If some of those who died in the aftermath of Hurricane Katrina have been described as stubborn holdouts who ignored an order to evacuate, then these citizens of New Orleans defy that portrait:
The 16 whose bodies were wrapped in white sheets in the chapel of Memorial Hospital. The 34 whose corpses were abandoned and floating in St. Rita’s Nursing Home. The 15 whose bodies were stored in an operating room turned makeshift morgue at Methodist Hospital.
The count does not stop there. Of the dead collected so far in the New Orleans area, more than a quarter of them, or at least 154, are patients, mostly elderly, who died in hospitals or nursing homes, according to interviews with officials from six city hospitals and 26 nursing homes.
By the scores, people without choice of whether to leave or stay perished in New Orleans, trapped in health-care facilities and in many cases abandoned by their would-be government rescuers.
Heroic efforts by doctors and nurses across the city prevented the toll from being vastly higher.
Yet the breadth of the collapse of one of society’s most basic covenants – to care for the helpless – suggests that the elderly and critically ill plummeted to the bottom of priority lists as calamity engulfed New Orleans.
At least 91 patients died in hospitals and 63 in nursing homes not fully evacuated until five days after the storm, according to the interviews, although those numbers are believed to be incomplete.
In the end, withering heat, not floodwaters, proved the deadliest killer, with temperatures soaring to 110 degrees in stifling buildings without enough generator power for air conditioning.
Somehow, no one ever imagined that flooding might force the evacuation of all health- care facilities in a city that sits below sea level and is surrounded on three sides by water.
There were piecemeal plans. Hospitals were required to have enough emergency provisions to operate for two to three days during a disaster.
State officials said it was the hospitals’ responsibility to evacuate patients if necessary.
Nursing homes were required to have their own evacuation plans, complete with contracts with transportation companies.
But once the city filled with water, and the plans by hospitals and nursing homes became quickly overmatched, neither state nor federal agencies came to the rescue, and in some cases they appear to have thwarted efforts to evacuate patients.
In the end, public hospitals turned to a wealthy, for-profit hospital chain for help.
Yet when private companies dispatched helicopters, trucks and buses to evacuate hospitals and nursing homes, officials from the Federal Emergency Management Agency commandeered some of them for other uses, hospital and nursing- home officials said.
The rescue of those who had remained in their homes, or were sheltered in an increasingly chaotic Superdome, became the priority.
FEMA spokeswoman Natalie Rule denied that the agency confiscated any equipment.
Deep water blocked trucks from reaching 11 hospitals, leaving 2,200 patients and more than 11,000 staff members and city residents stranded.
In two public hospitals that primarily treat the poor, emergency generators and wiring were on the ground floor, vulnerable to flooding, because state legislators had repeatedly refused to pay for upgrades. Both washed out in the storm.
For days, individual evacuations by boat and helicopter dragged on, with patients spending up to 12 hours waiting in crowded stairwells and on rooftops before being told they would have to wait another day.