Historical Accuracy (Q&A):
How much water was Memorial Medical Center under after the levees broke?
The Five Days at Memorial true story reveals that by late Tuesday, August 30th, the day after Katrina hit, the hospital was flooded with ten feet of water (60 Minutes). In addition to the helipad on the roof (indicated in the photo below), airboats eventually arrived to help rescue patients.
After New Orleans' levees broke, Memorial Medical Center eventually found itself under ten feet of water.
Did Hurricane Katrina's floodwaters trap the staff and patients at Memorial Medical Center?Yes. In answering the question, "Is Five Days at Memorial accurate?" we learned that in addition to the floodwaters marooning more than 2,000 people in the hospital, including roughly 600 staff and more than 200 patients (as well as family members), the storm also knocked out the hospital's power, running water, and sanitation. Temperatures inside the hospital climbed above 100 degrees and food started to run out. The backup generators eventually stopped working about 48 hours after Katrina first hit, killing power to the only working elevator, which they had been using to get patients to the rooftop helipad for evacuation.
After making it to the rooftop, patients had to climb up two flights of lengthy metal stairs to the helipad. Photo: Apple TV+
Critically ill patients, including some of the 52 patients in the LifeCare acute care facility on the hospital's seventh floor, began to find themselves in dire situations when the machines on which they relied, including ventilators that were powering the lungs of seven patients, began to sputter out after their battery reserves died. Nurses and volunteers used Ambu bags to squeeze air into their lungs, but there wasn't enough manpower or oxygen to save them all and several died. -AMA Journal of Ethics
Why didn't they evacuate all of the patients at Memorial Medical Center?When the backup generators that were powering the only working elevator failed, staff and volunteers began carrying patients up many flights of stairs to the helipad. Some were transported to the parking garage where they were loaded into the back of a pickup truck and driven to the rooftop level. Patients were also carried down to the emergency room, where airboats came to help evacuate patients. After most of the ICU patients and patients in the LifeCare facility in the hospital had been evacuated, Coast Guard helicopters began arriving less frequently as operations shifted to other rooftop rescues around the city.
While conducting the Five Days at Memorial fact-check, we learned that the LifeCare patients on the seventh floor and the I.C.U. patients on the eighth floor that remained were in critical condition. They had yet to be moved to the helipad area or emergency room as resources were scarce and the staff was tiring from the constant climbing of stairs and carrying of patients. Doctors began to realize that it would be impossible to evacuate some of the LifeCare and severely ill (category 3) patients without machinery to stabilize them and adequate transportation to get them to the evacuation areas. Others weighed too much to be carried up or down stairs.
After more than 72 hours had passed since Hurricane Katrina first struck, some of the doctors, including Dr. Anna Pou (portrayed by Vera Farmiga), 49, made the decision to sedate some of the LifeCare and category 3 patients. They were given morphine and the sedative midazolam (Versed). In researching the Anna Pou case, she later claimed, as she does in the Apple TV+ miniseries, that her goal was to make the patients comfortable, not to kill them. -AMA Journal of Ethics
Were 45 dead bodies found at Memorial Medical Center?Yes. As Sheri Fink states in her 2009 article "The Deadly Choices at Memorial," investigators were surprised by the number of bodies in Memorial Medical Center's makeshift morgue. Like in the Apple TV+ miniseries, a total of 45 decomposing bodies were extracted from the hospital, far more than were found at any of the flooded city's other hospitals. This is what sparked the investigation into the Memorial Medical Center deaths. In her book, Fink notes that it was eventually determined that only "about five" of the 45 bodies found at Memorial were patients who had died just prior to the hurricane striking. Dr. Anna Pou's attorney, Rick Simmons, contests that number and says that 11 of the dead patients passed away prior to the hurricane.
The moment when bodies are discovered in the miniseries. Inset:
In real life, deceased patients were discovered in Memorial Medical Center's second-floor chapel.
Were patients at Memorial Medical Center euthanized?
Sheri Fink's New York Times Magazine article states that of the 41 bodies on which toxicology tests were performed, 23 were found to have one or both morphine and the fast-acting sedative Versed, despite only a small number of these patients having been prescribed morphine for pain. The levels found in the bodies were also much higher than what would normally be given for pain.
The Five Days at Memorial true story confirms that an internist at Memorial Medical Center named Bryant King (portrayed by Cornelius Smith Jr. in the series) told CNN that "the discussion of euthanasia was more than just talk." Based on conversations he had with other workers at the hospital, he publicly asserted that one or more employees had killed patients. King said that when he learned that they were going to kill patients, he boarded a rescue boat and left. "I'd rather be considered a person who abandoned patients than someone who aided in eliminating patients," he told CNN's Nancy Grace.
