Kathleen Fournier

Kathleen Fournier was an internal-medicine physician covering patients at Memorial Medical Center and LifeCare when Hurricane Katrina left the hospitals isolated. She worked long hours amid heat, failing power, and severe patient distress, while struggling with an increasingly urgent question: whether efforts to relieve suffering were becoming a proposal to end patients’ lives. Her conversations with Susan Mulderick, nurse manager Fran Butler, and physician Bryant King show both her alarm and the limits of what she understood about the plan. She ultimately told King she would not take part.

Work and Presence at Memorial

Fournier did not have a medical practice of her own. Richard Deichmann paid her a flat fee to cover his group’s internal-medicine patients, including inpatients at Memorial and LifeCare, when his group took its weekend call. She had not been scheduled to work during the storm, but agreed to fill in because the doctor who was due to take the shift wanted to attend his daughter’s birthday party. Deichmann later suggested that she leave after Katrina passed, but she stayed and worked alongside Anna Pou, often for long hours.

Her physical circumstances were precarious. Fournier had an injured eye covered by a patch held in place with ragged tape, which became less secure in the hospital’s oppressive humidity. On the second-floor lobby carpet, she worked beside patients in front of a box fan whose blades turned slowly on the overloaded generator. The generator’s breaker repeatedly tripped under the strain of extension cords and high electrical loads, sending someone to the parking garage again and again to reset it. Even amid these conditions, a doctor sent to encourage Fournier to leave thought she seemed fine and did not press the matter. Deichmann later emphasized her courage and dedication, saying she had worked very long hours to ensure patient care when others had abandoned it.

Patients, Pets, and a Disputed Proposal

The conflict that drew Fournier into the unfolding debate emerged against a scene of acute neglect and exhaustion. Susan Mulderick had just been shaken by the suffering of an elderly patient whose skin had broken down from heat, sweat, and the shortage of diapers and clean linens. Fournier approached Mulderick, upset about her sick cat, Tabby, who had stopped eating and drinking. Mulderick was angered that Fournier seemed concerned about the animal while patients nearby were suffering. She later described her own idea as relieving patients’ pain and dulling their senses to their surroundings—not necessarily killing them—but the word euthanasia entered the conversation in ways the participants understood differently.

Mulderick told a radiologist, “We are talking about euthanizing the animals, but not about what we can do to help the patients.” She asked him to convey her concerns to Deichmann, who was meeting daily with physicians. The radiologist understood the issue as a request to discuss euthanizing patients and wanted an open meeting rather than a decision made privately. Deichmann rejected the proposal. A physician colleague also considered euthanizing patients dangerous and worried that a doctor might go to jail for trying to help in an illegal way.

Deichmann would later recall a separate, quiet conversation in which Mulderick asked whether it would be humane to euthanize the hospital’s DNR patients. He said euthanasia was illegal and that nobody should be euthanized. Mulderick, through her attorney, denied ever raising that idea with him or anyone else at Memorial. The disagreement in these accounts matters: Fournier’s experience of the discussion is recorded as a series of questions and conversations, not as proof that she had settled on a single interpretation of Mulderick’s intentions.

Fournier’s Objections and Conversations

Fournier was present when Mulderick spoke with Anna Pou about giving patients medication. Fournier said, “I just disagree with this.” Mulderick replied, “OK, don’t order it,” and told her she did not have to give it. Fournier had not known Mulderick before the storm, and some nurses already found her outspoken manner aggravating. She was quick to voice concern, often loudly and with curses or comments others considered inappropriate; she did not filter her reactions.

She sought another opinion from Fran Butler, a nurse manager, about talk she had heard of putting patients to sleep or out of their misery. Butler’s answer was unequivocal: “That is not an option.” Butler said she would not increase morphine unless a patient appeared uncomfortable. She believed staff should remain on their wards and maintain care while awaiting the water to recede. Fournier did not simply accept or dismiss this response; she continued asking colleagues what the proposal meant and whether it was something she could take part in.

Fournier’s uncertainty also surfaced while she was helping John Thiele with two Siamese cats on the second floor. Their owner, a pharmacist who lived alone and considered the cats her children, had asked Fournier to euthanize them because she believed she would have to abandon them. Fournier held one cat while Thiele prepared to inject potassium chloride into its heart. During the attempt, she told him she did not want to participate in putting patients out of their misery. Thiele said he understood and that he and others would handle it, but Fournier was unsure what he meant. Before Thiele injected the cat, it struggled free and clawed his sweaty scrub shirt. Someone else injected the second cat and threw it through a broken window into the floodwaters. Fournier’s presence in this episode brought the debate about animals into immediate proximity with the unresolved debate about patients.

The Conversation with Bryant King

Fournier then pulled Bryant King aside on the second floor. She began, “This is between me, you, and the fence post,” and described her concerns about both her cat and the patients. She said patients were suffering miserably and asked what King thought about helping to end that suffering. When he suggested that air-conditioning or more fans might help, she clarified that this was not what she meant: she told him about her conversation with Mulderick and Pou.

King rejected the idea directly. “I can’t be a part of anything like that,” he said. “I disagree one hundred percent.” He argued that hastening death was not a doctor’s job and believed that the patients, though hot and uncomfortable, were not in the kind of pain that warranted sedation or mercy killing. King had visited the seventh-floor patients and assigned triage categories; his assessment of their condition differed from the account of unbearable suffering that had prompted Fournier’s question. Fournier’s report to him therefore exposed a real disagreement over both the patients’ circumstances and what action, if any, those circumstances justified.

The timing of these conversations is not consistent across recollections. Fournier thought her discussion with Mulderick occurred at night, while Mulderick recalled Thursday morning, which the book’s account considers more likely. Fournier believed the talk with King took place Wednesday evening; King thought it was Thursday morning. Thiele and Fournier’s accounts of their conversation about the cats were consistent in substance, although Thiele placed it during the attempt to euthanize them and Fournier did not specifically identify that moment. These differences leave the precise sequence unsettled without erasing the central point: Fournier raised her concerns, asked others what they understood the proposal to mean, and told King she would not participate.

Narrative Significance

Fournier’s role is defined less by a single decision than by the record of a proposal being heard, disputed, and interpreted under pressure. Her concern for Tabby existed alongside her alarm about patients, and the juxtaposition could make her appear callous when viewed through Mulderick’s anger. Yet Fournier’s subsequent conversations show her trying to clarify what was being discussed; she objected to participating in ending patients’ suffering, and King’s response made the disagreement explicit. The episode also places the hospital’s moral crisis in concrete surroundings: a slow fan, a repeatedly tripped generator, suffering patients, and a cat struggling out of a physician’s hands. Fournier remains a witness to—and participant in—the confusion over where comfort care ended and hastening death began, but the conflicting recollections resist reducing her to a simple advocate or opponent of euthanasia.