August 29, 2005

August 29, 2005, was the day Hurricane Katrina’s threat became an immediate test of New Orleans’s ability to protect people who could not simply drive away. The storm weakened as it moved inland, but thousands of patients remained in the city, transportation plans were faltering, and Memorial Medical Center’s emergency power could sustain only selected functions. The day’s brief relief—water receding and the hospital still operating—stood against a crisis that would continue well beyond the storm itself.

Evacuation and the patients left in the city

The emergency began before dawn on August 29, after Mayor Ray Nagin had ordered a mandatory evacuation the previous day. The order could not by itself move people without cars, and officials knew the city lacked enough drivers for its transportation plans. Residents who had left independently were already caught in interstate traffic. The New Orleans Superdome was designated a shelter of last resort, with shuttle buses intended for people unable to leave on their own. Nagin specifically urged people with medical conditions, including those requiring dialysis, to go there, but the public announcement did not explain what medical assistance would be available.

Hospitals and their staff were exempted from the evacuation order so that injured people would have somewhere to go. That decision left patients and workers inside facilities exposed to the same approaching storm. Planning documents and exercises had already recognized the scale of the problem: an emergency scenario earlier that week assumed more than 2,000 hospital patients would be in New Orleans during a catastrophic hurricane, while roughly 2,500 patients remained in the city as Katrina advanced. Yet no workable plan had been established to move so many patients to safety. A federal review found that only two of roughly eighteen hospitals in and around the city had placed both their generators and electrical switching equipment above ground-floor level; Memorial Medical Center had done neither.

The transportation shortfall was visible beyond Memorial. Dispatchers at Acadian Ambulance were overwhelmed by calls from hospitals, nursing homes, and homes. Many of the roughly two dozen ambulances made available were stuck on the jammed interstate, and some began taking patients to the New Orleans Superdome rather than attempting to get them out of the region. At Chalmette Medical Center, the main hospital in St. Bernard Parish, ambulances carried away an initial group of critically ill patients but did not return. Elsewhere, administrators weighing an airlift for nine very sick patients faced roads so congested that an ambulance journey could take as long as a day. These failures made evacuation not a single decision but a contest between medical urgency and the diminishing means to act.

The storm and power loss at Memorial

At 4:55 a.m., utility power to Memorial Medical Center failed. The hospital’s auxiliary generators started, but the system was designed to serve emergency lighting, selected critical equipment, and only a limited number of outlets on each floor. It could not run the air-conditioning system, and nurses used the box fans available to cool patients; there were not enough for everyone. The outage thus arrived before the storm’s full force and immediately narrowed what the hospital could provide.

Around six in the morning, Katrina’s eye moved over land near Buras, Louisiana, about sixty miles southeast of New Orleans, as a Category Three hurricane. Winds of 135 miles per hour were expected later that morning. At Memorial, exposed windows broke, rain entered the building, and water collected on floors. The basement, where several days’ worth of food was stored, began to flood. Incident commander Susan Mulderick helped move supplies upstairs on rolling dollies, a laborious task made slower by the shortage of hand trucks. The threat was not only damage from wind and water: the hospital’s stored provisions and ability to distribute them were also at risk.

By late morning, the rain eased and the winds weakened. Water outside Memorial stabilized at about three feet, and by midafternoon it began to recede. Staff carried pets and food back downstairs, mopped floors, and checked the building for broken windows, roof damage, and waterlogged interiors. By evening, people could walk dogs outside, and some nearby doctors returned to their homes or stayed there overnight. Katrina had weakened before arrival; the city experienced Category One or Two winds rather than the Category Five conditions imagined in the most severe forecasts. Memorial remained functional on backup power, encouraging the belief that the hospital had weathered another storm.

Relief, and the emergency beyond the weather

That sense of reprieve did not mean that patients could safely leave or that the city’s medical emergency had ended. In the days that followed, Memorial’s evacuation remained difficult: staff and relatives sought boats, while the seriously ill waited inside. Karen Wynn, caring for patients categorized as the highest priority, encountered an outpatient who had crossed floodwater to arrive for a scheduled chemotherapy appointment. The episode showed how people outside the hospital could mistake the receding water for a return to ordinary conditions, even while the hospital could not resume ordinary treatment. Wynn was also confronted with demands connected to patients transferred elsewhere, a reminder that the consequences of moving people reached institutions beyond Memorial.

The later accounting of the disaster placed that difficult hospital experience within a wider chain of failures. More than a thousand people died immediately in New Orleans, many in medical facilities and many others among the poor and elderly; further suffering and deaths followed disruptions to health care. The causes included the delayed city evacuation order, insufficient buses and drivers, uncoordinated rescue operations, communications failures, and hospitals and nursing homes that had not evacuated ahead of the storm or built sufficiently robust backup power and water systems. Fear of violence also interrupted rescues, while rumors of widespread attacks proved greatly exaggerated. The contrast between Memorial’s functioning lights and the city’s stalled evacuation illustrates why surviving the storm’s strongest winds was not the same as having a dependable disaster response.

Later echoes of August 29

The book returns to the date’s lessons through a later disaster. In January 2010, a United States disaster medical team established a tent hospital on a college campus in Port-au-Prince after the earthquake. A patient recorded as Jane Doe 326 was in fact Nathalie LeBrun, a 38-year-old woman whose breathing problems had worsened after the disaster. Staff found oxygen for her, but the supply ran out overnight; they obtained another tank, then tried a portable concentrator that repeatedly overheated and depended on electricity and scarce generator fuel. The episode recalled a vulnerability exposed in New Orleans: treatment depended not only on medical decisions but on fragile systems for power, supplies, patient identification, and transport.

August 29 therefore functions as more than a date of landfall. It marks the collision between a storm’s changing intensity and the unequal capacity of people and institutions to respond. The water around Memorial receded within a day, but the patients’ dependence on hospital infrastructure, the city’s transportation failures, and the consequences of incomplete preparation continued to shape what followed.