Sheri Fink - Five Days at Memorial

Many tourists whose flights had been canceled had no ability to flee on their own either, and so Nagin’s evacuation order exempted essential hotel workers to serve them. It also exempted essential criminal sheriff’s office workers, who were needed to keep their eyes on prisoners at the parish jail. They, too, were not being moved.

A questioner at the press conference asked for a clarification: “People should stay put in the hospitals… or what?” The mayor said he had exempted hospitals and their workers. People might get hurt in the hurricane. If hospitals closed and turned them away, that would, he said, create “a very dangerous situation.”

The possibility that a very dangerous situation could develop inside the hospitals if they stayed open had occurred to other officials who were, at that very moment, on a conference call discussing the matter. Louisiana had received more than $17 million from a federal grant program to help prepare its hospitals for bioterrorism and other emergencies after the September 11, 2001, attacks and subsequent anthrax mailings. A FEMA representative on the call wanted to know which hospitals in flood-prone regions of the state had located both their generators and electrical switching gear above ground-floor level. In and around New Orleans, only two out of about a dozen and a half hospitals had. Memorial was not one of them.

An emergency response leader from the US Centers for Disease Control and Prevention alerted several colleagues to the problem in an e-mail hours later. “It is assumed that many of the hospital generators will lose power given the expected height of the water.” He reported that around 2,500 hospital patients remained in New Orleans as Katrina advanced on the city. That should not have been a surprise. Planning sessions had gone on, after lengthy delays, for more than a year for a model “Hurricane Pam.” FEMA had sponsored an emergency exercise in New Orleans earlier that very week. The scenario assumed the presence of more than 2,000 hospital patients in New Orleans during a catastrophic hurricane. No one had yet figured out how so many patients might be moved to safety in a flood, and federal health officials had not participated in the latest planning sessions.

Dispatchers for the region’s largest ambulance company, Acadian, were swamped with calls to transport patients from threatened hospitals, nursing homes, and houses. Many of the roughly two dozen ambulances the company made available were frozen on the jammed interstate. To save time, some ambulances began delivering patients to the Superdome instead of taking them out of town.

The main hospital in St. Bernard Parish, Chalmette Medical Center, managed to begin evacuating, but after the first round of critically ill patients left, ambulances never returned. Administrators from one New Orleans hospital wanted to move nine of their sickest patients to western Louisiana. But unless they could arrange an urgent, costly airlift, it seemed to be too late. The roadways were now so clogged with evacuees, the vulnerable patients could be trapped for up to a day in an ambulance before arriving. One nursing home had, before hurricane season, retained a New Orleans tour company at a cost of $1,400 to drive its residents to Mississippi in seven large buses in case of emergency. The dispatcher had reported on Saturday night that he only had two buses and no driver and would not fulfill the contract.

AROUND MIDDAY, Linette Burgess Guidi burst into the intensive care unit at Memorial Medical Center, located her mother, and flew to her bedside. She planted kisses on her mother’s face. Jannie Burgess opened her large, almond-shaped eyes, raised her head from the pillow, and looked pleased. “Linette?”

“Yes, Mother, it’s me. I’m here. I wouldn’t be anywhere else.” Burgess Guidi had arrived the previous evening from her home in the Netherlands after learning her mother’s uterine cancer had spread and was inoperable. She looked down at her mother’s hands in mock horror. “Your nails look terrible, Mother. You need a manicure.”

Jannie Burgess had always been a lady who knew her lipstick, powder, and paint. She was seventy-nine years old now and obese, but in her youthful prime she had been tall with an hourglass figure and unlimited access to the beauty parlor owned by her older sister Gladys. She had fled an abusive husband as a young mother and lost her only son in Vietnam, but she knew joy, too, loved putting on the perfume and grabbing her daughter, Linette. “Let’s dance, let’s dance!”

The woman drifting in and out of consciousness had a history, and Burgess’s theatrical daughter couldn’t resist describing it to the young, dark-haired nurse who had been assigned to care for her mother that day. The nurse was worried and distracted. Her husband had come into the unit holding their toddler son. He pled with her to leave town with them for safety, but the nurse stayed on duty.

Linette Burgess Guidi took to regaling her with stories. Was she aware that Jannie Burgess was a licensed practical nurse who had worked thirty-five years in New Orleans’s hospitals and nursing homes? “Oh, really?” the nurse replied. “I didn’t know that.”

Burgess had taken up nursing to support her children after working jobs as various as taxi dispatcher and secretary to a mortician. But practicing nursing in mid-twentieth-century New Orleans had presented an unsettling paradox for a woman like Burgess with light-brown skin; she could care for patients at many of the private hospitals, but could not receive care at them. Though Jannie Burgess was born just a few months after Memorial opened in 1926 as Southern Baptist Hospital, it would be more than four decades before she could be a patient there.

In fact, Baptist was one of the last Southern hospitals to submit to integration. Medicare and other federal hospital programs were introduced in the mid-1960s, and hospitals were ineligible for reimbursements if they discriminated against or racially segregated patients. Baptist refused to join the programs. “It is our conviction,” a 1966 hospital statement said, “that we can serve all of the people better if we remain free of governmental entanglements that would dictate the terms and conditions under which this hospital shall be operated.”

New Orleanians sent supportive letters to the hospital’s administrator. “It’s heartening to realize that there are still some who do not succumb to the dictates of socialism,” one person wrote. “Congratulations,” wrote another, “on retaining the integrity of the hospital in the face of the ever growing pressure of the Federal government to take away the rights of the business and professional men of this nation.”

The hospital began quietly accepting African American patients in 1968, in line with newly adopted nondiscrimination statements made by the Southern Baptist Convention. The denomination’s history was entwined with segregation, but its actions were now changing under pressure. The following year, in November, the hospital set aside its opposition to Medicare and began participating in the health insurance program for seniors, “to ease the financial burden for these elderly patients,” its administrator explained in a hospital newsletter. In 1969, the federal government declared Southern Baptist Hospital in compliance with the Civil Rights Act of 1964. The decision to accept Medicare was good for business. The number of patients over sixty-five years old at Southern Baptist nearly tripled over the first two weeks.

Tensions persisted. A decade later, between the years 1979 and 1980, at least six employees filed charges of race discrimination against the hospital with the Equal Employment Opportunity Commission, the agency responsible for enforcing key parts of the Civil Rights Act of 1964 (in at least two of the cases, the agency found no cause to believe the allegations were true). One of the six employees, African American engineer Issac E. Frezel, sued Southern Baptist Hospitals, Inc., in federal district court. He alleged that it had violated his rights under the Civil Rights Acts of 1964 and 1866 by engaging in illegal racial discrimination when it placed him on probation for “unauthorized shift changes,” passed him over for promotion, and, ultimately, fired him. In his suit, he contended that a white coworker involved in the same offense was not disciplined. The hospital’s lawyers argued that nothing illegal had occurred. The suit settled out of court for an unreported sum.