Wednesday, September 07, 2005
In Flood, Hospital Becomes a Hell
04:11 PM CDT on Sunday, September 4, 2005
By SUDEEP REDDY / The Dallas Morning News
NEW ORLEANS -- They awoke Tuesday morning relieved. Hurricane Katrina had passed, and life for everyone inside Memorial Medical Center would soon return to normal.
Then the water started rising.
Dr. Bill Armington noticed an oily black puddle bubbling up from the sewer into the street. It pushed away leaves and debris as it grew.
"It was going the wrong way," he said. "Then it came faster and faster."
The hospital in uptown New Orleans would soon be submerged in 12 feet of water, contaminated with sewage and chemicals.
Over the next 72 hours, the people inside Memorial banded together as best they could -- first to keep their patients alive, then to improvise evacuation plans with the few resources at their disposal.
Over three days, gunshots pierced the air in the flooded residential neighborhoods around Memorial. The stench of sweat and human waste filled hospital hallways. Patients died as they lay splayed in sweltering heat on a parking garage floor, waiting desperately for helicopters.
The facility quickly ran out of body bags -- and eventually room in the chapel, which had become the morgue.
The roughly 2,000 patients, employees and family members inside knew little about the chaos unfolding in other corners of New Orleans. They were living their own hell, furiously trying to respond as events outside thwarted their plans inside at almost every turn.
"I've seen desperation," said nurse Darrel Sullivan, who had been in war zones for the Army, resting in a wheelchair and sipping juice in the parking garage after lifting patients. "But I've never seen this before in my life."
Hurricanes were nothing new for Memorial. They'd become a seasonal certainty in its 80 years on Napoleon Avenue. Patients who could leave would leave. Backup generators would stock up on fuel in case the power grid went down. Staffing levels, food and supplies would be prepped.
As Hurricane Katrina approached last Sunday, the long-rehearsed plans went into effect.
Employees brought their husbands, wives, parents and pets to sit out the storm. Several brought teenage kids. Four-year-old Zachary Perry tagged along with his father, hospital chef Scott Perry. Zachary's mother -- a nurse at another area hospital -- took his 6-year-old sister with her.
Those permitted to be there Sunday received wristbands, helping security block outsiders looking for shelter.
By Sunday night, the hospital had about 2,000 people, including 260 patients. The electricity flashed out early Monday morning. Clocks froze at 4:55 a.m. Air conditioning shut down. But ventilators, hallway lighting and other key equipment ran off backup generators.
Doctors began making plans to return to regular schedules. Some went home to shower, others simply took a walk along the dry neighborhood streets to view Katrina's damage.
'From bad to desperate'
But early Tuesday, the levees protecting New Orleans failed.
Hospital team leaders held emergency meetings that morning to evaluate the situation. "It went from bad to desperate," said Ann Seal, a director of nurses.
The staff still had to prepare three meals a day for 2,000 people, with special dietary provisions for patients.
Fifteen workers slapped turkey, ham and chicken salad between slices of bread. Breakfast consisted of grits, an egg and sausage crammed into a coffee cup, with a plastic cover on top. They were the last hot meals served. By day's end, the kitchen was underwater.
Hospital officials sent an S.O.S. to area hospitals, trying to see where Memorial's patients could go. The first evacuees were 25 premature infants from the neonatal intensive care unit.
Lacking enough equipment, a doctor ventilated a palm-sized baby by hand for the helicopter trip to Woman's Hospital in Baton Rouge.
That was the last time the Memorial staff would know where its patients had gone. Others went wherever the helicopters could land -- to New Orleans International Airport, other hospitals, on the ground somewhere.
Through Tuesday, hospital administrators were still communicating regularly with executives at Dallas' Tenet Healthcare, which owns Memorial. But once e-mail went down, so did links with the headquarters.
Guards tried to keep everyone out. Officials feared looting -- of food, hospital equipment, drugs in the pharmacy. Gunfire erupted during the day and night in the area.
