Dr. Pou’s fog of Katrina

Anna%20M%20Pou%20010808.jpgThis Dr. Susan Okie/New England Journal of Medicine article (H/T Kolahun) provides the most extensive analysis to date of the circumstances surrounding the tragic deaths of the nine New Orleans area hospital patients during the aftermath of Hurricane Katrina that led to the egregious prosecutorial decision to bring criminal charges against one of the treating physicians, former University of Texas Medical School physician, Dr. Anna Pou (previous posts here). Dr. Okie addresses the key question of why these nine patients died “. . . in light of the eventual evacuation of about 200 patients from [the hospital], including patients from the intensive care unit, premature infants, critically ill patients who required dialysis, patients with DNR orders, and two 400-lb men who could not walk.” It’s an important question to address, but not in the context of a criminal case.
The fog of war analogy is certainly appropriate. Even with as good information as we have about the horrific conditions at the hospital in the aftermath of Katrina, it’s still hard to imagine how difficult it was making even basic decisions in the face of the breakdown of civil society and infrastructure. What we do know is that Dr. Pou, who was not experienced in providing emergency medical services in what amounted to a heavy combat war zone, was no ethicist on mission to make a political statement. Rather, she was simply a physician doing the best she could to make the right decisions under the worst circumstances imaginable. It should not surprise us if, with the benefit of hindsight bias, some of those decisions would not have been the ones that a reasonable physician would have made under better conditions.

The power of words

power%20of%20words.gifJames Fallows hits on what I believe is a very important dynamic in Barack Obama’s surge past Hillary Clinton among Democrats — the power of words:

Words and deeds. Talk and action. Poetry and prose. Presidents obviously do best when they can do both.
But only Obama captured what is unique about a president’s role. A President’s actions matter — Lyndon Johnson with his legislation, Richard Nixon with his opening to China — but lots of other people can help shape policies. A President’s words often matter more, and only he — or she — can express them. Grant led the Union Army, but Abraham Lincoln, in addition to selecting Grant, wrote and delivered his inaugural and Gettysburg addresses. Long before Franklin Roosevelt actually did anything about the Great Depression, his first inaugural address (“the only thing we have to fear…”) was important in itself. The same was true of Winston Churchill just after he succeeded Neville Chamberlain. It would be years before the Nazi advance would be contained, but Churchill’s words and bearing were indispensable to Britain’s recovery.

On the other hand, George W. Bush’s difficulty in expressing himself publicly has exacerbated the perception of a rudderless Administration. With that constant reminder over the past seven years, I’m surprised that Clinton’s handlers don’t have her better prepared to express herself well in public debates. Perhaps, as with Bush, she simply lacks the public speaking gift of her husband. But I am continually amazed at how often her extemporaneous public statements are littered with the ubiquitous “you know” crutch as she gathers her thoughts. That habit, as well as her instinct to default to a government solution on virtually every issue, fuels the perception that she lacks substance.

YouTube for eggheads?

bigthink_logo.gifThis looks as if it has great potential. The NY Times has the background story on the project.