New Orleans

New Orleans appears as both a disaster-struck city and a network of places where the crisis was experienced differently: an interstate cloverleaf crowded with stranded residents, a convention center where separated families waited, and hospitals and nursing homes whose patients faced danger from the storm and the failures of evacuation. The city’s medical deaths became the focus of investigations into whether the tragedy reflected natural disaster and governmental disorder alone, or also failures of planning, oversight, and institutional decision-making.

A City of Stranded Residents and Separated Families

The book’s view of New Orleans includes people trapped far from home as well as those inside hospitals. On Thursday night, a television camera went live from the trash-filled Interstate 10 cloverleaf, where thousands of people were stranded. The reporter estimated that 90 percent had come from inner-city housing projects, then turned to two employees of Memorial Medical Center, describing them as frightened. Her question to them—that they could have been safe in warm beds but were instead out there—set their predicament against the broader mass of people left in the disaster. The camera’s presence did not erase the divide between the stranded residents and the reporter, whose made-up face seemed out of place to survivors.

The city’s emergency scattered families as well as patients. Memorial’s maternal-child nursing director, Marirose Bernard, agreed to appear on camera because she believed the news crew had promised to help rescue her children, husband, and mother. They had left Memorial on Wednesday but ended up hungry, thirsty, and frightened at the New Orleans Convention Center. The family’s separation links the hospital evacuation to the wider crisis: leaving one threatened place did not necessarily bring people to safety.

For relatives outside the facilities, even a brief assurance could become the last contact they received. Emmett Everett was at LifeCare awaiting colostomy surgery to relieve a chronic bowel obstruction. Carrie Mae Hall had visited him daily, but was told to stay home when LifeCare patients from Chalmette were transferred to Memorial Medical Center. Everett called to say he had arrived safely and brought a photograph of his granddaughter; Hall heard nothing further from him. Linette Burgess Guidi, meanwhile, searched online for her mother, Jannie Burgess, a licensed practical nurse with advanced uterine cancer whom she had flown in from Europe to visit in the intensive care unit as the storm approached. Relatives in Louisiana, Chicago, Holland, and Italy joined the effort, calling and checking missing-person listings.

Hospitals, Nursing Homes, and the Dead

The discovery of bodies made the scale of the city’s medical crisis visible. On September 6, after days of disputes among officials over responsibility for recovery, MSNBC cameraman Tony Zumbado paddled by kayak to Memorial Medical Center. He followed the smell of death to the Myron C. Madden Chapel, where a small piece of yellow lined paper marked DO NOT ENTER had been taped to the wooden door. Inside, the camera recorded more than a dozen bodies on low cots and on the floor, covered by white sheets. Small details—a wisp of gray hair, a knee turned awkwardly, a pale hand reaching across a blue gown—made the dead present without identifying them.

The chapel became the site of an improvised, prolonged wake. National Guardsmen from San Diego, DynCorp security guards recently returned from Iraq and Afghanistan, a Christianity Today reporter, and a relief worker who vomited from the stench all passed through. A chaplain searching for survivors compared the scene to Dante’s The Divine Comedy when speaking on CNN. The disaster mortuary team arrived on September 11, more than a week after the last living patients and staff had departed, and recovered forty-five bodies from the chapel, morgues, hallways, the LifeCare floor, and the emergency room. No hospital or nursing home struck by Katrina yielded more bodies. The shocking discovery drew major news coverage, while Anna Pou struggled in a televised interview to explain the deaths and described critically ill patients who had do-not-resuscitate orders.

Memorial was not the only facility through which the book measures the disaster. At St. Rita’s Nursing Home, a single-story facility near failed levees in St. Bernard Parish, more than thirty residents had apparently drowned. Its owners, a married couple reportedly urged to evacuate before the storm, could not be found. The deaths at nursing homes and hospitals appeared to account for a significant share of the overall disaster’s fatalities. The comparison broadens the account beyond a single hospital: New Orleans’s medical tragedy was part of a regional failure affecting people dependent on institutions for care and evacuation.

Investigation and Responsibility

The growing number of deaths prompted a question that reached beyond mourning: what had caused them, and what could be learned before another catastrophe? The book sets several possible explanations beside one another. Deaths might have resulted from the force of nature, a chaotic governmental response, and poorly constructed flood protection in a degraded environment. But investigators also had to consider lax oversight, individual or corporate financial interests, emergency plans not followed, missing pre-storm investments, and inadequate preparation of health workers. These possibilities are posed as questions rather than settled findings.

Butch Schafer began probing the deaths after returning home from mourning his daughter. An experienced criminal prosecutor specializing in complex cases, he worked for Louisiana attorney general Charles Foti. Foti, a former elected Orleans Parish sheriff, had a substantial constituency among elderly residents and had cared for his own father until his death at ninety-two that May, driving him away from the predicted path of several hurricanes. He publicly promised a full investigation into what he called a horrific tragedy at St. Rita’s. The Medicaid Fraud Control Unit opened investigations into every hospital and nursing home where patients had died.

The unit’s jurisdiction covered facilities participating in Medicaid, supported by state and federal funds. That authority brought the inquiry directly to Memorial’s corporate owners, who received a government investigator’s telephone request for a list of deceased patients and a copy of the hospital disaster plan. If the company could demonstrate that the plan had been followed, the case might close quickly and blame might be pursued elsewhere. Yet the city’s evacuation orders complicated any simple account of institutional responsibility: Mayor Ray Nagin’s pre-storm evacuation order did not apply to hospitals, which had instead been ordered to remain open and staffed.

The City as a Record of Crisis

New Orleans is also present through the records and testimony used to reconstruct what happened. WWL Radio furnished digital recordings of broadcasts from August 29 through September 1, 2005; their transcripts preserve the radio station’s emergency reporting. Accounts of Chalmette Medical Center draw on Dr. Bong Mui’s recollections and investigative memoranda. Patients transferred from Chalmette before the storm were moved to its sister campus, Pendleton Memorial Methodist Hospital, in the New Orleans area; that hospital was itself severely disabled by floodwaters and generator failures. The movement of patients between facilities therefore did not remove them from the region’s cascading risks.

The book’s discussion of Charity Hospital likewise draws on emergency call-ins, published medical accounts, oral histories, interviews, and other records. Rather than presenting New Orleans as a single scene of catastrophe, these materials assemble a city through separate institutional experiences and the people trying to account for them. The interstate, convention center, hospital chapel, and nursing homes are not interchangeable settings: together they show how evacuation, medical dependence, family separation, and the recovery of the dead unfolded across the same disaster-stricken city.