having worked in disasters I I worked after Katrina with a public health team in the state of Louisiana I was not in a hospital I didn't uh experience the same conditions that the people who I'm writing about did but I have worked in other disaster zones and conflict zones as you've said at delivering humanitarian assistance and I have been in the situation unfortunately where um I was standing outside of a a tent in a muddy no man's land where tens of thousands of people were massing because they'd been uh pushed out of an area where
there was conflict and I had to decide who could get treatment right away and who had to wait and I had to see people suffer because we didn't have everything we could give them so I I myself have been in that situation but now you're a journalist yes one of the remarkable things about your story one of the most successful aspects of it from a journalistic point of view a craft point of view is the cander the remarkable cander of um many of the medical professionals who involved uh Dr po wouldn't talk to you about
her choices that particular day but she talked about other background issues um some of the doctors uh drors Ying Dr Tila I guess it is talked in great detail about very difficult choices that they made that day and how they saw these issues playing out how did you um prepare for these interviews what went into them um well first of all I have to say I'm so grateful that they did because a lot of the the people I spoke with they they pointed out that nobody wants to touch these issues everybody in medicine knows that
certain issues come up in terms of end of life care that are they are things that people don't like to talk about so yes it it was uh a big deal for for these Physicians and nurses to open up about their real feelings about these issues and what they're talking about are there real feelings about whether or not to administer to drugs morphine and uh versed versed yes to patients who may or may not be dying but in any event who've been given that number three um takes a lot of trust for even physician who
wants to talk about or somebody who could be branded unethical or could be branded a perpetrator to talk to you how did that go how did you how did you prepare for that very few people in this world do things to be evil people generally believe in what it is they've done and I feel like as a journalist if you can go in there and um be willing to hear that that honest honest truth that their their reality um that's that's the real key and and that was the same in Bosnia you know I wrote
about a hospital where there was a a genocide there was a genocide in the town that I wrote about and I interviewed people on both sides of that conflict and and it was that same idea of going in there and just wanting genuinely wanting to hear their perspective and I feel like people are generally want to to share that when you've got all these accounts of the day and you've got interviews with multiple people and you've got documents how did you go about choosing details and structure what were some of the things you considered what
makes something a good detail versus a finally a detail we can sacrifice oh I didn't want to sacrifice any of that there are so many good details that nobody knows about after reading the story because we just couldn't put them in and we went back and forth and I I don't know necessarily that there's a right answer to that question because there are things that could very well have been in there but I think one thing that really helped was a chronological structure which is always your start in journalism it's a great way to structure
a narrative and we did that for the most part so that helped a great deal and then there was the question of perspective and whose perspectives to tell this from and and this story did call for multiple perspectives because every single person in that hospital hital had a very different experience of what actually happened and in order to get some sense of a totality or at least a larger sense of of what went on there you do have to have different people's perspectives in there but that was hard and I'm glad you think that it
worked oh I'm sure readers will will think it worked um let's talk since we don't have all the time in the world um about some of the broader issues I mean on the one hand this is simply a fascinating inside narrative of a terrible incident but it does have some broader implications which you get to toward the end of your story talk a little bit about that um why why is the story particularly important number one people in a hospital should never have to face this kind of thing again if at all possible we need
to do better as a country to prevent people from Ever having to make these decisions and being put in this situation so I hope that sort of the the the overarching uh impression that people Come Away with and in terms there there are I think two major things that have come out of the story before I got involved in it and that that are ongoing and that I hope that we can maybe look at with with different eyes after knowing more about what happened there two things one is that regular Physicians nurses who heard about
what happened who heard that a doctor and two nurses who were highly respected had been arrested very much became worried and wanted liability reform wanted special laws that would say from state to state or even federally that you can't you can't uh prosecute people you can't sue people for doing their best in an awful circumstance and where do you come down on that after looking at this for a while the idea that many people are arguing for now is that we need a set of standards that are not the same usual medical standards that would
apply during disasters and the idea that doctors and nurses can't practice as they normally would in a disaster situation when resources are limited obviously that's that's that's a given however should we the question of whether we should change standards and how we do it I think is something that Americans regular Citizens need to be brought into this conversation for example many people probably don't know that the uh ventilator protocol in a for a pandemic for New York City require calls for certain patients to be taken off ventilators to allow patients who could benefit more from
that to be put on them now that might sound awful you know theoretically it it might come as a shock to a lot of people it's because the public hasn't really been involved the public doesn't know what are the rationale and the number one number one lesson about triage that I think is important for people to walk away with is you always have to be looking at what your resources are and what the status of the patient is and a lot of these new standards aren't emphasizing the fact fact the need for constantly reassessing those
things so as often happens with journalists your story is hitting at a time that may give it a particular context the story is hitting in the middle of a great National debate about the healthc care system is there a way in which the either Katrina RIT large or the events at Memorial tie in at all to this great National discussion that's going on now yeah absolutely it does it's it's sort of a case study for these larger issues of how we manage resources and it's it is the extreme example of having a limited set of
resources that you need to figure out how to Steward or uh split up between various people so yeah so I think we can read this and and think about what we would want on a larger level and the other aspect is I think that we aren't perhaps talking enough about the importance of putting some investment into disaster preparedness of our health system there there is more going on in this Arena but it's not really been brought into the healthc care reform debate and perhaps it should be so I guess the real relevance here from a
journalistic standpoint is to look at the fact that America is going to face future disasters we're going to have more hurricanes we have threats of pandemic diseases including influenza this season uh there are going to be times where resources are limited there are going to be times unfortunately where government fails as Government failed these people and health workers and patients get trapped in very difficult situations so the question that the whole reason to go back and look at this is to say what can we learn what what is it that this story teaches us is
there anything you think I should be asking you that's always the best question to ask at the end of your interview I've heard that and by the way as a physician to it goes the same for the medical interview so is there anything I should be asking you I don't think so all right I've enjoyed speaking with you likewise thank you
