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Life and Death in a Storm-Ravaged Hospital

Written by Sheri FinkAuthor Alerts:  Random House will alert you to new works by Sheri Fink



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ABOUT THE BOOK ABOUT THE BOOK
ABOUT THE AUTHOR ABOUT THE AUTHOR
PRAISE & AWARDS PRAISE & AWARDS
READER'S GUIDE READER'S GUIDE
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Synopsis

Synopsis

One of the New York Times’s Best Ten Books of the Year

Winner of the National Book Critics Circle Award for Nonfiction


Winner of the 2014 J. Anthony Lukas Book Prize, the Los Angeles Times Book Prize, the Ridenhour Book Prize, the 2014 American Medical Writers Association Medical Book Award (Public/Healthcare Consumers), a 2014 Science in Society Journalism Award, and the SIBA 2014 Book Award for Nonfiction


An ALA Notable Book, finalist for the NYPL 2014 Helen Bernstein Award, and shortlisted for the PEN/E.O. Wilson Award and the ALA Andrew Carnegie Medal


An NPR “Great Reads” Book, a Chicago Tribune Best Book, a Seattle Times Best Book, a Time Magazine Best Book, Entertainment Weekly’s #1 Nonfiction Book, a Christian Science Monitor Best Book, and a Kansas City Star Best Book


Pulitzer Prize winner Sheri Fink’s landmark investigation of patient deaths at a New Orleans hospital ravaged by Hurricane Katrina – and her suspenseful portrayal of the quest for truth and justice.

In the tradition of the best investigative journalism, physician and reporter Sheri Fink reconstructs 5 days at Memorial Medical Center and draws the reader into the lives of those who struggled mightily to survive and to maintain life amid chaos.

After Katrina struck and the floodwaters rose, the power failed, and the heat climbed, exhausted caregivers chose to designate certain patients last for rescue. Months later, several health professionals faced criminal allegations that they deliberately injected numerous patients with drugs to hasten their deaths.

Five Days at Memorial, the culmination of six years of reporting, unspools the mystery of what happened in those days, bringing the reader into a hospital fighting for its life and into a conversation about the most terrifying form of health care rationing.

In a voice at once involving and fair, masterful and intimate, Fink exposes the hidden dilemmas of end-of-life care and reveals just how ill-prepared we are in America for the impact of large-scale disasters—and how we can do better. A remarkable book, engrossing from start to finish, Five Days at Memorial radically transforms your understanding of human nature in crisis.
 

Sheri Fink

About Sheri Fink

Sheri Fink - Five Days at Memorial

Photo © Jen Dessinger

SHERI FINK'S reporting has won the Pulitzer Prize, the National Magazine Award, and the Overseas Press Club Lowell Thomas Award, among other journalism prizes. Most recently, her coverage of Hurricanes Sandy and Isaac received the Mike Berger Award from Columbia University and the Beat Reporting Award from the Association of Healthcare Journalists. Fink, a former relief worker in disaster and conflict zones, received her MD and PhD from Stanford University. Her first book, War Hospital, is about medical professionals under siege during the genocide in Srebrenica, Bosnia-Herzegovina.
Praise | Awards

Praise

New York Times Bestseller

“What we have here is masterly reporting and the glow of fine writing.” – Sherwin B. Nuland, New York Times Book Review

“I’ve a tower of books by the bed, on quite a range of subjects. I’m reading Sheri Fink’s Five Days at Memorial, which is a brilliantly researched dissection of what went on at Memorial hospital in New Orleans during Hurricane Katrina. It reads like a Saramago novel.” - Colum McCann, By the Book, New York Times Book Review 

“Dr. Fink more than delivers. She writes with a seasoned sense of how doctors and nurses improvise in emergencies, and about the ethical realms in which they work. The first half of this book, which is well paced, covers the five days of the title. Then the viewfinder shifts to an entwined legal and political story in which state authorities pursue a homicide investigation. That so many people, starkly divided over the question of whether crimes had been committed, come off as decent and appealing makes this book an absorbing read. Dr. Fink brings a shimmering intelligence to its many narrative cul-de-sacs, which consider medical, legal and ethical issues…. By reporting the depth of those gruesome hours in Memorial before the helicopters came, and giving weight to medical ethics as grounded in the law, Sheri Fink has written an unforgettable story. Five Days at Memorial is social reporting of the first rank.”– Jason Berry, New York Times

“A stunning feat of journalism.”– New York Review of Books

“The journalist and doctor Sheri Fink published a meticulous investigation of these deaths in the New York Times Magazine and on the Web site of ProPublica, in 2009. Her work won a Pulitzer Prize. And now comes the book. In Five Days at Memorial, the contours of the story remain the same, yet Fink imbues them with far more narrative richness, making the doctors seem both more sympathetic and more culpable. Fink also expands on the ethical conundrums, which have festered over time and seem to gain fresh urgency.”—TheNewYorker.com

“A triumph of journalism...Fink re-creates this world with mastery and sensitivity, revealing the full humanity of each character. Unlike post-storm commentary that jumped to black and white conclusions, painting the doctors as heroes or villains, Fink’s narrative wades through the muck and finds only real people making tough choices under circumstances the rest of us, if we’re lucky, will never experience.” – Houston Chronicle

“Every page gives evidence of meticulous research, thousands of hours spent interviewing, prowling the halls at Memorial, reviewing legal documents and transcripts...[Fink] offers no easy answers, no rush to judgment. But she does deliver an amazing tale, as inexorable as a Greek tragedy and as gripping as a whodunit.”– Dallas Morning News

“Fink has done a masterful reporting job, and Five Days at Memorial is often engrossing, particularly those pages that take readers inside the hospital...Fink’s book is essential reading for anyone who cares about New Orleans, the breakdown of order in disaster zones, and medical dilemmas under crisis circumstances.” - Boston Globe

“Fink, a Pulitzer Prize-winning journalist who trained as a physician, writes powerfully of the investigation into the Memorial deaths and, in her epilogue, of subsequent disasters: the earthquake in Haiti, Hurricane Sandy in the Northeast, an influenza pandemic in India.” – Radhika Jones, TIME

“Powerful…Fink, a trained physician turned journalist, is able to re-create in minute detail the sights, smells and sounds of Memorial in the days following the storm. It’s safe to say that her medical background gave her a unique perspective, which, coupled with her fine writing, offers the reader an evocative narrative of how the hospital staff and patients struggled to cope with the lack of electricity, climbing temperatures, and a sense that they might not make it out alive.” USAToday.com

“This isn’t just a policy brief ornamented with characters. It is, like all great journalism, a document unto itself, an artifact of what we thought about ‘life and death’ issues in the early twenty-first century… Magnificent.” Bookforum

“An important book… Fink, an M.D. and Pulitzer-winning journalist, certainly knows how to craft a nonfiction page-turner.” – Laura Miller, Salon

"It’s a marvel of journalistic effort that brings an objective and sympathetic eye to the suffering and tough decisions at Memorial Medical Center.” Bloomberg

“[Fink] has shaped her research into an elegant narrative, Five Days at Memorial, with all the page-turning pull of a novel, no easy feat given the complexity of the story… riveting.” – Entertainment Weekly

“Pulitzer Prize-winning journalist Sheri Fink spells out the story of Memorial – and its consequences – in a book that is as excellent as it is alarming.” – Christian Science Monitor

“This year's most important book is also one of its most enthralling.”– East Bay Express

“Fink’s descriptions of the flooded hospital, her extensive interviews with those who were there, profiles of investigators and study of the history and ethics of triage and euthanasia come very close to a full airing of how a disaster can upset society’s usual ethical codes, and how that played out at New Orleans’ Memorial Medical Center....Fink has written a compelling and revealing account.”– Seattle Times

“Five Days At Memorial unfolds in two parts—an impeccably researched reconstruction of the events inside the hospital during the disaster, and a gripping account of the investigation and trial that followed. Pulitzer-Prize-winning Sheri Fink, who is also a physician and a former relief worker in combat zones, lays out every shred of evidence, but leaves the final judgment to the reader. Five Days at Memorial treats the chain of events at the hospital as a microcosm that raises vital and increasingly relevant questions about end-of-life care, and the ethics of euthanasia in extraordinary circumstances.”– Macleans