Hospital officials took their own measures to protect those inside. The hospital CEO carried a sidearm, visible on his belt. So did the chief operating officer, a few engineers and members of the security team.
Still, people tried to climb in through windows, the parking garage or any of two dozen entry points to the hospital. Some simply wanted shelter, but the hospital couldn't take anyone else.
Two patients with stab wounds -- a mother stabbed in the chest by her daughter, and a drunk man who had been hit in the abdomen -- were taken in and lifted away.
As evacuations continued Tuesday night, pilots said they wouldn't land without lights. Until that day, Memorial's helipad hadn't been used for years. But now they had little choice.
So engineers taped down flashlights around the helipad, allowing some choppers to land. The electricians found construction lights on cords and tied them down to the helipad with medical gauze. They built extension cords to stretch down nine floors.
Late Tuesday night, the backup electricity started cutting out. Fuel for the generators was secure in underground tanks, but the electrical system was being flooded. As the water level rose, breakers clipped out.
Unthinkable conditions
By 5 a.m. Wednesday, the building no longer had power. Memorial Medical Center was no longer a hospital.
Batteries on ventilators on the acute care floor went dead. The patients would survive as long as nurses could manage to manually compress the bags attached to ventilation masks. Eventually, the patients could only receive comfort measures in their final moments.
A man swam toward the hospital with his dehydrated 3-year-old son. The hospital offered to take the baby, but not the father. But he wouldn't leave without his son, so he took the boy back and left.
"People think of a hospital as a refuge," said Dr. Timothy Allen, an anesthesiologist. "This was no longer a refuge. This was a place where people would die if they weren't evacuated."
The building had no running water, no communication, no power. Blood, urine and feces filled toilets that couldn't flush. Patients who had been in stable condition turned critical. Guests started getting ill as well.
Some rooms were already considered too hot or unsafe because of gunfire outside, and patients were moved into hallways where pods of fans had been rigged together.
Employees and guests were cut back to two meals a day, trying to preserve food after much had been lost in the flooding. They had to prepare to stay as long as possible.
A few family members of patients complained about the conditions. But almost everyone else jumped in to help. Employees' titles effectively disappeared.
Evacuation plans became more creative. The goal: Speed up the process to move people out.
Some pets were thrown alive over the edge of buildings, into the fetid waters around the hospital. A doctor decided to euthanize pets that their owners couldn't take.
The elevators were dead. So the 187 remaining patients had to be carried from the seventh floor in one building to the helipad on the 11th floor of the neighboring parking garage.
The teams first used six handheld radios to communicate between the floors. Then the batteries died.
Workers created a human chain, relaying messages through people stationed at every level of the stairwell and across the parking garage.
Chains also formed to carry patients out to departure points. They tried to build a slide ramp using padded mats to move patients between floors instead of lifting them. It wasn't safe enough, and they ditched the plan.
Choppers were arriving slowly for evacuations, but boats became an easier means of transportation. The emergency room ramp had been flooded, so they knocked out the windows and moved people into arriving boats.
Airboats, fishing boats, flatboats, rafts. Nobody knew where they were coming from. People floated up with their own boats. Some grabbed boats that were adrift without owners, hot-wiring the motors.
Eric Yancovich, the head of maintenance, used rope to attach a rowboat to a motorboat, doubling the number of people who could leave.
The boaters received simple directions: Go down the street, turn right at Napoleon, then 12 blocks to St. Charles.
There, the water met road. Buses, cars and ambulances could take patients away -- somewhere.
"We weren't exactly sure what we were sending the patients to," Dr. Armington said. "But we felt it was better than what we had here."
The workers created a second boat exit from the parking garage. But getting people there proved difficult.
Engineers realized that patients could move through a 4-by-4 hole in the boiler room.
Like a rescue out of a coalmine, the workers used their human chain to carry patients down flights of stairs into the cramped space lit up with flashlights.
