Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital (46 page)

CASTAING advised that his other client was asked to go up to the seventh floor later in the afternoon. There was one patient who was still alive on the seventh floor at that time but was experiencing agonal breathing. CASTAING’s client observed DR. ANNA POU inject the patient.

As Rider and Schafer understood it, the nurses were essentially offering to help the state prosecute Pou in exchange for their own protection. And it looked like three nurses were involved, not two as recalled by the LifeCare employees, and a fourth nurse was a witness. Rider and Schafer now believed they had the names of two of the nurses who had come to the seventh floor with Pou; their lawyer’s opinion that injecting the patients was intended to kill them; and new details about what had occurred on the second floor, including the possibility that another doctor had played a key role.

Rider and Schafer’s problem was that they could not simply interview these women and learn even more. The attorney general’s office was investigating potential murders, but it was unclear whether it would be prosecuting them. Control of criminal proceedings generally rested with local officials, in this case the district attorney of Orleans Parish, Eddie J. Jordan Jr. He would choose whether to step aside and allow the attorney general’s office to prosecute after its investigation. District attorneys considered it their duty to prosecute the cases in their parish. Recusals were relatively rare, usually stemming from ethical conflicts, and early signs were that Jordan would keep the complicated, high-profile case for himself, even though his office was considered by many to have been inept even before the chaos of Katrina, with a poor rate of convictions. The attorney general’s staff were under instructions not to communicate with the district attorney’s staff about the case.

Because it appeared that prosecution of any alleged murders might ultimately fall to the district attorney, Schafer, Rider, and their colleagues from the attorney general’s office didn’t believe they could provide anyone with full immunity. That would be up to District Attorney Jordan. For now, based on the usual terms of a legal proffer, anything the
prosecutors and investigators might gain from what Castaing had told them would be tainted, in attorney parlance, like “fruit of the poisonous tree.” The information couldn’t be used in any way to incriminate the nurses, even if Schafer and Rider confirmed it from other sources, unless they could prove they would have discovered it through an alternative and natural course of the investigation.

Castaing would, years later, say he had spoken with the attorney general’s staff and requested assurances that anyone being interviewed would not be prosecuted, but he denied that he had sought immunity for the nurses, “because immunity means you did something wrong and you’re immunized for it. I never made any admission like that.” He would specifically deny and strenuously disagree that he had given an account of what allegedly happened on the seventh and second floors, although he said he did not keep notes on the meeting. “They already had those facts,” he would say of the investigators. “They told me.”

Castaing added: “It didn’t make sense for me to go in there and tell them all this incriminating stuff and say, ‘You can’t prosecute.’ ” However offering information in advance of any non-prosecution guarantee is just what another attorney did the following month. She took over representing Mary Jo D’Amico and made an oral proffer to Schafer and another assistant attorney general, detailing what D’Amico would say if given immunity from prosecution in the case. The lawyer wrote a letter emphasizing that the proffer was made off the record and could not be used against D’Amico either directly or derivatively. D’Amico’s new attorney even said she would, if requested, provide the proffer directly to the district attorney, too, and she had also reached out to the feds, who still had a case open on Memorial.

Schafer, Rider, and their colleagues had visited the US Attorney in New Orleans,
Jim Letten, to see what federal statutes might apply. Murders were typically prosecuted by local authorities, and
federal jurisdiction over them was limited. The Memorial deaths had not occurred on federal land, or during the commission of another federal crime, and
none of the deceased seemed to fall within a category—for example, that of high government officials—that would make their alleged murders prosecutable under federal law. Causing a death in the course of “depriving the person of his or her civil rights under color of law” could be considered a federal crime, as could murder to further a drug offense, but these were not seen, for the moment, to apply to the Memorial cases.

The most serious federal charge the group could imagine applying was quickly rejected. A conviction for inappropriately prescribing narcotics would carry perhaps a five-year sentence, akin to punishing a hit-and-run killer for having expired license tags.

