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Quadriplegic & Paraplegic Spinal Cord Injuries > Disabled Living & Spinal Cord Injuries > Spinal Cord Injury Health Issues
ButterflyInAmbr
Today I was reading an article in the New York Times (Link to Article) about triage practices in a hospital after Hurricane Katrina. One of the things that it mentioned, and that made me feel sick, was that there was a large paraplegic man who died because they decided they couldn't carry him down the stairs, so they ended up overdosing him on sedatives rather than getting him out of the hospital.

QUOTE
Robichaux remembered Pou saying that the LifeCare patients were “not aware or not alert or something along those lines.” Robichaux recounted to investigators that she told Pou that that wasn’t true and said that one of LifeCare’s patients — Emmett Everett, a 380-pound man — was “very aware” of his surroundings. He had fed himself breakfast that morning and asked Robichaux, “So are we ready to rock and roll?”

The 61-year-old Honduran-born manual laborer was at LifeCare awaiting colostomy surgery to ease chronic bowel obstruction, according to his medical records. Despite a freakish spinal-cord stroke that left him a paraplegic at age 50, his wife and nurses who worked with him say he maintained a good sense of humor and a rich family life, and he rarely complained. He, along with three of the other LifeCare patients on the floor, had no D.N.R. order.

Everett’s roommates had already been taken downstairs on their way to the helicopters, whose loud propellers sent a breeze through the windows on his side of the LifeCare floor. Several times he appealed to his nurse, “Don’t let them leave me behind.” His only complaint that morning was dizziness, a LifeCare worker told Pou.

“Oh, my goodness,” a LifeCare employee recalled Pou replying.

Two Memorial nurses — identified as Cheri Landry and Lori Budo from the I.C.U. to investigators by a LifeCare pharmacist, Steven Harris — joined the discussion along with other LifeCare workers. (Through their lawyers, Landry and Budo declined to be interviewed. Harris never returned my calls.) They talked about how Everett was paralyzed and had complex medical problems and had been designated a “3” [last to get out] on the triage scale. According to Robichaux, the group concluded that Everett was too heavy to be maneuvered down the stairs, through the machine-room wall and onto a helicopter. Several medical staff members who helped lead boat and helicopter transport that day say they would certainly have found a way to evacuate Everett. They say they were never made aware of his presence....

Kristy Johnson, LifeCare’s director of physical medicine, said she saw what happened next. She told Justice Department investigators that she watched Pou and two nurses draw fluid from vials into syringes. Then Johnson guided them to Emmett Everett in Room 7307. Johnson said she had never seen a physician look as nervous as Pou did. As they walked, she told investigators, she heard Pou say that she was going to give him something “to help him with his dizziness.” Pou disappeared into Everett’s room and shut the door.


This makes me so angry, partially because I'm scared that it could happen to me one day (I'm not currently heavy enough that I couldn't be carried, but who knows what may happen as I age). What do you all think? Are we as paraplegics and quadriplegics enough of a difficulty to transport that it makes sense to save others first in a crisis situation, or should people concentrate their efforts on getting us out because we're more vulnerable in some ways than able-bodied people?
ClaraTaylor
It is the fact that he was a para the issue for them... or the fact that he was just too heavy?
E-DOG
QUOTE (ClaraTaylor @ Aug 27 2009, 01:05 PM) *
It is the fact that he was a para the issue for them... or the fact that he was just too heavy?

Sounds like both.

Fact is, the good of the many must outweigh the good of the few. (Pun not intended)
I weigh about 350 myself. I could see myself getting into the same situation.
If more lives are saved by leaving him behind, then shit, ya gotta do what ya gotta do.

Though it seems like he was put down like a rabid dog, and without his knowing what was going on or given a choice in the matter.
Which is outright murder. First degree murder at that.

But then again, if he'd been told what was gonna happen next he might have gone berserk, creating more problems for the doctors and nurses trying to save everyone else.

Many sides to be seen. Who is of more use to society. Who has family, and how do they feel about the matter. How badly does one person want to live over another. AND the big one, who has more money to freely distribute to all involved after the helicopter lands.
Hell. If I was a doctor and in the right position, I'd kill off a whole ward of patients just to save one rich guy if the money was good enough. But then, my morals are, well, you know the dawg.......

I'll trade these magic beans, I mean these stem cells for a cheese burger today and pay you interest on the deal next week. Promise!
NO! Really!

E-dog wink05.gif
ButterflyInAmbr
yeah, I think you're right, it probably was both his weight and his inability to walk. Maybe I'm overreacting to this, because the article definitely didn't say that all people in wheelchairs were left behind, but the whole thing is just so disturbing. I guess it makes me think of the people who react to the story of my accident by saying "wow, you're doing so well. I would kill myself if that happened to me." So many people seem to think that life in a wheelchair isn't worth living.
bocktribe
Are you all kidding? Pou should be boiled.
chickadee
What an incredible article.

I know that SCI folk will feel strongly about this issue. To be honest, this is one that's going to have to ruminate in my head for a little while. At this point, I know that this may be an obvious point - but the fact that the situation came to this extreme is the most horrifying. The resulting behavior? Ethical or not?

I dunno. In the case of Everett (the man described in the article and quoted above), I'm downright stunned.

Will it be necessary to make living wills to include disaster occurrences?
CR_L1
QUOTE (E-DOG @ Aug 27 2009, 10:02 PM) *
Though it seems like he was put down like a rabid dog, and without his knowing what was going on or given a choice in the matter.
Which is outright murder. First degree murder at that.

