I just finished reading Sheri Fink’s gut-wrenching book ‘Five Days at Memorial’, which delves into the agonizing decisions some medical professionals were forced to make at Memorial Medical Center in New Orleans after Hurricane Katrina disrupted the power supply to that facility. Generators provided only spurts of electricity, toilets ran over, hundreds of people were isolated at the medical center, temperatures rose to over 100, the air was stifling, gunshots rang out nearby, and more than 50 patients lay at the intensive care unit, many requiring oxygen.
In what resembled a war-torn environment, caregivers found themselves confronted with harrowing choices. How to care for critically ill patients who—seemingly—weren’t going to be evacuated anytime soon (and might not survive an evacuation if they were). In the end, 45 of these patients never made it out of Memorial alive and forensic consultants subsequently found that more than half of those bodies held high levels of morphine and similar drugs. They determined that 20 of the patients had been victims of homicide. While ones initial reaction to the notion of medical personnel injecting powerless patients with lethal doses of morphine is surely one of horror and disgust, ‘Five Days at Memorial’ erases all snap judgments and makes you consider fundamental ethical, medical, and legal issues.
It also made me consider Hurricane Sandy plowing through New York just over a year ago. Was New York better prepared? Had we learned from Katrina? What happened to our hospitals? Elderly? Residents of public housing complexes?
The answer is: not much.
At Bellevue Medical Center, for example, flood waters knocked out the power grid and generator fuel pumps failed (located below flood level). The only way to keep generators going (and critical patients hydrated, ventilated, and hooked up to essential life-saving machines) was by forming a human chain up 13 flights of stairs in order to hand-carry fuel to the 13th floor generators.
Individual and collaborative human efforts—improvised—are what saved hospital patients. No procedural disaster plan.
Similarly, in Red Hook, Brooklyn, the borough’s largest public housing complex was without power for weeks after Sandy. No water, no heat, no electricity. An 80 year-old great grandmother on the 12th floor. Deserted. No access to food or water. A 72 year-old man, blind, unable to descend the 14 flights of stairs to come by basic necessities. After initial deliveries of food from the National Guard, these residents remained stranded. The only reason these, and others like them, survived was the remarkably efficient—unrehearsed—efforts of community volunteers. Every day, for weeks after Sandy, volunteers with no organizing experience gathered in the basement of a Red Hook church and community center to accept food donations which would subsequently be hand-delivered to upper-story residents in powerless housing complexes. And every day, reliable as clockwork, around 10 or 11 a.m. Brooklynites from near and far began driving, walking, or cycling up with tray upon tray upon tray of freshly cooked food. Baked beans and rice. Deep dishes of peas. Dinner rolls, homemade brownies, corn bread, baked chicken, water, juice, fruit, chips, and more. An amalgam of volunteers, none of whom was officially in charge, we lined up conveyor-belt style to fill dinner trays with samplings of each of the dishes, being careful to include vegetables and deserts for every meal. A fleet of volunteer drivers was then dispatched with a pair of able-bodied volunteers who would hike up 10, 12, 14 flights of stairs with towering dinner trays.
Again, individual and collaborative human efforts—improvised—are what saved people.