Doctor's arrest in New Orleans

[cubs3canes]

First. I worked with Dr. Pou as a medical student. I can tell you that she is an excellent ENT surgeon. She only did the toughest of Bilateral necks and 2-5 dissections. She averaged 8-10 hours in the OR (not the fastest of ENTs but good for an academic practice), but she was always pleasant, allowed the chief resident to drive the cases and just observed, and truely cared about her patients.

Second, she was arrested today on 2nd degree murder along with two nurses from Memorial. She was arrested and NOT charged..there has been no grand jury. She is accussed of euthenizing DNR patients with midazolam and morphine on the wednesday after Katrina.

There are some things I want to say about this case. First, none of us were there to assess the patients and can put ourselves in her shoes. Second, I know that the SICU is on the second floor and the first floor was flooded. Third, she was seen by Dr. Bryant King "carrying syringes filled with medications to those patient's room."

Lastly, the sheriff has something to prove here. I do not know what it was, but he is making a political statement. She offered to come in if they were going to arrest her. Instead, the police showed up to her home and she was brought to NO Central lock-up and booked. I am not against arresting people at home, but not if they offer to come in.

All of the names are of public record so I felt it was safe to use them. Comments?

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[cubs3canes]

One more thing. There is something weird about Dr. King that I wanted to mention. He was the chief resident when I was a 3rd year medical student. I started my rotation in Jan. and he was fired from the service in Feb. I do not know the background..but I just wanted to mention this. He was the one that told the press about this story immediately after Katrina.

 

[caroladybelle]

They should be locking up the real criminals....the forprofit management idiots that didn't evacuate th hospital , knowing full well the danger.

And when no MDs or nurses (2 were also arrested) will work in NO, well, I guess they will just have longer rides/waits for care.

 

[VolatileAgent]

just a general comment. DNR/DNI does not mean "withdraw support", a common misconception in the medical field among doctors, nurses, and other healthcare providers. i recently saw a patient that was "made" DNR/DNI who's hemodialysis was promptly discontinued shortly thereafter by the nephrology service. this resulted in a lengthy "retraining" of that attending (yes, attending) who entered the discontinuation order.

to the original post, i don't even remotely pretend to understand the circumstances surrounding this event. but, if it was done to prevent what she estimated and perceived to be forthcoming suffering, then she was wrong. just not her call to make ethically or otherwise, although i'm sure that her heart was likely ultimately in the right place. we are not licensed to make such decisions no matter how much we might occassionally believe beyond all belief that we are doing the right thing.

 

[tncekm]

Disgusting. Unfortunately, this does not surprise me.

I dont have any idea how they could indict anybody though. With what evidence? Are they going to go off of the lone statement of Dr. King who, according to the thread started, has a sketchy history in the first place?

If she did in fact contribute to their deaths, she should be reprimanded somehow. but 2nd degree murder is quite the charge.

 

[Noyac]

It amuzes me how we have the compassion to end suffering in our pets and other animals but not in our own race.

 

[jetproppilot]

First. I worked with Dr. Pou as a medical student. I can tell you that she is an excellent ENT surgeon. She only did the toughest of Bilateral necks and 2-5 dissections. She averaged 8-10 hours in the OR (not the fastest of ENTs but good for an academic practice), but she was always pleasant, allowed the chief resident to drive the cases and just observed, and truely cared about her patients.

Second, she was arrested today on 2nd degree murder along with two nurses from Memorial. She was arrested and NOT charged..there has been no grand jury. She is accussed of euthenizing DNR patients with midazolam and morphine on the wednesday after Katrina.

There are some things I want to say about this case. First, none of us were there to assess the patients and can put ourselves in her shoes. Second, I know that the SICU is on the second floor and the first floor was flooded. Third, she was seen by Dr. Bryant King "carrying syringes filled with medications to those patient's room."

Lastly, the sheriff has something to prove here. I do not know what it was, but he is making a political statement. She offered to come in if they were going to arrest her. Instead, the police showed up to her home and she was brought to NO Central lock-up and booked. I am not against arresting people at home, but not if they offer to come in.

All of the names are of public record so I felt it was safe to use them. Comments?

I was in New Orleans at a neighboring hospital during Katrina.

I had two of my children with me...one a teenager, one a toddler...

The storm passed....then the power went out. Was nightmarish Monday night...blackness except for the dim emergency bulbs scantily glowing, fire alarm going off about once an hour from faulty smoke detectors....rising temperature....sweating...no air circulation....generators failed....

Tues morning we receive news the levies have breached and catastrophic flooding was imminent. Suggestions of possible thirty foot flood surges received (AM radio). Pandemonium starting to break out. Looting. Gunfire. Reported murders.

I was released. All I could think of was my toddler...young, beautiful, innocent, oblivious. Sucking on his binky. Not worried about me or my teenage son. We could make it. But what about my 2 year old? How do I defend him? I'm weaponless. He cant swim.

Keep in mind we had no communication. No reports of rescue teams.

I had to get out.

Drove out on St Charles Avenue in a convoy with 3 other cars, searching for a side street that would lead us to Tchopatoulas St, which lead to the only bridge outta the city. Everything was blocked by wires, debris, trees...kept glancing back at my 2 year old, sitting oblivious in his carseat....thinking to myself..."Sons, I love you. We may not get outta here in time."