“Fink's reporting is stellar…[the] book is first-rate: riveting reading, morally probing, scrupulously fair. Anyone interested in Hurricane Katrina, human behavior in times of crisis, or medical ethics should read it.” – Milwaukee Journal Sentinel

Five Days at Memorial should be required reading for any American interested in whether their hospital is ready for its disaster, and especially required reading for those who lead those hospitals — board members, administrators, leading physicians and nurses, etc. Plans need to assume help is not coming in five days, and how to decide which patients will not continue getting care if resources to care for them run out, etc.” – Bangor Daily News

“Meticulously researched… Throughout this horrifying, fascinating book, Fink, a physician, maintains the highest journalistic standards. Her reporting is detailed, nuanced and far-reaching, yet it is never biased--a stunning accomplishment in a story with this kind of moral complexity. [Fink] gives voice to all sides–the doctors, nurses, families, and patients themselves–and leaves the conclusions and judgments, none of which can or ever will be easily reached, to the reader. This is a book not to be missed. It is, quite simply, required reading.”Shelf Awareness (starred)

“[Fink] offers a stunning re-creation of the storm, its aftermath, and the investigation that followed…She evenhandedly compels readers to consider larger questions, not just of ethics but race, resources, history, and what constitutes the greater good, while humanizing the countless smaller tragedies that make up the whole. And, crucially, she provides context, relating how other hospitals fared in similar situations. Both a breathtaking read and an essential book for understanding how people behave in times of crisis.” – Booklist (starred)

“In this astonishing blend of Pulitzer Prize–winning journalism (Fink, who also has an M.D. and Ph.D., won the award for the investigative reporting on which this book is based) and breathtaking narration, she chronicles the chaotic evacuation of the hospital and the agonizing ethical, physical, and emotional quandaries facing Memorial nurses and doctors, including a nightmarish triage process that led to the controversial decision to inject critically ill patients with fatal doses of morphine in order to refocus attention on those with a chance of surviving.”- Publishers Weekly (starred)

“Pulitzer Prize–winning medical journalist/investigator Fink (War Hospital, 2003) submits a sophisticated, detailed recounting of what happened at Memorial Medical Center in New Orleans during and after Hurricane Katrina. Fink draws those few days in the hospital’s life with a fine, lively pen, providing stunningly framed vignettes of activities in the hospital and sharp pocket profiles of many of the characters. She gives measured consideration to such explosive issues as class and race discrimination in medicine, end-of-life care, medical rationing and euthanasia, and she presents the injection of some patients with a cocktail of drugs to reduce their breathing in such a manner that readers will be able to fully fashion their own opinions. The book is an artful blend of drama and philosophy [and] with apparent effortlessness, Fink tells the Memorial story with cogency and atmosphere.” - Kirkus Reviews (starred)

“Fink’s six years of research and more than 500 interviews yield a rich narrative full of complex characters, wrenching ethical dilemmas, and mounting suspense. General readers and medical professionals alike will finish the book haunted by the question,'What would I have done?'” - Library Journal (starred)

“[Fink] raises important ethical questions in this fast-paced reconstruction of heart-wrenching events.” Ms. Magazine

“In a high speed world that reduces reality to black and white, Sheri Fink slows down to examine every achingly tough decision made by medical responders to Hurricane Katrina. The riveting result is nuanced and leaves you asking, 'Well, what would I have done?' Wow.” - Laurie Garrett, Pulitzer Prize-winning writer and author of I Heard the Sirens Scream

“Sheri Fink is one of the best medical journalists working in the United States today and Five Days at Memorial stands as evidence of her ability to tell a can't-put-down story, and also her ability to delve into the troubled and sometimes heart-breaking state of medical care in this country today. Read it because it's a compelling look at a hurricane-driven medical catastrophe - and read it because it matters.” -Deborah Blum, author of The Poisoner's Handbook

“Sheri Fink has once again revealed the necessity of honorable journalism: to show us, precisely, why intelligence and information are of critical use. She respects the reader by her labor—gathering the details, earning our engagement as she unfolds the complexity of this story, fact by painstaking fact. Fink invites us into a fuller understanding of five days at Memorial Hospital, the deeper dynamics of which are much in play in America, today. The stakes couldn’t be higher.” –Adrian LeBlanc, author of Random Family

Awards

WINNER 2014 Los Angeles Times Book Prizes
WINNER 2013 National Book Critics Circle Awards
FINALIST 2014 New York Public Library Helen Bernstein Award for Excellence in Journalism
WINNER 2014 Ron Ridenhour Book Award
WINNER 2014 Lukas Prize Project: J. Anthony Lukas Book Prize
FINALIST 2014 Carnegie Medal
FINALIST 2014 PEN/E. O. Wilson Literary Science Writing Award
WINNER 2014 SIBA Book Award
WINNER 2014 American Medical Writers Association Medical Book Award
WINNER 2014 Science in Society Journalism Awards
SELECTION 2013 ALA Notable Adult Books
SELECTION 2013 AudioFile Best Audiobook
Teachers Guide

Teacher's Guide



NOTE TO TEACHERS

Please click on the PDF link at the bottom of this page to download the Teacher's Guide.

note to teachers
 
Five Days at Memorial examines the tragedy of Hurricane Katrina as it unfolded, focusing on events at Memorial Medical Center, where medical staff cared for patients without running water or electricity for four days as they awaited evacuation. After the storm, three medical professionals – a doctor and two ICU nurses – were investigated for intentionally administering medication to hasten the deaths of critically ill patients.
 
As a work of nonfiction, Five Days at Memorial can be used to study structure, research, and rhetoric. It is an exceptional choice as a cornerstone text for a unit on media literacy since its careful research and objective tone place it in stark contrast to the initial news reports about Katrina. In the social sciences, it can provide a springboard for discussing a range of issues, including ethics, the role of government, the legal system, disaster preparedness, and social justice. At the college level, the book is appropriate for nursing, pre-med, public health, sociology, communications, law, and criminal justice courses, and is also ideal for first-year/ common reading programs.
 
This guide is aligned with the Common Core Standards for English, with an emphasis on reading informational texts and writing and speaking persuasively. It is also linked to standards for history/social studies.
 
about this book
 
When Hurricane Katrina hit New Orleans, the city was caught unprepared. In the days following the storm, as levees failed, temperatures rose, and the city flooded, those that had stayed in the city were caught in an escalating nightmare. Hospitals and nursing homes had been exempted from mandatory evacuation orders and, after the storm, conditions degenerated rapidly. Without electricity or running
water, surrounded by chaos, and with no clear idea of when or how they would be evacuated, medical staff struggled, often heroically, to provide basic care for patients. After the last survivors were rescued from the city and cleanup began, the number of dead bodies discovered in several medical facilities, including Memorial, raised questions about what had happened in the days after the storm. There were rumors that doctors and nurses had euthanized patients, and an investigation was launched.
 
Sheri Fink’s Five Days at Memorial began as a Pulitzer Prize-winning article, investigating the events at Memorial Medical Center during and after Hurricane Katrina. Fink observes: “The hospital was a microcosm of these larger failures, with compromised physical infrastructure, compromised operating systems, and compromised individuals. And also instances of heroism” (348).
 
In the first section of the book, Fink examines just what happened at Memorial Medical Center with painstaking attention to detail and accuracy. Readers are able to experience the harrowing and chaotic aftermath of the storm, as conditions spiraled further and further out of control and doctors and nurses were forced to make choices about how to ration care and prioritize patients for evacuation.
 
In the second section, Fink explores the investigation into the suspicious deaths at Memorial, devoting time to both sides of the case – those leading the investigation: Virginia Rider, Arthur “Butch” Schafer, Charles Foti, and Eddie Jordan – and those being investigated: Dr. Anna Pou and nurses Lori Budo and Cheri Landry. She reveals the complexities of situational ethics and raises questions about whether we have an adequate ethical framework for dealing with the questions that are raised in the face of catastrophic events.
 
