Wednesday, July 19, 2006

Just Any Other Day in New Orleans

That’s what Attorney General Charles Foti Jr. thinks the four days after Katrina were at Memorial Medical Center. Just like any other days.

On any other day in New Orleans, it would be hard to justify four mercy killings in a hospital like Memorial. On any other day, the hospital’s power would be on, and so would the air-conditioner and essential life-sustaining machines. On any other day, diesel trucks carrying fuel for the backup generators wouldn’t be blocked by flood waters. On any other day, the hospital would be fully-staffed and those caring for patients would not be sleep-deprived and on the verge of dehydration.

On any other day, those who were struggling to save their patients’ lives would not have been fearing for their own lives.

*If* the three people arrested for second-degree murder intentionally gave the four patients who died a combination of drugs that resulted in the patients’ deaths, the criminal justice community can not view the incident as if it happened on just any other day in New Orleans. You didn’t have to stay in New Orleans during Katrina to know that.

But the doctor and the two nurses arrested *did* stay. Foti focused on the four lives he thinks they took. How many lives were saved because they were here?

According to the T-P (previous link):

…the four patients were not under Pou's direct care. Instead, the four were patients of LifeCare Hospital as part of its arrangement to run the acute-care unit at Memorial.

"They were not her patients," Simmons said. "These were patients that didn't have doctors."
Where were the patients’ doctors? Do they bear any responsibility for the patients who died because they weren’t there to help?

And where does LifeCare’s responsibility end? Of the 34 people who died at Memorial after the storm, 24 were LifeCare patients. Either LifeCare didn’t evacuate the patients or the patients were too sick to be evacuated. It was most likely the latter because LifeCare was a long-term acute care facility. They took care of complex medical conditions. Therefore, we can assume that LifeCare made a medical decision – not a moral or ethical decision – to leave those patients even though they may die.

One family member’s experience demonstrates this:
“When I left she wasn’t dying,” said McManus, whose mother, Wilda McManus, was staying at Memorial Medical Center in New Orleans during and after Hurricane Katrina. “If she had been evacuated, she could be here today.”

McManus said her mother was being treated for a blood infection, not a life-threatening illness. McManus also said that when she left her mother Sept. 1 it wasn’t by choice.

“Police told me I had to go,” she said, adding that when she told them no, an officer drew his weapon. “When I told her I was going she screamed.”

***

McManus said her mother was in the facility run by LifeCare Holdings Inc.
A medical decision was made, and then enforced, to *not* evacuate Mrs. McManus. And, yet, Mrs. McManus still died. I am very sorry for her family’s loss, but the medical community disagreed with her daughter’s assertion that if she had been evacuated she would have lived. According to the experts – the people we rely on to make these tough medical decisions on any other day and especially in times of crises – Mrs. McManus would have died no matter what. This is the reality of Katrina.

And on this day that was not just any other day in New Orleans, another medical decision may have been made. If any medical professional intentionally gave a combination of drugs to a patient that resulted in the patient’s death, that too was a medical decision – not an ethical or moral decision. While ethics and morals may have been involved in the process, the ultimate decision would have to be based on medical principles – what can be done medically to help the patient.

Doctors can not sustain life, and certainly quality of life, indefinitely. Once the medical diagnosis was given that a patient would not live through the laborious rescue operation (remember, there were no operating elevators to get up to a helicopter on the roof or down to a boat at the ground, or flood, level), the only medical option was to ease the suffering of a slow, most likely painful death if the patient were left alone in the 100+ degree temperature with no food or water. And a lethal dose of medicine may have been the only thing a good doctor could have done for his or her patient on this day like no other in New Orleans.

17 comments:

TravelingMermaid said...

As an ex-Tenet employee who lost her job after K, I am restraining myself from posting about this situation. It would be a major rant. Suffice it to say I will be closely watching the company reaction and PR. Can the tiger change it's stripes?
It's horrifying what is happening to these people. Everyone I've talked to (as a employee in the medical arena) is appalled.

Diane said...

As for Foti, I was sickened when the blogosphere liberal community got so excited that a Democrat was elected attorney general. They knew nothing about him. It is he who was on watch when all of those Parish Prison inmates died over the years from medical neglect.

adrastos said...

Excellent post, o geek wannabe.

N. Mallory said...

I'm sorry but LifeCare is not a Hospice and those four patients were not terminal. There were LifeCare employees there in fact and one of the witnesses in the case is a LifeCare employee. The doctor made the decision to inject a a lethal mixture of drugs that are not meant to be given to a patient at the same time.

These patients were most likely not asked what they wanted and certainly their families weren't. A decision was made for them by someone playing God, deciding who lived and who died.

If Dr. Kevorkian is a criminal for assisted suicide (something I support, btw) when the so-called victim is willing, then certainly four victims who didn't know and couldn't protect themselves deserve justice.

Trust me, I understand the horror of the situation they had to be in; I grew up in that area; heck, my mother was an administrator in that hospital when I was a little girl and I practically grew up in those halls so I have a vivid vision of the whole thing, but I have to sympathize with the families of the victims.

Plus, unfortunately...I've known about this story since last September so I've had longer to think about it.

Sophist said...

I'm sorry but LifeCare is not a Hospice and those four patients were not terminal.

Maybe not under normal circumstances, but the extension of "terminal" kind of expands when you ax the electricity, crank the temperature to 100, and remove most of the medical staff and supplies.

shrimplate said...

What would you have done?

da po' boy said...

