The doc stood on the burning deck
July 20, 2006 -- Today The New York Times ran a piece about the physician recently arrested, along with two nurses, for allegedly using lethal injections to kill several patients at Memorial Medical Center in the wake of Hurricane Katrina last year. "Louisiana Doctor Said to Have Faced Chaos" was written by Christopher Drew and Shaila Dewan. The piece weaves details about the legal action into an account of Dr. Anna Pou's background and what she did at the New Orleans hospital after the storm. It includes many quotes from her attorney and supportive colleagues. Unlike many pieces, this one does give some sense of why the patients' deaths may have been excusable. Indeed, its tone and content clearly favor Dr. Pou rather than the Louisiana attorney general's office. However, the piece is typical of national media coverage of the case in barely managing even to name the two nurses--Lori Budo and Cheri Landry--and in sending the clear message that only Dr. Pou's actions were of any consequence following Katrina.
The piece's sympathy for Pou is evident from the start. It says that in the midst of many overheated and dying patients, dwindling supplies of medicine, and no electric power, Pou "was left to care for many patients she did not know." By the time "the ordeal" ended, when "the water and the temperature and the body count had risen beyond endurance," Pou was reportedly "one of the few doctors left in a hospital that had become a nightmare." This last phrase in particular reveals the heroic physician narrative--why is it so important to focus only on how many physicians were left? Are they so much more valuable than the nurses and others that they're like vials of morphine in a drawer of aspirin? Or so exalted that it's astonishing that any of their number would deign to stay in such a horrific setting? Whatever the reason, we never learn how many total staff were left. Nor does the piece appear to consider that Pou was not caring for patients alone, nor how the adverse conditions would have affected the care of the two nurses. Of course, nurses generally spend far more time with patients, and their work would likely be more directly affected by such conditions.
In discussing whether Pou "cross[ed] a line during those harrowing days" by "using lethal injections to kill several patients who were in extreme distress," as the attorney general contends, the piece offers many quotes from Pou's lawyer and supportive physician colleagues. They suggest Pou was trying to "calm and comfort" desperate patients. University of Pittsburgh physician Eugene Myers, who "helped train" Pou, reportedly said that Pou told him that she and the two arrested nurses had "either helped evacuate the last patients or tried to make them comfortable with pain medications." The piece also includes testimonials for Pou from Myers and two other named physicians. It notes that Pou was "known among fellow doctors as a fierce advocate for her patients" and a prominent expert in endocrine surgery. The piece includes a fairly lengthy account of Pou's training and career, including her family background, her formal education at Louisiana State, her residencies and fellowships, and her respected work since then. We learn how long her resume is. The piece also finds it noteworthy that her father and two uncles were physicians. And it is in this discussion that we get the piece's only quote (an indirect one) from a nurse. That is the statement that Pou's sister Jeannie, "a nurse," describes theirs as "a close family." This suggests that there may be a role here for nurses after all--if they can supply helpful personal details about physicians.
The piece does explore the state's legal case in some detail, which makes its failure to discuss the two arrested nurses all the more glaring. There are extensive quotes from Pou's lawyer Richard Simmons, some from state attorney general Charles Foti, and a brief one from a fourth named physician. But there is no mention of whether the nurses even have lawyers, or whether the reporters made any efforts to contact them. All we learn is that part of the attorney general's criminal affidavit alleges that (as the piece describes it) "Pou and the two nurses went from room to room with a set of syringes and vials, injecting at least four patients with a combination of drugs intended to kill those who could not easily be evacuated from the hospital." Another witness cited in the affidavit reportedly "said that out of the corner of her eye, she saw one of the two nurses inject one of the patients with something." (Very persuasive.) Simmons appears to counter that the patients in question were dying, and that they would not have survived even if an attempt had been made to evacuate them, which would itself have been extremely difficult. The piece notes that a grand jury will decide whether to bring formal charges against the three, and it ends with one of the physician testimonials for Pou from Dr. Michael Ryan. He states that Pou "always put her patients' interests before all else" and that he doubted she would "intentionally harm any of her patients."