Hard to describe the desparation I felt...knowing very well (at least at the time) that our lives were at risk....we may die here and theres not a god d am ned thing I can do about it, I thought...

finally found an unobstructed sidestreet to the Holy Grail and made it out, glancing at the Walmart near the bridge being looted....

we were free.

Thank God.

Now, keep in mind the ENT doctor was trapped in a flooded hospital...no water, no power, no sewer, no communication....and most importantly, no sign of rescue...water is rising...gunshots outside...

Again, cant describe to you the feeling of being trapped with no sign of rescue...truly a battleground scenerio with insurgents surrounding you..impending doom...

point being...

and I'm not implying anything here...

but, Mr Counselor, WHO ARE YOU TO JUDGE?

Were you there?

Or were you safely 200 miles away surrounded by your family, air condition, a TV set, a toilet, and food?

While doctors/health care workers are fighting for their lives and patient's lives, in 100 degree buildings, with no power, people s hitting in an overflowing toilet, violence outside the door, and flood water everywhere?

Hand-ventilating a critically ill patient who is on deaths-door even before the storm...and now the world, at least from the trapped-doctor's perspective, is literally coming to an end? Again, no rescue in sight.

WHO ARE YOU TO JUDGE? What if she DID what is frequently done to end-stage cancer patients, i.e. morphine infusion for "comfort"?

Huh, Counselor?

Were you there, beside the ENT doctor?

 

[sdn1977]

I was in New Orleans at a neighboring hospital during Katrina.

I had two of my children with me...one a teenager, one a toddler...

The storm passed....then the power went out. Was nightmarish Monday night...blackness except for the dim emergency bulbs scantily glowing, fire alarm going off about once an hour from faulty smoke detectors....rising temperature....sweating...no air circulation....generators failed....

Tues morning we receive news the levies have breached and catastrophic flooding was imminent. Suggestions of possible thirty foot flood surges received. Pandemonium starting to break out. Looting. Gunfire. Reported murders.

I was released. All I could think of was my toddler...young, beautiful, innocent, oblivious. Sucking on his binky. Not worried about me or my teenage son. We could make it. But what about my 2 year old? How do I defend him? I'm weaponless. He cant swim.

Keep in mind we had no communication. No reports of rescue teams.

I had to get out.

Drove out on St Charles Avenue in a convoy with 3 other cars, searching for a side street that would lead us to Tchopatoulas St, which lead to the only bridge outta the city. Everything was blocked by wires, debris, trees...kept glancing back at my 2 year old, sitting oblivious in his carseat....thinking to myself..."Sons, I love you. We may not get outta here in time."

Hard to describe the desparation I felt...knowing very well (at least at the time) that our lives were at risk....we may die here and theres not a god d am ned thing I can do about it, I thought...

finally found an unobstructed sidestreet to the Holy Grail and made it out, glancing at the Walmart near the bridge being looted....

we were free.

Thank God.

Now, keep in mind the ENT doctor was trapped in a flooded hospital...no water, no power, no sewer, no communication....and most importantly, no sign of rescue...water is rising...gunshots outside...

Again, cant describe to you the feeling of being trapped with no sign of rescue...truly a battleground scenerio with insurgents surrounding you..impending doom...

point being...

and I'm not implying anything here...

but, Mr Counselor, WHO ARE YOU TO JUDGE?

Were you there?

Or were you safely 200 miles away surrounded by your family, air condition, a TV set, a toilet, and food?

While doctors/health care workers are fighting for their lives and patient's lives, in 100 degree buildings, with no power, people s hitting in an overflowing toilet, violence outside the door, and flood water everywhere?

Hand-ventilating a critically ill patient who is on deaths-door even before the storm...and now the world, at least from the trapped-doctor's perspective, is literally coming to an end? Again, no rescue in sight.

WHO ARE YOU TO JUDGE? What if she DID what is frequently done to end-stage cancer patients, i.e. morphine infusion for "comfort"?

Huh, Counselor?

Were you there, beside the ENT doctor?

WOW!

I recall reading a few of your posts from last fall - especially taking your children with you to the hospital.

This is the stuff of nightmares! You obviously still recall the events/emotions very well & your toddler probably doesn't remember. How is your teenager?

No judgement here - only admiration for those of you who had to make it work & grateful to not have to sit on this jury!

All the best!

 

[ntubebate]

Something just isn't right here.
Was reading an article on MSN where one of the "witnesses" says that Dr. Pou was going to administer "morphine & ativan". However if you read the reports the investigation is involving morphine & midazolam. Maybe not significant but just one of many things that "doesn't seem right".

No one, let alone a physician, should be put in the position those poor people were left in.

ntubebate

 

[jetproppilot]

WOW!

I recall reading a few of your posts from last fall - especially taking your children with you to the hospital.

This is the stuff of nightmares! You obviously still recall the events/emotions very well & your toddler probably doesn't remember. How is your teenager?

No judgement here - only admiration for those of you who had to make it work & grateful to not have to sit on this jury!

All the best!

Teenager is fine, back to worrying about "important" stuff...girls, the blown head gasket on his 4 wheel drive truck, etc.

I still recall my drive outta the city.

Sounds melodramatic, I'm sure.

Still bothers me sometimes. The toddler part.

 

[cloud9]

Three charged over Katrina deaths

A doctor and two nurses have been charged with murdering hospital patients in the US city of New Orleans after Hurricane Katrina last year.

The three, who were arrested and then released on bail, are accused of giving lethal injections to four people.

