JOANNA SCUTTS

Biographile, September 10 2013.

A HOSPITAL AND A HURRICANE: A Q&A WITH SHERI FINK
Joanna Scutts

FIVE DAYS AT MEMORIAL: LIFE AND DEATH IN A STORM-RAVAGED HOSPITAL
By Sheri Fink
Crown. 576pp. $27

Investigative journalist Sheri Fink’s new book, Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital, is a riveting two-part study of the experience and aftermath of Hurricane Katrina at one privately owned New Orleans hospital. The first section meticulously, and harrowingly, describes five days of storm and floods, followed by a series of disastrous failures of power – both electrical and human. The second part of the book spans the months and years of investigation into what happened during those five days and why, eventually focusing on a small group of doctors and the vials of morphine they had in their possession. In the course of its gripping and razor-sharp investigation into the Memorial case, the book challenges us to examine our deepest assumptions about medical ethics, human rights, sickness, survival, and the right to die with dignity.

BIOGRAPHILE: What first led you to this subject?

SHERI FINK: When I saw in the news that three well-regarded health professionals had been arrested for having allegedly murdered their patients during a terrible disaster, I wanted to know more. I’d been a medical aid worker in several conflict and disaster zones and written a book about a war hospital that was under siege for three years in Bosnia-Herzegovina, but I’d never heard of allegations like this arising in any of those situations.

BIOG: How did your background, as a trained physician who has worked in disaster areas, inform your writing?

SF: I’d experienced how the stresses of a prolonged emergency, the exhaustion that can accompany it, can make it hard to think clearly and act effectively as a caregiver, particularly the first time someone is confronting that without a lot of preparedness. I’d also witnessed how people who are older, chronically ill, can’t walk, or have trouble taking care of themselves are often the most vulnerable in a crisis and the easiest to neglect. And I had seen responders rise above challenges and save lives by improvising and persisting in far worse circumstances even than Katrina. Despite those experiences, I tried not to assume anything about this particular event, and I aimed to learn everything I could about it and to collect as many perspectives as possible.

BIOG: Although the initial timeframe of events is short, the book’s larger subject matter is huge and complex. Can you describe how you organized the material and chose whose stories to focus on?

SF: I stuck as much as possible to a chronological narrative, and when moving from event to event tried to keep either point-of-view, time, or location constant. The events provided opportunities to delve into larger subjects. The choice of perspectives was partly influenced by access – in other words who was generous enough to share their experiences – and partly by who was central to the important decisions made at the hospital or most affected by them. I also considered which people acted rather than were only acted upon by the events, and were changed by them.

BIOG: You give a very balanced and nuanced view of the events at Memorial and their aftermath. Was it hard to stay objective in the face of the evidence you had?

SF: Reporters naturally bring their own perspectives and life experience to the articles and books they write, and it’s easy to argue that objectivity is impossible. However, I think it’s a great and important goal. It’s similar to what’s done in science – you have to test your own assumptions and theories and expectations about how the world works and be open to discovering that you’re wrong. That’s the way we get closer to truth. A fair presentation of the evidence is its own best argument.

BIOG: You mention at the end that a lot of the documents from the investigation into the Memorial deaths remain sealed. How did you work around those gaps in the record?

SF: I interviewed many people involved in the events and viewed documents and other materials from a wide range of sources. It was helpful to work on the book over many years, because some people who were not initially willing to speak were later open to it, and some material that was difficult to access later became available.

BIOG: Are there other books or writers who you looked to as models for this kind of investigative writing?

SF: Yes, many. Katherine Boo’s Behind the Beautiful Forevers, Dave Cullen’s Colombine, Dave Eggers’ Zeitoun, Rebecca Skloot’s The Immortal Life of Henrietta Lacks, Richard Preston’s The Hot Zone, Chuck Sudetic’s Blood and Vengeance, Adrian LeBlanc’s Random Family, Nicholas Gage’s Eleni, the excellent books written by David Rohde, Deborah Blum, and Laurie Garrett … I could go on and on. There are many good models.

BIOG: You are resistant to the idea that disaster zones should be treated as war zones, and you give the example of the public hospital in NOLA that had better outcomes than Memorial largely because staff stuck more closely to their regular civilian routines. Do you think this approach has been downplayed in disaster planning – and should it get more attention? More generally, what lesson(s) would you like readers to take away from the book?

SF: Yes, disaster or war, it’s helpful to strive to maintain as much normalcy and routine as possible in a very abnormal situation. These events taught me the importance of remembering in the midst of a disaster that there will be a tomorrow and that the choices we make and how we treat each other at a time of crisis will be with us for a long time to come. I hope readers will understand this, too, and see the power of individual action, of flexibility and improvisation along with preparedness, and what disaster geeks call “situational awareness,” the ability to keep in mind the larger picture of what’s going on in a crisis and to respond proportionally. I also hope that reading about the human impact of a severe disaster can help people weigh how much to invest in preparing for unlikely but foreseeable events in balance with everyday urgent priorities. Critically, the rationing of lifesaving care is horrific, and as we prepare for situations where medical needs might temporarily outmatch resources (for example, a number of hospitals and state health departments are drawing up guidelines for how care might be rationed in an overwhelming pandemic or other emergency) the perspectives of a range of people from various backgrounds must be sought. We can’t just stick those value judgments to a few exhausted, frontline health professionals. There are so many other facets to the events portrayed in the book, and I’m hopeful readers will come away with their own insights.