Fink’s book explores what went wrong after Hurricane Katrina, and asks us to consider how we would react if we had to make decisions about prioritizing rescue and emergency services in a disaster. The book’s epilogue discusses policy changes that have resulted from Katrina and tests them in light of more recent disasters: Hurricane Sandy and the earthquakes in Haiti. In doing so, she raises questions about how prepared we are to deal with another catastrophic event.
 
about the author
 
SHERI FINK’S reporting has won the Pulitzer Prize, the National Magazine Award, and the Overseas Press Club’s Lowell Thomas Award, among other journalism prizes. Most recently, her coverage of Hurricanes Sandy and Isaac received the Mike Berger Award from Columbia University and the Beat Reporting Award from the Association of Healthcare Journalists. Fink, a former relief worker in disaster and conflict zones, received her MD and PhD from Stanford University. Her first book, War Hospital: A True Story of Surgery and Survival, is about medical professionals under siege during the genocide in Srebrenica, Bosnia-Herzegovina.
 
pre-reading activity
 
Since students may be unfamiliar with the magnitude of Hurricane Katrina and its aftermath, it may be helpful to begin this unit by showing some of the media coverage of Katrina. Links to archival coverage of Katrina are included in the resource section of this guide.
 
In order to walk students through the elements of nonfiction and investigative journalism, begin by asking them to discuss why objectivity and accuracy are important hallmarks of journalism. Ask students to brainstorm a list of potential difficulties that a journalist might encounter when writing about a catastrophic current event. You may wish to use a contemporary, real life situation as an example. In collaborative groups, have students play the role of investigative journalists and ask them to develop a plan for researching a current event and accurately reporting it. Without existing reports or publications about the event, what sources will they use? What locations, if any, will they visit? Who will they talk to? How will they ensure accuracy and objectivity? Have students share their plans with the class.
 
After students have explored the questions and made predictions about how to handle contemporary research, read Sheri Fink’s “Note to the Reader” at the beginning of Five Days at Memorial and examine the notes at the end of the book. What sources did Fink use to write her book? How did she ensure accuracy and objectivity?
 
Correlates to Common Core Standards: Reading Informational Text: Integration of Knowledge & Ideas RI. 11-12.7; Speaking & Listening: Comprehension & Collaboration SL. 11-12.1a-d, 11-12.2; History/Social Studies: Craft and Structure RH. 11-12.5, 11-12.6
 
classroom discussion
 
Prologue
 
1.  Five Days at Memorial begins in medias res. Why is this an effective structural choice?
 
2.  What specific details suggest that the deterioration at Memorial has reached a critical point?
 
3.  Why wasn’t the hospital evacuated before Katrina hit New Orleans? What did they expect to happen during and after the storm? What unexpected events complicated the situation?
 
4.  On page 6, Fink relates a disputed conversation between Dr. Thiele and Dr. Kokemor. How does she handle reporting the fact that the two doctors have different accounts of what happened during the conversation?
 
5.  Describe your first impressions of Dr. John Thiele, Dr. Anna Pou, and Karen Wynn.
 
Chapter One
 
1.  Describe the “modern conveniences” that were celebrated when Memorial Medical Center opened as Southern Baptist Hospital in 1926. Compare these details with the description of conditions in the hospital in the prologue.
 
2.  When the hospital was founded, what was its purpose and mission?
 
3.  What did the storms of 1926 and 1927 reveal about Memorial’s ability to withstand storms? What were its strengths and weaknesses?
 
4.  What did the storms of 1926 and 1927 reveal about the city of New Orleans’ ability to handle flooding? What did city officials blame for the flooding?
 
5.  In light of the events of Hurricane Katrina, what details in this chapter are ironic?
 
Chapter Two
 
1.  Explain the reasons for the decision to move LifeCare’s patients to leased space at Memorial. What were the risks associated with this decision?
 
2.  Fink notes that LifeCare was “not a hospice” (25). What is the difference between a hospice and a hospital?
 
3.  What details suggest that nursing director Gina Isbell was kind and caring towards her patients at LifeCare?
 
Chapter Three
 
1.  Create a timeline for the orders to evacuate New Orleans. How much time was there between the evacuation order and the arrival of Katrina? Which groups of people were exempted from the mandatory evacuation? Which groups were instructed to use the Superdome as an emergency shelter?
 
2.  Explain Memorial’s history regarding racial segregation.
 
3.  Analyze how the details Fink includes in Dr. Anna Pou’s biography reveal information about the doctor’s work ethic, personality, and motivation for practicing medicine. Which details do you find especially significant? What do they reveal about the doctor?
 
4.  Summarize “Governor Lamm Philosophy” in your own words. Based on your first impressions of Dr. Pou, Dr. Thiele, Susan Mulderick, Gina Isbell, and Karen Wynn, would any of them be supporters of this philosophy? Explain your answer.
 
5.  Describe the extent of the damage that Memorial sustained during the initial storm.
 
Chapter Four
 
1.  What evidence caused the staff at Memorial to believe that New Orleans was under martial law?
 
2.  Why did Memorial go into “survival mode?” How is survival mode different from normal operating procedures?
 
3.  Why would flooding present a serious problem for Memorial? Since they were aware of the potential problem, why didn’t they take steps to prevent it?
 
4.  What contingencies were not accounted for in the hospital’s emergency hurricane plan?
 
5.  Explain the role that JCAHO (now known as the Joint Commission) played in accrediting hospitals. What’s problematic about the way hospital emergency preparedness plans are created and evaluated?
 
6.  Which patients did Susan Mulderick suggest evacuating first? What was her reasoning for choosing them?
 
7.  How did officials at Tenet Healthcare respond to Memorial’s request for help evacuating patients? How did other Tenet hospitals respond when Memorial sent a request for assistance directly to them? Why do you think Tenet officials rejected offers of assistance from their other hospitals?
 
8.  Describe the evacuation procedure at Memorial. What challenges were doctors and nurses faced with as they began to evacuate patients? Which patients were evacuated first?
 
9.  Explain the difference between a “Do Not Resuscitate” order and a living will. What was the reasoning behind the decision to evacuate patients with DNR orders last? Do you agree with this decision?
 
10.  Describe the challenges that doctors and pilots were faced with during the helicopter evacuations of hospitals.
 
11.  Explain the confusion over the care for and evacuation of LifeCare patients at Memorial. Why were they excluded from Mulderick’s count of patients needing evacuation?
 
12.  Describe the deteriorating conditions in New Orleans. What events led to the Coast Guard helicopters stopping the evacuation efforts at Memorial? What role did the staff’s prevailing view of the remaining very sick patients play?
 
Chapter Five
 
1.  Summarize the reasons for the failure of all of Memorial’s emergency generators.
Explain why the backup generators were critical for the hospital’s operation.
 
2.  Why do you think evacuation helicopters were waved away from Memorial at one point? What does this reveal about the hospital’s preparation for handling an emergency like Katrina? What does it reveal about the values some staff held regarding which patients’ lives were worth saving?
 
3.  What factors made the evacuation of LifeCare patients especially difficult?
 
4.  Why did Gina Isbell stop manually providing oxygen to her patient, John Russell?
Why did his death “feel different” (128)?
 
5.  What did the new system for labeling patients for evacuation reveal about who was being given priority? What factors may have caused doctors to make this switch?
 
6.  Paraphrase the main idea of John Rawls’ principles of justice. How are these principles applied to the field of medicine?
 
7.  When are triage systems necessary? Why are they difficult to create and implement?
 
8.  Why were some family members trying to get the DNR orders on their relatives reversed?
 
Chapter Six
 
1.  Why were rescue helicopters diverted away from Memorial for a time? Do you find the reason for diverting aid from the hospital reasonable? Explain your answer.
 
2. Explain Dr. King’s opinion about the motivation behind the decision to refuse to admit new patients to Memorial. Do you agree with him?
 
3.  What did Dr. Cook decide needed to be done with some of the staff members’ pets that had been brought to Memorial?
 
4.  Explain the decision that Dr. Cook made regarding the treatment of Jannie Burgess. What were the reasons for his decision? Why did he feel that it was technically an illegal procedure?
 
