Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital (49 page)

The proud old hospital was now ringed by a fence. Camouflage-clad officers from the security firm DynCorp closed any gaps they found with plastic ties. DynCorp had more lucrative business in war-torn Iraq and Afghanistan, but Rider and Schafer learned the company had taken this commission for Tenet within days of the evacuation. Its first assignment had been to assist anyone who might have been left behind alive. Now, carrying long-necked automatic rifles, the guards patrolled the perimeter by foot and vehicle once an hour, staggering the start times. At night they checked on the buildings and escorted away drunks.

The attorney general’s staff and pharmacist Harris and his attorney signed an entry log at entry gate number 1. They went upstairs to the LifeCare pharmacy. Harris confirmed that his entire stock of morphine—125 10 mg vials—was missing, along with dozens of Versed and Ativan injection vials. Other controlled drugs were still present, suggesting the pharmacy had been selectively pilfered, not burglarized.

Also touring the shuttered hospital that afternoon, escorted by a Tenet attorney, were three women. Harris pulled prosecutor Butch Schafer aside to say he recognized them from the LifeCare physical therapy charting room on Thursday, September 1. He identified them as the doctor and two Memorial nurses who had joined her.

Anna Pou and Virginia Rider looked at each other from roughly the same height. They were introduced. They reached out and shook each other’s hands.

Here Pou was, at last, standing where Rider and Schafer had for months
imagined her. It was typical to meet a target in the course of an investigation, but they hadn’t until now met Pou, who spoke in the open to her lawyer, Rick Simmons. Here were words that might help explain what they still could not fully understand. They were hungry for the least clue.

POU TOURED MEMORIAL with Simmons and nurses Cheri Landry and Lori Budo, pinning locations to memories. They circulated throughout the hospital where both nurses had been born, and then above it, to the top of the parking garage, climbing three sets of rickety metal steps to the helipad. Pou took Simmons to Room 7312 on the LifeCare floor, where she had rushed to answer a “Code Blue” early in the disaster. The moment was frozen in the evidence that remained: a crash cart with medicines for resuscitating patients, a ventilator, and a monitor. In the sepia wash of indirect daylight, in the noticed quiet, disconnected from the normally ubiquitous cycling electrical buzz, the most modern equipment could appear oddly obsolete.

Down the hallway at the nursing station, a box held a metal laryngoscope with a folded beak that Pou had snapped open and pushed into the patient’s mouth, sliding away his tongue, clearing a path for her other hand to curve the breathing tube into his throat. Here was evidence that she had tried to save, not take away, a life. If only she could brandish it before a public that was, despite Simmons’s efforts at suppression, days away from learning her name.

“TONIGHT, A CNN EXCLUSIVE, from an act of God, to playing God, accusations of intentional killings in the wake of Katrina, as one doctor is worried a colleague may have done the unthinkable.” Anchor John King teased the story on a Wednesday night in late December.

Angela McManus appeared. Her eyelids looked heavy. She spoke of her mother, LifeCare patient Wilda McManus. “I think she died from the infection. I don’t know. I really don’t know. And, you know, hearing—this doctor was saying about euthanasia—euthanasia at the hospital, I just don’t know where to go.”

Dr. Bryant King said he had seen a doctor holding a handful of syringes on the second-floor lobby.

“Dr. Anna Pou,” the reporter, Drew Griffin, interrupted, identifying her.

“The words that I heard her say were, ‘I’m going to give you something to make you feel better.’ ”

Griffin read a statement from Pou’s attorney, Rick Simmons. “We feel confident that the facts will reveal heroic efforts by the physicians and the staff in a desperate situation.”

Pou was overcome by anger, grief, and outrage. Simmons counseled her not to watch the news, but that was hardly what mattered. Dozens of reporters called her and appeared at her home and the hospital where she had gone to work in Baton Rouge. They somehow found her family members. The curtain separating strangers from her private life was a scrim.

Pou considered herself harassed by the reporters, “
terrorized,” she called it. One day a resident at her hospital summoned her to see a visitor, a woman who claimed to represent a pharmaceutical company. “I don’t think she’s a drug rep,” the resident said.

Pou assumed the woman was a reporter. “Tell her to quit interfering with the care of my patients,” she told the resident. Pou could not abide this. Simmons, too, was worried. Imagine an operation went poorly: “You’re
that
doctor.” It was a bad environment for her to practice in, and she needed to let it cool.

Simmons, Pou, and the head of her department at Louisiana State University all drew the same conclusion. Days earlier it would have been unthinkable. She had to stop performing surgery.

Notifying her patients, some with advanced cancer, was heartbreaking. Pou called one of them,
James O’Bryant, to tell him and his wife, Brenda, he would need to see someone else for an upcoming operation, the third she would have performed on him.