They went through the hole onto the second floor of the parking garage, into the back of a Ford F-150 pickup. The truck took them to the ninth floor, where they were carried up two flights of old, rusty stairs to the helipad.
The last patient out was "Mr. Rodney." He was 450 pounds, hospitalized for lung disease and a gall bladder removal.
Teamwork
Early Thursday evening, 24 people joined in the effort. Eighteen stood around the stretcher inside the boiler room, sweat pouring off them. Six more people were on the other side of the hole.
"One, two, three!"
Mr. Rodney slid through the square, where he was grabbed and pushed onto the truck.
"The last patients are out."
The boiler room erupted in cheers, followed by a group hug. On the other side, they still had to continue treating their patient.
"How much O2 was he on?" one nurse cried out.
"He was on 4," another said.
"Shouldn't he be on 2?" one more voice said.
"3. Put him on 3."
Mr. Rodney was driven to the top of the garage and carried up the stairs
One by one, dozens had been moved the same way. Urine and feces rolled off the beds and onto the workers, forcing them all to wipe down with sanitizing liquid every time.
Patients who could walk up stairs were marked with an X on their foreheads. Others were segregated based on which choppers could take them.
Some helicopters didn't show, forcing the staff to move patients from the parking garage back inside the same way they came in -- through the boiler room.
Those who waited in the garage lay in parking spaces, on the mattresses from their hospital beds. They sat quietly, sweating and gasping for air as employees fanned them and held their hands.
Some died as they waited.
"We had him sitting in the garage for five hours," Roberta Stewart, a hospital administrator, said of one patient. "Nobody came."
Bodies were wrapped in sheets and left in the chapel. Others were placed along hospital hallways. Employees took patient wristbands to try to notify families later.
As two workers walked through the parking garage Thursday evening, they tried to locate which vehicle had a body inside. They couldn't remember where the body had been placed, and were forced to leave it.
Nobody could remember the death toll. A few estimated it at perhaps 20 patients in the last two days there. Normally, 20 patients die with 1,000 monthly admissions.
Even as they lost patients they had carried through the hospital, most people tried to focus instead on how many more they could save if they acted faster.
"I know a lot of people in the hospital didn't make it out," said Dave Matherne, who stayed to help even after his stepfather, a patient, had been evacuated. "That's not the point. The people we got out is."
Risky operation
By Thursday afternoon, Memorial was down to 37 patients and 120 employees and family members.
State police eventually wouldn't guard any more boats, employees said. It was too dangerous. But people were sent out anyway, police protection or not. Eventually, workers said, government responders had commandeered some of the boats that had been used, shutting down the operation.
Tenet executives had already realized that the government rescues were taking too long and hired private helicopters to help get everyone out of its hospitals.
Choppers arrived from across the region. A Puma helicopter rushed in from Montana. It was better suited for hauling cargo and supplies, but 20 people could pile in -- five or six times more than most others would take.
It arrived Thursday afternoon, but could only do one trip. Tom Uglialoro, hired late Wednesday night to oversee Tenet's private rescue effort, said the military had commandeered all the fuel in the area. The Puma pilots were running low.
Everyone had left the parking garage by nightfall Thursday, waiting on a ramp leading up to the helipad and on a gravel rooftop one level down.
The garage was covered with trash and medical equipment. Used gloves, shoes, pillows, stretchers, blankets and cups were littered everywhere. Pet cages lined the walls. Two seven-pound cans of opened ravioli, spoons sticking out from the top, sat along the edge of walls with other leftovers.
One young nurse who had been lifting heavy patients all day collapsed on the ramp, his legs shaking as nurses and doctors crowded around. They guessed that he broke a rib while lifting a wheelchair patient into a chopper. Doctors concluded he might have a bruised lung. He was loaded onto a Coast Guard helicopter and taken away.
By dark, most military choppers had been grounded because of concerns about gunfire in the region. Later, even with a small portable generator feeding the rigged landing lights, the private helicopters were grounded because of fog.