5.  Why did the treatment for the elderly lung cancer patient upset nurse Cathy Green? Do you think the doctor was right to tell Green to stop administering oxygen?
 
6.  Explain the role that Mark and Sandra Leblanc played in the rescue efforts at Memorial. Why were they concerned about the patients in this particular hospital?
 
7.  Describe the steps that Tenet officials took to try to get help to Memorial. What factors complicated their attempts to get aid for the patients and staff members stranded at the hospital?
 
Chapter Seven
 
1.  Describe the role that Angela McManus played in the care of her mother, Wilda.  Why did Angela finally agree to leave the hospital? What happened to her mother after she left?
 
2.  Why did police arrive at the hospital? What does this incident suggest about conditions in New Orleans?
 
3.  Describe the system for care that Dr. Bryant King organized. What factors in his own life helped prepare him to deal with a disaster?
 
4.  What do the emails included on page 192 reveal about the chain of command and evacuation plans for Memorial?
 
5.  Explain the inconsistencies (or differences in interpretation) in the memories of Deichmann, Mulderick, and Kokemor regarding conversations about euthanizing patients.
 
6.  Who did Pou appeal to for help in determining what combination of medication to give suffering patients? Why did she choose to ask this particular doctor for assistance?
 
7.  What could be a consequence of giving patients the prescribed drug cocktail?  Do you think Pou was aware of what she was doing by giving patients high doses of morphine? Explain your answer.
 
8.  How did Dr. Kathleen Fournier find out that some doctors and nurses were discussing the possible option of euthanizing patients? How did she feel about this option? Summarize the responses of the people to whom she reached out to express concerns about the possibility that patients would be euthanized.
 
9.  What is the effect of Fink’s decision to include brief descriptions of Angela McManus and Kathryn Nelson’s anguish over leaving their critically ill mothers?  How does it impact your reaction to the idea of euthanizing patients?
 
10.  Explain Karen Wynn’s perspective regarding euthanasia.
 
11.  What does the email from Ben Russo suggest about Tenet Healthcare’s priorities and awareness of the gravity of the situation at Memorial? What is the effect of Fink’s decision to juxtapose the email with scenes about euthanizing patients?
 
12.  Who made the decision to give Merle Lagasse potentially fatal doses of morphine? Why did he feel that this was necessary?
 
PART TWO
Chapter  Eight
 
1.  What was Arthur “Butch” Schafer’s job? Why did he decide to go to New Orleans after Katrina? Describe his working relationship with Virginia Rider.
 
2.  Describe the conditions that reporters witnessed when they entered New Orleans to survey the situation post-Katrina. Why was the discovery of forty-five bodies at Memorial shocking?
 
3.  What prompted Schafer to open an investigation into what happened at health care facilities after Katrina? What caused him to be suspicious about the way Memorial operated during the disaster?
 
4.  How did Tenet officials respond to initial requests for information about the hospital’s disaster plan and deceased patients?
 
5.  Were reports of euthanasia limited to Memorial? Explain.
 
6.  Summarize the “talking points” that were given to Tenet employees who called the families of deceased patients.
 
7.  How did Pou learn that she was being investigated? Who did she initially reach out to for advice and assistance?
 
8.  Who did Pou hire as her attorney? What steps did he immediately take in her defense?
 
9.  Who was the first witness that Rider interviewed? Summarize the key points of her interview.
 
10.  Why did LifeCare officials decide to cooperate with the investigation?
 
11.  What facts about the evacuations before Katrina and Rita suggest that evacuating nursing homes and hospitals before a hurricane is not a simple solution?
 
12.  What details about events at Memorial were consistent among the interviews of Robichaux, Mendez, Johnson, and Harris?
 
13.  What items were Schafer and his team looking for when they searched Memorial?  What evidence were they able to recover? What evidence were they unable to locate?
 
14.  Explain the role that families of deceased patients played in the investigation of Memorial.
 
15.  What were the results of the autopsies performed on the patients from Memorial?
 
16.  Why did Schafer feel personally invested in the Memorial investigation?
 
17. Summarize Dr. King’s interview with Schafer. What was Dr. King sure about? What was he unsure about?
 
18.  How did Tenet treat hospital employees after the hurricane? What specific actions by the company caused anger among the staff?
 
19.  Describe the various approaches taken by media outlets reporting on the Memorial investigation. Do you think any of the reports constitute responsible journalism? Explain your answer.
 
20. Explain Tenet’s legal response to the investigation. Who were they protecting?
 
21.  According to Rider, why did Castaing approach her office regarding his clients, nurses Lori Budo and Mary Jo D’Amico?
 
22.  What events did Dr. Thiele witness at the airport where evacuated patients were taken? What was it about this experience that reassured him that hastening the deaths of patients had been the right thing to do?
 
23. Describe Dr. Baltz’s experience at Memorial during Katrina. Why did he decide to get involved in the investigation?
 
24. Explain Schafer and Rider’s personal beliefs about euthanasia. Why did they use Emmett Everett as an example of what was wrong about what doctors at Memorial did to hasten the deaths of critical patients?
 
25. Which deaths did Dr. Roy Culotta discuss with investigators? What role did he play in the deaths? Based on his testimony, why was assigning moral and/or legal blame for the deaths complicated?
 
26. How did the public discover the name of Dr. Pou? Why did this cause Pou to stop performing surgeries?
 
27.  Why do you think Sheri Fink decided to include the details about Pou’s care of James O’Bryant in this section?
 
28. Who is Dr. Cyril Wecht? What details does Sheri Fink include that could cast doubt on his judgment and ethics?
 
29. Do you believe that the testimonies of Terence Stahelin and Kristy Johnson are reliable? Explain your answer.
 
30. Analyze specific ways that Skinner’s testimony seemed to reveal “small, important, and maddening inconsistencies” in the investigation (318).
 
31.  What did the investigation reveal about the hospital’s CEO, René Goux, and other key Memorial executives’ experiences during the days after Katrina?
 
32. What did Schafer suspect about the role that Tenet Healthcare might have played in the events at Memorial? Why didn’t he seek to prosecute the corporation?
 
Chapter Nine
 
1.  Why do you think Fink begins this chapter with further discussion of Pou’s care for her terminally ill patient, James O’Bryant?
 
2.  What is self-surrender? What did Pou, Landry, and Budo’s attorneys tell Schafer about their clients’ willingness to self-surrender?
 
3.  Who was in favor of surprise arrests of Pou, Landry, and Budo? Who was against it?
 
4.  Examine Fink’s description of Anna Pou’s arrest and mug shot. What does the description suggest about Pou’s reaction to being arrested?
 
5.  What is your impression of Attorney General Foti’s statements during the press conference about the arrests? Compare and contrast his press conference with the one given by Pou’s attorney, Rick Simmons.
 
6.  Summarize the immediate public response to the arrests of Pou, Landry, and Budo.
 
7.  Why didn’t Dr. Cook speak out in defense of the women that had been arrested?
 
8.  Summarize the response of their colleagues to their arrests. What specific steps did people take to try to help Pou, Landry, and Budo?
 
9.  After reviewing the autopsy reports, toxicology reports, and medical charts (when available) of all of the deceased patients from Memorial, what conclusions did Wecht, Minyard, and Baden draw about how many deaths were homicides or likely homicides?
 
10.  Why were Assistant District Attorney Michael Morales and District Attorney Eddie Jordan ambivalent about the Memorial case?
 
11.  By the one-year anniversary of Katrina, what steps had former hospital workers, patients, and family members taken against Tenet Healthcare and Memorial?
 
12.  Describe the similarities in the disaster response during the days following Katrina at Memorial, Lindy Boggs Medical Center, and Touro Infirmary.
 
13.  In what ways was the situation at Charity Hospital similar to the situations at Memorial, Lindy Boggs, and Touro? How did their responses to Katrina differ? What explanations does Fink offer as possible reasons for the vastly different response and outcome at Charity?
 
14. What is the ethical concept of double effect? Explain why Morales might begin to view the Memorial case as an example of double effect.
 
15.  Why did Pou’s lawyer, Rick Simmons, work to protect Pou’s initial conversations with lawyers from Tenet Healthcare? Was he successful?
 
