For the first time, the Pulitzer Prize for investigative reporting went to an online news outlet – the not-for-profit ProPublica.org – for its story about the decision doctors made to euthanize patients at Memorial Medical Center in the aftermath of Hurricane Katrina. ProPublica reporter Sheri Fink talks about her piece.
BOB GARFIELD: Those who despair over the fate of newspapers and probing journalism may look to this year’s Pulitzer Prizes as one hopeful indication of the future. For the first time, the award for investigative reporting went to an online news outlet, in this case the not-for-profit website ProPublica.org, for its story about a beleaguered hospital in the aftermath of Hurricane Katrina. On Monday, August 29th, 2005, as the hurricane made landfall, hundreds of patients and staff were stranded inside of Memorial Medical Center in New Orleans. Over the next three days, as the levees broke and the floodwaters rose, conditions inside Memorial deteriorated so severely that some doctors allegedly euthanized patients they deemed too sick or too immobile to be evacuated. The fog of warlike atmosphere evoked by the story is at the core of the reporting’s subtlety and strength. ProPublica’s Sheri Fink wrote the 13,000-word account, which appeared also in The New York Times Magazine. Sheri, congratulations.
DR. SHERI FINK: Thank you.
BOB GARFIELD: Before we get to some of the journalistic issues, I want to talk about the events themselves. Your story begins at Memorial just as the hurricane hits. Tell me what the patients and the staff were facing.
DR. SHERI FINK: The power was knocked out. It grew really, really hot inside. It was very hot outside, summer in New Orleans. There was no running water. Rescue was taking a lot longer than people had anticipated, and they started to get worried and, in some cases, panic. And nobody was really prepared for this kind of situation.
BOB GARFIELD: A number of patients in various degrees of extremis, a couple dozen of them, were injected, according to pathology reports, with some mix of morphine and another drug that effectively put them to sleep and eventually killed them. As I read the story, a group of exhausted, frightened, desperate medical personnel found themselves playing God, and they did a very bad job [LAUGHS] of it.
DR. SHERI FINK: That is certainly one interpretation of events. Were they trying to give these medicines to treat pain? If so, that’s considered okay under medical ethics. If they were trying to hasten death, which some of the doctors actually told me they were, then that’s something altogether different, and then it fits much more into the category of what you’re talking about. The danger, which is something that arguably happened at this hospital, is that we kind of decide that a group of patients isn't savable, and then when they finally are savable, that doesn't register. That sort of rigid categorization ends up sealing these people’s fates.
BOB GARFIELD: The story gets particularly chilling as you discuss one patient, a man named Emmett Everett, who was paraplegic and scheduled for some difficult surgery but also alert and actually quite jolly, you know, a day or two before he was, I guess, lethally injected.
DR. SHERI FINK: Mr. Everett was a man in his mid-60s. He had something called a spinal cord stroke, which is very rare, but it left him paraplegic, and also he had grown quite obese. The morning before he died, he had fed himself breakfast. He had no medical complaints that morning, aside from dizziness, according to the medical staff who were interviewed by investigators after these events. And he could hear that morning when the helicopters finally arrived, one after the other, taking people away. He asked his nurses, he said: don't let them leave me behind. Reportedly, a doctor and two nurses who came up to the seventh floor to discuss the situation of the seven patients who were still there assumed that everybody on that floor was really, really sick and was out of it, was unconscious. And the people who actually cared for those patients, they say they told this doctor, well, we have one patient who doesn't fit that category at all. He’s actually alert, but he’s quite obese. And at that point, according to several sources, there was a discussion about could we get Mr. Everett out. The way that the evacuations were working was that patients would have to be walked down the stairways because, of course, there were no elevators, down to a second floor, put through a little hole that was a shortcut into the parking garage, then driven up to the top of the garage, carried up two flights of stairs and then evacuated off the helipad. And they just decided that would just be - not possible. Dr. Anna Pou who was kind of at the center of these events, because she was arrested and accused of murder, she, according to the witnesses - and Dr. Pou, will not discuss this, of course – but they said that Dr. Pou took these drugs, morphine and Midazolam, and went into Mr. Everett’s room, closed the door, and several hours later he was seen by other staff to have died.
BOB GARFIELD: You mentioned sources. You know, from a reporter’s point of view, the bad news is that some of the physicians you spoke to would not speak with you explicitly about the injection of drugs. They talked about the other conditions. The good news is that you were able to assemble a remarkable, almost hour-by-hour narrative. What did you have at your disposal to do this with?
DR. SHERI FINK: The narrative was based on interviews with people who were there, and many, many people. I think I at some point figured out that it was about 140 people. The other thing was documents.
BOB GARFIELD: For example, physicians’ orders that you referred to at various times in the piece.
DR. SHERI FINK: That’s one example. So there were prescriptions that Dr. Pou actually wrote to get some of these drugs, signed with her name, and then also the scientific evidence. So I had access to the toxicology results and was able to speak with the laboratory head and talk with all of the forensic pathologists and coroner who were involved in the investigation. So it was really triangulating, trying to get several pieces of evidence for each fact that I might be asserting. I went back to every single person who was mentioned in the story and read them what was being said about them and gave them the chance to give their side. All of that helped to put the narrative together.
BOB GARFIELD: Now, what I haven't mentioned, ‘til now, is that you are yourself a physician. Did your personal experience in dealing with critically ill patients inform your reporting on how the doctors dealt with the nightmare that you’re writing about?
DR. SHERI FINK: There are certain principles in medicine, certain ethical principles that everybody who goes through med school, like I have, learns. And I think the big question is whether it’s okay to let some of those ethical principles slide in a disaster, because the situation is different from normal, in many ways, or whether that’s a time where you need to fight harder to uphold those medical principles as best you can. And I've heard people really argue both sides of that.
BOB GARFIELD: But, you know, we began this conversation by talking about playing God. I want to ask you, because you are both reporter and doctor, about “there but for the grace of God.” I want you to, for a moment, put yourself in Memorial Hospital, deprive yourself of sleep for a few days, can you imagine yourself having been not the reporter of this story but the subject of it?
DR. SHERI FINK: I, actually, after medical school, ended up volunteering for humanitarian aid organizations for a few years in disaster and conflict situations. And, you know, thank heavens I never faced exactly this situation, but I've certainly been out there doing triage and feeling really overwhelmed. And it’s really hard. This story is not about pointing the finger of blame at any of these individuals. It’s really, I hope, to give people a taste of what they were faced with when they made these choices and what led them to make these choices. These are well-respected people who had sterling careers before this point. It’s about what can we take from the story into the future, so that medical professionals, patients, don't get stuck in this kind of situation again.
BOB GARFIELD: Sheri, thank you very much.
DR. SHERI FINK: Thank you.
BOB GARFIELD: Dr. Sheri Fink is a reporter for ProPublica.org and recipient this week of the Pulitzer Prize. A grand jury declined to indict Dr. Anna Pou, the focus of Fink’s story, and all charges against her were dropped.