For the remaining 75 employees and their families, some of the only time to reflect came Thursday night after patients were gone.
"This has been the most horrifying thing I've ever experienced in my life," said hospital catering manager Sal Armato, wearing women's tennis shoes four sizes too small because his had been soaked.
He had to be there this time, he said, "but I don't think I'd do it again."
Employees would be gone by morning, but few knew what was next.
"Almost all of us lost our homes," said Rene Goux, Memorial's CEO. "But no one has had time to focus on that."
Sleep at last
That night, most slept along the side of a walkway leading to the ramp, below windows that had been shattered. About 20 sprawled out on the helipad, with the rocky asphalt surface poking against their heads and backs. But with all the patients finally gone, it was the first time some employees had slept in days.
The area was mostly silent that night, except for occasional rumbling as people seemed to enter nearby buildings. New Orleans was pitch black, except for the stars and a few distant lights.
Every few minutes a Coast Guard chopper could be seen flying somewhere over the city, at times hovering over a site to perform a rescue operation.
At 4:34 a.m. Friday, a flash of bright light from behind downtown broke the darkness. What first seemed like lightning grew intense, pulsated, then turned red and ballooned. Smoke rose into the air.
Mr. Uglialoro picked up the satellite phone to call his operations center in Dallas. They warned the FAA that a quicker rescue might be needed, in case it was a chemical explosion with winds coming toward Memorial.
Just after dawn, workers threw trash from the helipad over the edge of the building to keep it from flying at them when helicopters landed. The entire city had already become a giant trashcan.
After sunrise, dozens of choppers began flying over the city. The first flight lifted off at 7:46 a.m. with about 20 people.
It was the first of six flights -- with Tenet's hired helicopters, Navy Seahawks and Army Black Hawks -- that would quickly take everyone else away.
Other military choppers queued up over Memorial, ready to come down like a choreographed ballet. They wouldn't be needed.
Memorial's last survivors climbed onto the Puma at 8:21 a.m.
Four minutes later, they were gone.
By SUDEEP REDDY / The Dallas Morning News
NEW ORLEANS -- They awoke Tuesday morning relieved. Hurricane Katrina had passed, and life for everyone inside Memorial Medical Center would soon return to normal.
Then the water started rising.
Dr. Bill Armington noticed an oily black puddle bubbling up from the sewer into the street. It pushed away leaves and debris as it grew.
"It was going the wrong way," he said. "Then it came faster and faster."
The hospital in uptown New Orleans would soon be submerged in 12 feet of water, contaminated with sewage and chemicals.
Over the next 72 hours, the people inside Memorial banded together as best they could -- first to keep their patients alive, then to improvise evacuation plans with the few resources at their disposal.
Over three days, gunshots pierced the air in the flooded residential neighborhoods around Memorial. The stench of sweat and human waste filled hospital hallways. Patients died as they lay splayed in sweltering heat on a parking garage floor, waiting desperately for helicopters.
The facility quickly ran out of body bags -- and eventually room in the chapel, which had become the morgue.
The roughly 2,000 patients, employees and family members inside knew little about the chaos unfolding in other corners of New Orleans. They were living their own hell, furiously trying to respond as events outside thwarted their plans inside at almost every turn.
"I've seen desperation," said nurse Darrel Sullivan, who had been in war zones for the Army, resting in a wheelchair and sipping juice in the parking garage after lifting patients. "But I've never seen this before in my life."
Hurricanes were nothing new for Memorial. They'd become a seasonal certainty in its 80 years on Napoleon Avenue. Patients who could leave would leave. Backup generators would stock up on fuel in case the power grid went down. Staffing levels, food and supplies would be prepped.
As Hurricane Katrina approached last Sunday, the long-rehearsed plans went into effect.
Employees brought their husbands, wives, parents and pets to sit out the storm. Several brought teenage kids. Four-year-old Zachary Perry tagged along with his father, hospital chef Scott Perry. Zachary's mother -- a nurse at another area hospital -- took his 6-year-old sister with her.
