Extreme heat inside Memorial

Extreme heat inside Memorial Medical Center turned the hospital’s loss of power into a medical emergency in its own right. With air-conditioning gone, water and sanitation failing, and patients crowded into dark corridors, heat threatened organ damage, deepened the danger to people already ill, and compounded the strain of moving them to safety. The heat was not a separate hardship laid over the crisis: it became one of the forces that made care and evacuation harder at every step.

A Known Vulnerability Meets a Power Failure

The hospital’s exposure to flooding had been recognized before Hurricane Katrina. After Hurricane Ivan narrowly missed the city in September 2004, plant operations director Eric Yancovich studied storm-surge models with the U.S. Army Corps of Engineers and worked out the elevations of Memorial’s entrances and critical equipment. His calculations showed that less than four feet of water on Magnolia Street could spill across the loading dock and into the hospital. The backup generators were on the second floor, but parts of the emergency power distribution system were at or below ground level. Yancovich warned that relatively little water could disable most of the medical center, potentially forcing patients into the newer Clara Wing, where he believed the electrical circuitry was better protected.

Some precautions were taken, including adding floodgates and raising the vent for underground diesel tanks, but recommended work on transfer switches and pumps supplying medical air and vacuum suction was not completed. A partial bid for electrical work exceeded a quarter of a million dollars, and lack of capital kept it from being approved. The generators themselves were designed and tested for brief interruptions, not prolonged operation, even though the disaster plan expected them to support the hospital for at least three days. By the time the crisis reached its second day, the system’s vulnerable switches and distribution equipment were exposed to flooding.

Heat Spreads Through the Hospital

On Wednesday morning, August 31, the sun rose and the temperature climbed. The hospital was stifling; water had stopped running from taps, toilets were backed up, and sewage odors mingled with the smell of many unwashed bodies. Corridors were dark, with flashlight beams providing intermittent light. Phones, televisions, computers, and overhead pagers no longer worked, so staff relied on messages passed from person to person on the stairs. The heat was inseparable from these other failures: patients could not be kept clean, communications were limited, and the ordinary resources of a functioning hospital were disappearing.

The electrical crisis had been building through the night. Memorial’s three large diesel generators had already run for two days. When one overheated, maintenance workers added water to its radiator and restarted it; later, they tried to address low oil pressure by bringing in diesel and priming the engines. As generators failed, staff attempted to shift electrical loads, wading through knee-deep basement water to reach equipment. About a third of the automatic transfer switches were at a low level and appeared likely to be submerged, as Yancovich had predicted. Workers used a bypass handle to connect a failed generator’s load to a working one, then backed away when a gauge showed the remaining engine drawing too much current. They also shut off circuits serving unused equipment. After another generator failed and an attempted repair came to nothing, the last one surged and died at about two in the morning on August 31, nearly forty-eight hours after Katrina made landfall near New Orleans.

The Body Under Heat Stress

Karen Wynn, Memorial’s nurse manager, repeatedly helped move patients from LifeCare Hospitals of New Orleans. When she rolled patients onto backboards, she was struck by how hot they felt. Elderly people and those with conditions such as stroke or head injury were especially vulnerable; heart disease, dehydration, extra weight, and some medications could also interfere with the body’s ability to shed heat. Wynn feared that the patients’ condition was worsening even before she could determine the extent of the damage.

After roughly two days without air-conditioning, patients’ core temperatures were likely rising. In severe heat stress, sweating can fail even as the body needs it, and heatstroke can bring widespread inflammation and dysfunction in multiple organs, especially the brain. Confusion may progress to coma. Cooling measures such as ice baths, wetting the skin and fanning, oxygen, and sometimes fluids can reverse heatstroke; most people survive when it is treated. But Wynn worried that prolonged heat could leave irreversible damage in patients’ cells and organs. The danger was particularly acute for people already dependent on others for care, and the hospital had little capacity to provide the controlled cooling and treatment they needed.

The heat also narrowed the margin for evacuation. On Wednesday, Anna Pou helped coordinate the movement of patients through rancid air and pitch-black rooms, worried that even healthy people were becoming ill and struggling to breathe. Staff and family members carried patients to the second-floor lobby, where Pou and nurses assigned categories for evacuation. Meanwhile, Susan Mulderick encountered patients in the lobby amid intense fecal stench and insufficient diapers and fresh linens. She cleaned an elderly woman whose skin was raw and had developed a sore above her buttocks; the slightest touch caused pain. The episode showed how heat, immobility, and shortages translated into suffering that could not be addressed by moving patients alone.

Aftermath and Unequal Responses

The crisis left physical and emotional traces among those who had worked through it. Ewing Cook, exhausted and filthy on Wednesday afternoon, was also dealing with a painful boil and bladder spasms in a hospital bathroom whose toilet would not flush. Gina Isbell later described sleeping poorly, having nightmares in which she saw patients’ faces, and feeling guilty about both the staff she had selected to work the storm and the patients who died. She had evacuated in a small flat boat with a heat rash and, on reaching safety, discovered that her home and community in St. Bernard Parish had been devastated. Years later, she still wore a hurricane-shaped pendant and considered herself changed by the storm and its ending.

The hospital’s ordeal also formed part of a wider contrast in New Orleans. Charity Hospital had lost power and functioning plumbing, computers, telephones, and elevators, and took until Friday afternoon, September 2, to transfer its patients, compared with Thursday at Memorial. Yet fewer than ten patients died there. Its staff held frequent meetings, organized a talent show by flashlight, and had obtained portable generators, oxygen-powered ventilators, and a ham radio system through preparedness funds. The comparison does not erase the danger at either hospital; it makes clear that exposure to extreme conditions alone does not explain what happened. At Memorial, the heat magnified vulnerabilities in infrastructure and patient care, while the consequences remained present in the memories and lives of those who had endured it.