From the Macedonian health ministry saying you know take these people into Macedonia they're not a threat open your border take them in they need care and the health ministry kept refusing and so they stayed in this tent day after day. Sometimes for 456 days and several The people in this tent they died Cherrie says this experience haunted her and years later when she was a full blown reporter and traveling all around the world looking at different scenarios she would return to this memory again and again and wonder how do people in that situation make that decision how should they. This is the scenario that people in New Orleans have been fearing for a long time a Category 5 hurricane headed right toward the city because it's going to be our 1st stop we all have heard the story of Katrina told and retold But in this story the hurricane is really just a backdrop really we're going to focus in on one building this hospital Memorial Medical Center built in 1926 in one of the lowest parts of that city which is really like a bull is a sturdy brick building 8 stories tall stretching over 2 city blocks that had served in every storm until that point it was really seen a somewhere safe. And this hospital became for Sherry a kind of poor. These questions about tree Irish she ended up spending 6 and a half years interviewing doctors or the hospital patients nurses family members government officials ethicists hospital administrators she conducted over 500 interviews to reconstruct moment for moment what happened at the hospital during Hurricane Katrina. Get ready because of the most intense part of the storm is getting ready to come across day one Monday August 29th 2005 around 6 am. Trina this. I've never seen anything in my life like this and. They get through the storm OK. The city power is gone but they've got their backup power but this hospital it had a vulnerability a lot of American hospitals have which is that they had to move the generators to the 2nd floor so that they would be higher up in case of flooding but electricity is all about circuits and they had elements of that backup power system that were below flood level things like switches and other electrical material but they got through the 1st day OK and it seemed at that point that the worst was over and then . Actually after. The levees failed. Water surrounds this hospital in New Orleans and as the water started to rise around the hospital that is the moment that the people in charge knew they were in big big trouble. They knew what their vulnerability was how many patients were in the hospital at this point there were 250 patients there about 2000 people because you had so many staff and then all the visitors who had come with the staff members and with the patients So Sherry says mid-morning on that 2nd day this is Tuesday August 30th just as the waters are starting to rise a group of doctors got together and they did come up with a system which evolved a little bit over the crisis but they decided 1st get the babies out get the critical care patients out and they knew that they had to high water trucks from the National Guard in the water wasn't so so high yet at that point it was only part way up the sloping emergency room ramp and they decided to put patients who could walk on those trucks so. Helicopters start to arrive and medical staff start to bundle tiny babies in incubators I.C.U. Patients in wheelchairs on to the elevator and up to the help at how many patients can a single helicopter take the ones that were landing How many can they do one or 2 while so this is slow going yeah it was late evening before they got all the intensive care unit patients out in the you know the babies and they had all the babies all in on that 2nd day they evacuated about 60 people there 60 of the most critical patients although we should also say that if a patient had signed a D.N.R. a Do Not Resuscitate order the doctors decided those patients should not go 1st and they were held back and will sort of explain their thinking on that in just a 2nd. Darkness falls on day 2 the doctors and nurses are exhausted they've been working really really hard carrying patients in the heat many of them lay down on cots and bacon beds to rest for the night. And then. Before the sun rises few hours before. About 2 am. The buzz of the generators suddenly just. Stopped as quiet. The water had reached those electrical switches in the basement Dr Dr Cook Ewing cook a long time I see a doctor he was lying not far from where those generators were and he said to me it was quote the sickest sound of his life absence Yeah and that is when it became an absolute emergency in this hospital. It's pitch blackness some of the medical equipment they have backup battery so they started beeping to warn that the electrical power had stopped you still had 9 patients who relied on ventilators to breathe it became a hive of activity and we got to get everyone out everybody was running around with flashlights these beams in the blackness trying desperately to move those patients down the stairs now there's no elevators that the other big thing fortunately somebody found a hole in the machine room wall on the 2nd floor that led directly to a parking garage and so they figured out they can pass patients through this roughly 3 by 3 foot hole onto the back