Charity Hospital’s evacuation during Hurricane Katrina became a striking contrast to other New Orleans hospital responses: despite flooding, failed utilities, shortages, and a prolonged evacuation, staff continued patient care and removed the sickest patients first. By September 2, 2005, all patients had been transferred from its two campuses, and fewer than ten had died. The account attributes this outcome not to favorable conditions but to preparation, improvisation, and a deliberate refusal to mark the most critically ill as beyond rescue.

Background and Conditions

Charity Hospital faced a crisis comparable to, and in some respects worse than, that at Memorial Medical Center. The public hospital had flooded and lost power, functioning plumbing, computers, telephones, and elevators. It had no helipad and no corporate overseers to provide assistance. More than a hundred psychiatric patients were inside, and soldiers brought additional patients dependent on ventilators. Reports of a gunman on a nearby roof disrupted evacuation, while convoys trying to reach the hospital over water were reportedly shot at and looted. News accounts even suggested Charity had already been evacuated when patients remained there.

The transfer took until Friday, September 2, one day later than the transfer at Memorial. Charity had approximately twice as many patients across its two campuses, with a lower staff-to-patient ratio. Its staff nevertheless continued providing medical care in patients’ rooms until the end. The scale of the task and the hostile conditions make the comparatively low number of deaths a central fact of the episode, rather than evidence that the evacuation was easy or that the hospital avoided crisis.

Preparation and Staff Practices

Charity officials had drilled for a Category Three hurricane and levee failure. With federal preparedness funding made available after the September 11 attacks, the hospital bought portable generators, oxygen-powered ventilators, and a ham-radio system; its security officers also received special disaster training. These preparations did not prevent the hospital from flooding or losing its ordinary utilities, but they gave staff equipment and experience to draw on when normal systems failed.

The book also presents morale and routine as part of the response. Leaders held meetings in the lobby every four hours, including staff from doctors to janitorial workers. Employees staged a talent show by flashlight, and they painted and laughed. Charity continued physical and occupational therapy, encouraged workers to keep shifts and regular sleep schedules, and made an active effort to contain rumors. Staff were told to repeat something only if they had seen it. These practices preserved recognizable forms of hospital life amid conditions that threatened to make the situation feel wholly uncontrolled.

Improvisation and Evacuation Decisions

When fuel was needed, staff siphoned gasoline from cars to run ten small portable generators. They used them to power ventilators and cardiac monitors in the intensive care units, sustaining critically ill patients, including a very premature baby. This use of improvised power sharply contrasts with the account of Memorial: after its power failed, patients were ventilated by hand with Ambu bags, while two similar generators were later used for lights and fans in common areas and at the helipad rather than for medical equipment.

Charity’s leaders also made a consequential choice about evacuation order. They did not classify a group of patients as too ill to rescue. Instead, the sickest patients were taken out first. That decision reversed the priority applied at Memorial, where patients with Do Not Resuscitate orders had been placed last. At Charity, a patient’s critical condition did not become a reason to defer evacuation; the most urgent needs guided who was taken first.

Outcome and Significance

All patients were transferred from Charity’s two campuses by September 2, after staff had maintained care through the breakdown of essential services and the dangers affecting access to the hospital. Fewer than ten patients died, despite the hospital’s larger patient population and smaller staff ratio compared with Memorial. The evidence does not reduce that outcome to a single intervention: equipment, training, staff practices, improvisation, and evacuation priorities appear together in the account.

Set beside the failures and disputed decisions elsewhere in New Orleans, Charity’s experience shows that extreme conditions did not dictate one inevitable response. The hospital remained overwhelmed and exposed to serious danger, but its staff continued bedside care, sustained critical equipment where they could, tried to limit panic, and evacuated the sickest first. The episode’s significance lies in that contrast: disaster narrowed the resources available, yet preparation and institutional choices still shaped who received care and how the evacuation proceeded.