Dr. Pou and the Hurricane — Implications for Patient Care during Disasters (New Eng Jour Med)

Dr. Pou and the Hurricane — Implications for Patient Care during Disasters
Susan Okie, M.D.

During the flood after Hurricane Katrina in August 2005, health care providers in marooned New Orleans hospitals worked in almost unimaginably difficult conditions while awaiting rescue. Nowhere was the situation more desperate than at Memorial Medical Center, where for 4 days a small staff struggled to care for critically ill patients in a dark building with no electric power, no fresh water, a flooded first floor, a nonfunctional sanitation system, and an interior temperature above 100°F.

Dr. Anna Maria Pou, a cancer surgeon on the faculty of Louisiana State University School of Medicine, was supervising residents at Memorial when Katrina hit on Monday, August 29, and she remained at the hospital after the storm. Pou, 51, is a New Orleans native whom colleagues describe as a dedicated, hardworking physician who, though physically small, "had a huge presence."1 At least 34 patients died at Memorial during and after the storm, and shortly thereafter, media reports began to suggest that some had been euthanized. In July 2006, Louisiana's attorney general, Charles Foti, shocked the country by arresting Pou and two nurses, accusing them of administering morphine and midazolam to kill four elderly patients on September 1, 2005, the day patient evacuation was completed. In a television interview aired in September 2006, Pou denied the accusation, stating, "I did not murder those patients. . . . I do not believe in euthanasia. I don't think it's anyone's decision to make when a patient dies. However, what I do believe in is comfort care, and that means that we ensure that they do not suffer pain."

A grand jury considered possible murder charges in the deaths of these four patients plus five others on the same floor, and the attorney general agreed not to pursue charges against the nurses in exchange for their testimony against Pou. Many New Orleans residents rallied to Pou's support, calling her a hero for remaining on duty when other doctors had fled, and numerous medical organizations issued statements in her defense. This past August, the grand jury refused to indict Pou, but she still faces three civil suits that have been brought by relatives of patients who died. After the grand jury's decision, she acknowledged in an interview that she had administered morphine and midazolam to the nine patients knowing that their deaths might be hastened, but she said that she did not intend to kill them. "God strike me dead — what we were trying to do was help," she said.2

What precisely happened? And what lessons does the episode hold for health care workers, hospital administrators, and policymakers as they prepare for natural disasters, terrorist attacks, or epidemics?

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http://content.nejm.org/cgi/content/full/358/1/1?query=TOC

The New England Journal of Medicine is owned, published, and copyrighted © 2008 Massachusetts Medical Society. All rights reserved.

turned out to be politicial suicide for the Attorney General. He didn't even make the runoff in his reelection bid.

--that slimy piece of Republican crap Royal Alexander-- is running for a recently opened seat from Shreveport in the Louisiana House. I think he is laying the groundwork to run for Jim McCrery's seat next election, since McCrery is retiring. I hope the people in North Louisiana realize what a turd he is and give him a beating like he took in the AG's race. Royal Alexander is a disgrace to the people of Louisiana.

but I don't have faith that the people of North Louisiana realize much of anything relative to politics (which is good for themselves or their state or the country.) New Iberia. Home of James Lee Burke. What a fabulous town on the Bayou. And Yes. Royal is quite the disgrace.