It’s a Thursday evening in Oakland, and luckily, the current rain hasn’t gotten in the way of tonight’s book club at Novel Brewing, a book-themed brewery in the heart of the San Pablo corridor. I’m excited that Michael Marsh, a paramedic with decades of disaster and operational experience, and Dr. John Brown, the San Francisco EMS medical director who is also active in our local Disaster Medical Assistance Team (DMAT), will be joining us. Their first-hand perspectives of Katrina will add a more personal touch to the dark drama that Fink so eloquently regales.

In Five Days at Memorial: Life and Death in a Storm Ravaged Hospital, Sheri Fink, an MD-turned-journalist, describes the fate of the patients and staff who faced the storm from within Memorial Hospital’s walls. As the decisions made during this unique, chaotic time cannot be evaluated from the place of our normal lives, she begins her expose by providing a historical and sociological context. When Katrina strikes, she provides a clear timeline of how the social framework and other mores governing our everyday lives start to break down, both inside and outside the hospital. We see how the uncoordinated, ineffective initial disaster response leads to further hopelessness.

Physicians and nurses start to make up their own triage methods, including giving last priority to any patient with a DNR status, irrespective of their current clinical condition. When the first patients are euthanized, Fink almost makes it seem like the only option. Although a reader might think that this situation was a complete anomaly born out of the unique events that occurred at one crazy hospital, Dr. Mary Mercer, the medical director of the San Francisco Base Hospital, adds that the “expectant death” category of triage was being used in many parts of New Orleans. Before Katrina, this category had never before been utilized in the United States; it had never been necessary. The second half of the book follows the legal battles that ensued, seemingly punishing those that had stayed behind to help.