16.  Describe the reasons for Minyard’s conflict over the Memorial case. Why did he feel it should be prosecuted as a homicide case? Why did he hesitate to do so?
 
17.  How did Rider respond to Minyard’s report?
 
18.  What question is raised by Fink’s inclusion of the details regarding violent crimes and the criminal justice system in New Orleans?
 
19.  Explain the differences between voluntary, involuntary, passive, and active euthanasia.
 
20. What factors contributed to Coroner Minyard’s decision not to rule the Memorial deaths as homicides?
 
21.  What guideline from the World Medical Association did Pou and Simmons use to justify the decisions she made in wake of Katrina? Do you believe the guideline applied in this situation? Explain your answer.
 
22.  Why were Budo, Landry, and D’Amico subpoenaed? Why did they try to fight the subpoenas?
 
23. Explain the model legislation that the AMA drafted to guide medical care in the aftermath of a disaster. What rhetorical strategies does Fink use in this section to suggest that there is an opposing viewpoint to that of the AMA?
 
24. Pages 430-432 contain a narrative of Minyard’s internal thoughts as he prepared his testimony for the hearing. Examine the author’s notes for this section. What sources did she use to write this section?
 
25. Whose testimonies were presented at the grand jury hearings? Whose testimonies were left out?
 
26. Why do you think Fink includes details about Dr. Thiele’s illness and treatment?
 
27.  Why do you think Fink juxtaposes the description of the lavish medical staff banquet with a description of the court building (444)?
 
28. What was the grand jury’s decision regarding the charges against Pou?
 
29. Pages 446-451 contain a narrative account of what happened to Foti and Pou after the grand jury’s decision. Contrast the impact the investigation and hearing had on each person’s career.
 
30. What did Cyril Wecht call a “very dangerous, bad precedent” (454)?
 
31.  If the juror Fink references on the last page is correct in her belief that “all her fellow jurors” were convinced that a crime occurred on the fifth day at Memorial, why did they vote not to proceed with the charges against Pou?
 
Epilogue
 
1.  What did Hurricanes Isaac and Sandy reveal about the progress (or lack thereof) that hospitals have made in preparation for natural disasters that result in a loss of power?
 
2.  Explain the legislation that Pou’s advocacy helped pass.
 
3.  Explain how the proposed protocols for triage or rationing care work. What problems exist with current protocols?
 
4.  What problems with the management of healthcare in a crisis does the case of
Nathalie LeBrun reveal?
 
5.  What has been revealed by attempts to engage the public in questions about disaster protocols for healthcare?
 
6.  Discuss the opposing viewpoints of Schultz and Knebel. Whose position do you agree with? Explain your answer.
 
Correlates to Common Core Standards Reading: Informational Text Key Ideas and Details RI. 11-12.1, 11-12.2, 11-12.3; Craft and Structure RI. 11-12.4, 11-12.5, 11-12.6; Writing: Range of Writing W. 11-12.10; Speaking & Listening: Comprehension & Collaboration SL. 11-12.1a-d; Language: Vocabulary Acquisition & Use L. 11-12.4, 11-12.5a-b, 11-12.6; History/Social Studies: Key Ideas & Details RH.11-12.1, 11-12.2, 11-12.3, Craft & Structure RH 11-12.4, 11-12.5; Integration of Knowledge & Ideas
RH. 11-12.8
 
activities
 
1.  Five Days at Memorial begins with a quote from Jose Saramago’s Nobel Prize- winning novel, Blindness. In many ways, the plot of Blindness seems to predict some of the events that occurred in the aftermath of Hurricane Katrina. Compose a thoughtful analysis that uses the novel Blindness as an interpretive lens, relating it to the unfolding tragedy in Five Days at Memorial.
 
Correlates to Common Core Standards Reading: Literature Key Ideas & Details RL. 11-12.1, 11-12.2; Reading: Informational Text Key Ideas & Details RI. 11-12.3; Integration of Knowledge & Ideas RI. 11-12.7; Writing: Text Types & Purposes W. 11-12.2a-f; Production & Distribution of Writing W. 11-12.4, 11-12.5
 
2.  Explain the “Governor Lamm Philosophy” regarding end-of-life care (47-48).  Do you agree or disagree with this philosophy? Support your position with a carefully researched and crafted argument.
 
Correlates to Common Core Standards Writing: Text Types & Purposes W. 11-12.1a-e; Production & Distribution of Writing W. 11-12.4, 11-12.5: Research to Build & Present Knowledge  W. 11-12.7, 11 12.9; History/Social Studies Writing: Text Types & Purposes WHST. 11-12.1a-e; Production & Distribution of Writing WHST. 11-12.4, 11-12.5
 
3.  In recent years, there have been a number of high-profile cases (ex. Terri Schiavo, Jahi McMath, Karen Ann Quinlan, Marlise Muñoz) involving a family’s right (or lack thereof) to remove life support from a relative that has been declared to be in a persistent vegetative state. Research one of these cases and thoughtfully analyze both sides of the debate. Construct your own response in reaction to the case, supporting your position with research and rhetorical strategies.
 
Correlates to Common Core Standards Writing: Text Types & Purposes W. 11-12.1a-e; Production & Distribution of Writing W. 11-12.4, 11-12.5, Research to Build & Present Knowledge W. 11-12.7, 11 12.8, 11-12.9; History/Social Studies: Key Ideas & Details RH. 11-12.1, 11-12.2, 11-12,3; Craft & Structure RH. 11-12.6; Integration of Knowledge & Ideas RH. 11-12.7, 11-12.8, 11-12.9; Writing: Text Types & Purposes WHST. 11-12.1a-e; Production & Distribution of Writing WHST. 11-12.4, 11-12.5
 
4.  Memorial Medical Center began as a non-profit Baptist hospital. In the mid-1980’s, Dr. Horace Baltz commented on the increasingly commercialized landscape of medicine in the Baptist Hospital newsletter: “Many of us have trouble accepting the business motive in medicine rather than the professional ethic” (45). Research the emergence of for-profit healthcare in the United States. What are the intended and unintended consequences of having a market-driven healthcare system? What complications arise when dealing with a disaster? Should medicine be practiced using a “business motive?” Support your position with carefully chosen and correctly cited research.
 
Correlates to Common Core Standards Writing: Text Types & Purposes W. 11-12.1a-e; Production & Distribution of Writing W. 11-12.4, 11-12.5; Research to Build & Present Knowledge W. 11-12.7, 11-12.8, 11-12.9; History/Social Studies Writing: Text Types & Purposes WHST. 11-12.1a-e; Production & Distribution of Writing WHST. 11-12.4,m 11-12.5
 
5.  In spite of the fact that New Orleans (and Memorial Medical Center) had a history of flooding as a result of hurricanes, one of the weaknesses that the storm revealed was the hospital’s lack of an adequate emergency plan for a major hurricane. Is your city prepared to deal with a major disaster? Consider the most likely threat to your school or town (this will vary by location) and research the current emergency plan to deal with this potential disaster. Do you think the plan is adequate? If it is not, what changes do you propose? Share the results of your research with the current head of security.
 
Correlates to Common Core Standards Writing: Text Types & Purposes W. 11-12.1a-e; Production & Distribution of Writing W. 11-12.4, 11-12.5; Research to Build & Present Knowledge W. 11-12.7, 11-12.8, 11-12.9; History/Social Studies Writing: Text Types & Purposes WHST. 11-12.1a-e; Production & Distribution of Writing WHST. 11-12.4, 11-12.5; Research to Build & Present Knowledge WHST. 11-12.7, 11-12.9
 
6.  Dr. Bryant King told investigators that he had been deeply troubled by the events at Memorial, saying “he had sent messages to his best friend telling him that ‘evil entities’ were planning to euthanize patients”(267). Examine the way that King responded to both the crisis and its aftermath. Does a person have a moral responsibility to stand up to the powers that be when they believe something is immoral or unethical? If you had been in Dr. King’s position, what would you have done? Compose an argument about individual responsibility when faced with a moral or ethical conflict.
 