At least 34 patients died at Memorial Medical Center, which was cut off after Katrina hit the city on 29 August.

Prosecutors have investigated claims of negligence and euthanasia, and subpoenaed 73 staff in the inquiry.

Dr Anna Pou and nurses Lori Budo and Cheri Landry have been charged with four counts of second-degree murder.

They are accused of giving four patients - two in their 90s and two in their 60s - lethal doses of morphine and a sedative.

Louisiana Attorney General Charles C Foti said: "This is not euthanasia. This is homicide."

He added: "While I am aware of the horrendous conditions that existed after Hurricane Katrina... I believe that there is no excuse for intentionally killing another living human being."

He said he expected more arrests to follow.

A lawyer for Dr Pou said she was innocent of the charges.

Stranded

Patients at the 317-bed hospital spent four days stranded in floodwater, with no electricity, after Hurricane Katrina struck Louisiana.

Before rescuers reached the hospital, at least 34 patients had died.

Tenet Healthcare Corporation, which owns Memorial, said the arrest warrants alleged that the medics "may have administered pain medication that hastened the deaths of certain patients in the chaotic aftermath of Hurricane Katrina".

"If proven true, these allegations are very disturbing. Euthanasia is repugnant to everything we believe as ethical healthcare providers, and it violates every precept of ethical behaviour and the law."

In all, more than 970 people are known to have died in Louisiana in the aftermath of Katrina, and more than 200 in neighbouring Mississippi.

In a separate case, two nursing home owners were charged with manslaughter last year over the deaths of dozens of people at the St Rita's home.

They are accused of ignoring orders to move residents out.

 

[tncekm]

It amuzes me how we have the compassion to end suffering in our pets and other animals but not in our own race.

It has nothing to do with compassion. its all about votes, unfortunately. :sad: This is even worse to me. To me, this proves that to many of our politicians, human lives are almost worthless to them--for the greater good, of course .

 

[Monty Python]

It has nothing to do with compassion. its all about votes, unfortunately. :sad: This is even worse to me. To me, this proves that to many of our politicians, human lives are almost worthless to them--for the greater good, of course .

This truly upsets me from a multitude of perspectives.

I was born and raised in New Orleans. I was born in that hospital as was my mother and mother-in-law. It's the former Southern Baptist Hospital, renamed Memorial when sold to Tenet.

The deaths occured on the long-term rehab floor, which was sub-let by Lifecare. Technically those pts were not Memorial pts, but were Lifecare's.

Dr. Pou was not a Lifecare physician. Those were not her pts. That's the main smoking gun which got the attention of the legal system.

Of course this is probably grandstanding by the Louisiana Attorney General. But remember, he had to present evidence to the Grand Jury before indictments were handed down. He and the police issued arrest warrants only after the Grand Jury (a jury of our peers) examined the evidence and decided there was probable cause.

I'm not defending anyone, just reciting the facts.

There is also the probability of medical staff internal personality conflicts and getting even here.

Nobody is going to jail unless proven guilty at trial, convicted by a different jury of their peers. Given all the horrible conditions aptly described by JPP, how do they expect to find 12 citizens willing to convict? Highly doubtful.

 

[Noyac]

Given all the horrible conditions aptly described by JPP, how do they expect to find 12 citizens willing to convict? Highly doubtful.

You'd be surprised.

Remeber OJ?

 

[lexrageorge]

...
Nobody is going to jail unless proven guilty at trial, convicted by a different jury of their peers. Given all the horrible conditions aptly described by JPP, how do they expect to find 12 citizens willing to convict? Highly doubtful.

Very easily, actually. Just paint the defendants as well-off individuals (we all know that all doctors are "rich" to most jurors). Have a relative of one of the so-called victims explain how his life was ruined by the premature death of his 90 year old grandmother who had 2 weeks to live. Go on about how these patients trusted the medical staff to save their life through this tragedy. And so on.

Don't ever trust DA's to not use every dirty trick in the book to get a high profile conviction.

At the very least, the true victims in this case will incur huge legal fees.

 

[Dr. J?]

I was in New Orleans at a neighboring hospital during Katrina.

I had two of my children with me...one a teenager, one a toddler...

The storm passed....then the power went out. Was nightmarish Monday night...blackness except for the dim emergency bulbs scantily glowing, fire alarm going off about once an hour from faulty smoke detectors....rising temperature....sweating...no air circulation....generators failed....

Tues morning we receive news the levies have breached and catastrophic flooding was imminent. Suggestions of possible thirty foot flood surges received (AM radio). Pandemonium starting to break out. Looting. Gunfire. Reported murders.

I was released. All I could think of was my toddler...young, beautiful, innocent, oblivious. Sucking on his binky. Not worried about me or my teenage son. We could make it. But what about my 2 year old? How do I defend him? I'm weaponless. He cant swim.

Keep in mind we had no communication. No reports of rescue teams.

I had to get out.

Drove out on St Charles Avenue in a convoy with 3 other cars, searching for a side street that would lead us to Tchopatoulas St, which lead to the only bridge outta the city. Everything was blocked by wires, debris, trees...kept glancing back at my 2 year old, sitting oblivious in his carseat....thinking to myself..."Sons, I love you. We may not get outta here in time."

Hard to describe the desparation I felt...knowing very well (at least at the time) that our lives were at risk....we may die here and theres not a god d am ned thing I can do about it, I thought...

finally found an unobstructed sidestreet to the Holy Grail and made it out, glancing at the Walmart near the bridge being looted....

we were free.

