Four days after Hurricane Katrina strikes New Orleans in 2005 and knocks out power and water, Memorial Medical Center hospital still houses 12 patients, mostly elderly, who have not been evacuated and lie on filthy stretchers “in the foul-smelling second-floor lobby” (1). Staff and volunteers try to help them, offering “sips of water” (3)and what comfort they can. 

Critical care and lung specialist Dr. John Thiele, a “stocky man with a round face and belly, and skinny legs” (4), attends the dozen patients. He knows that, in a crisis, it’s important “to attend to the most critical patients first. It was strange to see the sickest here at Memorial prioritized last for rescue” (5). Patients most likely to survive have been evacuated first. The remaining patients, desperately ill and unable to be moved, will be euthanized. 

“He accepted the premise that the patients could not be moved and the staff had to go” (9), but Dr. Thiele turns to nurse Karen Wynn, “the head of the hospital’s bioethics committee,” and asks, “Do we really have to do this?” (10).