Memorial Hospital Shifts to Survival Mode and Prepares for Evacuation

Memorial Hospital Shifts to Survival Mode and Prepares for Evacuation describes the moment Memorial Medical Center stopped treating the hurricane as an emergency that could soon pass and began preparing for a prolonged crisis. News that a canal had breached transformed the hospital’s immediate outlook: staff who had expected to hand patients to the next shift and go home might instead be stranded with them. The shift to survival mode organized the hospital’s response, but it also revealed that its emergency plans did not cover the conditions now converging around it.

The City’s Evacuation and the Hospital’s Place in It

New Orleans mayor Ray Nagin ordered an immediate mandatory evacuation, but the order did not mean that everyone could leave. Residents without cars depended on a transport system officials knew had serious gaps, including too few drivers, while traffic already clogged the interstate. The New Orleans Superdome was designated a shelter of last resort, and shuttle buses were meant to bring people there. Nagin specifically urged people with medical conditions, including those needing dialysis, to move to the shelter promptly, without explaining what assistance would be available there.

Hospitals, by contrast, were exempted from the order. When a reporter asked whether people should remain in hospitals, Nagin said he had exempted both the facilities and their workers, arguing that hurricane injuries would make hospital closures dangerous. That rationale addressed the risk of turning away new casualties but not the danger to patients and staff if the hospitals themselves lost power, water, or access. The conflict was already visible in the city’s transport scramble: Acadian Ambulance dispatchers were overwhelmed by requests from hospitals, nursing homes, and homes, and many of the roughly two dozen ambulances available were stuck in traffic. Some began taking patients to the Superdome rather than attempting to carry them out of town.

The Turn to Survival Mode

The hospital’s command team met in a room where staff gathered around a television with a rabbit-ear antenna; it showed mostly static. The meeting’s decisive news came from an Acadian Ambulance worker at the hospital, who had confirmed with dispatchers that a New Orleans canal had been breached and water might be moving toward Memorial. The team announced that hospital operations would shift from assault mode to survival mode. The change was practical as well as symbolic: staff could no longer assume that the next team would arrive to take over, or that the people already working could leave.

Reports from department heads initially described a hospital still functioning almost normally despite the heat. Maintenance staff cleared debris, removed floodgates, and patched roof damage; kitchen workers prepared food for patients and the many relatives and neighbors sheltering inside. But the apparent routine existed alongside signs of mounting strain. Trees and power lines were down, reports of flooding came from nearby, and people who ventured to a darkened supermarket returned with supplies. Once the meeting ended, a memo made the decision official: Incident Command had declared survival mode for Memorial Medical Center.

The instructions recast the hospital as a place of prolonged shelter and triage. Staff and physicians were told to stay, and family members were advised to remain as well. The hospital expected flooding. Elective surgery and major imaging procedures were suspended, while medically stable patients were to be discharged—even if they had no clear destination or means of getting there. Some waited in wheelchairs in the lobby. Meanwhile, the head pharmacist tried to arrange a delivery to replenish dwindling medicines. Each department was ordered to report its staff and family members, medicines, supplies, equipment, and cell phones by noon, because landline service was intermittent.

Essential Care Under Threat

The survival order had to account for patients whose care could not simply be paused. With city dialysis clinics closed, people in renal failure were arriving at Memorial, including patients transferred from Chalmette Medical Center. Only one dialysis nurse was available for patients from both Memorial and LifeCare. A LifeCare nursing director and another nurse volunteered, then helped a kidney specialist who was accustomed to ordering dialysis rather than performing it.

Dialysis required water, but city water was reportedly contaminated with chemicals and bacteria. The doctor faced a choice between attempting the treatment with uncertain water or leaving patients who needed dialysis at risk while evacuation remained unclear. Staff decided to filter the water and proceed, while workers boiled water in microwaves and stored it for other uses. This improvised work sat at the center of survival mode: the hospital was trying to sustain essential treatment even as the systems and supplies that made that treatment possible grew less dependable.

The Evacuation Problem the Plans Missed

The threat exposed a vulnerability already identified by Memorial’s facilities director, Eric Yancovich. In a note written months before Katrina, he warned that relatively little floodwater could disable much of the medical center and predicted that the main hospital could lose power. He thought patients might need to be moved to the newer Clara Wing, whose electrical circuitry he believed was better protected. The hospital had added floodgates and raised a vent for underground diesel tanks, but his proposed larger safeguards—including raising emergency power transfer switches and pumps supplying medical air and suction—had not been funded. A partial bid for the electrical work exceeded a quarter of a million dollars; Yancovich recorded that he did not expect approval because of the lack of capital.

As water approached, Yancovich and Susan Mulderick understood that people needed to get out. Mulderick advised Memorial chief executive René Goux, who contacted his superiors at Tenet Healthcare and told them evacuation appeared likely. Yet the hospital’s 273 pages of emergency plans, divided among twenty separate plans, offered no guidance for complete power failure or evacuation with flooded streets. The hurricane plan assumed generators would function for at least seventy-two hours, though they had never been tested for that duration; the plans did not contemplate helicopters, and Memorial had no contract or arrangement for helicopter evacuation. Nor did the plans connect the separate hazards into the single crisis now unfolding: the hurricane plan did not anticipate flooding, the flooding plan did not anticipate evacuation, and the evacuation plan did not anticipate loss of power or communications.

Consequences and Wider Significance

The shift to survival mode was therefore both an operational decision and a belated recognition of interlocking risks. In the wider disaster, more than a thousand people died immediately in New Orleans, many in medical facilities and many others among the poor and elderly; others suffered or died later amid disrupted health care. Accounts of the catastrophe identify the delayed evacuation order, inadequate buses and drivers, uncoordinated rescue efforts, poor communications, and hospitals’ weak backup power and water systems among the contributing failures. Memorial’s preparations took shape inside that larger breakdown, not apart from it.

The pressure inside the hospital also narrowed staff members’ sense of what was happening beyond its walls. Later, Karen Wynn encountered an outpatient who had made her way through floodwater for a regularly scheduled chemotherapy appointment, unaware that treatment could not proceed. Wynn also struggled to imagine how severe conditions outside Memorial had become. These moments show the uneven reach of the crisis: the hospital itself was struggling to preserve care, while people elsewhere encountered its limits through interrupted treatment, blocked transport, and uncertain access to help. Survival mode named the institution’s attempt to adapt, but it could not supply the evacuation arrangements, resilient infrastructure, or reliable communications its plans had failed to provide.