Thank God.

Wow...I cannot imagine. Something to think about while following the case through the courts. Nice post, indeed.

 

[TIVA]

If I had been one of those patients in the ICU ...

stranded, helpless, on life support or whatever of life support was remaining, with the heat, bugs, no one to change the bedsheets or diapers, rapidly rising flood waters, darkness, and depleting supply of oxygen ...

I would hope that a doctor or nurse would be brave enough and kind enough to put me out of my misery.

One of the most noble things any human can do in such a catastrophe is to say, "leave me, and rescue yourself."

 

[militarymd]

.............We could make it. But what about my 2 year old? How do I defend him? I'm weaponless..............

Jet,

You need to get one of these....and no...it's not an Airsoft.

 

[Monty Python]

Jet,

You need to get one of these....and no...it's not an Airsoft.

and for close in protection, a Glock model 27 (sub-nose .40 cal), combined with a Louisiana concealed handgun permit, honored in ~30 other states via reciprocity.

http://www.lsp.org/handguns.html

Apologies to the anti-gun readers.

 

[underdog27]

No need to apologize Trinity......BTW nice gun Mil!!!!!

 

[jetproppilot]

[He added: "While I am aware of the horrendous conditions that existed after Hurricane Katrina... I believe that there is no excuse for intentionally killing another living human being...

HAHHAHAHAHAHAHAHAHAHAHAHHAAHAH

I am just eating up the politically motivated, publicity driven comments....

"WHILE I AM AWARE OF THE HORRENDOUS CONDITIONS...."

what a politically motivated comment, huh?

HEY, COUNSELOR FOTI!!!!! I WAS THERE, MOTHER FUC K ER!!!!!

WERE YOU THERE????

Did you feel the despair/hopelessness that we felt?

Are you REALLY SURE Doctor Pou is a cold-blooded killer????

Or are you just like all other politically-motivated-a s sholes, looking for a great story to promote yourself to the national media for personal-gain????????

This s h it makes me sick to my stomach. Literally.

The doctor-chick's life is ruined. No matter what. Hefty lawyer fees. Public scrutiny. Personal-emotional stress.

And, I'm sure, Dr Pou was trying to do the right thing IN THE ABSENCE OF ANY IMPENDING RESCUE....

again, I emphasize, BEING SOMEONE WHO EXPERIENCED IT, UNLIKE COUNSELOR FOTI,

as far as we knew,

THE WORLD WAS ENDING. OUR LIVES WERE OVER. OH, BY THE WAY, THE UNITED STATES GOVERNMENT WAS SENDING NOONE TO RESCUE US.

Yeah, that sounds funny now. But read the above again. Thats what everyone who was in New Orleans following Katrina felt, at least initially.

Our nation took too long to respond to the catastrophes in New Orleans following Katrina. But thats a completely different thread.

UHHHHHHHHHHHHHHHHHHHHHHHHHH,

COUNSELOR FOTI,

You are prosecuting a well-intended physician who was caught in one of the largest United States catastrophes (unlike you.....you werent here) WHO WAS ACTING OUT OF COMPASSION FOR THE HELPLESS PATIENTS SURROUNDING HER.

 

[jetproppilot]

HAHHAHAHAHAHAHAHAHAHAHAHHAAHAH

I am just eating up the politically motivated, publicity driven comments....

"WHILE I AM AWARE OF THE HORRENDOUS CONDITIONS...."

what a politically motivated comment, huh?

HEY, COUNSELOR FOTI!!!!! I WAS THERE, MOTHER FUC K ER!!!!!

WERE YOU THERE????

Did you feel the despair/hopelessness that we felt?

Are you REALLY SURE Doctor Pou is a cold-blooded killer????

Or are you just like all other politically-motivated-a s sholes, looking for a great story to promote yourself to the national media for personal-gain????????

This s h it makes me sick to my stomach. Literally.

The doctor-chick's life is ruined. No matter what. Hefty lawyer fees. Public scrutiny. Personal-emotional stress.

And, I'm sure, Dr Pou was trying to do the right thing IN THE ABSENCE OF ANY IMPENDING RESCUE....

again, I emphasize, BEING SOMEONE WHO EXPERIENCED IT, UNLIKE COUNSELOR FOTI,

as far as we knew,

THE WORLD WAS ENDING. OUR LIVES WERE OVER. OH, BY THE WAY, THE UNITED STATES GOVERNMENT WAS SENDING NOONE TO RESCUE US.

Yeah, that sounds funny now. But read the above again. Thats what everyone who was in New Orleans following Katrina felt, at least initially.

Our nation took too long to respond to the catastrophes in New Orleans following Katrina. But thats a completely different thread.

UHHHHHHHHHHHHHHHHHHHHHHHHHH,

COUNSELOR FOTI,

You are prosecuting a well-intended physician who was caught in one of the largest United States catastrophes (unlike you.....you werent here) WHO WAS ACTING OUT OF COMPASSION FOR THE HELPLESS PATIENTS SURROUNDING HER.

OH! HEY! COUNSELOR FOTI!

Have you heard?

A familymember of one of the patients involved in this issue is speaking out IN SUPPORT OF DOCTOR POU'S ACTIONS.

Hmmmmm...

maybe the familymember has no need/desire to politically-grandstand, and is speaking from the heart about the truth , unlike you, Counselor Foti, you spineless-publicity-seeking-mothr-fkkkkrrrr, who is

trying to distort the truth, at THE EXPENSE OF OTHERS.