From the first time Pou met him, that January, she had worried about him. James O’Bryant was a busy working father of two who lived on a bayou off the Pearl River, far from a big city. Months earlier, thinking the pain in his mouth was from bad teeth, he’d put off going to see a doctor. He wasn’t a smoker or a drinker like most of Pou’s other patients with disfiguring facial cancers.

Pou gave the terrified couple her cell-phone number with instructions to call anytime, day or night, to talk about anything at all. They used it frequently.

Before the first surgery Pou had come into the hospital room and enveloped O’Bryant’s family members—including his children, James Lawrence and Tabatha—in kisses and embraces. “We’re all going to pray and we’re not going to stop praying,” she’d said. She rehearsed each step of the surgery with them, describing how she would remove the large tumor from the sinus above O’Bryant’s teeth and reconstruct his face. She hugged and kissed them again and disappeared through a door to scrub for the surgery, leaving O’Bryant’s brother-in-law in tears. He cried at Pou’s tenderness. He had a history of health problems and had never had a doctor treat him this way. The operation lasted more than twenty hours.

At follow-up appointments over months of radiation therapy, the O’Bryants would wait three or four hours to see Pou. Once they were in, she checked James “up one side and down the other,” Brenda would joke. The couple stayed as long as they needed, asked any questions they liked.

The month before the storm, Pou had lifted a flap of skin from O’Bryant’s forehead and swung it on a pedicle across his nose to fill in a hole under his right eye where the skin broke down after radiation therapy.

The flap took root in its new location, and a new surgery was planned
to sever the stalklike connection. But with Katrina bearing down, Pou had decided to delay it. She told the O’Bryants she didn’t want to put James in the hospital with the storm coming at them.

She had promised always to be there for him. Now she said she couldn’t practice and needed some time away; there were questions about what had gone on during the hurricane. She told Brenda her experiences had been horrifying, that anyone who was not there could never, ever understand. That words could never explain it.

BY DECEMBER, Rider, Schafer, and their small team of coworkers had gathered all the pieces of information—detailed toxicology reports, medical records, and autopsies—that an expert would need to determine causes of death for four of the LifeCare patients on the seventh floor. The New Orleans coroner, Frank Minyard, was a gynecologist, not trained to interpret these results to a level of certainty that could verify the prosecutors’ suspicions, so he recommended a forensic pathologist, Cyril Wecht, a longtime friend and colleague who had worked on the John F. Kennedy assassination case and the O.J. Simpson murder trial.

The fast-talking coroner of Allegheny County, Pennsylvania, was a media fixture and had commented on the Memorial investigation on CNN weeks before he was hired. “If you find any morphine in a patient for whom morphine had never been ordered, now, in my opinion, from a forensic, scientific, legal, investigative standpoint, that’s enough, because what are they doing with morphine?”

Wecht reported back to Butch Schafer by phone in early December. “Mr. Schafer, I have reviewed the four cases you sent to me,” he said. All four patients had been found with drugs in their bodies that had not been prescribed for them in the medical records. “I believe that they can be said to have caused or to have substantially contributed to the deaths of the individuals.”

Schafer asked if the drug levels found by the laboratory were abnormally high. Wecht said that didn’t matter.

“When you talk about morphine and you talk about Demerol, any amount when it is not prescribed is significant.”

“Yes sir.”

“Especially with somebody who was severely compromised to begin with …”

“Oh, I agree with you.”

“Morphine is a central nervous system depressant drug that slows down respiration, slows down GI motility, slow down heart rate, lower blood pressure. That is the last thing in the world that they need.”

Still, Schafer homed in on a potential defense. Could the drugs at the levels detected have been given with the intention of relieving pain and not of causing death?

“I see your point,” Wecht said, as if the possibility hadn’t occurred to him. “Let me do this. Let me go back to the levels and deal with that. That is a very good question and yeah, right, absolutely. Let me do that and then I will get back to you on that, whether or not they could be said to be present in therapeutic doses.”

Wecht supplied his answer by fax two days before Christmas. He had found, in a
respected textbook, Randall C. Baselt’s
Disposition of Toxic Drugs and Chemicals in Man
, a range of morphine concentrations associated with previous fatalities. Wecht compared them with the drug levels found in the tissues of the four LifeCare patients. “In all four of the cases it appears that a lethal amount of morphine was administered,” he wrote.

Wecht’s findings seemed to supply the probable cause needed to prosecute Pou and two of the Memorial nurses who the prosecutors believed had first accompanied her on the seventh floor, Cheri Landry and Lori Budo.
Rider and Schafer had not accumulated enough evidence on a third ICU nurse they were investigating. Rider and her colleagues began preparing arrest warrants.

In January, Wecht sent a $7,500 bill to the attorney general’s office
for fifteen hours of work at $500 an hour on the Memorial case. The same day a federal grand jury indicted him on eighty-four counts of alleged wrongdoing, including mixing expenses from his public office and private consulting work. Some argued that the charges were politically motivated, elements of a wave of prosecutions of outspoken Democratic elected officials under the Justice Department of Republican president George W. Bush.