Sheri Fink
ProPublica

Citation
Who should be saved first when disaster strikes? That's the question that doctors and nurses at Memorial Medical Center in New Orleans faced in the harrowing days after Hurricane Katrina when scores of patients were trapped in a building without electricity or running water. In "The Deadly Choices at Memorial," ProPublica writer and medical doctor Sheri Fink reconstructed the decisions that resulted in some patients being injected with lethal doses of morphine as others were boarded onto rescue helicopters. As a result of her two-year investigation, published in The New York Times Magazine, Fink informed the state and national debate over instituting medical guidelines on dealing with shortages of life-saving resources in the event of a disaster.

Excerpt
The smell of death was overpowering the moment a relief worker cracked open one of the hospital chapel's wooden doors. Inside, more than a dozen bodies lay motionless on low cots and on the ground, shrouded in white sheets. Here, a wisp of gray hair peeked out. There, a knee was flung akimbo. A pallid hand reached across a blue gown.

Within days, the grisly tableau became the focus of an investigation into what happened when the floodwaters of Hurricane Katrina marooned Memorial Medical Center in Uptown New Orleans. The hurricane knocked out power and running water and sent the temperatures inside above 100 degrees. Still, investigators were surprised at the number of bodies in the makeshift morgue and were stunned when health care workers charged that a well-regarded doctor and two respected nurses had hastened the deaths of some patients by injecting them with lethal doses of drugs. Mortuary workers eventually carried 45 corpses from Memorial, more than from any comparable-size hospital in the drowned city.

Investigators pored over the evidence, and in July 2006, nearly a year after Katrina, Louisiana Department of Justice agents arrested the doctor and the nurses in connection with the deaths of four patients. The physician, Anna Pou, defended herself on national television, saying her role was to "help" patients "through their pain," a position she maintains today. After a New Orleans grand jury declined to indict her on second-degree murder charges, the case faded from view.

In the four years since Katrina, Pou has helped write and pass three laws in Louisiana that offer immunity to health care professionals from most civil lawsuits - though not in cases of willful misconduct - for their work in future disasters, from hurricanes to terrorist attacks to pandemic influenza. The laws also encourage prosecutors to await the findings of a medical panel before deciding whether to prosecute medical professionals. Pou has also been advising state and national medical organizations on disaster preparedness and legal reform; she has lectured on medicine and ethics at national conferences and addressed military medical trainees. In her advocacy, she argues for changing the standards of medical care in emergencies. She has said that informed consent is impossible during disasters and that doctors need to be able to evacuate the sickest or most severely injured patients last - along with those who have Do Not Resuscitate orders - an approach that she and her colleagues used as conditions worsened after Katrina.

Pou and others cite what happened at Memorial and Pou's subsequent arrest - which she has referred to as a "personal tragedy" - to justify changing the standards of care during crises. But the story of what happened in the frantic days when Memorial was cut off from the world has not been fully told. Over the past two and a half years, I have obtained previously unavailable records and interviewed dozens of people who were involved in the events at Memorial and the investigation that followed.

The interviews and documents cast the story of Pou and her colleagues in a new light. It is now evident that more medical professionals were involved in the decision to inject patients - and far more patients were injected - than was previously understood.




Biography
Dr. Sheri Fink has reported on health, medicine and science in the U.S. and from every continent except Antarctica. She was a frequent contributor to the public radio newsmagazine PRI's "The World," covering the global HIV/AIDS pandemic and international aid in development, conflict and disaster settings. Her articles have appeared in such publications as The New York Times, Discover and Scientific American.

Fink's book, War Hospital: A True Story of Surgery and Survival (Public Affairs, 2003), won the American Medical Writer's Association special book award and was a finalist for the Overseas Press Club and PEN Martha Albrand awards. Fink received her M.D. and Ph.D. from Stanford, and worked with humanitarian aid organizations in more than a half dozen emergencies in the U.S. and overseas. She has taught at Harvard, Tulane and the New School. Most recently Fink was the recipient of a Kaiser Media Fellowship in Health from the Kaiser Family Foundation and she is currently a Public Policy Scholar at the Woodrow Wilson Center.