Said familymember was interviewed and realized the significance of Doctor Pou's care....uhhhh.....Counselor Foti.....

DOCTOR POU COULDVE PADDLED HERSELF TO SAFETY.

BUT SHE CONTINUED TO CARE FOR PATIENTS. WHO, BY THE WAY, WERE NOT HER PATIENTS.

HER INTERVENTION WAS PHILANTHROPIC.

 

[MirrorTodd]

Jet,

You need to get one of these....and no...it's not an Airsoft.

Nice got the CCO as well I see.

 

[rn29306]

and for close in protection, a Glock model 27 (sub-nose .40 cal), combined with a Louisiana concealed handgun permit, honored in ~30 other states via reciprocity.

http://www.lsp.org/handguns.html

Apologies to the anti-gun readers.

Nice selection. That same gun with night sights resides in my ankle holster. Virtually undetectable with pants on. Pants off is another story.

 

[jetproppilot]

Nice selection. That same gun with night sights resides in my ankle holster. Virtually undetectable with pants on. Pants off is another story.

Thanks for the heads-up, Mil and Trin.

Looks like I need to modify myself, here in the Chocolate City.

 

[PainDr]

and for close in protection, a Glock model 27 (sub-nose .40 cal), combined with a Louisiana concealed handgun permit, honored in ~30 other states via reciprocity.

Nice...however, I prefer the Glock 38, .45 GAP.

Again, cant describe to you the feeling of being trapped with no sign of rescue...truly a battleground scenerio with insurgents surrounding you..impending doom...

I can't imagine...

 

[tkim]

Nice selection. That same gun with night sights resides in my ankle holster. Virtually undetectable with pants on. Pants off is another story.

Got the 27 as a present for being the best man.

The tritium sights are getting a tad dim, though.

Note the ejected case at the 12 o'clock.

 

[militarymd]

for low mainetenance reasons, and also for ultimate stopping power....my ride along buddy is a Ruger GP100 4 inch in .357 magnum.

 

[dhb]

like they say: guns for the show, knifes for the pro

 

[boulux]

Comments?

That makes me very sad. I fail to see how she's a criminal, at least by the standards of my society. I'm not a hater at all, but there's something wrong about these events that seem to occur pretty often in the states.

 

[rn29306]

like they say: guns for the show, knifes for the pro

I prefer not to get that close to someone for a knifefight, but hey, that's just me. Apologies to the OP for the slight hijacking here.

 

[VolatileAgent]

spin, spin, spin... and this will be a quagmire of public opinion...

http://www.latimes.com/news/local/la-na-katrina21jul21,0,6607636.story?coll=la-home-headlines

maybe, just maybe, an interesting counterploy would be to arrest Foti for dereliction of duty, and charge him with murder. seems just as reasonable after reading this article, doesn't it?

i don't know what to think about this. the jury is definitely out for me. but, just remember this, current and future healthcare providers:

DNR does not mean withdraw support!

say that to yourselves over and over again until it completely sinks in. i'm stunned how, on a daily basis, i see intelligent, caring, and otherwise well-meaning people repeatedly get these two distinct concepts confused.

 

[PainDr]

DNR does not mean withdraw support!

say that to yourselves over and over again until it completely sinks in. i'm stunned how, on a daily basis, i see intelligent, caring, and otherwise well-meaning people repeatedly get these two distinct concepts confused.

I don't think anyone is getting anything confused. I wasn't in NO but have a close friend who was. It WAS like a war zone and even worse, the water was rising with no end in sight. It RAPIDLY became evident that all bets were off and everyone was on their own. No running water, electricity or waste disposal and very limited food, water, medical supplies and generator capacity. At one hospital (probably the same scene at many hospitals), they had to move patients to upper floors (manually) to protect them from the water and the looters down below. YES...PEOPLE WERE LOOTING THE HOSPITALS!!! Unless you were there yourself, you don't have to right to judge anyone.

 

[VolatileAgent]

Unless you were there yourself, you have to right to judge anyone.

i believe you meand to say "don't" have the right to judge. but, frankly, i can do whatever i want. this is an open forum where opinions are shared. but, nonetheless (and to redirect you away from your distracted rant and back on point) what part of this statement did you not understand...

i don't know what to think about this. the jury is definitely out for me.

i wasn't there. i have no idea what dr. pou was thinking. there will be a trial both in the criminal courts as well as the court of public opinion. posturing has already started on all sides. so, despite that i'm as fully entitled to my personal opinion as much as you are, it really doesn't matter what i (or you, for that matter) think. frankly, i could care less about her actions. they don't effect me or what i do in my life, personal or professional, in any way, shape, or form, unless the ripples of the forthcoming case somehow affects public policy on a national level. so, in trying to point some "holier-than-thou" finger at me, don't misdirect your own brand of judgmentalism back on me.

when i say DNR does not equate to withdrawing support, i'm speaking in general terms. i'm in training in the middle of pennsylvania far, far away from katrina's aftermath, and i still see this concept confused on a daily basis. there is a bigger lesson to be learned here.

drill this into your head now. remember this concept. that is all i'm saying. it will serve you well if/when you find yourself trying to defend your actions in either criminal or civil court (or both). or, if you want to do what you perceive to be merciful, be prepared for the aftermath and bearing the wrath of the ineluctable exorcising of someone else's theopolitical agenda, in this case a good 'ole boy sheriff up for re-election in the buckle of the god-fearing bible belt. you of all people should know that we scary doctor's can't be trusted to do the right thing.

