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Hospital workers describe effort to save patients

NEW ORLEANS—The hospital is deserted now, its hallways silent, its beds empty, the curious turned away by security guards. Yet for days after Hurricane Katrina struck, it was a sweltering prison of suffering and death.

Day after day, the patients and staff huddled in the Memorial Medical Center were stranded. Surrounded by water. No power. No air conditioning. And fading hopes of being able to get the most vulnerable among them out to safety.

The last of the living made it out more than a week ago. They stayed as long as there was anyone alive to care for. The bodies of the roughly 45 who died were removed over the weekend. The emerging tale of those who died and those who survived provided a haunting microcosm of the hurricane's aftermath.

The removal of the bodies to a morgue for autopsies, prompted a new fear Tuesday—that more such grisly scenes could wait in other hospitals around the city. Only seven of roughly 50 New Orleans area hospitals have been searched, state officials said.

"It's going to be a monumental task to go through every single one," said Bob Johannessen, a spokesman for the Louisiana Department of Health and Hospitals. "It's going to take awhile."

On Monday, Aug. 29, as Katrina hit, 260 patients and more than 1,800 staffers, family members and others were at Memorial.

Dr. John J. Kokemor, an internal medicine specialist, made his normal rounds to see some of his patients. By Tuesday morning, however, water was rising by the hospital, eventually reaching six feet above street level.

As the water rose, the hospital turned away people who asked for refuge. Whether swimming, floating or boating to the hospital's doors, they were told to keep moving to dry ground several blocks away.

There was one exception, Kokemor said: An elderly, frail woman who was brought in a boat. She was near death, and she and her husband were let in. She died soon thereafter. "Her husband held her hand for 12 hours before we took her away to the morgue," Kokemor said. "I would imagine he held a dead body's hand for 12 hours."

The hospital generator cut out, and temperatures in the facility soared as high as 106 degrees.

"There was no plumbing; the toilets were overflowing," said Rene Goux, the hospital's chief executive officer, in a written account of the ordeal.

"The stench was overwhelming. ... The smell of sewage was nauseating and it was unbearably hot. We started breaking windows to give our patients some ventilation."

It was excruciatingly difficult getting patients evacuated to other medical facilities.

On Monday night, the Coast Guard airlifted some critically ill patients, but gunmen shot at the helicopters and those flights stopped temporarily. Waiting patients had to be carried down seven flights of darkened stairs, driven up through the hospital's parking garage and carried up two more flights to reach the helipad.

The next day, Kokemor said, the hospital managed to evacuate about 24 dialysis patients on National Guard trucks. On Wednesday, airboats operated by volunteers from Louisiana's Cajun country helped move some patients to safety.

"There was no sign of any organized rescue effort, just these people who came from out of nowhere, " Goux wrote.

Doctors even commandeered the fishing boat of a fellow physician that was locked up in a nearby garage. Hospital workers hot-wired it and used it to evacuate several patients, including a 400-pound woman on oxygen and in a wheelchair.

By Wednesday night, 100 patients had been evacuated, leaving 160 "bed-ridden, very sick patients," Goux said.

Panic started to build on Thursday after the hospital was told it ranked low on the state's evacuation list, Kokemor said. "The panic level was increasing every day," he said. The hospital kept scrambling to find other evacuation boats.

Louisiana officials Tuesday said there were not enough helicopters to get 8,000 people out of the local hospitals.

"Those Medevac helicopters were going in as fast as they could," said Denise Bottcher, press secretary for Louisiana Gov. Kathleen Babineaux Blanco. "We asked for helicopters, boats, anything we could get from the federal government. We certainly didn't have the assets."

David Passey, a spokesman for the Federal Emergency Management Agency, said extraordinary communications and transportation difficulties made it difficult to rescue more than the 2,000 patients who were evacuated from regional hospitals.

Tenet Healthcare Corp., owner of Memorial, announced on Thursday from its Dallas headquarters that it was having difficulty evacuating the hospital. It said it had hired a private helicopter service and was using boats, security guards and vendors to evacuate many patients and staff.

"This enormous rescue effort by Tenet was required because local emergency and law enforcement agencies were overwhelmed," the company said.

Still, it warned: "More than 40 patients along with about 200 staff and others are still to be evacuated. The hospital has been without electricity, air conditioning and water since Monday."

"There were absolutely, positively, no patients that were neglected," Kokemor said by phone from his temporary home in Gulf Shores, Ala. "Everybody got food, water and custodial care to the bitter end."

Patients who died were first kept in a makeshift morgue in the hospital's second-floor chapel. After that, patients who died were left in their upper-level hospital rooms.

Kokemor said the patients died of natural causes, some from terminal illnesses. Some had do-not-resuscitate orders on their charts.

"No one died of hurricane or flooding causes—wind, glass, anything like that," he said. Patients who needed oxygen kept getting it, even while on the emergency ramp.

He said everybody from the hospital leadership was there throughout the ordeal.

By Friday of the storm week, those still alive had been rescued. Dozens of bodies were left in temporary morgues in the hospital.

Brobson Lutz, an infectious disease specialist who practices at the hospital, said he spoke with a friend who was among the last to leave alive.

"When she left on Friday," he said, "there were no live patients in there."


(Adams and Fitzgerald reported from New Orleans, and Joyce Tsai reported from Baton Rouge. Thomma reported from Washington.)


(c) 2005, Knight Ridder/Tribune Information Services.

PHOTO (from KRT Photo Service, 202-383-6099): KATRINA-HOSPITAL

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