One-Minute Book Reviews

September 22, 2013

Sherri Fink’s ‘Five Days at Memorial’ – Fatal Choices at a Hospital Hit by Katrina

Filed under: Current Events,Nonfiction — 1minutebookreviewswordpresscom @ 12:47 am
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“What is the line between appropriate comfort care and mercy killing?”

Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital. By Sherri Fink. Crown, 558 pp., $27.

By Janice Harayda

If you’d like to read a horror story, you could pick up Stephen King’s just-published sequel to The Shining. Or you could brace yourself for this nonfiction account of the disasters that unfolded after Hurricane Katrina trapped more than 200 patients at Memorial Medical Center in New Orleans.

The scale of the calamities took on an alarming legal dimension when, a year after the 2005 storm, the Louisiana attorney general ordered the arrests of a doctor and two nurses suspected of having given fatal overdoses of morphine and a sedative to critically ill patients stranded at Memorial by floodwaters. The case was complicated by an ad hoc evacuation plan that the hospital staff had developed as the crisis intensified: The healthiest patients, doctors decided, would leave first when rescuers arrived. Two groups would go last: the sickest patients and those who had filled out Do Not Resuscitate orders — even if, as was true of 81-year-old Vera LeBlanc, a patient had filled out the form more than a decade earlier. The evacuation plan specified that patients who could walk would be among the first to board the Coast Guard helicopters and privately hired airboats that were arriving intermittently. And it meant that in the five days before the last person left Memorial, doctors and nurses had to make life-or-death decisions they might have avoided if they had received a timely rescue or if the hospital had followed the widely accepted medical protocol of giving the highest priority to the sickest patients and those whose lives depended on machines.

Faced with these realities, a grand jury declined to indict the arrested doctor and the New Orleans district attorney decided not to prosecute the nurses. But the situation raised lingering ethical issues that the physician-turned-journalist Sherri Fink explored in a Pulitzer Prize-winning article for the New York Times and the nonprofit website ProPublica. As Fink summarized them in the Times: “Which patients should get a share of limited resources, and who decides? What does it mean to do the greatest good for the greatest number, and does that end justify all means? Where is the line between appropriate comfort care and mercy killing? How, if at all, should doctors and nurses be held accountable for their actions in the most desperate of circumstances, especially when their government fails them?”

Fink explores those questions further in a book that is as important as it is repetitive and disorganized. Laura Miller has noted on Salon that parts of Five Days at Memorial read like a “notebook dump.” If that is perhaps too harsh, it suggests the lack of a cohesive point of view that might have unified a book for which the author says she drew on more than 500 interviews. Fink tells her story from multiple perspectives — among them, those of doctors, nurses, and relatives of patients who died while waiting to be evacuated. As she moves from the hospital that provides the setting the first half of the book to the legal proceedings that inform the second, she repeats facts and shifts gears imperfectly. Fink says five times that a patient named Emmett Everett weighed 380 pounds. And a long dramatis personae does not always prevent confusion about who is speaking or why someone appears in the book.

Amid the welter of viewpoints, Fink withholds her own except in an epilogue that deals with what doctors in New Orleans and elsewhere have learned — or not learned — about disaster relief.  Does she believe staff members at the Memorial committed murder or euthanasia? She offers only clues. In one of them, she gives the last line of her story to a grand juror who says she was convinced — and believed her fellow jurors were, too – that “a crime had occurred” at Memorial.

That is a remarkably tepid conclusion for a book about 45 deaths, more than a few of them suspicious. Unlike physician-authors such as Atul Gawande and Perri Klass, who merge elegantly their literary and medical identities, Fink seems to be groping for a voice. In the absence of one, she relies on the honorable journalistic tradition of looking for sources who express her views. But that approach works best when reporters structure their books in a way that leads to the clear and inevitable — if implicit – conclusion that is missing from this one. Few people can be better-informed than Fink on some of the urgent questions raised by Five Days at Memorial. As valuable as her book is, it might have been all the more so had she risked offering a few of the answers that she is uniquely qualified to give.

Best line: Fink notes that Charity Hospital in New Orleans had nearly twice as many patients as Memorial and faced similar challenges, including lost power and a lack of working plumbing, elevators, telephones and computers. But fewer than 10 people died at Charity while 45 did at Memorial. Charity did better, in part, because the staff continued to provide services like physical therapy and encouraged workers to maintain shifts and a regular sleep schedule: “This signaled that the situation was under some degree of control and kept panic to a minimum. There was an active effort to stem rumors. ‘You can only say it if you’ve seen it,’ staff were told.
“Perhaps most important, Charity’s leaders avoided categorizing a group of patients as too ill to rescue. The sickest were taken out first instead of last.”

Worst line: “Like many of the hospital staff around him, his professional association with what was now Memorial Medical Center” stretched back decades.

Published: September 2013

Read Fink’s Pulitzer Prize-winning article on how doctors at Memorial cared for patients during and after Katrina.

Jan is a novelist and award-winning journalist who spent 11 years as the book editor of The Plain Dealer. You can follow her (@janiceharayda) on Twitter by clicking on the “Follow” button at right.