According to Dr. Bryant King, he decided to board a rescue boat and leave Memorial Medical Center because he didn't want to be part of euthanizing patients. Photo: Apple TV+
A lawyer for LifeCare, a long-term acute care facility that leased out space in the hospital, alerted Louisiana Attorney General Charles Foti, Jr. to nine possible cases of euthanasia at the facility. The attorney general's office hired Orleans Parish Coroner Frank Minyard to conduct autopsies on the nine bodies, and Minyard found significant traces of morphine in all nine. A forensic pathologist was hired to go over the toxicology reports of four of the nine patients, including Emmett Everett Sr. (61), Ireatha Watson (89), Rose Savoie (90), and Hollis Alford (66). The pathologist found that all four patients died by way of homicide as a result of human intervention. -AMA Journal of Ethics
Several other forensic experts, including Cyril Wecht, James Young, and Michael Baden, reviewed the reports on the nine suspicious LifeCare facility deaths. Wecht believed that eight of the nine were homicides. Baden thought all nine were homicides. Young stated, "All these patients survived the adverse events of the previous days, and for every patient on a floor to have died in one three-and-a-half-hour period with drug toxicity is beyond coincidence." -The Deadly Choices at Memorial
Is Cherry Jones character, Susan Mulderick, based on a real person?Yes. Born in 1951, Susan Mulderick (pictured below) was a nursing director and the rotating emergency-incident commander for Hurricane Katrina. Like in the Apple TV+ Five Days at Memorial miniseries, she was in charge of directing hospital operations during the crisis while in communication with the hospital's top executives. According to Sheri Fink's article, Mulderick had helped to draft the hospital's emergency plan, a plan that lacked guidance for how to deal with a complete power failure or for how to conduct an evacuation when the streets are flooded. In his memoir Code Blue, Memorial Hospital's medical-department chairman, Richard Deichmann, said that Mulderick asked him his thoughts on whether it would be "humane" to euthanize Memorial's D.N.R. patients, something that Mulderick's lawyer denies she ever asked.
Did all of the forensic experts agree that patients at Memorial Medical Center had been euthanized?
No. Orleans Parish Coroner Frank Minyard also hired pathologist Steven Karch, an expert who specializes in scrutinizing drug toxicology tests that are carried out postmortem. According to Sheri Fink's New York Times Magazine article, Karch came to New Orleans and examined the evidence. He concluded that it's ridiculous to try and pinpoint a cause of death in bodies that had been sitting for ten days in 100-degree temperatures. He advised Minyard that in each case, the cause of death should remain undetermined.
Following Dr. Anna Pou's arrest in February 2007, Minyard told the media that for the time being he was leaving the Memorial Medical Center deaths in question classified as "undetermined." He said that if Anna Pou's case went to trial, the defense would put someone like Steven Karch on the stand who would offer reasonable doubt. In Sheri Fink's 2009 article, she states that Minyard later told her that he believed Dr. Pou was responsible for four of nine patient deaths on the seventh floor. "I strongly do not believe she planned to kill anybody, but it looks like she did," Minyard said.
Was Dr. Anna Pou charged with murder?The Five Days at Memorial fact-check confirms that approximately one year after Hurricane Katrina, Louisiana Department of Justice agents arrested Dr. Anna Pou and a 10-count bill of indictment was prepared against her that included one count of second-degree murder (Emmett Everett), in addition to nine counts of conspiracy to commit second-degree murder. Two nurses, Lori Budo and Cheri Landry, were also arrested but the charges against them were dropped in exchange for their testimony. -The Deadly Choices at Memorial
"When you use both [morphine and Versed] together, it becomes a lethal cocktail that guarantees they're gonna die," said Louisiana Attorney General Charles Foti, Jr. at a press conference following the arrests. "This is not euthanasia. This is plain and simple homicide." -60 Minutes
Three staff members, nurse Cheri Landry (left), Dr. Anna Pou (center), and Lori Budo (right), were arrested in relation to the 2005 deaths at Memorial Medical Center during the aftermath of Hurricane Katrina.
Did Dr. Anna Pou's case ever go to trial?
