’s waves and storm surge could rise as much as twenty-eight feet above normal tide level and overtop some of the levees protecting the city. Pou had decided to remain in case people trapped in New Orleans needed the specialized care she and relatively few others could provide. Because her department performed most of its roughly 1,000 annual surgeries at Memorial, she chose the hospital as her base.

A Night at Memorial

That evening, the surgical staff settled into the endoscopy suite they had claimed as quarters. For Pou and many of the nurses, the time together had the ease of a slumber party: they were of similar ages, had grown up in New Orleans, attended private and Catholic schools, and discovered friends in common. Their personal familiarity briefly softened the strangeness of sheltering inside a hospital as a major hurricane approached.

The conversation turned to Pou’s first serious boyfriend, an anesthetist who had worked at Memorial but had recently left his job. The nurses teased her about him. At midnight, Pou took out her lipstick and began applying it in case she saw him; the nurses laughed and reminded her that it was late. The small, playful scene sits beside the day’s warnings and evacuation decisions, showing the hospital not only as a place of emergency preparation but also as a temporary refuge in which ordinary relationships and routines persisted.

The Day’s Turning Point

Across the city, August 28 exposed the difference between an evacuation order and an evacuation people could actually carry out. Residents without cars depended on plans with known transportation deficiencies, while the designated shelter offered a destination without a clear account of the help available there. At Memorial, the same emergency produced a different obligation: Pou remained because she believed specialized medical care might be needed, even as her chairman and husband urged her to leave.

The day thus established two tracks of response before the storm’s full consequences were visible: an evacuation effort constrained by access and logistics, and a hospital staff preparing to endure the threat while caring for patients. Pou’s decision to base herself at Memorial connected those tracks to the later crisis inside the hospital.