Those permitted to be there Sunday received wristbands, helping security block outsiders looking for shelter.
By Sunday night, the hospital had about 2,000 people, including 260 patients. The electricity flashed out early Monday morning. Clocks froze at 4:55 a.m. Air conditioning shut down. But ventilators, hallway lighting and other key equipment ran off backup generators.
Doctors began making plans to return to regular schedules. Some went home to shower, others simply took a walk along the dry neighborhood streets to view Katrina's damage.
'From bad to desperate'
But early Tuesday, the levees protecting New Orleans failed.
Hospital team leaders held emergency meetings that morning to evaluate the situation. "It went from bad to desperate," said Ann Seal, a director of nurses.
The staff still had to prepare three meals a day for 2,000 people, with special dietary provisions for patients.
Fifteen workers slapped turkey, ham and chicken salad between slices of bread. Breakfast consisted of grits, an egg and sausage crammed into a coffee cup, with a plastic cover on top. They were the last hot meals served. By day's end, the kitchen was underwater.
Hospital officials sent an S.O.S. to area hospitals, trying to see where Memorial's patients could go. The first evacuees were 25 premature infants from the neonatal intensive care unit.
Lacking enough equipment, a doctor ventilated a palm-sized baby by hand for the helicopter trip to Woman's Hospital in Baton Rouge.
That was the last time the Memorial staff would know where its patients had gone. Others went wherever the helicopters could land -- to New Orleans International Airport, other hospitals, on the ground somewhere.
Through Tuesday, hospital administrators were still communicating regularly with executives at Dallas' Tenet Healthcare, which owns Memorial. But once e-mail went down, so did links with the headquarters.
Guards tried to keep everyone out. Officials feared looting -- of food, hospital equipment, drugs in the pharmacy. Gunfire erupted during the day and night in the area.
Hospital officials took their own measures to protect those inside. The hospital CEO carried a sidearm, visible on his belt. So did the chief operating officer, a few engineers and members of the security team.
Still, people tried to climb in through windows, the parking garage or any of two dozen entry points to the hospital. Some simply wanted shelter, but the hospital couldn't take anyone else.
Two patients with stab wounds -- a mother stabbed in the chest by her daughter, and a drunk man who had been hit in the abdomen -- were taken in and lifted away.
As evacuations continued Tuesday night, pilots said they wouldn't land without lights. Until that day, Memorial's helipad hadn't been used for years. But now they had little choice.
So engineers taped down flashlights around the helipad, allowing some choppers to land. The electricians found construction lights on cords and tied them down to the helipad with medical gauze. They built extension cords to stretch down nine floors.
Late Tuesday night, the backup electricity started cutting out. Fuel for the generators was secure in underground tanks, but the electrical system was being flooded. As the water level rose, breakers clipped out.
Unthinkable conditions
By 5 a.m. Wednesday, the building no longer had power. Memorial Medical Center was no longer a hospital.
Batteries on ventilators on the acute care floor went dead. The patients would survive as long as nurses could manage to manually compress the bags attached to ventilation masks. Eventually, the patients could only receive comfort measures in their final moments.
A man swam toward the hospital with his dehydrated 3-year-old son. The hospital offered to take the baby, but not the father. But he wouldn't leave without his son, so he took the boy back and left.
"People think of a hospital as a refuge," said Dr. Timothy Allen, an anesthesiologist. "This was no longer a refuge. This was a place where people would die if they weren't evacuated."
The building had no running water, no communication, no power. Blood, urine and feces filled toilets that couldn't flush. Patients who had been in stable condition turned critical. Guests started getting ill as well.
Some rooms were already considered too hot or unsafe because of gunfire outside, and patients were moved into hallways where pods of fans had been rigged together.
Employees and guests were cut back to two meals a day, trying to preserve food after much had been lost in the flooding. They had to prepare to stay as long as possible.