of a pickup truck drive them up to the 8th story of that parking garage and then carry them up 3 flights of steps to the formerly unused tell a pad. And 5 of the 9 patients on ventilators died just right then it's just like I said I've been trying to put it away. But I want to make this is accurate as I can for you and this is tape of an interview that she did back in 2008 when she was doing research for the story OK OK I mean if you know this film is OK just like it's family you know it was a nursing director working on the 7th floor of the hospital that day she'd actually been attending to those 9 patients that didn't make the 1st helicopter ride and she described to Sherry that right after the power went out and after the ventilator shut down one of her patients flatline and. We brought him back we had fun and We're day 3 Wednesday August 31st 2005 sun rises and that's when they're expecting all the helicopters come back and they wait and they wait and they wait and an occasional helicopter comes but this concerted rescue effort that had taken place the evening before has stopped now we know now looking back. That on that Wednesday the helicopters were doing their own tree on the Coast Guard rescue people and looking at people on rooftops waving rags so much higher family is on that roof right. But the people inside the hospital. Most of them had no idea all they knew was we're in this horrific situation where are the helicopters at this point there's still nearly 200 patients at the hospital and some of the staff there panics because it takes them so long to move the patients to the top of the parking garage just below that Hella Pad So she says on that 3rd day at about 7 in the morning bunch of doctors and hospital administrator maybe a dozen dozen and a half they got together and they decided that they needed a system a way of organizing their patients so that when those helicopters started to show up again they wouldn't waste any time at all they'd know exactly who to evacuate in water order another words Who are we going to get out 1st. That was the question and that's the moment where they come up with the ones twos and threes. This is true there are a limited number of resources in this case helicopters in a few boats and we have to decide which people get access to those resources. There are couple of ways to look at this she says if you go back to the very beginning of the 1st conception of it 790 S. Napoleon's chief surgeon he made a rule on the battlefield that you take the people who are in the acute need 1st so the sickest are going to be treated 1st and with the most resources and this is the way it works in most emergency rooms there's a long waiting line of fevers and cuts but if you've got a heart attack you get right to the front of the line another way to look at it is the utilitarian concept this got to start with some philosophers in the 18th in 1900. 80 degree just good you want to maximize some sort of good outcome amongst a population so rather than think about what one individual needs you think how can I save the most number of lives or the most number of years of life we want to maximize years of life we might want to pick people who are have a better chance of surviving who are younger people and this method of tree Ajah is what you often see in a war zone where say there's a bombing and you have more injured victims than there are ambulances or medics so 123. Imagine a lobby area and a hospital waiting area Sheri says in this case with the doctors did they ask the staff to get everyone out of their rooms bring them down to that 2nd floor lobby and then some doctors including one whose name might be relevant for later Dr and a pope she was the head next surgeon she and another doctor they stationed themselves on the landing where the patients were brought down to on that 2nd floor and as the nurses would bring them they would look quickly at the patient's chart look at the patient and decide on a number and the nurses would take a magic marker and a piece of paper and write either 12 or 3 on that paper and then she says they would tape that number on to the patient's gown so the ones where you're relatively healthy patients patient maybe who had an appendicitis and their appendix out but they're looking good they could even be discharged the ones would be rescued by boat presumably among the 1st the tubes where your more typical hospital patients patient maybe who had a heart attack who wasn't fully recovered who would need ongoing care they would go by helicopter presumably 2nd and then the Threes were those super sick patients or anyone with a Do Not Resuscitate order. Those patients would go last one of the doctors when I said why did you choose the sickest patients to go last one of them said well I figured anyone with a Do Not Resuscitate order would have a terminal or irreversible condition which by the way isn't always the case and he said I thought that that patient would have quote the least to lose so it sounds like in some way they went to more of a utilitarian way of thinking yeah and you could see everything that follows as flowing from that utilitarian decision and actually made a few different points to prioritize the healthiest people 1st and the 6 people last all 3 groups were placed in different parts of the hospital