Five Days At Memorial, Fink - B +

                                      American's (perhaps humanity's) propensity to call in the cavalry for one's ill loved ones and gotcha second guessing are the dominant themes of this Pulitzer Prize winning book's harrowing true story,   subtitled,  'Life And Death In A Storm-Ravaged Hospital'.  Memorial was an older hospital in downtown New Orleans and one that probably wouldn't have been mentioned in a discussion of great medical centers. Its patients were poor, its staff came from the same neighborhoods, as did some of its physicians.  It was owned by an out-of-town for-profit firm and seems to have been supervised/regulated by more federal and state agencies than one could keep track of. Underfunded, understaffed and totally unprepared for Hurricane Katrina when it hit, Memorial really didn't have a plan for dealing with disasters.  In the past when hurricanes threatened, the staff would bring their kids and pets and usually, after a day of heavy lifting, things went back to normal.  This time, things slowly cascaded into a living and dying hell. A 21st century hospital without power is, perhaps, a step above the Bedlams and Bellevues of yore.  Without lights, air-conditioning, ventilator machines, life support monitors, phones ( neither land nor cellular), water, flushing toilets, elevators, computers, food, a tall building filled with very, very ill people quickly becomes another level of Dante's Inferno.  Almost all of the staff performed heroically and at the highest levels of their professions.  On the fifth day, one doctor 'sedated' quite a few patients, many of whom were comatose, unmovable and had signed DNR's, as well as one morbidly obese man, who had seemed ok that morning.    All signs pointed to the conclusion that under extraordinary stress,  Dr. Anna Pou had euthanized the patients.  Was it second-degree murder?  The state Attorney General thought so, as did the national forensic consultants who reviewed the case.  But, the local coroner wasn't so sure about autopsies done on bodies that had sat in the sweltering heat for ten days.  The local prosecutor's office was overwhelmed in a city with the most per capita murders in the country. Additionally, this case was factually very complex, and just about every medical organization in the state had rallied around the two nurses who had been accused with Pou. In the end, the coroner said there was no homicide and the grand jury went along with that conclusion. The 'good news' of this story is that a concerted national effort has begun to design protocols to ration healthcare in future emergencies.