No. Like in the Five Days at Memorial miniseries, the true story confirms that the grand jury decided not to indict Anna Pou, thereby eliminating the chance of finding her guilty in a criminal trial. Fink's article points out that the prosecutors, Assistant District Attorney Michael Morales and Orleans Parish District Attorney Eddie Jordan, "weren't gung-ho" about prosecuting Dr. Pou, and instead of presenting evidence and experts to the grand jury, they instructed the jurors to decide what evidence they wanted to consider. Morales' office had reportedly been receiving letters condemning him for considering the case against Dr. Pou. Following the grand jury's decision not to prosecute, the charges against Pou were expunged and the State of Louisiana paid her legal fees, which totaled more than $450,000.
Dr. Pou did face three civil suits (Everett, Alford, and Savoie) brought by the families of three of the patients who died. Yet, the Health Emergency Powers Act that was passed in Louisiana in 2003 stated that in order to be civilly liable for the deaths of her patients, Dr. Pou must have acted with "gross negligence or willful misconduct" or in "bad faith." While this could be argued, the cases were eventually settled, with the families agreeing not to speak publically about the terms. -AMA Journal of Ethics
The real Dr. Anna Pou is pictured on the left. Actress Vera Farmiga (right) portrays Pou in the Apple TV+ miniseries.
Did Dr. Anna Pou admit to injecting the patients who died?Yes. In analyzing is Five Days at Memorial accurate, we discovered that after a grand jury opted not to move forward with Dr. Anna Pou's case, she publicly admitted to injecting some patients with morphine and the sedative midazolam (Versed). Like in the miniseries, Pou says that the purpose was not to euthanize them. She told Newsweek, "The intention was to help the patients that were having pain and sedate the patients who were anxious. Any medicines given were for comfort. If in doing so it hastened their deaths, then that's what happened. But, this was not, 'I'm going to go to the seventh floor and murder some people.'" In the fall of 2006, Pou told 60 Minutes' Morley Safer, "No, I did not murder those patients. Mr. Safer, I've spent my entire life taking care of patients."
Her statements contradict what witnesses told Sheri Fink, author of The New York Times Magazine article "The Deadly Choices at Memorial" and the subsequent book on which the Apple TV+ series is based. For example, in the case of patient Emmett Everett, a paraplegic who weighed approximately 380 pounds, witnesses described Pou administering a lethal cocktail of drugs with the intent of ending his life. LifeCare's director of physical medicine, Kristy Johnson, witnessed a nervous Dr. Pou standing outside of Everett's room beforehand saying that she planned to tell him she was giving him something for the dizziness he'd mentioned earlier (New England Journal of Medicine).
According to staff members who were part of the discussion, Dr. Pou decided to end Everett's life because she felt that due to his weight, they would not be able to evacuate him. Everett had been alert that morning and fed himself breakfast, telling his nurse, "Cindy, don't let them leave me behind" (Five Days at Memorial book).
Witnesses said that the life of Emmett Everett (inset) was ended by Dr. Anna Pou. Damon Standifer (right) portrays Everett in the miniseries.
For what reason did Dr. Anna Pou tell the patients she was giving them the drugs?According to Kristy Johnson, the director of physical medicine at the LifeCare facility in the hospital, Dr. Pou told one of the patients, "I am going to give you something to make you feel better." Internist Bryant King said that he heard Dr. Pou say the same thing to a patient near the A.T.M. as Pou held a handful of syringes. -The Deadly Choices at Memorial
Did other doctors and nurses admit to trying to euthanize patients?
Yes. According to Sheri Fink, author of the Five Days at Memorial book, other doctors and nurses also divulged that they injected patients. While Dr. Anna Pou publicly stated that her goal was not to kill the patients but to merely make them comfortable, this seems to contradict statements made by other medical professionals regarding their intentions. For example, Dr. John Thiele told Fink, "The goal was death; our goal was to let these people die."
This was certainly true in the case of Jannie Burgess, a 79-year-old patient in the I.C.U. with kidney failure and advanced uterine cancer. When Dr. Ewing Cook, a senior physician at the hospital, arrived and assessed her condition, he asked the nurse, "Do you mind just increasing the morphine and giving her enough until she goes?" Cook figured that she only had another day or so to live, and at 350 pounds, it would be impossible to carry her down six flights of stairs. "To me, it was a no-brainer, and to this day I don't feel bad about what I did," said Cook. "I gave her medicine so I could get rid of her faster, get the nurses off the floor." He added, "There's no question I hastened her demise." -The Deadly Choices at Memorial
Source: The Deadly Choices at Memorial
As stated earlier, in addition to Dr. Pou and other physicians, healthcare workers at Memorial Medical Center pointed the finger at two respected nurses, Cheri Landry and Lori Budo, who assisted in hastening the deaths of some patients. -People
Did rescuers ever return for the remaining patients?In researching the Five Days at Memorial true story, we learned that unbeknownst to those still inside Memorial Medical Center, the hospital's owners had chartered five helicopters to rescue the other patients. Ironically, the helicopters arrived just hours after a number of patients were injected with morphine and Versed, which allegedly led to their deaths. -60 Minutes
Did Sheri Fink, the author of the book on which the miniseries is based, interview the real Dr. Anna Pou?