and the Threes were kept in the lobby the 2nd floor lobby to just wait. So as the day goes on the area started to get really full patient next to patient on these cots in one corner she says yet about 18 people lined up side by side and these are people with heart conditions symptoms of pneumonia stroke there were nurses standing around Fanning people get it just it was so so hot some people guessed that the temperature inside the building must have been 100 degrees I don't know there's any way for me to describe to you how intense the heat was this is Dr Ann Apolo in an interview with 60 Minutes she was one of the doctors who did the number there was the word lab. It was suffocating and made it extremely difficult to breathe and with the heat came the terrible smell it started to smell really bad and that was that's Gina Isabel again she said sewage was sort of backing up in the toilet Fannie Mae just a sewage everywhere on the ground and everywhere he just personally I didn't want to eat or drink anything because I didn't want to. Asked to his pastor and as the day went on Some people started really feeling abandoned. Why are they here why aren't they helping us and you know when you're having. Your own war zone here it looks like a war zone on the 7th floor there was this radio that was playing in the corridors . For. The local talk station and the radio was. One of the only ways they were getting information from the outside the mindset the needs to hunger the anger the rage is growing among some of the nurses have carts that they would roll around and they'd have the little radio on the cart and they'd be listening basic jungle human instincts are beginning to creep in and there were tales on the radio that were alarming the staff someone is breaking into businesses and merchandise these people should be shot things that turned out not to be true like you know one of much more near that they had declared martial law there was literally a deputy sheriff who got on air and told people that even both commented said that it looked like a shark then he saw a shark swimming around a hotel they're walking like zombies like Knights of the living dead just imagine how that would feel if you were in this hospital that was the only word you were having about what was going on outside at all until he's just like happens right can actually get out in the garage. By afternoon or that 3rd day that Wednesday some of the staff are having nervous breakdowns more aroused really really low because all these patients are still there basically. So there's this level of of panic what happened. Well so there is also the situation of the pets and this may make no sense to most people but they would offer staff members they could bring their pets if they were coming in to work a storm and they turned medical records over into a kennel and people start to worry about their pets apparently on that Wednesday one of the larger dogs in Newfoundland started having seizures from the heat so some of the staff chose to have doctors euthanize their pets and then just try to imagine if you can literally are running free right it's trying to shatter when you know it's time to climb into stores it's hot people are dying you're hearing gunshots in the neighborhood you're afraid. You don't know if there's real violence breaking out in the city there are bodies floating in the water there you don't know how many rescue resources are going to comments night time and your colleague walks up to you and says you know. We're euthanizing the pets to put them out of their misery what about the suffering patients shouldn't we put some of them out of their misery and I interviewed all these people and trying to figure out like where did this idea come from and tracing it back and there were all these little informal conversations. And. This starts just going around the hospital this this sort of idea. Of putting patients out of their misery I don't know. But that's what I heard. And you know in those circumstances what. If you're at war and you have someone that's not going to be picked up and you can carry him to safety and have believed that yeah. He did. You know let him suffer to let him. Kerry says that as this idea spread around the hospital people fell into different camps some people thought this was the most humane thing they could do it would be criminal to let people suffer more other people when they heard about it were outraged for example Dr Bryant King whose colleague Dr Forney a she walks up to him and says there's this discussion going on and you know what do you think and he says you got to get me to actually think that that's a good idea this is Dr King in an interview on C.N.N. Doc if you possibly think that that's a good idea. Day for Thursday September 1st here's what ends up happening. And accounts here are a bit vague and in dispute but according to Dr King who spoke about this on C.N.N. He says and other people say they saw this as well he says he saw one of the doctors we talked about earlier Dr Anna pope who's still there that Thursday morning caring for patients these patients on the 2nd floor who were chosen to go last he says he saw her talking to patients while holding a handful of syringes and us standing over there with a handful of Saran just talking to a patient and the words