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Pulitzer Prize in Investigative Reporting: Deadly Choices at Memorial

Pulitzer Prize in Investigative Reporting: Deadly Choices at Memorial

Few forms of writing are more difficult than the reconstructed narrative. It is hard enough to craft a compelling story when you have observed the events yourself. It is harder still when you must rely on witnesses trying their best to recall what happened. But the greatest challenge arises when a writer seeks to assemble a narrative against the wishes of key figures who face possible legal jeopardy if the truth is revealed.

That was the situation Sheri Fink faced when she set out to tell the story of what happened at a New Orleans hospital cut off by the floodwaters of Hurricane Katrina.

Fink was unusually qualified to attempt such reporting. A medical doctor who also holds a Ph.D. in neuroscience, she had delivered aid in combat zones and reported on how medical professionals cope with catastrophe in places like war-torn Bosnia.

The experiences of doctors and nurses during Katrina, she recognized, were emerging at the center of a quiet national debate certain to resonate in the decades ahead: What legal and ethical standards must doctors meet in a disaster such as a pandemic flu or terrorist attack? Who should be saved first? Who decides? To understand the pressures doctors and nurses faced, readers needed to know exactly what it felt like to be trapped in a sweltering hospital in a city that had descended into chaos.

When Fink began working on the story, a New Orleans doctor, Anna Pou, was leading a national campaign for laws that would shield medical professionals from legal liability for their conduct in disasters. Pou had been investigated for mercy killing at the hospital, Memorial Medical Center, after a large number of patients died there during the flood. A local grand jury declined to bring charges, and Pou was pressing state lawmakers and the American Medical Association to learn the lessons of Katrina.

But what were those lessons?

Fink tried to interview Pou and others who figured in the investigation. They refused to talk about what had happened, so she set out to find others familiar with events at Memorial. There was an abiding sense among many in New Orleans that Katrina was a miserable experience best left unexamined, complicating the reporting task even more.

Over many months of slow, painstaking pursuit of sources and documents, Fink began to assemble a new account that called into question Pou’s arguments for looser standards as well as her version of what had happened. Several health professionals from Memorial acknowledged that they had deliberately injected severely ill patients with lethal doses of drugs. They described scenes of chaos, in which sleep-deprived doctors and nurses trapped in a building without electricity or running water improvised plans for triage. 

Fink reported this story over more than two years, first as a freelancer working as a Kaiser Media Fellow and then as a reporter at ProPublica. She interviewed more than 140 people, most of them multiple times.

On the fourth anniversary of Katrina, the New York Times magazine published “The Deadly Choices at Memorial,’’ a 13,000-word chronicle of what happened when the floodwaters rose, the generators failed, and the hospital was cut off from the world. The article was dramatic yet understated. Fink depicted the deepening confusion that gripped the hospital as it waited for help to arrive, reconstructing the decisions that ended with the injections of ill patients as the helicopters arrived to rescue them.

Remarkable in these days when so many hide behind the shield of anonymity, every source was quoted by name. One doctor, Ewing Cook, acknowledged that he had ordered a nurse to give a lethal dose of morphine to a patient. “It was actually to the point where you were considering that you couldn’t just leave them; the humane thing would be to put ’em out,’’ Cook told Fink.

The article had immediate impact. The New Orleans coroner launched a new investigation of the death of Jannie Burgess, the patient of Cook’s who was given the morphine. Days later, the article went to members of an Institute of Medicine panel who were crafting national guidelines on how to deal with shortages of life-saving equipment in case of a major medical emergency, like a 1918-style flu pandemic. The resulting IOM report, which was widely distributed to local, state and federal officials, included recommendations directly influenced by the article.

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Photo by flickr user sparkieblues http://www.flickr.com/photos/sparkieblues/3971258497/

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ProPublica was a recipient of the 2011 Pulitzer Prize in National Reporting and a 2010 Pulitzer Prize in Investigative Reporting. See a full list of our awards.