© 2013 Janice Harayda. All rights reserved.
http://www.janiceharayda.com

February 11, 2013

What I’m Reading … Frances Parkinson Keyes’ Mardi Gras Novel, ‘Crescent Carnival’

Filed under: Novels,What I'm Reading — 1minutebookreviewswordpresscom @ 3:08 am
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“What I’m Reading” is a series that describes books I’m reading that I may or may not review later on One-Minute Book Reviews

What I’m reading: Crescent Carnival, a 1942 novel by Frances Parkinson Keyes, best known for Dinner at Antoine’s. 

What it is: A saga of two prominent New Orleans families and the Mardi Gras balls and other rituals that defined their lives between 1890 and 1940. Keyes drew in part on the recollections of her friend Dorothy Selden Spencer, a former Carnival queen.

Why I’m reading it: Few novels focus on Mardi Grass celebrations and how they preserved the distinctions of social class in New Orleans even as such differences were fading elsewhere. Crescent Carnival is one that you can still find without too much trouble in libraries and online.

How much I’ve read: About 150 pages of more than 800.

Quotes from the book: “Estelle always loved Carnival and the preparations for it. But she grew up without daring to dream that some day she, herself, would be the Queen of one of the Carnival Balls. She did not believe it even when she heard that Monsieur Leroux, who held the fate of all potential queens firmly in his hands, had spoken formally to her father, asking if he could conveniently be received on a certain day at a certain hour in the Lenoir’s house on Royal Street.

“She could hardly believe it even after the ritual champagne had been bought, and the silver ice bucket polished until it shone like a mirror, and the one placed inside the other, beside a plate of little frosted cakes, on the center table in the  salon, under the chandelier, there to await the arrival of Monsieur Leroux. She went into the  salon, and she was still filled with incredulity mingled with awe.”

Furthermore: Jonathan Yardley of the Washington Post said that Keyes was a “middlebrow” novelist in the sense that she “wrote for readers of some education and taste who expected their entertainments to be literate and intelligent as well as entertaining.” Based on what I’ve read, that gets it exactly right: Crescent Carnival is, by today’s standards, a potboiler, but one that reflects higher standards than most now labeled as such. A journalist by instinct if not by training, Keyes shows a Tom Wolfean attention to the details of social status that evoke the eras she describes.

You can follow Jan on Twitter by clicking on the “Follow” button a right.

© 2013 Janice Harayda

www.janiceharayda.com

January 21, 2010

A Victim of Hurricane Katrina, Then of FEMA

Filed under: Biography,Nonfiction — 1minutebookreviewswordpresscom @ 10:32 pm
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The story of a man who stayed in New Orleans when others left

Zeitoun. By Dave Eggers. McSweeney’s Books, 349 pp., $24.

By Janice Harayda

Like Infidel and A Long Way Gone, Zeitoun tells such an important story, you wish you could believe more of it. Dave Eggers gives a captivating if hagiographic account of the plight of Abdulrahman Zeitoun, a well-off Syrian-born painting contractor and landlord who refused to leave New Orleans when the mayor ordered a mandatory evacuation of the city during Hurricane Katrina.

As the book has it, Abdul Zeitoun stayed to look after his buildings when his wife and four children fled to Baton Rouge. Then he traveled by canoe through the flooded New Orleans streets, performing humanitarian acts such as rescuing trapped people and feeding abandoned dogs.

The Federal Emergency Management Agency was not impressed. More than a week after defying the evacuation order, Zeitoun was arrested. And he says his jailors refused to let him to make a phone call — to his wife or anyone else – and deprived him of other rights while implying that he belonged to the Taliban.

If all of this is true, it adds to the damning evidence of FEMA’s mishandling of Katrina. But Eggers writes from point of view of the Zeitouns, and their accounts are often self-serving or inconsistent. In one vivid incident, Zeitoun returns to check on dogs – no breed specified – that he had fed by crossing a plank bridge he rigged up between a tree and the house abandoned by the animals’ owners. He finds the pets dead: “The dogs were just under the windowsill, a tangle of limbs, heads to the heavens, as if they had been waiting, for weeks, for him.”

This scene, on first reading, seems heartbreaking. But it holds up poorly under scrutiny. Zeitoun casts himself as wholly innocent, but his repeated entry into a stranger’s house was – for however worthy a reason — tempting fate when the police were watching for and arresting looters. And the incident reflects questionable dog behavior. Eggers says that after feeding the abandoned pets, Zeitoun left a window open so they would have fresh air. Dogs can swim and leap out of windows. And Eggers gives us no reason to believe that the dogs he describes, in their desperation, wouldn’t have tried. Like much else in Zeitoun, the incident may have unfolded exactly as he says. Or it may be nothing more than a great story.

Best line: “This day he ventured closer to downtown, passing families wading through the water, pushing laundry tubs full of their possessions. He paddled by a pair of women pushing an inflatable baby pool, their clothes and food inside.” Zeitoun has many details like these that make you see life in New Orleans after Hurricane Katrina hit.

Worst line: “Laying on sweat-soaked sheets, he had a thought.” Was one of those thoughts: What’s that difference between “lie” and “lay” again?

Published: 2009

Furthermore: Eggers’s books include A Heartbreaking Work of Staggering Genius and What Is the What, a National Book Critics Circle Award finalist about the civil war in Sudan.

You can also follow Jan Harayda (@janiceharayda) on Twitter at www.twitter.com/janiceharayda. She satirizes American literary culture, including the book publishing industry, at www.twitter.com/FakeBookNews.

© 2010 Janice Harayda. All rights reserved.

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