Memorial's Appeal to Tenet for Evacuation Assistance

Memorial's Appeal to Tenet for Evacuation Assistance was an urgent effort to secure help for a hospital facing rising floodwater and the prospect of evacuation without a workable transport plan. Through community relations manager Sandra Cordray, Memorial asked its parent company, Tenet Healthcare, for help moving patients and obtaining essential supplies. The correspondence revealed both the scale of the hospital’s immediate needs and the limits of corporate emergency coordination: help was offered from outside New Orleans, but the available offers did not become a coordinated evacuation response.

Rising water and the request for help

On August 30, 2005, Cordray was Memorial’s designated communications leader for Hurricane Katrina. With telephone connections difficult but e-mail still working, she became the hospital’s channel to Tenet’s headquarters in Dallas. Her messages described a hospital locked down because of reports of looting, while water rose in the basement and was expected to continue rising for days. Other hospitals were evacuating, and a breach in the 17th Street Canal levee was reported as flooding New Orleans.

Cordray also relayed that National Guard members were at Memorial. She passed along the phone number of an Air National Guard major identified by Susan Mulderick’s ex-husband, hoping someone at headquarters could reach him. The detail showed how the hospital was trying to turn whatever connections it could find into assistance. The Guard contingent already present, however, could not by itself resolve the hospital’s wider needs.

As Cordray’s messages became more urgent, Memorial chief operating officer Sean Fowler pulled his chair beside hers and instructed her while she typed. The request was not limited to removing patients. Memorial needed medicines and blood products, as well as water and food; Cordray asked what Tenet could supply, how quickly it could deliver those items, and what air and ground transport the company was arranging. Her appeal distilled the immediate priority into the message, “WE NEED PATIENTS OUT OF HERE NOW!” The words conveyed a concrete operational demand: the hospital needed a way to move its patients, not simply reassurance that help was being considered.

A corporate response without an emergency system

Michael Arvin, a Tenet executive, eventually replied that the company had been told it would not be possible to get into the city and asked whether Memorial had contacted the National Guard. Cordray had already told him Guard members were on site. The exchange made the mismatch between the hospital’s situation and headquarters’ response especially clear: the existence of a Guard presence did not amount to a plan for evacuating Memorial’s patients or supplying the hospital.

Arvin’s ordinary work was business development for Tenet in the Gulf Coast region, which he called “the market”; he had no emergency-management background. Two days earlier, as Katrina approached the coast, he had interrupted a tennis match with his children at a Dallas country club to join a conference call with Tenet hospital chief executives in the Gulf region. Now three of the company’s six hurricane-affected hospitals needed evacuation. The rapid change in his responsibilities underscored that Tenet was confronting an emergency for which its usual business roles had not prepared it.

The corporate infrastructure was itself a constraint. Tenet had no preexisting contracts with medical transport companies and no incident command system at headquarters. One executive with National Guard experience and some crisis-management knowledge was on vacation at a secluded beach retreat in Oregon, offering advice by cell phone. Arvin told Cordray that Tenet was trying to secure medicines and blood, but he was unsure how to get them to Memorial. He also cited the company’s Lindy Boggs Medical Center, which was waiting for troops, and recommended that Memorial do the same if it was beginning evacuation plans. The advice placed the burden back on a hospital whose central request was for help arranging a way out.

Memorial broadens the appeal

Cordray answered with a direct challenge: “Are you telling us we are on our own and you cannot help?” At 12:28 p.m., Memorial’s director of case management tried another route, sending colleagues at Tenet hospitals outside New Orleans an e-mail with “HELP!!!!” in the subject line. The message said Memorial expected fifteen feet of water and needed places for its current census of 187 patients. Hospitals able to accept patients were asked to contact Arvin at Tenet headquarters.

Responses arrived quickly, with many hospitals offering space and at least one offering relief staff. Arvin had also been contacting Tenet hospitals in Houston and Nacogdoches to arrange assistance. Faced with requests and offers spreading across the company, he told the Memorial administrator to route further requests through him and Bob Smith, adding that the company was being overwhelmed by the message sent to the entire organization. The exchange showed that the response was not a simple absence of willingness: facilities were offering help, but the effort was becoming difficult to coordinate through the channels then in use.

Offers held back

Atlanta Medical Center, a former Baptist hospital founded in the early 1900s and also owned by Tenet, offered support by e-mail and phone, including aeromedical helicopters to assist with Memorial’s evacuation. The offer made the stakes of coordination tangible: a possible means of air transport had been put forward by another hospital within the same corporate network.

Arvin nevertheless told Atlanta Medical Center that the National Guard was coordinating relief, and the Atlanta chief executive agreed to “sit tight” until someone from Arvin or the Dallas office requested assistance. The helicopters were therefore offered but held in reserve. Memorial’s appeal had reached beyond the hospital and elicited concrete offers, yet the assumption that another authority was coordinating relief kept those resources from being activated through the exchange. The episode captures the difference between having potential help somewhere in a corporate network and converting it into an organized response at the hospital that needed it.