that are heard her say were I want to give you something to make you feel better they say had a handful of syringes I don't and nobody nobody walks around with a handful of the when this thing goes and gives the same thing these patients that this is not we do it. To jump forward for B. After this whole ordeal is over and the rescue teams in the mortuary teams arrived many bodies were found in this hospital. About $45.00 bodies found and so there was an investigation launched they found these bodies they tested these bodies for drugs and what they found was that nearly 2 dozen patients had received either morphine or versed said a powerful sedative or a combination of the 2 you in a very short time period on that Thursday September 1st 2005 you know how many it was I think 21 in the end but it's complicated in medicine what is comfort and what is murder depend to a large degree on the intentions of the doctor it's called the principle of the double effect it's sometimes credited to St Thomas Aquinas and it's this idea that an act that that can cause harm but if your intention is to do good then that's ethical. In doctor and a pope did you murder those patients as the attorney general alleges No I did not murder those patients and I want everybody to know that I am not a murderer that we are not murderers in that 60 Minutes interview Dr Post flatly denies euthanizing anybody and at various points in the interview she is clearly distraught at the accusation it completely ripped my heart out because my entire life I have taught to do good and my entire adult life I have given everything that I have within me to take care of my patients but Sherri did talk to one doctor Dr Ewing cook we mentioned earlier we were talking about the generators he's a doctor who deals a lot with end of life care and he was very open with her about the decisions he made he had gone upstairs visited Mrs Burr Jess cancer patient to see how she was doing and he was just thinking to himself she's so so sick she's got advanced cancer I can't imagine she would have more than maybe a week to live at the best of circumstances she is weighted down with fluid which can happen toward the end of life so she weighs a lot she's on the 8th floor so we'd have to carry her downstairs and plus there's 4 nurses up here taking care of her Couldn't we use them somewhere else so he literally turned to one of the nurses and said Can you give her enough morphine till she goes. And that nurse charted huge increase in morphine for her and she died. And that was his thought so he made this decision and to this day or at least the last time we spoke he felt he did the right thing he said to me he thought it was desperate he saw only 2 choices quickened their deaths or abandon them and I mean if that was the real situation there some at this would say either of those choices would be you know not justified but excusable but one of the arguments you could make is that when you give up on one person it then becomes a little bit easier to give up on the next person and then the next person then suddenly you're on a slippery slope and Sherry did tell us about this one case his case was very haunting and that Everett 61 year old doting grandfather very very heavy he weighed 380 pounds and he was up on the 7th floor of the hospital he was conscious alert fed him self breakfast asked his nurses are we ready to rock N roll he said to one nurse who never forgot it Cindy don't let him leave me behind don't let them leave me behind but he had had a spinal cord stroke he couldn't walk he was on the 7th floor of the hospital with no working elevators and the staff told me they couldn't imagine how they would carry him down those flights of stairs let alone what a helicopter take a man of his size and he was one of the patients who was found with this drug combination in this body and he was and he died he died found his body was found and by the way the other tragedy was just as those injections took place was when the helicopters finally were focused on this hospital did a judge or jury find anyone guilty of manslaughter or murder or 2nd degree murder you know nobody nobody ends up getting convicted. And again just to remind you how quickly a hospital can go from a normal American well regarded functioning hospital to a place where this was even considered and discussed was so short Monday morning the storm hits Tuesday morning the water rises early Wednesday morning all power goes out and this is Thursday while it's kind of chilling to think. After Katrina as we hear after the break people sort of paint all kinds of attention to try. Thinking about it in new ways and as you hear some surprising new places that's coming up hello. This is Mark Owen from Berlin Germany it's supported by transfer one which was built to make it easier to send money international 4000000 people in. And leave and convert her and 70 countries more. From Long Island New York radio ordered by new yellow green and red approach to food is designed to help people make. Weight. Learn more at. You're listening to Radio Lab here on Jefferson Public Radio coming up at noon it's each town this week Nick and Helen welcome Liz vice to the show along with the traveling McCurry S mountain stages got heavy Jenkins today along with bottle rockets and Amy helm and later