Memorial Medical Center's Hurricane Katrina Evacuation was a prolonged, improvised effort to move patients, staff, and visitors from a flood-isolated hospital. It began in a city where officials ordered residents to leave but lacked the transport to make that possible for many, and it ended only when Rodney Scott, the last living patient to leave Memorial, was airlifted from the parking garage. The evacuation’s shifting routes and priorities expose how a nominally general call to safety could become a series of unequal, uncertain chances to get out.

A city ordered to leave without enough transport

At around ten in the morning, New Orleans mayor Ray Nagin issued a mandatory evacuation order. Hospitals and their workers were exempted: Nagin said hospitals might be needed if people were injured during the storm. But remaining open did not mean a hospital could be supplied, protected, or evacuated if conditions worsened. Officials had already discussed the danger that floodwater could disable hospital generators; Memorial had not located both its generators and electrical switching gear above ground-floor level.

The order also reached residents who had no car and no assured means of leaving. The New Orleans Superdome was designated a shelter of last resort, and shuttle buses were intended to bring people there, including people with medical conditions. Yet the city’s transport plans had serious gaps, including too few drivers, while residents able to leave on their own were already caught in traffic. Acadian Ambulance dispatchers were swamped with requests to move patients from hospitals, nursing homes, and homes. Many of the roughly two dozen ambulances made available were themselves stuck on the interstate; some began bringing patients to the Superdome rather than attempting the trip out of town.

The larger evacuation problem was visible before Memorial’s final days. About 2,500 hospital patients remained in New Orleans as the storm approached, a number anticipated by the Hurricane Pam exercise, but planners had not worked out how to move so many people safely through a flood. At Memorial, the population that needed to be moved included patients and the people caring for them, while the city’s roads and transport system were already under pressure.

An evacuation that changed shape

Boats and helicopters became essential routes out once ordinary road travel was no longer a workable answer. The evacuation strategy did not remain fixed: at one stage, boats took only the relatively few patients well enough to be discharged. Doctors moved to the emergency-room ramp to load them and oversee the process. Employees and patients’ family members were also allowed to leave with the boats, and a line of evacuees stretched from the ramp through the emergency room into reception.

For people waiting to go, even reaching a boat did not settle where they would end up. Karen Wynn fielded repeated questions about the destination, which she did not know. One woman would not board after learning that she could not bring her purse; Wynn offered to take responsibility for it, but the woman still refused to leave. The moment places an individual’s immediate attachment and uncertainty beside the scale of the emergency without suggesting that evacuation was a simple choice for everyone.

The available figures record both the scale of the effort and its limits. A pilot’s log noted three aviation-services lifts, two to Slidell and one to Kenner, and recorded five Coast Guard lifts using three HH-65 aircraft to move ambulances, children, and women to an ambulance ground site near the Superdome. Each lift carried about five or six people, with Coast Guard shuttles running about every fifteen minutes. At 10 a.m. on September 1, the reported population at Memorial and its associated hospital was about 450, including approximately 120 patients; the total population had been about 1,500 before surface craft moved many people the previous day. The log also noted that critical patients had been moved on Monday and Tuesday. These counts give the evacuation a practical scale: the departures were repeated and substantial, but they did not make the remaining people disappear at once.

Patients, staff, and the improvised route to the roof

As the day continued, staff cared for patients categorized as the most urgent, including people from both Memorial and LifeCare who had been brought to the first floor in anticipation of rescue. They waited in wheelchairs on the sloping sides of the ambulance ramp. Wynn memorized their faces to avoid losing track of anyone in the crowded, changing scene. One additional man had waded to the hospital from the neighborhood because he was overdue for dialysis; his catheter lacked a protective dressing. His arrival showed that Memorial’s evacuation was entangled with the needs of people outside the hospital as well as those already admitted.

Getting patients to aircraft demanded further adaptations. Some helicopter pilots would not take patients confined to beds, so doctors and staff moved some into wheelchairs and used sheets around their torsos to present them as sitting patients. When patients died, Wynn and colleagues covered them with sheets and moved them to the chapel, trying to avoid drawing the attention of patients still waiting in the evacuation line. By the end of the day, boats and helicopters had carried away nearly all the patients and visitors; nurses then helped lift the last few patients through an opening in the machine-room wall.

At about nine that evening, Scott was carried up the narrow route to the helipad. He weighed more than three hundred pounds, was recovering from surgery and heart trouble, and could not walk. After he was assigned to go last through the wall, workers moved him across to the garage and loaded him onto a pickup truck for the trip to the upper level. The earlier day had included an error with grave implications: Ewing Cook had mistaken Scott for dead. Scott was alive, and the helicopter took him away. He became the last living patient to leave Memorial.

What the departure did not resolve

The evacuation’s completion did not undo the conditions that had made it so precarious. The account of New Orleans’ deaths and disrupted care identifies a chain of failures: the delayed city evacuation order, insufficient buses and drivers, uncoordinated rescues, poor communications, and hospitals and nursing homes that had not evacuated before the storm or invested in backup power and water systems robust enough for a prolonged emergency. Fear of violence also interrupted rescue work; officials’ anxieties about disorder could lead first responders to abandon posts and patients, even as later investigations found that many of the worst reported crimes had not occurred.

Memorial’s departure was therefore neither a single orderly procession nor evidence that everyone had equal access to rescue. The log’s intervals, the shifting eligibility for boats, the makeshift passage through the machine-room wall, and the final airlift of Scott mark an evacuation assembled in stages under severe constraints. Its last image is not simply a hospital emptied, but a patient once mistaken for dead carried out alive—a conclusion that underscores both the importance of individual decisions and the peril of a system in which rescue arrived unevenly.