Correlates to Common Core Standards Writing: Text Types & Purposes W. 11-12.1a-e; Production & Distribution of Writing W. 11-12.4, 11-12.5; Research to Build & Present Knowledge W. 11-12.9; History/Social Studies Writing: Text Types & Purposes WHST. 11-12.1a-e; Production & Distribution of Writing WHST. 11-12.4, 11-12.5; Research to Build & Present Knowledge WHST. 11-12.9
 
7.  After Katrina, Tenet was criticized for the way they dealt with employees (272).
Do corporations have a responsibility to take care of employees in ways beyond simply paying them for services rendered? Defend your answer with thoughtful evidence and the effective use of persuasive techniques.
 
Correlates to Common Core Standards Writing: Text Types & Purposes W. 11-12.1a-e; Production & Distribution of Writing W. 11-12.4, 11-12.5; Research to Build & Present Knowledge W. 11-12.9; History/Social Studies Writing: Text Types & Purposes WHST. 11-12.1a-e; Production & Distribution of Writing WHST. 11-12.4, 11-12.5; Research to Build & Present Knowledge WHST. 11-12.9
 
8.  As a companion text to Five Days at Memorial, consider Josh Neufeld’s award- winning graphic novel A.D.: New Orleans After the Deluge. How is the perspective of the hurricane survivors profiled in Neufeld’s text similar to the experience of those at Memorial? How is it different? How does reading multiple perspectives of the same event help deepen your understanding of the event?
 
Correlates to Common Core Standards Reading: Informational Text Key Ideas & Details RI. 11-12.3; Integration of Knowledge & Ideas RI. 11-12.7; Writing: Text Types & Purposes W. 11-12.2a-f; Production & Distribution of Writing W. 11-12.4, 11-12.5; History/Social Studies: Integration of Knowledge & Ideas RH. 11-12.1, 11-12.3; Writing: Text Types & Purposes WHST. 11-12.1a-e; Production & Distribution of Writing WHST. 11-12.4, 11-12.5; Research to Build & Present Knowledge WHST. 11-12.9
 
9.  In a report about the alleged euthanasia at Memorial, Anderson Cooper reported: “We begin tonight at a moment when Hurricane Katrina went from being a disaster to a tragedy, when people began making choices that leave a mark on the soul”(274). Research the aftermath of Hurricane Katrina and compose a persuasive presentation that answers the following question: In your opinion,
at what point did the disaster become a tragedy, and does it meet the classic definition of a tragedy? Defend your answer with carefully selected evidence and effective persuasive techniques and incorporate multimedia resources into your presentation. You may wish to use the format of a TED talk as a model for your presentation.
 
Correlates to Common Core Standards: Writing Research to Build & Present Knowledge W. 11-2.7,11-12.8, 11-12.9; Speaking & Listening, Comprehension & Collaboration SL. 11-12.2; Presentation of Knowledge & Ideas SL. 11-12.4, 11-12.5, 11-12.6; History/Social Studies: Integration of Knowledge & Ideas RH. 11-12.7, 11-12.8, 11-12.9; Writing: Research to Build & Present Knowledge RHST. 11-12.7, 11-12.8,
11-12.9
 
10.  One of the difficulties that investigators had as they probed the events at Memorial was encountering witnesses whose memories may have been changed or influenced by what they read, heard, or saw relating to the investigation. According to Fink: “Researchers had shown that recollections of alleged crimes, as of all events, were fallible, malleable, and subject to possible contamination
by new information and discussions with other witnesses” (282). Research the problem of eyewitness memory and testimony and write an informative paper that explores the problem and offers possible solutions.
 
Correlates to Common Core Standards: Writing, Text Types & Purposes W. 11-12.2a-f; Production & Distribution of Writing W. 11-12.4, 11-12.5; Research to Build & Present Knowledge W. 11-12.7, 11-12.8, 11-12.9; History/Social Studies: Integration of Knowledge & Ideas RH. 11-12.7, 11-12.8, 11-12.9; Writing: Text Types & Purposes WHST. 11-12.2a-e; Production & Distribution of Writing WHST. 11-12.4, 11-12.5; Research to Build & Present Knowledge WHST. 11-12.9
 
11.  One of the striking revelations about Fink’s investigative reporting on the events at Memorial is the fact that there are widely differing opinions among medical professionals regarding end-of-life care. Should a doctor’s personal beliefs or religious convictions be allowed to influence the types of care that they provide to patients, especially if those personal beliefs involve end-of-life treatment, emergency care, and/or contraception?
 
Correlates to Common Core Standards: Writing Text Types & Purposes W. 11-12.1a-e; Production and Distribution of Writing W. 11-12.4, 11-12.5; Research to Build &
 
Present Knowledge W. 11-12.9 History/Social Studies: Writing Text Types & Purposes WHST. 11-12.1a-e; Production & Distribution of Writing WHST. 11-12.4, 11-12.5; Research to Build & Present Knowledge WHST. 11-12.9
 
12.  Research the emergence of intensive care. What medical breakthroughs helped create intensive care options? What ethical questions arose as a result of these options? You may wish to expand this topic to look at current advances in neonatal intensive care and resulting ethical debates.
 
Correlates to Common Core Standards: Writing Text Types & Purposes W. 11-12.1a-e; Production & Distribution of Writing W. 11-12.4, 11-12.5; Research to Build & Present Knowledge W. 11-12.7, 11-12.8, 11-12.9 History/Social Studies: Writing Text Types & Purposes WHST. 11-12.1a-e; Production & Distribution of Writing WHST. 11-12.4, 11-12.5; Research to Build & Present Knowledge WHST. 11-12.9
 
13.  Examine the structure of Fink’s book, looking closely at the way she interweaves biographical information about the people in the text with details about the events at Memorial. How do the biographical sections highlight issues or raise questions in the reader’s mind? How do they help provide a more nuanced story?
 
Correlates to Common Core Standards: Reading Informational Text Key Ideas & Details RI. 11-12.2, 11-12.3, 11-12.5; Writing Text Types & Purposes W. 11-12.2a-f; Production & Distribution of Writing W. 11-12.4, 11-12.5 History/Social Studies: Craft & Structure RH. 11-12.5, 11-12.6; Writing Text Types & Purposes WHST. 11-12.2a-e; Production & Distribution of Writing WHST. 11-12.4, 11-12.5; Research to Build & Present Knowledge WHST. 11-12.9
 
14.  Fink spends some time discussing the difficulties people had caring for their
pets in the aftermath of Katrina, sometimes using these details as a juxtaposition for the way people were cared for. After Katrina, the Louisiana legislature passed legislation that requires local governments to develop evacuation plans for service animals and household pets. Write a persuasive essay that answers the following questions: Should pets be included in emergency evacuations? If so, how would this be handled given the scarcity of resources after a disaster? If not, what should be done with pets? You may want to expand this project by finding out if your local animal shelter or government has an emergency plan for dealing with the aftermath of a disaster. If not, compose a persuasive letter to the director of the shelter asking him/her to create an emergency plan.
 
Correlates to Common Core Standards: Reading Informational Text Key Ideas & Details RI. 11-12.5, 11-2.6; Writing: Text Types and Purposes. 11-12.1a-e; Production and Distribution of Writing. 11-12.4, 11-12.5; Research to Build and Present Knowledge, 11-12.9; History/Social Studies: Writing Text Types & Purposes WHST. 11-12.1a-e; Production & Distribution of Writing WHST. 11-12.4, 11-12.5; Research to Build & Present Knowledge WHST. 11-12.9
 
15.  In her discussion of the final moments at Memorial, Fink writes about Dr. Thiele: “Perhaps he realized at the moment of action that what seemed right didn’t quite feel right; that a gulf existed between ending a life in theory and in practice”(10). Consider a time that you believed in something in theory, but found it difficult to act on your belief in practice and compose a reflective personal narrative that examines your experience. How did you resolve your dilemma? What did you learn about yourself as a result?
 