 

[PainDr]

DNR does not mean withdraw support!

say that to yourselves over and over again until it completely sinks in. i'm stunned how, on a daily basis, i see intelligent, caring, and otherwise well-meaning people repeatedly get these two distinct concepts confused.

If you had been more observant, you might have taken note of the fact that I was only responding to the above statements. You are correct, you are entitled to your opinion and yes, my post was a rant. It's just frustrating when someone such as yourself presumes that others don't know what they're doing. I wasn't really questioning your right to an opinion, just responding to your inane presumptions and condescending point of view. I don't think anyone here really needs a RANT about the meaning of DNR.

when i say DNR does not equate to withdrawing support, i'm speaking in general terms. i'm in training in the middle of pennsylvania far, far away from katrina's aftermath, and i still see this concept confused on a daily basis. there is a bigger lesson to be learned here.

If you were closer to the aftermath you might have different opinions and/or choose a diffferent thread in which to discuss the GENERAL meaning of DNR. BTW, I'm sorry you're surrounded by so many idiots, but I'm sure you can educate them.

 

[bubalus]

like they say: guns for the show, knifes for the pro

Like they say: Never bring a knife to a gunfight.

 

[dogbone65]

spin, spin, spin... and this will be a quagmire of public opinion...

http://www.latimes.com/news/local/la-na-katrina21jul21,0,6607636.story?coll=la-home-headlines

maybe, just maybe, an interesting counterploy would be to arrest Foti for dereliction of duty, and charge him with murder. seems just as reasonable after reading this article, doesn't it?

i don't know what to think about this. the jury is definitely out for me. but, just remember this, current and future healthcare providers:

DNR does not mean withdraw support!

say that to yourselves over and over again until it completely sinks in. i'm stunned how, on a daily basis, i see intelligent, caring, and otherwise well-meaning people repeatedly get these two distinct concepts confused.

Nice article. Good job doctors.....thanks for having a spine and a pair....those in the article, that is.

 

[undecided05]

I'm in agreeance with "volatile agent" as I had a few run-ins with a ICU fellow who hemmed and hawed about admitting patients to the ICU for treating septic patients with early goal directed therapy b/c they were DNR/DNI and more than one time it led to patient's not getting the treatment they DESERVED. That fellow felt that the ICU was not a place for DNR/DNI.

DNR/DNI does not equate do not treat... it's ok to give fluids, atbx, O2, blood, +/- pressors based on the DNR... but to sit by and make judgements about whether a patient is better off dead isn't our call, it's the patients.

While some may think that this is obvious, you'd be shocked at how many get this confused.... it has nothing to do with NOLA.

 

[VolatileAgent]

If you were closer to the aftermath you might have different opinions and/or choose a diffferent thread in which to discuss the GENERAL meaning of DNR. BTW, I'm sorry you're surrounded by so many idiots, but I'm sure you can educate them.

While some may think that this is obvious, you'd be shocked at how many get this confused.... it has nothing to do with NOLA.

i can't help but think that this issue, in likely no small way, contributed to dr. pou's decision to do what she did. but, i admit i may be wrong.

 

[Dr. J?]

I'm in agreeance with "volatile agent" as I had a few run-ins with a ICU fellow who hemmed and hawed about admitting patients to the ICU for treating septic patients with early goal directed therapy b/c they were DNR/DNI and more than one time it led to patient's not getting the treatment they DESERVED. That fellow felt that the ICU was not a place for DNR/DNI.

DNR/DNI does not equate do not treat... it's ok to give fluids, atbx, O2, blood, +/- pressors based on the DNR... but to sit by and make judgements about whether a patient is better off dead isn't our call, it's the patients.

While some may think that this is obvious, you'd be shocked at how many get this confused.... it has nothing to do with NOLA.

I have also seen the "DNR/DNI = no treatment" issue come up several times while on different services. In fact, just two days ago a CRNA was complaining to me about having to do sedation for colonoscopies on geriatric pts who were DNR - he said, "what was the point?" I just let it go.

I agree that this is a very common misconception in the hospital (esp among nursing, but even among physicians, as well). May not be germane to the current Katrina discussion, though. Still a good point.

 

[Robert Loblaw]

DNR/DNI does not equate do not treat... it's ok to give fluids, atbx, O2, blood, +/- pressors based on the DNR... but to sit by and make judgements about whether a patient is better off dead isn't our call, it's the patients.

While some may think that this is obvious, you'd be shocked at how many get this confused.... it has nothing to do with NOLA.

It is very unfortunate that something so important as a DNR order can be so badly misunderstood. We typically clarify by making people DNR A, B, or C, with each level based on the interventions a patient would have done...usually A means no heroic measures, including CPR, shocking, etc; B usually means that we would not ADD further therapies to support essential functions, i.e. no pressors, no intubations, but still ABX, etc; and C usually means comfort care only.

The point that I wanted to make is that, so long as the primary motivation is to relieve suffering and not to kill a patient, it is entirely ethical to treat a critically ill, DNR C, patient's pain with as much narcotic as needed to relieve suffering, EVEN IF the dosage required may be of sufficient quantity to stop the patient from breathing. This is very important. If a patient is suffering and in pain, you give narcotic until the suffering and pain is relieved.