on LIVE FROM here with Kristy Lee Guster a deal Victoria and Matt Braunger That's all coming up right here on the rhythm a new service of J.P. Our. Support for J P R comes from Magic Man fun shop magic man would like to thank all of their customers they're celebrating with a store wide costume and managers event all September long magic man is your local Halloween costume or and has many choices for accessories and make up plus costumes and masks for the season magic man is located in the Bear Creek Plaza Medford at the Town Center Plaza in Grants Pass on Redwood Avenue and West Grants Pass more at Magic Man Shop dot com. A few times each hour you hear us take a moment to acknowledge one of the many underwriters who support Jefferson Public Radio we want you to know who helps us pay for the news and entertainment programs you enjoy every day if you want to get the word out about your company's products or services and let J.P. Your listeners know you support their favorite radio station call us at 18726191 or go to or website I J P R dot org and click on the support tab Hey I'm jet I will rock I am Robert Krulwich This is Radio Lab And this hour we're talking about trash and before the break we were talking to reporters Sheri Fink about what happened in one hospital New Orleans during Hurricane Katrina and the consequences of some of the decisions made there but now we shift focus all of that began with a tree house decision about which patients should go 1st. I'm trying to put myself in the position of the people of that hospital and I'm thinking to myself it would be really nice have like a checklist like a checklist on a wall that says here's how you do this so that I can just check the boxes because God I wouldn't be able to think my way through that you know that's where I go next I wonder whether this story you've just told us leads us anywhere the 1st place that would lead me would be to ask is there a system that people could set up people who are reasonable and who have the expectation that something like this is going to happen again somehow somewhere maybe in my town my hospital my place so what could we do. To make this not happen well it's interesting you ask because of course after Katrina there have been efforts since then to come up with a protocol going to Sherry the experience of Katrina was basically a wake up call for doctors and hospitals and state governments to think about. Like how should we ration medical resources like if something bad happens again which patients do we prioritize 1st which patients don't we prioritize how do we do this and one of the interesting things was that the state of Maryland decided we're going to throw this open to our population and have what they call deliberative democracy so pull people together in a room from all walks of life and have them grapple with this and I was there oh you went to the very 1st one I did I mention like a town hall meeting was it like that or no yeah. So just imagine a church basement in inner city Baltimore or a conference room in Wealthy Howard County thank you for giving up this quarter this Saturday to have we think it's a really really important conversation and they're specially people have been recruited to be a part of this and when I say people it's just regular folks you know so the researchers let's call them that they get people together and what are you starting to make. The sort of scenario is laid out so obviously it already I mean hasn't your doctor just over time stuck in and we're going to be talking about today is how we make decisions about yes life saving resources ready in that in a situation where we literally you know take care of everything today Syria will talk about these heavy influence they basically tell people OK imagine a flu is sweeping the country millions of people are sick coughing some are dying the only way that folks are going to get better they say is if they have a ventilator to help them breathed. The problem is. There just aren't enough this is stuff this is a terrible situation we're talking so here you have too many patients too few resources how do we choose who gets those ventilators what or excess costs what might be the right answers The researchers then essentially lay out 3 different kinds of options. Number one try to save the most lives or years of life by picking people the best chance of surviving the pandemic such as giving the ventilators young people or healthier people Number 2 picking people who will be the most helpful during a pandemic so 1st responders health care providers vaccine workers that are often really bitter or number 3 leave it up to fate something like 1st come 1st serve or a lottery. So you will not does that make sense OK and then they say we're here to answer your question talk amongst yourselves right OK You know. It's talk about something else called call to let their 1st because you know they're not got their hands full 2nd and not going to travel and there wasn't a lot of agreement I respect your opinion but I'm just doing what you could to. Get us off I think that time of crisis there's no room for emotion here no B.S. Some people are going to have to go to one of the the big findings was that there are certain ways in which we will not make these decisions there were things that the researchers wanted