''Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital'' is a 2013

non-fiction Nonfiction, or non-fiction, is any document or media content that attempts, in good faith, to provide information (and sometimes opinions) grounded only in facts and real life, rather than in imagination. Nonfiction is often associated with b ...

book by the American journalist

Sheri Fink Sheri Fink is an American journalist who writes about health, medicine and science. She received the 2010 Pulitzer Prize for Investigative Reporting "for a story that chronicles the urgent life-and-death decisions made by one hospital’s exhau ...

. The book details the aftermath of Hurricane Katrina at Memorial Medical Center in

New Orleans New Orleans ( , ,New Orleans

in August 2005, and is an expansion of a Pulitzer Prize-winning article written by Fink and published in ''

The New York Times Magazine ''The New York Times Magazine'' is an American Sunday magazine supplement included with the Sunday edition of ''The New York Times''. It features articles longer than those typically in the newspaper and has attracted many notable contributors. ...

'' in 2009. It describes the events that took place at Memorial Medical Center over five days as thousands of people were trapped in the hospital without power. The

triage In medicine, triage () is a practice invoked when acute care cannot be provided for lack of resources. The process rations care towards those who are most in need of immediate care, and who benefit most from it. More generally it refers to prio ...

system put into effect deprioritized critically ill patients for evacuation, and it was later alleged that a number of these patients were

euthanized Animal euthanasia ( euthanasia from el, εὐθανασία; "good death") is the act of killing an animal or allowing it to die by withholding extreme medical measures. Reasons for euthanasia include incurable (and especially painful) conditi ...

by medical and nursing staff shortly before the entire hospital was evacuated on the fifth day of the crisis. Fink examines the legal and political consequences of the decision to euthanize patients and the ethical issues surrounding euthanasia and health care in disaster scenarios. The book was well received by most critics and won three awards, including a

true crime True crime is a nonfiction literary, podcast, and film genre in which the author examines an actual crime and details the actions of real people associated with and affected by criminal events. The crimes most commonly include murder; about 40 pe ...

series ''

American Crime Story ''American Crime Story'' is an American anthology true crime television series developed by Scott Alexander and Larry Karaszewski, who are also executive producers, alongside Brad Falchuk, Nina Jacobson, Ryan Murphy, and Brad Simpson. The ser ...

'' before being scrapped. It has been adapted as a miniseries by

John Ridley John Ridley IV (born 1965) is an American screenwriter, television director, novelist, and showrunner, known for '' 12 Years a Slave'', for which he won an Academy Award for Best Adapted Screenplay. He is also the creator and showrunner of the a ...

and

Carlton Cuse Arthur Carlton Cuse (born March 22, 1959) is a screenwriter, showrunner, producer, and director, best known for the American television series ''Lost'', for which he made the '' Time'' list of the 100 most influential people in the world in 2010 ...

for

Apple TV+ Apple TV is a digital media player and microconsole developed and marketed by Apple Inc. It is a small network appliance hardware that plays received media data such as video and audio to a television set or external display. Since its secon ...

Background

''Five Days at Memorial'' originated as a 13,000-word magazine article titled "The Deadly Choices at Memorial", published by ''

'' in August 2009, the fourth anniversary of Hurricane Katrina. The story focused on the events that unfolded in

New Orleans New Orleans ( , ,New Orleans

' Memorial Medical Center (now

Ochsner Baptist Medical Center Ochsner Baptist Medical Center is a hospital in New Orleans, Louisiana. The complex of hospital buildings is located on Napoleon Avenue in Uptown New Orleans. History Formerly known as Southern Baptist Hospital, it was founded in 1926 by the ...

) when the hospital was flooded and its generators failed in the aftermath of Katrina, drawing particular attention to the euthanasia of numerous patients by the medical and nursing staff. Fink was drawn to the subject matter because of her experience as a doctor working in areas of conflict and as a journalist reporting on hospitals in war zones. The article, which was a joint assignment for

ProPublica ProPublica (), legally Pro Publica, Inc., is a nonprofit organization based in New York City. In 2010, it became the first online news source to win a Pulitzer Prize, for a piece written by one of its journalists''The Guardian'', April 13, 2010P ...

and ''The New York Times Magazine'', drew on two years' worth of research and interviews with 140 people and won the 2009 Pulitzer Prize for Investigative Reporting. While she was writing "The Deadly Choices at Memorial", Fink decided to expand the article into a book. Since she "kept finding out new facts and trying to fit them into the story because they seemed essential", she was encouraged by her editor to save the extra material to publish in a book. Expanding on her original research, Fink conducted over 500 interviews with people who were at the hospital during the disaster, families of the dead patients, hospital executives, law enforcement officials and ethicists. She interviewed Dr. Anna Pou, one of the principal characters of the story, about her experiences at Memorial, but Pou declined to discuss details related to patient deaths based on her lawyer's advice. Fink said that while "some of the medical and nursing professionals were observing a code of silence", she was impressed by the openness of several staff members, including two doctors who talked freely of their decision to euthanize their patients. Fink also reviewed photographs, videos, emails and diary entries produced at the time, and consulted weather reports and the hospital's floor plans.