We do not know the histories or the circumstances, but I would say that if it were Mrs C, whom I met in our SICU in 2005, who was, sadly, 52 years old, emaciated and dying slowly from pancreatic cancer and starvation, I would most certainly have humanely treated her suffering. I can still see her slumped over in her bed Cheyne-Stoke'ing away...

I think I speak for most of us when I say that this is something that no sheriff or prosecutor could ever understand.

 

[jetproppilot]

i believe you meand to say "don't" have the right to judge. but, frankly, i can do whatever i want. this is an open forum where opinions are shared. but, nonetheless (and to redirect you away from your distracted rant and back on point) what part of this statement did you not understand...



i wasn't there. i have no idea what dr. pou was thinking. there will be a trial both in the criminal courts as well as the court of public opinion. posturing has already started on all sides. so, despite that i'm as fully entitled to my personal opinion as much as you are, it really doesn't matter what i (or you, for that matter) think. frankly, i could care less about her actions. they don't effect me or what i do in my life, personal or professional, in any way, shape, or form, unless the ripples of the forthcoming case somehow affects public policy on a national level. so, in trying to point some "holier-than-thou" finger at me, don't misdirect your own brand of judgmentalism back on me.

when i say DNR does not equate to withdrawing support, i'm speaking in general terms. i'm in training in the middle of pennsylvania far, far away from katrina's aftermath, and i still see this concept confused on a daily basis. there is a bigger lesson to be learned here.

drill this into your head now. remember this concept. that is all i'm saying. it will serve you well if/when you find yourself trying to defend your actions in either criminal or civil court (or both). or, if you want to do what you perceive to be merciful, be prepared for the aftermath and bearing the wrath of the ineluctable exorcising of someone else's theopolitical agenda, in this case a good 'ole boy sheriff up for re-election in the buckle of the god-fearing bible belt. you of all people should know that we scary doctor's can't be trusted to do the right thing.

I understand the meaning of DNR.

I also am confused to how the definition of DNR relates to this thread.

Uhhh, I was there, folks.

Unfortunately.

This was not a case of someone being DNR or not.

By the way, the definition of DNR was made while everyone, doctors, lawyers and indian chiefs were sitting around a big cherrywood table, room temperature about 72 degrees, getting up periodically during the meeting to refill their coffee cup or take a pee....

trying to give guidelines to their physician colleagues practicing in america, most of which occurs in non-threatening hospital environments with temperatures of about 72 degrees, where the doctors, during rounds on said potential DNR patients take periodic coffee/pee breaks, rounding on critically ill patients who lay in an ICU bed in an air-conditioned ICU complete with power to run the ventilator and IV pumps, ample nursing staff, respiratory therapists, pharmacists, nurses aids to clean the poo away, housekeeping to change the sheets and mop the floors....

DON'T YOU GET IT????

NEW ORLEANS, LOUISIANA ON-AND-SHORTLY-THEREAFTER-AUGUST 29th, 2005,

WAS NOT AMERICA.

It was a warzone for those unfortunately trapped in the nightmare that, despite pleas for help, heard no response.

How can you project the definition of DNR as it is known in real-world america and expect me, a dude who experienced the horror/fear/despair/loneliness (albeit to a lesser extent than Dr Pou since I left on Tuesday) of being isolated in a lawless, flood-water-rising city, to recognize the definition of DNR IN THOSE CIRCUMSTANCES???

You're REALLY trying to apply a definition that, IMHO, didnt apply.

Let me ask you....and answer it truthfully...not for me, nor not on this board....but answer it for yourself, then reread your effort to apply the DNR definition to this situation:

Have you ever, truthfully, been in a situation, on a global level, where you've been isolated from the rest of the world, communication has been cut off, you have limited food/water, rising flood waters, no sewage system, with looting criminals surrounding you?

And as far as you know, noone is coming to help you, or the critically ill people around you.

You feel there is no way out.

In other words, the world has begun its end, at least in your microcosm/city.

Stop a minute.

Read the above again.

I ain't making this s h it up. Wish I was. This stuff really happened. And was felt...thats right.....HEART-felt...by the individuals unfortunately trapped in this situation...

...guess I feel the need to qualify the above, to let you know this is being posted by a confident, assertive, successful, goal-oriented, fearless, 210 lb-gym-rat....who was reduced to a fear-filled, despair-ridden, hopeless, I-gotta-try-and-get-Sooga (nickname of my 2 year old)-outta-here-motherfu kkk er, due to the hopeless-surrounding scenerio.......

Sounds to me like you are trying to apply real-world ethics to a warzone.

Sounds like you werent here to see and feel what I saw/felt, and are trying to apply real-world definitions to a non-real-world scenerio.

Just like the politically-motivated lawyers.

 

[jetproppilot]

when i say DNR does not equate to withdrawing support, i'm speaking in general terms. i'm in training in the middle of pennsylvania far, far away from katrina's aftermath, and i still see this concept confused on a daily basis. there is a bigger lesson to be learned here.

drill this into your head now. remember this concept.

No Dude,

you listen to me.

Drill this into your head now. Remember this concept.

Post Katrina in New Orleans was like no other catastrophe known to this country.

We were cut off from the rest of the world.

Our world was coming to an end.

I left my hospital on the Tuesday after the storm FULLY CONVINCED I would never see it again.

I thought I was gonna die. And I ain't no drama-king...

Worse yet, I thought my two-year-old was gonna die.

