Janine Burgess, Emmett Everett

Catherine posted a comment yesterday linking to this article in the NYT about what happened in Memorial Hospital during Hurricane Katrina.  The article itself is worth a full read, if you’re not squeamish (like me.) It raises some important questions about medical ethics, triage, and natural disasters.

The gist is during the hurricane they were trying to evacuate the hospital.  They prioritized the patients, making some questionable decisions about who would go first.  As the evacuation winds down and they get to the lower priority patients the nurses and doctors end up “Administering Large Doses of Drugs” or, y’know MURDERING an indeterminate number of patients, (around 20 or so) rather than attempt to evacuate them.    So there were a number of patients, who could possibly have made it out of Katrina alive, but who didn’t because of decisions made by the hospital staff.

Specifically mentioned in the article are three patients who weighed over 300 pounds.  Only one of them was evacuated.  300 pounds, appears to, be the magical weight at which point your weight is worth mentioning.   Weight is not mentioned as a factor for other individuals mentioned in the article, though another man who was injected with drugs and then either evacuated or smothered was described as being “heavyset.” Perhaps he only weighed 250.

Below are the stories of these “obese” patients:

Janine Burgess

Most of the patients had been evacuated on Tuesday, but a few with D.N.R. orders had not.“What’s going on here?” he asked the four nurses in the unit. “Whaddya have left?” The nurses said they were down to one patient: Jannie Burgess, a 79-year-old woman with advanced uterine cancer and kidney failure. She was being treated for comfort only and had been sedated to the point of unconsciousness with morphine. She was so weighted down by fluid from her diseases thatCook sized her up at 350 pounds.

…..

the worst thing Cook could imagine would be for the drugs to wear off and for Burgess to wake up and find herself in her ravaged condition as she was being moved. “Do you mind just increasing the morphine and giving her enough until she goes?” Cook told me he asked Burgess’s nurse.

Cook scribbled “pronounced dead at” in Burgess’s chart, left the time blank and signed the note with a large squiggle. Then he walked back downstairs, believing that he had done the right thing for Burgess. “To me, it was a no-brainer, and to this day I don’t feel bad about what I did,” he told me. “I gave her medicine so I could get rid of her faster, get the nurses off the floor.” He added, “There’s no question I hastened her demise.”

Emmett Everett

Emmett Everett, a 380-pound man — was “very aware” of his surroundings. He had fed himself breakfast that morning and asked Robichaux, “So are we ready to rock and roll?”

The 61-year-old Honduran-born manual laborer was at LifeCare awaiting colostomy surgery to ease chronic bowel obstruction, according to his medical records. Despite a freakish spinal-cord stroke that left him a paraplegic at age 50, his wife and nurses who worked with him say he maintained a good sense of humor and a rich family life, and he rarely complained. He, along with three of the other LifeCare patients on the floor, had no D.N.R. order.

Everett’s roommates had already been taken downstairs on their way to the helicopters, whose loud propellers sent a breeze through the windows on his side of the LifeCare floor. Several times he appealed to his nurse, “Don’t let them leave me behind.” His only complaint that morning was dizziness, a LifeCare worker told Pou.

“Oh, my goodness,” a LifeCare employee recalled Pou replying.

Two Memorial nurses — identified as Cheri Landry and Lori Budo from the I.C.U. to investigators by a LifeCare pharmacist, Steven Harris — joined the discussion along with other LifeCare workers. (Through their lawyers, Landry and Budo declined to be interviewed. Harris never returned my calls.) They talked about how Everett was paralyzed and had complex medical problems and had been designated a “3” on the triage scale. According to Robichaux, the group concluded that Everett was too heavy to be maneuvered down the stairs, through the machine-room wall and onto a helicopter. Several medical staff members who helped lead boat and helicopter transport that day say they would certainly have found a way to evacuate Everett. They say they were never made aware of his presence.(emph mine)
…..
Then Johnson guided them to Emmett Everett in Room 7307. Johnson said she had never seen a physician look as nervous as Pou did. As they walked, she told investigators, she heard Pou say that she was going to give him something “to help him with his dizziness.” Pou disappeared into Everett’s room and shut the door.

What they actually gave him was a lethal combination of morphine and midazolam.

Rodney Scott

Rodney Scott, an obese I.C.U. patient who was recovering from heart problems and several operations, lay motionless on a stretcher, covered in sweat and almost nothing else. A doctor had decided that he should be the last patient to leave the hospital because he weighed more than 300 pounds and might get stuck in the machine-room hole, backing up the evacuation line. Cook thought Scott was dead, and he touched him to make sure. But Scott turned over and looked at him.

“I’m O.K., Doc,” Scott said. “Go take care of somebody else.”
………

At around 9 p.m., Rodney Scott, the obese I.C.U. patient who was recovering from surgery and heart trouble, at last felt himself being hoisted up the open metal steps to the helipad. Weighing more than 300 pounds and unable to walk, Scott was the last living patient to leave the hospital grounds. He felt relief. The four men surrounding him shouted, “Push! Push!” and rolled his heavy wheelchair into a Coast Guard helicopter. Evacuating someone as large as Scott had a cost — a nurse was briefly pinned against the helicopter, bruising his ribs and spleen — but it had been done.

No one is being prosecuted for the deaths of Emette Everette and Janine Burgess. As for Robert Scott, I am sure that his life is worth much more than some bruised ribs and spleen.

I can’t help but wonder now, how often the weight of a patient is an excuse not to even try.