A few family members of patients complained about the conditions. But almost everyone else jumped in to help. Employees' titles effectively disappeared.
Evacuation plans became more creative. The goal: Speed up the process to move people out.
Some pets were thrown alive over the edge of buildings, into the fetid waters around the hospital. A doctor decided to euthanize pets that their owners couldn't take.
The elevators were dead. So the 187 remaining patients had to be carried from the seventh floor in one building to the helipad on the 11th floor of the neighboring parking garage.
The teams first used six handheld radios to communicate between the floors. Then the batteries died.
Workers created a human chain, relaying messages through people stationed at every level of the stairwell and across the parking garage.
Chains also formed to carry patients out to departure points. They tried to build a slide ramp using padded mats to move patients between floors instead of lifting them. It wasn't safe enough, and they ditched the plan.
Choppers were arriving slowly for evacuations, but boats became an easier means of transportation. The emergency room ramp had been flooded, so they knocked out the windows and moved people into arriving boats.
Airboats, fishing boats, flatboats, rafts. Nobody knew where they were coming from. People floated up with their own boats. Some grabbed boats that were adrift without owners, hot-wiring the motors.
Eric Yancovich, the head of maintenance, used rope to attach a rowboat to a motorboat, doubling the number of people who could leave.
The boaters received simple directions: Go down the street, turn right at Napoleon, then 12 blocks to St. Charles.
There, the water met road. Buses, cars and ambulances could take patients away -- somewhere.
"We weren't exactly sure what we were sending the patients to," Dr. Armington said. "But we felt it was better than what we had here."
The workers created a second boat exit from the parking garage. But getting people there proved difficult.
Engineers realized that patients could move through a 4-by-4 hole in the boiler room.
Like a rescue out of a coalmine, the workers used their human chain to carry patients down flights of stairs into the cramped space lit up with flashlights.
They went through the hole onto the second floor of the parking garage, into the back of a Ford F-150 pickup. The truck took them to the ninth floor, where they were carried up two flights of old, rusty stairs to the helipad.
The last patient out was "Mr. Rodney." He was 450 pounds, hospitalized for lung disease and a gall bladder removal.
Teamwork
Early Thursday evening, 24 people joined in the effort. Eighteen stood around the stretcher inside the boiler room, sweat pouring off them. Six more people were on the other side of the hole.
"One, two, three!"
Mr. Rodney slid through the square, where he was grabbed and pushed onto the truck.
"The last patients are out."
The boiler room erupted in cheers, followed by a group hug. On the other side, they still had to continue treating their patient.
"How much O2 was he on?" one nurse cried out.
"He was on 4," another said.
"Shouldn't he be on 2?" one more voice said.
"3. Put him on 3."
Mr. Rodney was driven to the top of the garage and carried up the stairs
One by one, dozens had been moved the same way. Urine and feces rolled off the beds and onto the workers, forcing them all to wipe down with sanitizing liquid every time.
Patients who could walk up stairs were marked with an X on their foreheads. Others were segregated based on which choppers could take them.
Some helicopters didn't show, forcing the staff to move patients from the parking garage back inside the same way they came in -- through the boiler room.
Those who waited in the garage lay in parking spaces, on the mattresses from their hospital beds. They sat quietly, sweating and gasping for air as employees fanned them and held their hands.
Some died as they waited.
"We had him sitting in the garage for five hours," Roberta Stewart, a hospital administrator, said of one patient. "Nobody came."
Bodies were wrapped in sheets and left in the chapel. Others were placed along hospital hallways. Employees took patient wristbands to try to notify families later.
As two workers walked through the parking garage Thursday evening, they tried to locate which vehicle had a body inside. They couldn't remember where the body had been placed, and were forced to leave it.
Nobody could remember the death toll. A few estimated it at perhaps 20 patients in the last two days there. Normally, 20 patients die with 1,000 monthly admissions.