How you think normal medical-ethics rules applies to this scenerio is beyond me.

 

[rn29306]

From what I heard, the RNs/RTs where having themselves resus with IV fluids after sitting on rooftops (in NOLA mind you) with previously vent-dependent, now Ambu-dependent patients, awaiting helicopter liftoffs. And that was after evac'ing the depedent out on backboards up stairs.


I'm sorry, but when the healthcare providers / staff start having to have IVs for basic physiological functioning, the rules go out the f'ing window.

 

[jetproppilot]

spin, spin, spin... and this will be a quagmire of public opinion...

i'm stunned how, on a DAILY BASIS, i see intelligent, caring, and otherwise well-meaning people repeatedly get these two distinct concepts confused.

And since I'm on a roll,

for tertiary (third post) emphasis,

I take insult to how you apply your DAILY BASIS observation to this scenerio.

This was not a Daily Basis scenerio.

All bets are off with your comparisons of "daily basis... concept confusion" when referring to the health care professionals stuck in New Orleans post-Katrina where, during the following several days, there was NO LOCAL/REGIONAL/NATIONAL rescue response.

Whats really funny about this (hey, dudes gotta find some humor here) is the Fox-news-dudes were able to get in and get the storyline going...

So the Fox-News-Dudes can drive their vans in but the US can't respond to a national crisis in a more timely fashion????

HAHAHAHAHHAHAHAHAHA.

Cracks me up.

 

[DreamMachine]

.

 

[jetproppilot]

i can't help but think that this issue, in likely no small way, contributed to dr. pou's decision to do what she did. but, i admit i may be wrong.

Let me take this one step further by giving you a little inside information about what had to happen at our hospital in order for patients/staff to get rescued.....hey, we're all buddies, right?

Our chief of medical staff, a heart surgeon, was becoming desperate on Wednesday evening or thereabouts.

Despite pleas, nothing concrete was materializing concerning rescue.

Turns out said chief's dad was a doctor/clout-carrying-dude in a neighboring city......chief calls his dad with pleas for help...to save the patients, said-chief's-wife and kids-and himself....

chief's dad comes through, sends a caravan of vans/armed-guards/helicopters to our hospital to evacuate whos-left.....

I'm on the brink of writing chief's name, cuz he's a hero....and his dad is a hero....but will refrain, at least for now...

sad our country didnt provide more support to New Orleans when it really needed it, i.e. 0-72 hours post Katrina....

sad the chief MD of a stranded United States hospital has to make a call to his dad for help....

 

[jetproppilot]

Let me take this one step further by giving you a little inside information about what had to happen at our hospital in order for patients/staff to get rescued.....hey, we're all buddies, right?

Our chief of medical staff, a heart surgeon, was becoming desperate on Wednesday evening or thereabouts.

Despite pleas, nothing concrete was materializing concerning rescue.

Turns out said chief's dad was a doctor/clout-carrying-dude in a neighboring city......chief calls his dad with pleas for help...to save the patients, said-chief's-wife and kids-and himself....

chief's dad comes through, sends a caravan of vans/armed-guards/helicopters to our hospital to evacuate whos-left.....

I'm on the brink of writing chief's name, cuz he's a hero....and his dad is a hero....but will refrain, at least for now...

sad our country didnt provide more support to New Orleans when it really needed it, i.e. 0-72 hours post Katrina....

sad the chief MD of a stranded United States hospital has to make a call to his dad for help....

And heres another (I guess this is a quaternary) post....

if you're ever in a situation like I was in with this Katrina s h it...

LOOK FOR AN OLD FASHION PAY PHONE.

Tuesday morning around 7 am I was wandering my war-zone-bitten hospital...on the ground floor theres a line of five-or-so pay phones...

...picked up a phone....

....DIAL TONE!!!!!

Called my sister....geez this is bringing back some f u kkk ed up memories....told her I, Evan and Sooga (the affectionate nickname of my toddler) were OK and were about to try and blow this joint....and that...if we didnt make it...that...well, you know, I loved everyone, blah blah blah...

I wish the stuff you were reading was melodrama I was making up....but its not....true stuff here....

anyway, point being,

if you don't have a satellite cell phone in a natural disaster, look for an old fashion pay-phone.

You'll probably pick it up and hear a most-comforting sound....a sound that has the potential to reconnect you to the world...something everyone takes for granted every day of our lives....

a dial tone.

 

[GasEmDee]

I understand the meaning of DNR.

I also am confused to how the definition of DNR relates to this thread.

I agree with Jet and PainDr. The definition of DNR is not relevant to this thread. How would this discussion be any different if the patients were full code?

I personally find it hard to judge people in extreme circumstances that are well beyond my own experience and imagination. Furthermore, I think it is an insult to claim understanding of the Katrina situation, if you werent there and have not had a comparable experience elsewhere.

Unfortunately, Dr. Pou cannot escape from this battle unscathed. She is irrevocably tainted, not only by the nightmarish experience, but now also by the media and the legal system. However, I hope she will be judged by her true peers, i.e., those who have a personal understanding if what it was like to be at Katrina's ground zero.

 

[GasEmDee]

when i say DNR does not equate to withdrawing support, i'm speaking in general terms. i'm in training in the middle of pennsylvania far, far away from katrina's aftermath, and i still see this concept confused on a daily basis. there is a bigger lesson to be learned here.

The definition of DNR is a bigger lesson than the Katrina disaster? I could not disagree with you more.