Correlates to Common Core Standards: Writing Text Types and Purposes W. 11-12.3a-e; Research to Build and Present Knowledge W. 11-12.9
 
16.  Research advance care directives (living wills). Who developed the first living will? What information is typically contained in an advance care directive? How legally binding are they? How are medical decisions made in the absence of an advanced care directive? Discuss advance care directives with your family. Do you all agree about the extent of care that you would want to receive? If not, how will you resolve your differing opinions? As an extension to this activity, extend your research by interviewing a doctor about his/her perspective on advanced care directives. Does he/she have any insight that you find especially valuable? (Note to teachers: the nonprofit organization City Lore has excellent resources for teaching students how to conduct and document an interview as research.)
 
Correlates to Common Core Standards: Writing Text Types & Purposes W. 11-12.2a-f; Research to Build & Present Knowledge W. 11-12.7, 11-12.8, 11-12.9; Speaking & Listening: Comprehension & Collaboration SL. 11-12.1, 11-12.2; History/Social Studies: Craft & Structure RH. 11-12.6; Writing: Text Types & Purposes WHST. 11-12.2a-e; Production & Distribution of Writing WHST. 11-12.4, 11-12.5; Research to Build & Present Knowledge WHST. 11-12.7, 11-12.8, 11-12.9
 
17.  Hurricane Katrina was a national tragedy, and, as is the case with all national tragedies, we have an impulse to move on and not dwell on it. While this approach can be helpful for those that experienced first-hand or remember the events in question, it raises a potential problem: how to inform future generations about the tragedy in a way that gives them an adequate understanding of the tragedy. What are the lessons of Katrina? How should students be made aware of what happened? Create an informative video about Katrina to show to future high school students. (Note to teachers: you may wish to give students the option of modeling videos after Crash Course.)
 
Correlates to Common Core Standards: Reading Informational Text Integration of Knowledge & Ideas RI. 11-12.7; Writing: Research to Build & Present Knowledge W. 11-12.7, 11-12.8, 11-12.9; Speaking & Listening: Presentation of Knowledge & Ideas SL. 11-12.4, 11-12.5, 11-12.6; History/Social Studies: Key Ideas & Details RH. 11-12.2, 11-12.3; Integration of Knowledge & Ideas RH. 11-12.7, 11-12.8, 11-12.9; Writing: Research to Build & Present Knowledge WHST. 11-12.9
 
18.  Read the excerpt from Dr. Horace Baltz’s reply to Richard Deichmann (389-90).
Do you agree or disagree with his stance on euthanasia? Compose an editorial letter that expresses your position using logical, ethical, and emotional appeals.
 
Correlates to Common Core Standards: Writing Text Types & Purposes W. 11-12.1a-e; Production & Distribution of Writing W. 11-12.4, 11-12.5; Research to Build & Present Knowledge W. 11-12.9
 
19.  Research the medical ethical concept of double effect. What is double effect?
As a primary source, read the section of St. Thomas Aquinas’ Summa Theologica that discusses double effect. How has this concept been applied in medical ethics? How has it been applied in courts of law? As a class, debate whether or
not double effect applies to the events at Memorial. Use specific textual evidence from Summa Theologica, Five Days at Memorial, and at least two other sources to defend your position.
 
Correlates to Common Core Standards: Reading Informational Text Craft and Structure RI. 11-12.4, 11-12.5; Integration of Knowledge & Ideas RI. 11-12.8; Writing Research to Build & Present Knowledge W. 11-12.7, 11-12.8, 11-12.9; Speaking & Listening: Comprehension and Collaboration SL. 11-12.1a-d, 11-12.3; Presentation of Knowledge & Ideas SL. 11-12.4; History/Social Studies: Key Ideas & Details
RH. 11-12.2, 11-12.3; Craft & Structure RH. 11-12.6; Integration of Knowledge & Ideas RH. 11-12.7, 11-12.8, 11-12.9; Writing: Text Types and Purposes WHST. 11-12.1a-e; Research to Build & Present Knowledge WHST. 11-12.9
 
20. One of the ethical issues raised by the events at Memorial was the complex task of creating a triage system to deal with emergencies where the number of people requiring care outnumbered the available resources. While there are several models of triage protocols, there is not a consensus about which one is the best; in fact, there is not even consensus about what the goal of triage care should
be. Research models for emergency triage, including military triage, and, as a class, debate which model you think should be adopted by the American Medical Association, including the process for deciding on the protocol. Support your position with relevant evidence from credible sources.
 
Correlates to Common Core Standards: Writing Research to Build & Present Knowledge W. 11-12.7, 11-12.8, 11-12.9; Speaking & Listening: Comprehension & Collaboration W. 11-12.1a-d, 11-12.3; Presentation of Knowledge & Ideas W. 11-12.4; History/Social Studies: Key Ideas & Details RH. 11-12.2, 11-12.3; Craft & Structure RH. 11-12.6; Integration of Knowledge & Ideas RH. 11-12.7, 11-12.8, 11-12.9
 
21.  Using news archive sites found online, watch some of the original broadcasts on Hurricane Katrina. Compare the way that different news outlets reported the events and evaluate the bias in the different reports. Pay close attention to the connotations of the words used to describe the storm and its aftermath. As an example, some media outlets have been criticized for using the word “refugees” rather than “survivors” to describe the people that evacuated after the storm. Why could choosing words with connotative meanings be problematic? Which news outlets seem the most and least biased? What is bias in news reporting?
 
Correlates to Common Core Standards: Reading Informational Text, Integration of Knowledge and Ideas RI. 11-12.7; Language: Vocabulary Acquisition & Use L. 11-12.5a-b; Writing: Text Types & Purposes W. 11-12.2a-f; Research to Build & Present Knowledge W. 11-12.7, 11-12.8, 11-12.9; History/Social Studies: Key Ideas & Details RH. 11-12.2, 11-12.3; Craft & Structure RH. 11-12.4, 11-12.5,11-12.6; Integration of Knowledge & Ideas RH. 11-12.7, 11-12.8, 11-12.9; Writing: Text Types & Purposes WHST. 11-12.2a-e
 
22.  On page 348 Fink writes: “The hospital was a microcosm of these larger failures, with compromised physical infrastructure, compromised operating systems, and compromised individuals. And also instances of heroism.” Examine this quote and compose a thoughtful research paper that expands on one of the ways that the hospital served as a microcosm for what happened in New Orleans.
 
Correlates to Common Core Standards: Reading Informational Text Key Ideas & Details RI. 11-12.1, 11-12.2, 11-12.3; Writing: Text Types & Purposes W. 11-12.2a-f; Production & Distribution of Writing W. 11-12.4, 11-12.5, 11-12.6; Research to Build & Present Knowledge W. 11-12.7, 11-12.8, 11-12.9; History/Social Studies: Key Ideas & Details RH. 11-12.1, 11-12.2, 11-12.3; Craft & Structure RH. 11-12.6; Integration of Knowledge & Ideas RH. 11-12.7, 11-12.8, 11-12.9; Writing: Text Types & Purposes WHST. 11-12.2a-e
 
23. Analyze Five Days at Memorial as a work of investigative journalism. What sources did Sheri Fink use to reconstruct the events at Memorial? Which rhetorical strategies did she use? Analyze the techniques she used to maintain an objective viewpoint. Cite specific passages that you find particularly effective or particularly problematic and analyze them in light of the entire text.
 
Correlates to Common Core Standards: Reading Informational Text Key Ideas & Details RI. 11-12.1, 11-12.2, 11-12.3; Craft & Structure RI. 11-12.5, 11-12.6; Writing: Texts Types & Purposes W. 11-12.2a-f
 
24. One of the problems that investigators faced was the fact that public opinion was overwhelmingly on the side of the medical professionals that served their communities during the storm. Television shows like Boston Legal and Law & Order have a history of creating fictional stories based on current news events and criminal investigations. Watch the Boston Legal episode (season 3, episode 11) “Angel of Death” based on the Memorial investigation. Should television shows be allowed to create episodes like this before a case has gone to trial? Do individuals have any legal outlet to stop a fictionalized version of their story from being printed or broadcast? Compose an argument about the ethics of this type of fictionalization of real people or events.
 