to be off the table like not even come into the discussion we're having to make decisions based on gender or race is right I mean status like people's jobs and incomes and citizenship status and you know whether they had a criminal history or were they upstanding members of society those things are out of bounds I just want to say up front that's not that's not up for grabs but those things kept popping up feeling about like a young pastor and you might imagine. Reprehensible alcoholic criminal type person and he might. Be nursed. Well here is a master plan or 2 more beneficial to society it isn't yours that this is a criminal record and simple well you know it written down personally Well you are sure to know if the territory there were out of the girl if they did it that is it that is a personal. There were people who thought that undocumented immigrants didn't get ventilators alcoholic smokers and the world will be a better place because there is the most brutal terms possible there saying do you deserve to survive or not can I say to you but should I try and say here. What's interesting is that people are really comfortable making utilitarian choices like saying Yeah that person should get the ventilator because they're going to benefit the greater good in some way but if that ever got formulated in a slightly different way which is to say that person should get the ventilator because they deserve it more than others or life has more value than another person well then people like we're not cool with that and yet you would hear people say it that way again and again and then immediately be repulsed when they heard someone else say it that way. And this was particularly acute when participants were asked the 2nd time can we move to an even more controversy all topics really hard question would it be acceptable to you Do you think it's acceptable to ever remove a ventilator from one patient to give it to somebody else this one I definitely don't have a clear answer myself and some people said well of course if it doesn't seem like someone is going to make it through the treatments or if we need to cut it cut their treatment sure of it because they're going to later on to someone else but you're going to murder my father there were other people who said no you take my father off the tunnel later. I was going to be true friendship that for the rest you're right but like never going to shut up and yes I can't think about right 1st let's just say I don't know if you was. So complicate what did they come to a conclusion did you publish or did you hear a conclusion the number one response was to try to get out of the situation and find ways to avoid having to ration that's the most important part of this like they want to do it before we prejudge this what is it the researchers are going to take away from all this well a couple of things that they got out of it Number one remember we talked about the different ways of deciding that they put out for people to discuss Well it turns out they wanted to combine some of those different perspectives and they were going to Sherry a lot of people thought Sure let's start out utilitarian Let's try and save the most lives by picking the people who are most likely to survive if they're likely to survive and they need it but chances are they're going to be a lot of people who fit in that category so if everybody is just about the same and we can't really we don't have like great science that allows us to know which patient is going to survive and which one is not going to so for that 2nd tier let's do it randomly let's just get really really fair and give everyone an equal chance so it's like you introduce a little bit of faith to keep things on as to exactly and in the research you said you know what this is a good idea let's see if we could maybe put this concept into the protocol in my writing thinking that these guidelines whatever they end up being are designed to avoid that sort of like sorting based on who deserves it and who doesn't Yeah I mean there's some fairness in having guidelines and especially guidelines that were developed with the input of lots of people so even if we don't like the choices that are made we don't end up getting the ventilator or our loved one doesn't overall if you know that there's a protocol out there and this is the rule here's why we had to adopt this rule it's being applied to everybody. And you're not going to be advantage or disadvantage over money or over these other things it sort of helps you accept it yeah in theory that sounds you know plausible but when you put theory to practice which you can do right after the break things get very hard That's coming up. a progressive dot com. Good morning you're listening to Radio Lab This is the rhythm a new service of Jefferson Public Radio you can also find us online and I.G.P. Are. In about 20 minutes on the town the traveling McCurry is and Liz vice take the stage then on mountain stage it's bottle rockets today along with Amy Helma Lila Diane John R. Miller and the engine lights and a set from hubby Jenkins live music starts at noon right here on G P R. 