Yes. Dr. Pou agreed to an interview after the grand jury opted not to indict her. While author Sheri Fink says that Dr. Pou consented to an in-depth interview, her lawyer advised her not to discuss the events of Thursday, September 1, 2005 and not to address the accusations against her. This meant that Fink had to find other sources for the key events in the book.
Fink says that in addition to Dr. Pou's attorney answering some of her questions, she "sought the observations of" many of Dr. Pou's colleagues at the hospital. She also reviewed Pou's public statements and available records. Fink personally conducted hundreds of interviews with individuals who were both critical of, and sympathetic to, Dr. Pou. All of this research resulted in a Pulitzer-Prize-winning 2009 article titled "The Deadly Choices at Memorial" that was co-published by ProPublica and The New York Times Magazine. She conducted additional years of research to write the Five Days at Memorial book on which the miniseries is based.
Author Fink points out that the text and extensive endnotes in her book address which issues were contested. She also makes it clear whose perspectives are being represented during each of the chapters of the book. She says that prior to publication, the book was fact-checked by a "seasoned researcher."
What do Dr. Anna Pou's patients think of her?In answering the question, "How accurate is Five Days at Memorial?" we learned that author Sheri Fink spoke to the family members of one of Dr. Pou's longtime cancer patients. They invited Fink to their home for an interview and kept in touch afterward by phone. From what Fink stated, it seems that they had mostly positive things to say about Dr. Pou. Fink says that their participation helped to shape her characterization of Dr. Pou in the book.
What are the perspectives of the family members of the patients who died?
Author Sheri Fink says that she spoke to the family members of almost all of the Memorial Medical Center deaths that happened on Thursday, September 1, 2005 after being injected with morphine and/or Versed. They are upset over what happened and critical of the actions of the medical professionals, including Dr. Pou. Patient Emmett Everett, who is portrayed by Damon Standifer in the Apple TV+ miniseries, was a 61-year-old grandpa who was morbidly obese and suffered from paraplegia. According to records and staff members, he was awake, fed himself breakfast, and begged his nurse not to leave him behind. "Who gave them the right to play God?" demanded Mr. Everett's widow.
A Five Days at Memorial fact-check verifies that a number of family members were present at the hospital with their loved ones during the disaster. They were told to leave while their loved ones were still alive and anticipating rescue. They said that they were neither informed nor did they consent to the medical staff's decision to give the medications, clearly stating that they would not have agreed to it. Not long before the release of the Apple TV+ miniseries in August 2022, Fink says that some family members "expressed lingering distress, anger and a sense of injustice about their relatives' deaths at Memorial."
Is Dr. Anna Pou in jail?
No. As stated previously, the charges against her were dropped. While there is no statute of limitations on murder, the Orleans Parish district attorneys have chosen not to take further action in bringing a case against Dr. Pou. District Attorney Leon A. Cannizzaro, Jr. testified in 2010 that he felt that "human beings were killed as a result of actions by doctors. Whether or not there was a homicide and whether or not there is a case that can be brought are different matters." Jason Williams, the District Attorney who replaced Cannizzaro in 2021, has not spoken publicly about the Memorial Hospital deaths.
Louisiana Attorney General Buddy Caldwell, the successor to Charles Foti, Jr., has taken a different tone by expressing support for Dr. Pou and the Memorial Medical Center staff, saying, "This is a prosecution that should never have been brought."
How has Dr. Anna Pou responded to the book that inspired the Apple TV+ miniseries?
Author Sheri Fink says that Dr. Pou's representatives have issued legal threats and made false claims about individuals who have tried to shed light on what happened at Memorial Medical Center. Fink says that Dr. Pou has been unable to identify evidence of errors in her article and subsequent book. The author points out that her goal was not to judge but to "tell the most accurate history possible" of the events that unfolded at the hospital during Hurricane Katrina.
Where is Dr. Anna Pou today?As of the release of the Five Days at Memorial miniseries on Apple TV+ in the summer of 2022, Dr. Anna Pou was practicing medicine in Louisiana as a head and neck oncologic surgeon. -Sheri Fink