Unable to use information from any attorney proffers, Schafer and Rider pursued other avenues. As a law enforcement official, Rider had the right to demand that the companies turn over whatever they might have discovered in their internal investigations. She sent requests to Tenet and LifeCare and subpoenas for various pieces of information. LifeCare turned over a file with summaries of debriefing interviews conducted with LifeCare leaders in the days after the evacuation.

Tenet, however, did not turn over information from its own interviews with medical staff. Rider received a legal notice stating that “certain Tenet attorneys” had spoken with Dr. Anna Pou, but Pou’s lawyer, Richard Simmons, had requested that the information Pou had given be kept confidential in light of her “reasonable belief” that what she had disclosed would be protected under law from being released. An attorney for a second doctor made a similar request. Dr. John Thiele, his lawyer said in a letter, had spoken with Tenet attorneys not realizing that they did not represent him, and he had “discussed facts with these attorneys that he would not have discussed had he known.”

UNWELCOME ATTENTION from the attorney general’s minions and CNN reporters was only the latest in a string of tribulations that
had dogged Johnny Thiele since Thursday, September 1, the day he had stood beside Karen Wynn on the second floor of Memorial and asked, “Can we do this?”

Flying away from Memorial that sunset, a sense of relief had settled over him with the realization that he had in fact survived what he’d been sure he wouldn’t. He landed at Louis Armstrong New Orleans International Airport with a posse of other Memorial staff and walked into a concourse teeming with hot, dirty, thirsty, antsy evacuees, some of them patients. No Tenet-dispatched buses awaited them as they had hoped. Fear returned and squeezed his insides. He kept it there, not wanting to alarm his colleagues. He lay down on cardboard and tucked a pliant military meal-ready-to-eat beneath his head as a pillow.

The next day he waited hours in the swirl of chaos with the small hospital group. They swayed in the pushing, pulling crowds. Teenage National Guardsmen armed with semiautomatic weapons failed to impose a sense of order. People skirmished. A nurse companion fainted. He maintained his doctor’s mien, bucking up his colleagues, but inside himself grew sure they would not make it out, that they were on the cusp of death, that any moment gunfire would erupt. “This is crazy.” He was white, his colleagues, too, and those around them were nearly all “Afro American.” And, he feared, desperate.

At last they climbed into the gaping bay of an Air Force cargo plane, where tanks had surely gone before them. It was hot. Nobody would say where they were going. The big African American man who sat across from him noticed Thiele’s silver acupressure bracelet, magnetic spheres at each end, admired it, and asked the woman next to him, honey, would you like one like that?
Oh Lord, this guy’s going to
 … Thiele steeled himself. “You Dr. Thiele?” The woman interrupted his imaginings. “Ya.” She, a relative of a hospital security officer, didn’t want his bracelet. She told the man, “You let him keep it.” They landed near San Antonio in a storm and surrendered their bags to sniffer dogs and inspectors who worked under the shelter of an airplane wing while they stood on the tarmac, the heavens
swiping them with rain. “We gotta get out of here,” the fainting nurse declared. They spoke with an Air Force somebody who put them in a cab on the way to a Holiday Inn. The Spanish-speaking driver prayed with them in the parking lot.

The next day Thiele paid $1,200 for a ticket to Atlanta to reunite with family. Two days later, on Labor Day, he awoke unable to speak clearly or lift his right arm. How would he ever practice medicine again? He thought for the third time in less than a week he was going to die. He looked out the window of the hospital where he was taken. “God, you’ve got my attention.” It was a stroke. He was only fifty-three. The doctor could find no reason. “It just had to be the stress of the storm.”

He had dropped twelve pounds over the period of the disaster and its aftermath. Slowly, his abilities returned. He learned to speak again, proud of his rapid, slurring, New Orleans blue-collar brogue.

