Free Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital by Sheri Fink Page A

spent seven years in Galveston, it would have been a challenge adjusting to the culture, etiquette, tools, and systems of any new hospital. When Pou was passionate about something, whether or not she was right, she stated her beliefs as unequivocally as a partisan talk-show host. Projecting surety was a defensive skill some doctors developed during their training, when attendings “pimped” them, barraging them with tough questions before their peers during rounds. Often, too, patients and families wanted clear answers when there weren’t clear answers to give.
    One day, Pou cornered the nurse in charge of her postsurgical patientsat Memorial. “We can’t have this!” she said. The previous night, one of her patients had become confused after surgery. Nurses caught him trying to get out of bed and pulling at the breathing tube in his neck. A nurse had paged the medical resident on duty to order a set of soft, loose cuffs with long straps. The nurses tied the straps to the bed and placed the soft cuffs on the man’s wrists. This would limit his movements and keep him safe until he was less agitated. When Pou arrived the next morning and saw her patient restrained, she was unhappy. She told the head nurse to ask a hospital risk manager for workers who would sit at the patient’s bedside twenty-four hours a day and watch him to make sure he was safe without the restraints. It was an unusual request. It earned Pou respect from the nurse in charge. To her, it meant that Pou had compassion for her patients.
    Unlike many surgeons who manifest their authority by getting ugly or impatient in the operating theater, Pou was methodical and explained things carefully to residents and nurses. She had a way of speaking like a schoolteacher, enunciating her words to draw out each syllable and nodding her head for emphasis.
    Perhaps more than anything it was the type of patients Pou cared for that impressed those around her. These patients were dealing not only with cancer, but also the way it deformed their faces. Some coughed and sputtered and had a hard time speaking. Pou split her time between several hospitals. At Charity, she created a clinic for low-income patients with head and neck cancers to receive advanced treatments and reconstructive surgery. She convinced an array of doctors and therapists to provide these services without receiving additional pay.
    On January 15, 2005, Pou attended an annual banquet at the RitzCarlton in New Orleans to celebrate the installation of Memorial Medical Center’s elected medical staff leaders. The festivities took place under crystal chandeliers. The Blackened Blues Band belted out rock, blues, and soul music. Giant trays of oysters and shrimp balanced on the banquet table beside bouquets bursting with lilies, birds-of-paradise, andirises. Dessert tables adorned with Mardi Gras beads, masks, and candles held trays laden with tarts.
    Pou wore a short-sleeved pantsuit with a double strand of pearls and pearl drop earrings and a sleek, chin-length hairstyle. She spent the evening socializing with other members of the medical staff and their spouses, flashing her broad, toothy smile for the event photographer.
    The doctors’ lavish party contrasted with the troubled state of Memorial’s parent company, Tenet Healthcare, which owed hundreds of millions of dollars in fees and settlements for allegations of fraud and unnecessary surgeries at other hospitals. Tenet faced falling stock prices, multibillion-dollar operating losses, a federal lawsuit for overbilling Medicare to inflate revenues, and a class-action lawsuit by shareholders for allegedly having misled investors. As part of an aggressive shift away from this troubled history, Tenet had moved its corporate headquarters from California to the Gulf South in Dallas, andwas in the process of selling twenty-seven hospitals that weren’t meeting financial goals.
    The doctors affiliated with Memorial followed the news, but they still hadmuch