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Dot org or call us at 18726191 am Jad Abumrad I am Robert Krulwich This is Radio Lab And returning now to our collaboration with The New York Times and Reporter Sheri Fink This is our final stop many ways are hard to stop because. It's to close as we're going to come to sort of the heart of the issues we've been talking about and you realize that when you get up close as Sherri's about to. Sometimes what's a success what's a failure kind of hard to measure. Test. The reason we can't even do the typical right I remember being in Haiti after the Haiti earthquake back in 2010 a player that I want to tell the one cat that I was invested with a group of us disaster responders the international medical and surgical response team in search what you're doing and Cherry You were in this tent hospital and at this point maybe about a week and a half after the earthquake there were so so many casualties for the 100000 people took there was patient after patient kind of lined up in a row with the things you can be a great ambassador. Company fracture and they didn't have enough resources and they were running out of oxygen tanks and then they were also trying to use these oxygen concentrators which pull oxygen from the environment but they rely on power and they were running out of diesel for the generators which is the word critical level with artificial supply. Oxygen for our soul AM FREAKING the day Rick Perry for us with your carry me here Mark this is a hospital that had set up to do surgery they needed oxygen they didn't have enough so the question became Who were they going to give it to and who were they not. At one point. I was following a couple of the doctors we walked into this tent. And we met this woman. She had braided hair a white night gown on and. Running into her notes. There were almost the same. To me. In speaking to her I found out that she was from Port au Prince the capital and that during the earthquake her house had collapsed and everyone inside it she said which was most of her extended family when they died. She told me that amazingly she had survived. Because she wasn't at home when the earthquake hit doesn't mean that she checked into this hospital. Very shortly before the earthquake happened because she had had chronic lung problems so she was there to get treatment and after the earthquake she was transferred to this American hospital. had just one of the hearts of the surgical staff there people loved her she was so thankful but. The severe heart failure. Pretention. Very hard pressed seriously. They told me they had plans to take her off oxygen and they were going to turn down the oxygen slowly to try to make it more comfortable and then they were going to send her off to a Haitian facility that didn't have oxygen but where she would presumably die and if you're thinking in terms of cold hard tree Amish theory you know this makes sense because they were trying to save oxygen she has a chronic problem that probably won't get better so that's like the theory of it but the practice of it was quite different. She had absolutely no idea that they were about to do this she had all this hope for her future seem to live. She prayed to God to have an opportunity to earn a living but others said look at the 7 let's put it. Anyway because the people were given somewhere to stay. A. Journalist and I don't know the answer to. Know what to say in such a hard situation. As I would and I remember the nurse who was doing the tree ash who'd made that decision to cut off her oxygen Patrick Cadillac commander for the insured and never met her I never let the patient. That's the rule and then we're running out of oxygen in the country at some. Doesn't have oxygen so we'll have to make the decision no she can't go about it and turn it off I have to look at the greater good that we can provide with the limited resources we have. And so then I followed that woman. Up I wanted to see this on a human level as well as an on the abstract level. The transporters came a few hours later around where he is the 82nd Airborne actually who were providing that service the remains and they came to pick her up and she's it's outlets here. They saw she was on oxygen and they said OK we're going to put her on their portable oxygen tanks and the representative from the hospital said OK. Oh no no. She doesn't get oxygen. So they yank the oxygen. Structure onto a stretcher. And lifted her up stuck her in the back of this Humvee ambulance. I rode with her. She started getting short of breath that. She put this as mine in her mouth over and over. She thought it was oxygen. Was terrific to watch her start to suffer I felt complicit I was doing a story and I knew very well that they had chosen for her to. Die and just watching didn't feel it didn't feel right. And so I'm going to. Say I am going to be it stopped at this hospital and I put over toward her and some of the medical staff went to look at her table and they could see she was in distress the broader inside. She was really struggling to breathe but then definitely see here I saw one of my medical school professors emergency doctor and I told him about her . Yes I need this moment to. Look at my. Foot. And. He improvised it was. Right and she used like all these directs to get fluid off for a long trip. And he found one thing of action that had a teeny bit last minute. To. Say and. He was able to extend her life right. To. Ultimately I actually felt a responsibility for