A couple of weeks later, someone called from CNN—“I hear you’re one of the heroes of the storm”—wanting Thiele’s story. Let me think about it, he said. Memorial’s media director was one of his airport kin. She had prepared him for this: If anyone contacts you, call this number. Thiele called and spoke with Tenet media in Dallas, then Tenet attorneys. He told them his story.

Later he would remember it this way. Wednesday, August 31, had its upsides. He had made two valuable discoveries. One was that the soda machines in the basement cafeteria at Memorial still worked. He took off his shoes and waded into ankle-deep water to fill his cup.

The other discovery: the cancer institute, with its lights, relative coolness, and its miraculous electrical outlets powered by a still-working generator. Thiele walked across a bridge from the hospital to a medical office building and followed its hallways to the cancer institute. He spent many hours there. Hospital administrators came and went, made coffee, charged cell phones, sat in front of fans. He had a breezy talk with the chief financial officer, a rangy, gray-haired, and affable good ol’ boy who reminded Thiele of Buddy Ebsen’s Jed Clampett from
The Beverly Hillbillies
. They spoke about their children, their home lives, and nothing about hospital administration, which Thiele found weird. Thiele fell asleep in a recliner chair for chemotherapy patients.

Over that day, Wednesday, August 31, Thiele also spent hours on the emergency ramp. Another doctor, John Kokemor, joined him to puff on cigars from the humidor Thiele had thought to bring to the hospital for safekeeping. Brown-leaf brothers, they called themselves, laughing. When do you suppose we’ll get out of here? Doctors are being asked to stay until last. Why?

That’s when Thiele’s friend had used his index finger to make the sign of an injection in the crook of his opposite elbow, and Thiele had said, “Man, I hope we don’t come to that.” It was an exchange his friend would say had never happened.

Overall, Wednesday had been frightening. Another doctor on the emergency room ramp said rescuers weren’t coming and the hospital was on its own. Thiele panicked at the sounds of shouting, and gunshots coming from the neighborhood scared him.

Returning to his office at night, he passed a plainclothes sentry posted for protection. “They gave me a gun,” the man said, “but I’ve never shot a gun before.” That didn’t inspire Thiele’s confidence. Climbing a stairwell in the pitch-dark, Thiele lost sense of where the steps and the railing lay. Disoriented, he took a friend’s cell phone to the garage and sat in the gusty, air-conditioned sanctuary of his car. He reached his family in Georgia and tried to prepare them for the worst. “I may never see you again,” he said.

That was the first time he felt sure he would not survive. They had no way to defend themselves. The long-repressed masses outside the hospital, brandishing looted guns and rifles, would revolt and overtake them. The enemy was near. A rowdy gang squatted in the credit union building across the street from Memorial. Thiele’s colleagues kept asking one another what anyone had to gain by killing people trying to evacuate a hospital. On the phone with his wife, Thiele heard
his daughter rage in the background, “Why is he there? … He didn’t have to be there!”

Thiele had spent nearly every hurricane at Baptist. He stayed even though he wasn’t a hospital-based doctor and didn’t need to do so. He had practiced for twenty-one years, but there was nothing in his experience, nothing in anyone’s experience there at Memorial, to prepare them to solve the problems they were facing. They were, he thought, in a war zone.

Daylight, Thursday morning, had refocused him. Susan Mulderick, taller, more confident than he, walked toward him from the emergency room. “
John, everybody has to be out of here tonight.” He heard the same from CEO Goux. Their words suggested the possibility of survival. He felt encouraged.

Evacuations had resumed by the time he began euthanizing the pharmacist’s cats. When Dr. Kathleen Fournier asked him about putting patients out of their misery, it was hard not to draw a parallel. Thiele felt that pet owners were right to euthanize their pets when the animals were close to death. As a doctor who worked with critically ill patients in the ICU, his beliefs about euthanasia had changed over the years. He no longer opposed it. He had seen people try and fail to commit suicide when they were in pain near the end and no longer wished to live.