Content

The book is divided into two parts. The first part, titled "Deadly Choices", focuses on the events that occurred at Memorial Medical Center over the "five days" referred to in the book's title: August 28 – September 1, 2005. During these five days, Memorial's emergency plans proved inadequate as the hospital lost power and its back-up generators had failed, leaving it without lights, air conditioning, sewer systems and essential medical equipment. Thousands of staff, patients and evacuees were trapped by floodwaters inside the building awaiting evacuation by boat or helicopter. Fink describes the unconventional method of

adopted by the medical staff, whereby ambulatory patients were prioritized for evacuation and those with "

do not resuscitate A do-not-resuscitate order (DNR), also known as Do Not Attempt Resuscitation (DNAR), Do Not Attempt Cardiopulmonary Resuscitation (DNACPR), no code or allow natural death, is a medical order, written or oral depending on country, indicating tha ...

" orders were placed last in the list. Patient evacuation began on the third day and progressed slowly until the fifth day, when some medical staff decided to hasten the deaths of critically ill patients, believing they would not survive, with lethal injections of

morphine Morphine is a strong opiate that is found naturally in opium, a dark brown resin in poppies (''Papaver somniferum''). It is mainly used as a pain medication, and is also commonly used recreationally, or to make other illicit opioids. T ...

. The story is described from the perspective of several participants, pieced together from interviews, emails and phone logs. MemorialNapoleonTrailers1

The second part, titled "Reckoning", discusses the legal and political ramifications of Memorial's response to the crisis and especially the decisions to euthanize patients. In total, 45 patients died before the hospital was evacuated and 23 were identified as having concentrations of morphine and other drugs in their tissues. Fink focuses largely on the investigation into the actions of Dr. Anna Pou and two intensive care nurses, Cheri Landry and Lori Budo, all three of whom were charged with second-degree murder following allegations that they had administered lethal doses of morphine to some patients. The public's sympathy lay largely with the three accused Memorial staff; the charges against Landry and Budo were eventually dropped, and a grand jury chose not to indict Pou in 2007. Fink discusses the ethical issues surrounding the events at Memorial, as well as those involved in disaster settings and euthanasia in general. A brief epilogue critiques health care protocols in disasters and uses the example of

Hurricane Sandy Hurricane Sandy (unofficially referred to as ''Superstorm Sandy'') was an extremely destructive and strong Atlantic hurricane, as well as the largest Atlantic hurricane on record as measured by diameter, with tropical-storm-force winds spann ...

in 2012 to illustrate the lack of change undertaken by hospitals in response to the disaster caused by Katrina and a failure of the US government to enforce standards for "emergency preparedness".

Reception

Critical reviews of ''Five Days at Memorial'' were mostly positive. Jason Berry of ''

The New York Times ''The New York Times'' (''the Times'', ''NYT'', or the Gray Lady) is a daily newspaper based in New York City with a worldwide readership reported in 2020 to comprise a declining 840,000 paid print subscribers, and a growing 6 million paid d ...

'' commended the "shimmering intelligence" of Fink's discussion of the events and their ethical issues, and summarized the book as "social reporting of the first rank". Another ''New York Times'' critic, bioethicist

Sherwin B. Nuland Sherwin Bernard Nuland (born Shepsel Ber Nudelman; December 8, 1930 – March 3, 2014) was an American surgeon and writer who taught bioethics, history of medicine, and medicine at the Yale School of Medicine, and occasionally bioethics and hist ...

, felt the book displayed "masterly reporting and the glow of fine writing" and offered particular praise for the tone and language of Fink's writing. ''

The Independent ''The Independent'' is a British online newspaper. It was established in 1986 as a national morning printed paper. Nicknamed the ''Indy'', it began as a broadsheet and changed to tabloid format in 2003. The last printed edition was publish ...

'' Hirsh Sawhney admired the detail and variety of perspectives offered in the book and described the book as "soar ngto artistic and intellectual heights undreamed of in other realms of media". Peter Beaumont, writing for ''

The Guardian ''The Guardian'' is a British daily newspaper. It was founded in 1821 as ''The Manchester Guardian'', and changed its name in 1959. Along with its sister papers ''The Observer'' and ''The Guardian Weekly'', ''The Guardian'' is part of the Gu ...

'', found parts of the book awkward in structure, but felt that overall it was "tight, provocative and gripping" with a "fair and deeply sympathetic" approach to the involved parties. A review by John B. Saul in ''

The Seattle Times ''The Seattle Times'' is a daily newspaper serving Seattle, Washington, United States. It was founded in 1891 and has been owned by the Blethen family since 1896. ''The Seattle Times'' has the largest circulation of any newspaper in Washington ...

'' commended Fink's ability to produce a "compelling and revealing account" of events despite limited access to evidence such as investigative reports and Pou's testimony, while the '' Star Tribune'' Curt Schleier described ''Five Days at Memorial'' as "an important book that will make your blood boil no matter which side of the issue you support". A more negative review came from Julia M. Klein of ''

The Boston Globe ''The Boston Globe'' is an American daily newspaper founded and based in Boston, Massachusetts. The newspaper has won a total of 27 Pulitzer Prizes, and has a total circulation of close to 300,000 print and digital subscribers. ''The Boston Glob ...