her that outlasted this story that I did and so after that came out I I did attempt to help her. Well I found a charitable group that was willing to bring her to the U.S. Under a certain type of visa program that allowed for humanitarian like a medical treatment and the cardiologists who had examined her in Haiti had thought she had a rheumatic heart disease that was causing her lung problems and that it could be surgically corrected but when she came to the U.S. In fact it was found that she had a much more serious condition and she really needed a transplant and she didn't didn't make it. So here you've got a rule and maybe in some broad way it's helping but in that vehicle looking at this woman you wanted to break the rules for very. Moral and decent reasons in these extreme circumstances where life and death are wrestling with each other. Can you make rules I mean yeah because it's like you can't fault the people for taking her off the oxygen and you can't fault you for trying to get her on the oxygen so what's the conclusion to draw well let's not give up you know the conclusion is let's not give up like it turns out there was there were options for this woman it turns out that somebody was able to extend her life now you could very well argue that she should have died in that moment because look at all the resources that were spent but I just feel like like there was some value in her existence there was so much value she came to the US and by God she took up a collection for all the patients back in the Haitian hospital who she was friends with she contributed to the day she died I don't know how to do the math on this one this is the problem though well they don't really guidelines require like a lack of compassion the cold hearted rigidness of it everything you're talking about has to do with compassion this is Simon Adler by the way our producer and how do you make compassion work on that larger scale without caring about people and that you care about some people what other people and I don't know you know we're hurting that's a very good point if you don't systematize it you you risk choosing people based on factors that are really not fair exactly it's just about the person in front of you and I think that the more unbearable it is so the more you have to look someone in the eyes the more it makes us try to figure out creative ways to avoid doing it OK but I do feel you somehow refusing to acknowledge the subject when it really really gets tough. You see but let's avoid that toughness over and over again let's know I'm facing the real problem which is that it's a problem to have to ration by a lot but it's some know what we're not going to figure out the best way to ration because there is no one best way because everyone in society will have a different view on that I think it that's in a somewhat unimpeachable I think you're absolutely right we should always strive to not have to make the choice but whiff we do have to make the choice how do we do it let me tell you that I think what you've hit upon here is an impossible piece of human business rationing tree whatever you call it is an inhuman act which humans are trying to do but the fact of their humanity makes it impossible you have a god role and nobody fits it. Thanks to New York Times correspondent Sheri Fink I'm Jad Abumrad I'm Robert Krulwich thanks for listening. Recognizes the nonprofit community support of the bee girl organization big girl presents hive to table Saturday September 14th at 5 pm a sweet feast at the Hanley farm in central point. The evening includes a multi-course dinner. Created in the farm to table style featuring food from local farmers with B. Girl Honey woven throughout every course attendees will also be treated to live music beer wine and meat and an auction have to table as a fundraiser for the organization a nonprofit with a mission to educate and inspire communities to conserve bees their flowers and countryside tickets and details at. Slash to table. This is southern Oregon University's Jefferson Public Radio 89 point one. N.P.R. News. Live for me Town Hall in the foothills of the Rocky Mountains it's the town this week yes born in Oregon Liz nice to see the winter mean a city of tar and Nashville Tennessee that traveling in a hurry is. Joining me right now in welcoming our host. Thank you everybody thank you hello and welcome to town hall. So the whole idea of making music is that it can be for both musicians and for folks listening a kind of a powerful experience experience that's kind of visceral thing a spiritual thing in the world of roots music things like blues and bluegrass a lot of that spirit comes from old work songs or old ballads and spiritual songs from the church we have 2 musical guest this week who have that spirit Liz Weiss is here she's from Portland she really got her start singing in church in the course of traveling with Curry's got their start singing with their dad McCurry and both of them bring a whole lot of spirit to their musical presentation so they're traveling with great band and a band that is walking a fine line between traditional bluegrass and a more modern approach covering songs by contemporary artists and playing to big crowds pretty wild jam Grass festival scenes and they.
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