I agree,

For others to say they were not made aware of the situation leaves you with the feeling Pou was playing god that day.

poo.gif If you haven’t got enough worries when going into hospital these days, we now learn that we got to keep an eye on the weather.

CR
Jax
I can almost guarantee you it was primarily the weight, and second was the paraplegia. My wife works as a rehab nurse, and I'm a therapy assistant. The rehab center takes in many patients it is not equipped to handle, as does the hospital next door. There are not enough mobile lifts in many places to be able to move heavier patients. At HealthSouth, one patient was 700lbs, and the transporters actually tried to use the 450lb-capacity lift to move him. It broke the lift, and hurt the patient. Also, that makes 1 less lift that they have to use to help other patients who might actually get some good from therapy. At Scott & White in Temple, when I was in rehab, there was a man who was just a tad over 360lbs, and the therapists had to make the hospital and health plan send him to another facility, as they had no lifts that were over 300lb capacity. It's a rapidly-growing problem here (at least in TX.). It's happened in 2 other rehab centers here in the Austin area alone, that the centers just are not equipped for the patients they are admitting.
fatdave
As my user name implies I am obese, and a low para. If I knew my death would save others I would agree, and ask for a large amount of narcotics to help ease the pain. This man did not give consent, therefore it was murder.

I understand that people will do strange things in a panic, but that is no excuse for what happened in this case.
qbounce
In the case of a "Code Red" (Fire), those who can walk are evacuated first. Next are those in a chair, and lastly anyone in a bed.

If you don't need any assistance transfering from bed to chair in the hospital, I recommend always keeping the chair nearby.
wheeliebear75
I think there are 2 major biases that were working against this poor man; #1 is that the majority of our society tends to look down on & devalue anything they don't find "pretty" & also that fat is seen merely as a self-inflicted affliction, the 2nd is that unfortunately those of us with "problems" are often seen as having less value as those who may be a rotten horrible person but hey they can walk down 3 flights of stairs so they're worth the evacuation!

Yes I see that his weight made it more difficult for him to be lifted & carried out but I'm sorry to allow someone to die would be unconscionable but to end someone's life when they clearly wanted to live is truly a crime. The crime here was not the man's weight but his murder because of his weight.
edlee
I read the quote,, but where was it quoted from? I would love to read more about the case. What was in the post didn't say what was actually done,,, simply pointed in a particular direction,,, and from experience with the media in general,, I don't know if it was the real direction or not.

There are so many unanswered questions,,, perhaps unanswerable. During the flooding there were so many needs,, so few people and pieces of equipment to fill those needs. Has there ever been a number given as to how many who were in care settings, died duing that time? I've heard horror stories, but not the follow up you would expect were the stories true.

Were I Pou,, what would I have done if I KNEW that a man would not be rescued? Would I stay with him after the choppers left? Would I leave him alone? If I KNEW he would die without the medical attention he needed,, would I help him to die without pain? Would I be able to sleep at night, no matter my choice? We can't Know what she KNEW.

If it were you,, would you rather lie there waiting for the pain and eventual death,, or would you rather have someone give you a shot? Sounds like a recent thread doesn't it.

The only thing I know for sure is that I would want to be asked.
ed
dancin' johnny
ButterflyInAmbr
QUOTE (edlee @ Aug 28 2009, 07:48 PM) *
I read the quote,, but where was it quoted from? I would love to read more about the case. What was in the post didn't say what was actually done,,, simply pointed in a particular direction,,, and from experience with the media in general,, I don't know if it was the real direction or not.


It was from the New York Times. Here's a link to the article, just click on the highlighted words and it should take you there.
Ratticis
QUOTE (qbounce @ Aug 28 2009, 08:03 PM) *
In the case of a "Code Red" (Fire), those who can walk are evacuated first. Next are those in a chair, and lastly anyone in a bed.

If you don't need any assistance transfering from bed to chair in the hospital, I recommend always keeping the chair nearby.

That's why it pisses me off so bad when those assholes move my chair across the room, or even worse, out into the hall where any asshole can help themselves to it (I was in rehab with a guy who had his chair swipped from the hallway). I refuse to let them move my chair where i can't see it at all times and if there's room, it's damn well gunna be within reach! 99.9% of the time I am completly independent, and that other .1% help is just a phonecall away. My cellphone never leaves my side.
edlee
Thank you for the link BFinA,., it was quite a read. It presented some of the same questions I raised earlier.

While I can certainly sympathize with Dr. Pou and her staff,, I don't agree with what they did. The one thing they couldn't be sure of was the possibility of rescue. No matter how remote the possibilityof rescue is,, death is absolute.

If even one of those "helped to die" had survived the evacuation, it would have been worth the effort of moving them all. I think a great deal of the blame should go to the extremely slow early response,,, to no small amount this was a trigger to the feeling of hopelessness that precipitated the events that followed.

As to Pou's pleas for legisation to protect doctors from prosecution in cases such as these,,,, I can only think of the oath they took when becoming Physicians,,, the most important part of which requires them to "DO NO HARM". I think that says it all.
ed
Ratticis
I blame whoever built a city in a swamp bottom below sea level
wheeliebear75
QUOTE (Ratticis @ Aug 29 2009, 10:18 PM) *
I blame whoever built a city in a swamp bottom below sea level



The city planners who came up with the "genius idea" to build a city so far below sea level their cemeteries must be above ground is himself in said above ground cemetery dead a good 200 yrs or so. Seeing as New Orleans was founded in 1718 by a shipping company.

http://en.wikipedia.org/wiki/New_Orleans
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