'', who found the book to be "overly long and detailed, sometimes hard to follow, and without a real narrative payoff" and felt that Fink's conclusions were presented more clearly in her original magazine article than in the book. '' Salon'' magazine's Laura Miller found the first half of the book lacking in "shape or coherence, the meaning of this or that detail unclear and the timeline occasionally muddled", but was more impressed with the discussion of the disaster aftermath in the second half.

NPR National Public Radio (NPR, stylized in all lowercase) is an American privately and state funded nonprofit media organization headquartered in Washington, D.C., with its NPR West headquarters in Culver City, California. It differs from other ...

critic Susan Jane Gilman faulted the book for "provok ngmore debate than it answers" but praised Fink's "fair and balanced", "nuanced" writing.

Awards and honors

''Five Days at Memorial'' won the 2014

National Book Critics Circle Award The National Book Critics Circle Awards are a set of annual American literary awards by the National Book Critics Circle (NBCC) to promote "the finest books and reviews published in English".Los Angeles Times Book Prize Since 1980, the ''Los Angeles Times'' has awarded a set of annual book prizes. The Prizes currently have nine categories: biography, current interest, fiction, first fiction (the Art Seidenbaum Award added in 1991), history, mystery/thriller ...

in the Current Interest category, the 2014 Ridenhour Book Prize, and the

PEN/John Kenneth Galbraith Award The PEN/John Kenneth Galbraith Award for nonfiction is awarded by PEN America (formerly PEN American Center) biennially "to a distinguished book of general nonfiction possessing notable literary merit and critical perspective and illuminating import ...

(2015). It was shortlisted for the 2014

Andrew Carnegie Medal for Excellence in Nonfiction __NOTOC__ The Andrew Carnegie Medals for Excellence in Fiction and Nonfiction were established in 2012 to recognize the best fiction and nonfiction books for adult readers published in the U.S. in the previous year. They are named in honor of ni ...

. It was an

ALA Notable Books for Adults American Library Association Notable lists are announced each year in January by various divisions within the American Library Association (ALA). There are six lists, part of the larger ALA awards structure. * ''ALA Notable Books for Adults'' (est ...

(2014),

YALSA The Young Adult Library Services Association (YALSA), established in 1957, is a division of the American Library Association. YALSA is a national association of librarians, library workers and advocates whose mission is to expand the capacity of l ...

Outstanding Books for the College Bound (2014; Science and Technology) and ''

Christian Science Monitor Christians () are people who follow or adhere to Christianity, a monotheistic Abrahamic religion based on the life and teachings of Jesus Christ. The words ''Christ'' and ''Christian'' derive from the Koine Greek title ''Christós'' (Χρισ ...

'' "15 Best" (2013; Nonfiction).

Miniseries

On September 1, 2020, it was announced that

had given a series order to a television limited series adaptation of the book.

and

will serve as showrunners, writers and executive producers. Ridley will direct the limited series and produced by

ABC Signature ABC Signature is an American television production studio that is a subsidiary of Disney Television Studios, a division of Walt Disney Television, which is part of the Disney General Entertainment Content division of The Walt Disney Compan ...

, and

Vera Farmiga Vera Ann Farmiga ( ; born August 6, 1973) is an American actress who is best known for portraying paranormal investigator Lorraine Warren in the Conjuring Universe films '' The Conjuring'' (2013), '' The Conjuring 2'' (2016), '' Annabelle Co ...

Adepero Oduye Adepero Oduye ( ) (born January 11, 1978) is an American actress, director, singer, and writer. She is known for '' Pariah'' (2011), '' 12 Years a Slave'' (2013), ''The Big Short'' (2015), and '' Widows'' (2018). Life and career Adepero Oduye ...

Cornelius Smith Jr. Cornelius Smith Jr. (born March 18, 1982) is an American actor best known for his portrayal of Marcus Walker on the ABC drama series ''Scandal'' from 2015 to 2018, and Frankie Hubbard on the ABC soap opera ''All My Children'' from December 2007 ...

Julie Ann Emery Julie Ann Emery (born January 16, 1975) is an American television and film actress. She is best known for her roles in the television series ''Better Call Saul'', ''Preacher'', and ''Five Days at Memorial''. She has appeared in films such as '' H ...

Cherry Jones Cherry Jones (born November 21, 1956) is an American actress known for her roles on screen and stage. She has received various accolades for her performances in television and theatre including three Primetime Emmy Awards, two Tony Awards, th ...

, Molly Hager, and

Michael Gaston Michael Gaston is an American film and television actor. He played agent Quinn on the show ''Prison Break'', Gray Anderson on the CBS drama series ''Jericho'', and appeared in the first episode of ''The Sopranos'' as Alex Mahaffey, a compulsive ga ...

will star.

References

{{reflist, 30em 2013 non-fiction books American non-fiction books Books about health care Ethics books Books about Hurricane Katrina Non-fiction books adapted into television shows Crown Publishing Group books J. Anthony Lukas Book Prize-winning works