What would you have done?

I don't know. I wasn't there and I am not trained to make those medical decisions.

da po' boy said...

Thank you for your comments n. mallory.

These patients were most likely not asked what they wanted and certainly their families weren't. A decision was made for them by someone playing God, deciding who lived and who died.

I don't think a decision was made by "someone playing god," but by someone being a doctor - making the best decisions they could under extreme circumstances.

If Dr. Kevorkian is a criminal for assisted suicide (something I support, btw) when the so-called victim is willing, then certainly four victims who didn't know and couldn't protect themselves deserve justice.

We don't know if the doctor and nurses "assisted" in any deaths. Also, Dr. Kevorkian performed his assisted suicides under ideal (or at least normal) conditions, not in "the horror of the situation they had to be in." I don't think that is a fair comparison. I support assisted suicide, too, btw.

Sophmom said...

Great post.

ashley said...

Ditto.

blue said...

I don't think it "can be assumed that LifeCare made a medical decision." Hospitals make decisions for business and liability reasons too. And if there's one thing we saw about institutions (government or private) during Katrina, it's that the mass evacuation of disabled people was not well planned, possibly never considered at all.

Also, there's a difference between death by triage, death by assisted suicide and death by involuntary euthanasia. Which situation caused these patients deaths is important regardless of the circumstances Katrina imposed upon medical professionals.

Anonymous said...

Having worked the storm during the hellish crisis, it cannot be compared to any other normal circumstance.

1. per the affadavit-- why did the Lifecare personnel leave if they felt it was so wrong? Especially the pharmacy director, he gave the names of the people who wouldnt make it and gave syringes and flushes. He had also previously inquired as to what the patients would be given? Why were so many narcotics freely available? NOT TYPICAL!!

2. as for Dr. Bryant -- a "contract" doctor. If he felt things that were going on were so bad, why did you get on a boat and leave?? That is what he said to CNN!! Why are so many not outraged at his ethical behavior. As a physician, why didn't you stay to help the others sort through this in a more "practical" manner. (sidebar: contract physicans pre-Katrina-- not typically the sharpest tools in the shed).

Ultimately, the local administration for Memorial Hospital as well as corportate execs for Tenet hold responsibility and liability here.

Lastly, families should not stand a chance to earn a dime over this. Your opportunity to make decisions for your loved ones passed the moment you left town and passed the buck of responsibility on to someone else.

dangerblond said...

Dear Bloggers:

This message is being sent to NOLA bloggers, Louisiana bloggers, Katrina bloggers and those blogging from the Diaspora. The one-year anniversary of Hurricane Katrina and the flooding of New Orleans will soon be here. On August 25-27, 2006, there will be a convention for all people who care about New Orleans, here in New Orleans. The Rising Tide Conference is being planned and hosted by bloggers and we are requesting your participation.

The Rising Tide Conference will be a gathering for all who wish to learn more and do more to assist New Orleans' recovery from the aftermath of Hurricanes Katrina and Rita. We will come together to dispel myths, promote facts, share personal testimonies, highlight progress and regress, discuss recovery ideas, and promote sound policies at all levels. We aim to be a "real life" demonstration of internet activism as the nation prepares to mark the one year anniversary of a massive natural disaster followed by governmental failures on a similar scale.

This e-mail is being sent to you to as part of an attempt to create a comprehensive e-mailing list of interested bloggers who would like to participate or attend. In the coming weeks, announcements will be made about venues and events via this list. Please forward this e-mail to anyone who may be interested in the Rising Tide Conference.

A Rising Tide Wiki has been assembled where you can find information, make suggestions, offer help and provide information.

Please go to the Blogger List part of the Wiki and check the entry for your blog and make sure the information is correct. If you see that a blog is missing, please add it to the list.

More information will be coming soon. Check the Wiki for updates.

Thanks from

Kim Marshall
Mark Moseley
Ashley Morris
Maitri Venkat-Ramani
Lisa Palumbo
Peter Athas
Jeffrey B.
Morwen Madrigal
Alan Gutierrez
Ray Shea
George Williams IV
and Blake Haney

bayoustjohndavid said...

O.K., please stop debating whether the doctor's actions were justifiable, if she euthanize the patients. I haven't seen anybody get sucked into yet, but some people are getting close. It's seems presumptuous, and it's certainly premature. Also, no reasonable person wants to turn it into another Schiavo-type debate.

Diane, can I ask what liberal bloggers you're talking about. I just did a quick check of the few local ones that have been around that long (that I know of) and couldn't find any image. The New Orleans Democrats that I know have always considered him a worm of a human being who was somehow sucessful at being a snake of a politician.

Diane said...

The swarm of posters and bloggers at Democratic Underground (including those from Louisiana), which I think is the largest liberal gathering on the Web, was ecstatic over his election.

Jean Lafitte said...

Even if we assume -- and it's a big assumption -- that those three did exactly what Foti says they did, I'd like to know why he thinks he could ever persuade a New Orleans jury to convict them.

Anonymous said...

All of these wonderful cases (sarcasm!) will only hurt those in need in the future. If this case results in conviction of the doctor and his staff, then i can guarantee you that, IF THIS KATRINA SITUATION happens again, then you will see NO ONE staying behind. No doctors. No nurses. Hell, the medical staff would rather be fired from hospital for leaving rather than seeing their whole career (& license) go up in flames for doing an ethical act.

Bottom line: i hate to be a patient of a Katrina-like disaster in the future.