CLSC author Fink to discuss lessons from ‘Five Days at Memorial’



William Faulkner once wrote that, “In writing, you must kill all your darlings.”

Sheri Fink found herself having to do that as she wrote “The Deadly Choices at Memorial,” an investigative piece for the New York Times Magazine and ProPublica that won Fink a Pulitzer Prize.

“My editor started saying, ‘Save it for the book. Save it for the book,’” Fink said. “And then I realized that, maybe, I should write it, because not everything that’s important can fit into this. So that’s what convinced me.”

Fink had the chance to bring some of those darlings back to life. She expanded her 13,000-word article into a nearly 600-page book, Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital, the Chautauqua Literary and Scientific Circle selection for Week Nine. Fink will discuss her book at 3:30 p.m. today in the Hall of Philosophy for Week Nine’s CLSC Roundtable.

Five Days at Memorial examines the effect of Hurricane Katrina on the Memorial Medical Center — now Ochsner Baptist Medical Center — in New Orleans. The disaster left the hospital without power, and medical professionals had to begin making literal life-or-death decisions. Doctors were forced to prioritize the lives of patients, leading to allegations that professionals had euthanized people in their care.

For Fink, the process of putting together her article and her book was one of exploration and discovery.

“It took many years to discover what had happened at this particular hospital that I wrote about in the book,” Fink said. “I guess it was all about exploration and discovery, but maybe not in the way that we think of them in terms of going to new places — this was trying to go back into the past and understand what had happened and piece it together.”

Fink said this also means looking ahead.

“And there’s also the ‘forward’ part: to take the lessons from the past and bring them into the future and see what we can learn from them,” Fink said.

Fink said that, when revisiting her research to start writing her book, she realized just how much she had to work with.

“I had a lot of material that couldn’t fit into the 13,000-word magazine piece, so it was nice to have an outlet for it,” Fink said. “It just took a long time because there are a lot of aspects to the process: there’s the research, the piecing through it and trying to put it together — figuring out what it means through different people’s accounts. And trying to triangulate the information, the material and the interviews, and then setting out a structure. And then writing.”

Fink said that, in the case of Five Days at Memorial, it’s the leadership at the hospital making huge decisions. But these are decisions that people may have to make in their own lives as well.

“Any of us — or our loved ones — could be in need of medical care, or in some kind of disaster or crisis situation,” Fink said. “And even more than that, anyone could find him- or herself in a situation of crisis. And it really is the people who are right there, whose actions can really spell the difference between life and death in the early moments.”

Fink said it’s important for everyone to think about these situations.

“So I think it is helpful for all of us to think through what could happen — in this case it’s a hospital, but within an organization, within a society — when an emergency happens,” she said. “There’s value in going through that in your head before you ever have to face it in reality.”

Fink said that it can be hard or disconcerting to think about emergencies and crises like those that happened at Memorial, but it is crucial.

“I just think it’s really worth thinking about these things,” Fink said. “We don’t want to think about scarcity. We don’t want to think about prioritizing one life versus another life. Ideally, we figure out ways to avoid ever having to do that. But it is much better to talk about it and think about it in advance than to have it happen and not be prepared and have some really bad things come out of that — societal ripples that go on for a very long time.”

Fink’s dedication to her topic attracted the attention of Sherra Babcock, vice president and Emily and Richard Smucker Chair for Education, when the author spoke for the Chautauqua Women’s Club last year on the Contemporary Issues Forum. Fink was in the process of writing Five Days at Memorial at the time.

Babcock realized it would be the perfect fit for Week Nine at Chautauqua, which focuses on health care.

“It’s a wonderful choice for this week — particularly because we’re talking about patient care in the morning and facing dying in the afternoon,” she said. “So it really does wrap up everything that we’re talking about this week in an amazing literary work and piece of journalism.”

Fink’s book has also found an advocate in Matt Ewalt, associate director of education and youth services.

“I just think it’s an extraordinary work of investigative journalism,” Ewalt said. “The way in which the book explores situational ethics is unlike anything I’ve experienced before, and it’s such an immense work.”

Both Babcock and Ewalt said that Fink’s book, despite its length, is an absorbing page-turner.

“It’s just more and more devastating, and it’s a story that you know will not end well,” Ewalt said. “And you know that many of the decisions that were made had absolutely devastating consequences. And yet, I think, what was most powerful to me was that the challenge for [Fink] — and what I think she succeeded so well at — is treating each and every person with respect. And thus, not painting anyone as a villain, but in fact trying to keep a journalist’s perspective of what those intentions were and how even what on the surface looked like the worst of decisions may have indeed been what someone believed was for the common good.”

Ewalt said that Five Days at Memorial is also a record of America’s all-too-recent history.

“Ultimately, it’s a reminder that this happened — in our country and not that long ago,” he said. “Again, these are extreme conditions, but these are the kinds of decisions that medical professionals are making each and every day.”

Fink said she is happy to see that her book has caught on with a wider audience, even though its subject matter can be difficult or disconcerting. While what happened to the people at Memorial is disastrous, Fink said, something hopeful can grow out of it.

“Maybe that’s the service that they give to us, or the positive thing we can say — that we learn from it,” Fink said.