Susan Mulderick—Ewing Cook

Susan Mulderick—Ewing Cook describes a long-standing professional relationship that took on acute significance during the evacuation crisis at Memorial Medical Center. Mulderick, the hospital’s incident commander, relied on Cook’s experience as a pulmonologist and his established approach to relieving suffering. As patients waited for rescue, their working connection carried a practical question—what medication could be given—and an unresolved one about what that medication was meant to do.

A Long Professional Association

Mulderick and Cook had worked together for decades. Their relationship dated back to Mulderick’s time as head nurse in the intensive care unit, giving her long familiarity with Cook’s practice as a physician. The account presents that history not as a private friendship but as accumulated clinical knowledge: Mulderick knew that Cook believed certain drugs could relieve suffering and that, unlike many doctors, he was willing to order them. As a pulmonologist, he had helped patients taken off life support die without pain or anxiety, and he believed dying patients should be made comfortable.

That knowledge shaped whom Mulderick approached when the hospital’s crisis changed from a question of ordinary care into one of what could still be done for patients who might not be evacuated. Her request drew on a specific, remembered feature of Cook’s medical practice. The text does not describe a formal consultation protocol between them; instead, it shows a colleague turning to a doctor whose judgment and prior work she knew.

A Crisis That Reached Their Working Relationship

By the afternoon, helicopters were landing only intermittently, and the sickest patients remained in the staging areas. Some patients from Memorial Medical Center and LifeCare Hospitals had been brought there, while nine LifeCare patients had not been brought downstairs at all. The prospect of carrying those nine patients down five flights of stairs, with exhausted staff and no outside help, made rescue seem increasingly uncertain. Mulderick shared her concern with Cook, who had worked alongside her for decades. He later recalled her saying, “We gotta do something about this. We’re never going to get these people out.”

The exchange joined Mulderick’s operational responsibility to Cook’s clinical experience. She was confronting a deteriorating evacuation, not merely asking about medication in the abstract. Cook, for his part, understood the patients’ predicament as desperate: he considered the LifeCare patients chronically near death even in ordinary circumstances and knew that the heat would have affected them severely. But he had not visited LifeCare since the hurricane began. He had no patients there, had not been asked to go, and understood that any doctor who went upstairs would face difficult decisions. His view of those patients’ circumstances was therefore serious but not based on his own assessment at their bedsides.

Mulderick Recruits Cook’s Advice

When Mulderick sought Cook out, he was preparing to leave Memorial by boat to try to rescue his son, who had been trapped since the flooding on Tuesday. She asked him to speak with Anna Pou before he left. That request shows the relationship at work under immediate personal and institutional pressure: Cook had a family emergency of his own, yet Mulderick sought his input for another physician facing urgent decisions about patients.

Cook met Pou on the second floor. He knew her from the year she had worked at Memorial and thought highly of her. The consultation thus passed through a chain of professional relationships: Mulderick, familiar with Cook’s approach to end-of-life care, brought him into conversation with Pou, who was directing care in the staging area. The material supports Mulderick’s role in arranging that exchange; it does not establish that she directed Cook’s specific medical advice or was present for every detail of the conversation.

Medication, Intention, and the Limits of Agreement

Cook told Pou how to administer morphine with a benzodiazepine sedative. He later said he believed Pou understood his instruction as a way to help patients “go to sleep and die.” He described the combination as suppressing respiration until a patient gradually stopped breathing. In his account, it was a way to ease patients out of a terrible situation. This was distinct from the comfort medication already being prescribed when patients appeared anxious or in pain. The relationship between Mulderick and Cook therefore mattered not only because she sought his expertise, but because that expertise entered a setting where comfort care and the possibility of hastened death could be understood differently.

The evidence also marks an important limit: it does not show that Mulderick and Cook shared an explicitly stated understanding of what should happen to each patient, or that they discussed the intended effect of every dose together. It records her concern, her decision to ask Cook to consult Pou, and Cook’s later account of what he told Pou and what he believed Pou understood. Those distinctions prevent the consultation from being reduced to a single, settled agreement between the two colleagues.

Significance

Their decades of work together made Mulderick’s referral consequential: she knew Cook as a physician who was prepared to use medication to ease suffering, and she turned to that experience when evacuation prospects narrowed. The crisis transformed a familiar professional resource into part of a disputed chain of care. Mulderick’s appeal conveyed the urgency of getting patients out; Cook’s advice addressed what to do when he could not see a workable way to get them out. The relationship is thus defined by both its depth of professional familiarity and the limits of what the surviving account establishes about their shared intentions.