It’s been years. Yet, the images of Memorial Medical Center in New Orleans, submerged in the toxic, black floodwaters of Hurricane Katrina, don't just fade away. If you’ve picked up the Five Days at Memorial book by Sheri Fink, you already know it’s not just a medical procedural. It’s a horror story. But it’s a true one. Honestly, it’s probably the most unsettling piece of non-fiction written in the last two decades because it forces you to ask: What would I do if the lights went out and nobody was coming to save me?
The book isn't just about a storm. It’s about the total collapse of a system we assume is unbreakable. When the levees broke on August 29, 2005, the hospital didn't just lose power. It lost its moral compass. Fink, who is both a journalist and a physician, spent six years reporting this. She conducted over 500 interviews. That’s why the detail is so suffocating. You can almost smell the stench of the un-flushed toilets and the decaying heat of a building with no air conditioning in a Louisiana summer.
The Reality Behind the Five Days at Memorial Book
People often get the timeline wrong. They think the tragedy happened during the hurricane. It didn't. Memorial survived the wind. The real nightmare began when the water rose afterward. By the second day, the basement flooded. The generators failed.
The hospital became a sweltering tomb.
Temperatures hit 110 degrees. Think about that for a second. You’re a patient in an ICU, hooked to a ventilator, and the power cuts. The machines stop chirping. The silence is actually worse than the noise. Nurses had to hand-bag patients, literally squeezing air into their lungs for hours until their hands cramped and they simply couldn't continue. This is the "choice" Fink explores—the impossible, jagged edge of triage.
Who was Dr. Anna Pou?
You can't talk about the Five Days at Memorial book without talking about Dr. Anna Pou. She’s the central, polarizing figure. Along with two nurses, Cheri Landry and Lori Budo, she was eventually arrested and accused of second-degree murder. The allegation? That they administered lethal doses of morphine and midazolam to patients who were deemed "too sick" to be evacuated.
It’s messy.
👉 See also: Why the Recent Snowfall Western New York State Emergency Was Different
Some people see Pou as a hero who stayed behind when others fled, a woman who provided comfort and "hastened" the inevitable to prevent suffering. Others see a doctor playing God. Fink doesn't give you an easy answer. She lays out the toxicology reports and the testimonies of witnesses like Dr. Bryant King, who was deeply disturbed by what he saw on the seventh floor. The book reveals that life-and-death decisions weren't always based on medical charts. Sometimes, they were based on weight. Or how much a person "seemed" to be struggling.
The Triage Chaos No One Talks About
Usually, in a disaster, you save the sickest people first. That’s standard. But at Memorial, everything flipped. Because the evacuation was so difficult—involving carrying people up dark, slippery stairwells to a helipad—the decision was made to evacuate the "healthiest" first. They were the easiest to move.
The "DNR" (Do Not Resuscitate) patients were pushed to the back of the line.
This is a crucial detail in the Five Days at Memorial book. Being a DNR means you don't want chest compressions if your heart stops. It doesn't mean "don't evacuate me" or "kill me." But in the heat and the panic, those definitions blurred. Life Care Hospitals, a separate entity that leased the seventh floor of Memorial, housed some of the most frail patients. They were the ones who ended up with the highest concentration of drugs in their systems after the evacuation ended.
- The total body count: 45 bodies were recovered from Memorial.
- The Toxicology: More than half of those bodies tested positive for morphine or midazolam, or both.
- The Legal Fallout: A grand jury eventually declined to indict Dr. Pou.
Why the Corporate Failure Matters
We love to blame individuals. It’s easier. But Fink spends a significant portion of the book looking at Tenet Healthcare, the corporation that owned Memorial. They had no real plan for a total power failure. Their "evacuation plan" was basically a few pages of vague suggestions.
The hospital was a profit center that lacked a backup for the backup.
✨ Don't miss: Nate Silver Trump Approval Rating: Why the 2026 Numbers Look So Different
When the doctors were making these harrowing choices, they felt abandoned. And they were. The coast guard was overwhelmed. The corporate office was paralyzed. The communication was non-existent. It’s a stark reminder that "preparedness" is often just a buzzword until the water is at the door. If the infrastructure had worked, the moral crisis wouldn't have existed.
The Ethical "Slippery Slope"
One of the most chilling parts of the Five Days at Memorial book is the description of how the mindset shifted. It started with "how do we get people out?" and ended with "how do we end this?"
There’s a specific scene where a doctor realizes they have to leave, and they can’t take everyone. The choice wasn't made in a vacuum. It was made by people who were dehydrated, sleep-deprived, and genuinely believed they were going to die in that building. Does that excuse the administration of lethal drugs? That’s the question that keeps the book on university syllabi for medical ethics.
The Long-Term Impact on Medicine
Since the book was published, and especially after the Apple TV+ miniseries brought it back into the spotlight, medical "Crisis Standards of Care" have been rewritten. We saw these debates resurface during the COVID-19 pandemic. Who gets the ventilator? Who gets the bed?
Fink’s work proved that without clear, pre-established ethical guidelines, humans will make subjective, biased decisions under pressure. We like to think we are rational. We aren't. We are biological creatures prone to panic.
The Five Days at Memorial book teaches us that the "hero" narrative is dangerous. When we call doctors heroes, we sometimes give them a pass to ignore the law or standard ethics. Pou was championed by the American Medical Association and the media as a victim of a "prosecutorial overreach." But the families of the patients, like the family of Emmett Everett—a man who was conscious and weighed 380 pounds, making him "un-evacuatable" in the eyes of some—see it very differently. He wasn't terminal. He was just heavy.
🔗 Read more: Weather Forecast Lockport NY: Why Today’s Snow Isn’t Just Hype
Practical Insights for the Future
If you’re reading this because you’re interested in disaster prep or medical ethics, there are actual takeaways from this tragedy that go beyond the "true crime" fascination.
Review Hospital Disaster Bylaws
If you or a loved one are in long-term care, ask about their specific evacuation plan for total infrastructure failure. "We have a generator" isn't an answer. Where is the generator? If it’s in the basement (like it was at Memorial), it’s useless in a flood.
Clarify DNR Status
Ensure that any Living Will or DNR order explicitly states that the order is for natural death only and does not waive the right to evacuation or basic life support during a disaster.
Demand Transparency in Triage
State governments have been working on "Crisis Standards of Care" protocols. These should be public. We deserve to know how the state plans to "rank" lives if resources run out. The lack of transparency in New Orleans led to the chaos at Memorial.
The Five Days at Memorial book serves as a permanent warning. It’s a 500-page reminder that civilization is about "three missed meals" or a few days of heat away from total breakdown. The doctors at Memorial didn't go to work that Monday planning to end lives. They were transformed by their environment.
To prevent another Memorial, we have to look at the systems, not just the people. We need to invest in resilient infrastructure and clear ethical frameworks that don't evaporate when the power goes out. Reading the book is the first step in understanding that "never again" requires more than just a slogan—it requires a massive, expensive, and unglamorous overhaul of how we value the most vulnerable members of society during a crisis.