Correlates to Common Core Standards: Writing Text Types & Purposes W. 11-12.1a-e; Research to Build & Present Knowledge W. 11-12.7; Speaking & Listening: Comprehension & Collaboration SL. 11-12.2, 11-12.3, 11-12.3
 
25. Compose a thorough analysis of the 60 Minutes episode featuring Dr. Pou, which helped sway public opinion during the Memorial investigation. As you watch the episode, make note of points that are reported objectively and points that may be biased.
 
Correlates to Common Core Standards: Writing Text Types and Purposes W. 11-12.2a-f; Research to Build & Present Knowledge W. 11-12.7; Speaking & Listening: Comprehension & Collaboration SL. 11-12.2, 11-12.3, 11-12.3; History/Social Studies: Craft & Structure. 11-12.6; Integration of Knowledge & Ideas RH. 11-12.7, 11-12.8, 11-12.9; Writing: Text Types & Purposes WHST. 11-12.2a-e
 
26. What rules and social codes should govern people in the face of a disaster? Is it true that a person’s actions should “be judged by a different standard from the one normally applied because they occurred in the confusing, dangerous environment of a disaster” (424), or does a time of crisis call for an even deeper commitment to fundamental moral values, as one ethicist in the book is quoted as saying? Debate this question as a class.
 
Correlates to Common Core Standards: Speaking and Listening Comprehension & Collaboration SL. 11-12.1a-d; Presentation of Knowledge & Ideas SL. 11-12.4, 11-12.6
 
27.  Consider the following quote: “Emergencies are crucibles that contain and reveal the daily, slower-burning problems of medicine and beyond – our vulnerabilities; our trouble grappling with uncertainty, how we die, how we prioritize and divide what is most precious and vital and limited; even our biases and blindness”(464). Think back on a time that you experienced a personal crisis or emergency. What did the experience reveal about yourself and/or those around you? Compose a reflective personal narrative about your experience.
 
Correlates to Common Core Standards: Writing Text Types & Purposes W. 11-12.3a-e; Production & Distribution of Writing W. 11-12.4, 11-12.5; Range of Writing W. 11-12.10
 
28. Sheri Fink ends her book with these words: “It is hard for any of us to know how we would act under such terrible pressure. But we, at least, have the luxury to prepare and resolve how we would want to make the decisions”(486). Put yourself in the position of a medical professional at Memorial and compose a personal narrative that details how you would have hoped to respond to the events that occurred.
 
Correlates to Common Core Standards: Writing Text Types & Purposes W. 11-12.3a-e; Research to Build & Present Knowledge W. 11-12.9; Production & Distribution of Writing W. 11-12.4, 11-12.5; Range of Writing W. 11-12.10
 
29. Examine the model legislation shielding medical professionals from civil lawsuits that the American Medical Association proposed after Katrina (428) and, as a class, debate whether or not this legislation should be adopted nationally. Structure your debate so that it is similar to a congressional debate, with class members presenting prepared arguments for or against the proposed legislation.
 
Correlates to Common Core Standards: Writing Research to Build & Present Knowledge W. 11-2.7, 11-12.8, 11-12.9; Speaking & Listening: Comprehension & Collaboration SL. 11-12.1a-d, 11-12.3; Presentation of Knowledge & Ideas SL. 11-12.4, 11-12.6; History/Social Studies: Key Ideas & Details RH. 11-12.1; Craft & Structure RH. 11-12.6; Integration of Knowledge & Ideas RH. 11-12.7, 11-12.8, 11-12.9; Writing: Text Types & Purposes WHST. 11-12.1a-e
 
30. In the epilogue, Fink references the earthquakes in Haiti and Hurricane Sandy as tests of our preparedness for a disaster. Research a catastrophic event that has happened since Katrina. What lessons, if any, have we learned since Katrina? What
progress still needs to be made?
 
Correlates to Common Core Standards: Reading Informational Text Key Ideas & Details RI. 11-12.1, 11-12.2, 11-12.3; Writing: Text Types & Purposes W. 11-12.2a-f; Production & Distribution of Writing W. 11-12.4, 11-12.5, 11-12.6; Research to Build & Present Knowledge W. 11-12.7, 11-12.8, 11-12.9; History/Social Studies: Key Ideas & Details RH. 11 12.1, 11-12.2, 11-12.3; Integration of Knowledge & Ideas RH. 11-12.7, 11-12.8, 11-12.9; Writing: Text Types & Purposes WHST. 11-12.2a-e
 
31.  Dr. Bryant King believes that race played a role in the way doctors handled the events at Memorial, and his criticism is mirrored by criticisms of the way we, as a nation, responded to Hurricane Katrina. Research both sides of the debate over the racial aspect of the response to Katrina. How much of a role do you think race played in the handling of the disaster at both local and national levels?
 
Correlates to Common Core Standards: Reading Informational Text Key Ideas & Details RI. 11-12.1, 11-12.2, 11-12.3; Writing: Text Types and Purposes W. 11-12.1a-e; Production & Distribution of Writing W. 11-12.4, 11-12.5, 11-12.6; Research to Build & Present Knowledge W. 11-12.7, 11-12.8, 11-12.9; History/Social Studies: Key Ideas & Details RH. 11-12.1, 11-12.3; Craft & Structure RH. 11-12.6; Integration of Knowledge & Ideas RH. 11-12.7, 11-12.8, 11-12.9; Writing: Text Types & Purposes WHST. 11-12.1a-e
 
32. Consider the Ebola outbreak that began in December 2013, applying the lessons and questions raised in Five Days at Memorial. What has the Ebola crisis revealed about our ability to respond to a public health crisis both domestically and internationally? What ethical questions has the crisis raised? Are we any closer to answering questions about how to ration and distribute care and supplies than we were before Hurricane Katrina? Compose a thoughtful research paper that connects the issues raised by Sheri Fink to the Ebola crisis.
 
Correlates to Common Core Standards: Reading Informational Text Key Ideas
& Details RI. 11-12.1, 11-12.2, 11-12.3; Writing: Text Types & Purposes W. 11-12.2a-f; Production & Distribution of Writing W. 11-12.4, 11-12.5, 11-12.6; Research to Build
& Present Knowledge W. 11-12.7, 11-12.8, 11-12.9; History/Social Studies: Key Ideas
& Details RH. 11-12.1, 11-12.2, 11-12.3; Integration of Knowledge & Ideas RH. 11-12.7,
11-12.8, 11-12.9; Writing: Text Types & Purposes WHST. 11-12.2a-e
 
other works of interest
 
1 Dead in the Attic: After Katrina by Chris Rose
A.D.: New Orleans After the Deluge by Josh Neufeld Beasts of the Southern Wild (2012) dir. Benh Zeitlin Blindness by José Saramago
Denial of the Soul: Spiritual and Medical Perspectives on Euthanasia and Mortality
by M. Scott Peck
Life’s Dominion: An Argument About Abortion, Euthanasia, and Individual Freedom
by Ronald Dworkin
Salvage the Bones: A Novel by Jesmyn Ward
Trouble the Water (2008) dirs. Tia Lessin and Carl Deal
War Hospital: A True Story of Surgery and Survival by Sheri Fink
When the Levees Broke: A Requiem in Four Acts (2006) dir. Spike Lee
 
archival resources about hurricane katrina
 
•  http://www.sherifink.net/resources/ - Includes interactive map of Memorial, timeline, photos, and the original series of articles: The Deadly Choices at Memorial
 
•  http://www.cbsnews.com/news/was-it-murder/ - 60 Minutes episode featuring
Dr. Pou
 
•  http://www.nola.com/katrina/ - This Times-Picayune site includes original local reporting on the disaster
 
•  http://youtu.be/eHcyC5sc_so - 105 minutes of archival 24 hour news footage from a variety of media outlets
 
about this guide’s writer
 
Amy Jurskis is the author of a number of teaching guides, including The Immortal Life of Henrietta Lacks by Rebecca Skloot and In the Garden of Beasts by Erik Larson. She holds a B.A. in English from the University of Georgia and a MAT from Agnes Scott College. She currently serves as a chairperson of curriculum and English teacher at Oxbridge Academy of the Palm Beaches. Download a PDF of the Teacher's Guide
Sheri Fink

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Sheri Fink - Five Days at Memorial

Photo © Jen Dessinger

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