Even as they lost patients they had carried through the hospital, most people tried to focus instead on how many more they could save if they acted faster.
"I know a lot of people in the hospital didn't make it out," said Dave Matherne, who stayed to help even after his stepfather, a patient, had been evacuated. "That's not the point. The people we got out is."
Risky operation
By Thursday afternoon, Memorial was down to 37 patients and 120 employees and family members.
State police eventually wouldn't guard any more boats, employees said. It was too dangerous. But people were sent out anyway, police protection or not. Eventually, workers said, government responders had commandeered some of the boats that had been used, shutting down the operation.
Tenet executives had already realized that the government rescues were taking too long and hired private helicopters to help get everyone out of its hospitals.
Choppers arrived from across the region. A Puma helicopter rushed in from Montana. It was better suited for hauling cargo and supplies, but 20 people could pile in -- five or six times more than most others would take.
It arrived Thursday afternoon, but could only do one trip. Tom Uglialoro, hired late Wednesday night to oversee Tenet's private rescue effort, said the military had commandeered all the fuel in the area. The Puma pilots were running low.
Everyone had left the parking garage by nightfall Thursday, waiting on a ramp leading up to the helipad and on a gravel rooftop one level down.
The garage was covered with trash and medical equipment. Used gloves, shoes, pillows, stretchers, blankets and cups were littered everywhere. Pet cages lined the walls. Two seven-pound cans of opened ravioli, spoons sticking out from the top, sat along the edge of walls with other leftovers.
One young nurse who had been lifting heavy patients all day collapsed on the ramp, his legs shaking as nurses and doctors crowded around. They guessed that he broke a rib while lifting a wheelchair patient into a chopper. Doctors concluded he might have a bruised lung. He was loaded onto a Coast Guard helicopter and taken away.
By dark, most military choppers had been grounded because of concerns about gunfire in the region. Later, even with a small portable generator feeding the rigged landing lights, the private helicopters were grounded because of fog.
For the remaining 75 employees and their families, some of the only time to reflect came Thursday night after patients were gone.
"This has been the most horrifying thing I've ever experienced in my life," said hospital catering manager Sal Armato, wearing women's tennis shoes four sizes too small because his had been soaked.
He had to be there this time, he said, "but I don't think I'd do it again."
Employees would be gone by morning, but few knew what was next.
"Almost all of us lost our homes," said Rene Goux, Memorial's CEO. "But no one has had time to focus on that."
Sleep at last
That night, most slept along the side of a walkway leading to the ramp, below windows that had been shattered. About 20 sprawled out on the helipad, with the rocky asphalt surface poking against their heads and backs. But with all the patients finally gone, it was the first time some employees had slept in days.
The area was mostly silent that night, except for occasional rumbling as people seemed to enter nearby buildings. New Orleans was pitch black, except for the stars and a few distant lights.
Every few minutes a Coast Guard chopper could be seen flying somewhere over the city, at times hovering over a site to perform a rescue operation.
At 4:34 a.m. Friday, a flash of bright light from behind downtown broke the darkness. What first seemed like lightning grew intense, pulsated, then turned red and ballooned. Smoke rose into the air.
Mr. Uglialoro picked up the satellite phone to call his operations center in Dallas. They warned the FAA that a quicker rescue might be needed, in case it was a chemical explosion with winds coming toward Memorial.
Just after dawn, workers threw trash from the helipad over the edge of the building to keep it from flying at them when helicopters landed. The entire city had already become a giant trashcan.
After sunrise, dozens of choppers began flying over the city. The first flight lifted off at 7:46 a.m. with about 20 people.
It was the first of six flights -- with Tenet's hired helicopters, Navy Seahawks and Army Black Hawks -- that would quickly take everyone else away.
Other military choppers queued up over Memorial, ready to come down like a choreographed ballet. They wouldn't be needed.
Memorial's last survivors climbed onto the Puma at 8:21 a.m.
Four minutes later, they were gone.