We don't object to all of the background about Pou and the character witnesses presented on her behalf, nor to the effort to present possible explanations for what she did, especially when so many other accounts have included maddeningly little that might explain why the three health workers might have ended up in this legal situation. Statements from the attorney general that the case involves "plain and simple homicide" do not strike us as a complete explanation of what these three health professionals were doing at Memorial Medical Center in the horrific conditions that prevailed several days after Katrina hit. This piece commendably includes Simmons's comment that the case may involve sensitive end-of-life issues that occur all the time in hospitals. These are just the issues that receive far too little attention in most stories of this kind. Indeed, in news stories that link nurses to unexplained deaths of very ill patients (including the "killer nurse" stories), little or no effort is typically made to examine the extent to which such issues may be implicated. In fact, many bedside nurses spend significant time trying to obtain adequate pain relief for their patients, particularly those near the end of their lives, in the face of a surrounding health care system that often appears to show little concern for their suffering.
But we know of no accounts in the national media that take an approach to the two New Orleans nurses that this one takes to Pou. The plain implication here is that Pou is a serious professional, while the nurses are at most her assistants. The piece's approach suggests that it's not necessary to learn about the nurses' backgrounds, their specialties, what they were going through during Katrina, what colleagues say about them, what their lawyers say, because at the end of the day Pou was calling all the shots and the nurses were just helping her. No reader will understand from this piece that these nurses are autonomous professionals, nor that they are obligated to exercise independent legal and ethical judgment in matters like these, whether a physician wants something done or not. Nurses cannot ethically give a medication unless they believe it is an appropriate action. Readers will come away with the impression that Dr. Pou is a "fierce advocate for her patients." But they will get no sense that patient advocacy is a central tenet of nursing, and that it is nurses like Budo and Landry who often take the lead in defending their patients against a range of threats, from natural disasters to inadequate pain relief. This piece presents Dr. Pou as the only one with the initiative and professional power to take real action (right or wrong) in these extreme conditions. Of course, we don't know what role these two nurses actually played at the hospital. But it is hard to believe that they were just the insignificant physician assistants that this piece implies they were.
We await the comparable New York Times articles about Lori Budo and Cheri Landry.
See the article "Louisiana Doctor Said to Have Faced Chaos" in the July 20, 2006 edition of the New York Times.
Click on the following links to email New York Times article co-authors Christopher Drew and Shaila Dewan. The links will take you to their New York Times author pages. Two lines beneath their names on these pages, you will see small links that you can click on to send them emails. If you do email them, please save and send us a copy at email@example.com. Thank you!
July 3, 2007 -- The Associated Press reported today that no charges would be filed against New Orleans nurses Lori Budo and Cheri Landry. The nurses were arrested last year for allegedly using lethal injections to kill several patients at the flooded Memorial Medical Center while waiting to be evacuated in the horrific conditions following Hurricane Katrina in 2005. The AP piece says that last month the nurses were compelled to testify before a grand jury under a grant of immunity. One of their attorneys reportedly says there is "no reason" to believe they testified against their colleague, physician Anna Pou. The case against Dr. Pou has not yet been dropped. see the article ...
Supporters of the three New Orleans health workers arrested in July for their alleged actions at Memorial Medical Center during Katrina have established funds for those wishing to contribute to their legal defense.
Donations to the defense fund for nurses Lori Budo and Cheri Landry
The website for the fund devoted to the defense of Ms. Budo and Ms. Landry, www.memorialnursessupportfund.com, was under construction as of September 3. If it is not fully operational at the time you visit, donations can be made to the "Memorial Nurses Support Fund" at any Chase bank worldwide, or checks can be sent to:
Karen Sanford, RN
Memorial Nurses Support Fund, Inc.
P.O. Box 55717
Metairie, LA 70055-5715 USA
Donations to the defense fund for physician Anna Pou may be sent to:
Daniel Nuss, MD
Professor and Chairman
LSU Dept. Of Otolaryngology
533 Bolivar St, 5th Floor ENT Suite
New Orleans, LA 70112 USA
If you do contribute, please let us know. Thank you.