Friday, July 21, 2006

"One of the greatest doctors I've ever worked with"

John Pope quoted LSU's Dr. Daniel Nuss in The Times-Picayune:

Calling Dr. Anna Maria Pou "one of the greatest doctors I've ever worked with," a Louisiana State University Health Sciences Center department chairman said Wednesday that the ear, nose and throat specialist arrested in connection with the post-Hurricane Katrina deaths of four patients at Memorial Medical Center will continue to teach and conduct research -- but not treat patients -- at LSU.

"Anna Pou is one of those rare people who has devoted her life to the care of her patients and the practice of medicine," said Dr. Daniel Nuss, chairman of the LSU department dealing with ear, nose and throat problems.

Nuss was one of several friends and colleagues who extolled Pou's professionalism and concern for her patients less than two days after Pou, a cancer specialist, and two nurses, Lori Budo and Cheri Landry, were arrested and booked with four counts of second-degree murder.

Dr. Isabel Ochsner, said her friend Pou, who performs facial reconstruction, works in a specialty which requires a "big heart":
"I'm so ashamed of what someone has put her through," Ochsner said. "For someone of her caliber to be wrongfully accused of killing is a sin."

I listened to some of the comments exchanged during Garland Robinette's show on WWL yesterday. He was (in typical fashion) ranting in the extreme. In this case, though, I think the radio producers probably had to tie him down -- but I think Robinette's tirade was justifiable.

Robinette's certifiable rant accused Foti of placing New Orleans medical professionals in an ethical dilemma that has absolutely no acceptable options: Either refuse care to patients, or face prosecution. Robinette said repeatedly that Foti's action was going to send a clear signal to other medical professionals to leave town, precipitating a further brain drain of essential personnel in a city that's already suffered an incredible loss of medical professionals.

One of the best comments I heard was made by a caller who said that when he was the Orleans Parish Criminal Sheriff, Charles Foti was responsible for more deaths due to his own failure to administer medical care to jail inmates than he's accusing Pou of committing.

A doctor called in to say that the cocktail of morphine and Versed (a central-nervous-system depressant) allegedly administered by Dr. Pou are in fact consistent with treatment for pain, but not at all consistent with what is being called "murder" by Foti. If Dr. Pou wanted to euthanize patients, there were better options.

Here's a Foti "roundup":

These specious charges will have a chilling effect on the practice of medicine in this area. The health care system here is already hemorrhaging doctors and nurses. And pressing these charges is likely to accelerate the departure of the experienced doctors and nurses we need to care for us. Shame on you, Mr. Foti.

And in another post:
Patients are eased out of pain and allowed to die in peace every day. I suspect that the people who scream the loudest about "mercy killing" haven't seen close friends and relatives die slowly and in agonizing pain. I have and it taught me that there are things that are much worse than death.

Interestingly, Pou and the two nurses were booked, but not charged. Eddie Jordan’s office has to file charges, either through a Bill of Information or a Grand Jury Indictment, and that has not yet been done. I[t] will be tough to convict these people of second degree murder, unless it is more craven than it appears.

Why didn't Tenet, which was operating Memorial Hospital, take precautions to prevent such life-and-death choices in the first place, asks Adrastos:
There are probably some valid causes of action against Memorial Hospital's soon to be former operator, Tenet.

Markus comment, in a Yatpundit post:
That will send a clear message to emergency responders: perform triage, go to prison for the rest of your life. That's helpful. I wonder if they're going to prosecute the FEMA workes who turned away a doctor from assiting at the airport? (I have the details stashed away somewhere), who watched a patient waiting for triage die because the physicial wasn't by authorized FEMA to help.

And Markus again:
We are also waiting for Mr. Foti to announce his indictment ... of the commanding officers of the U.S. Army Corp of Engineers for negligent homocide in the death of another 1,000 plus residents of his state. But I'm not holding my breath.

Ashley reiterates Robinette's fear that no doctor will ever want to practice in Louisiana, and those who do certainly won't stay through another hurricane. So who's going to care for patients who can't be evacuated? Some patients would be caused more harm by moving them. If moving them causes their death, should the people who move them be prosecuted for murder?

I think da po' boy tackled the real culprit in this affair:
The doctor and the two nurses arrested *did* stay. Foti focused on the four lives he thinks they took. How many lives were saved because they were here?

According to the T-P (previous link):
...the four patients were not under Pou's direct care. Instead, the four were patients of LifeCare Hospital as part of its arrangement to run the acute-care unit at Memorial.

"They were not her patients," Simmons said. "These were patients that didn't have doctors."

Where were the patients’ doctors? Do they bear any responsibility for the patients who died because they weren’t there to help?

And where does LifeCare’s responsibility end? Of the 34 people who died at Memorial after the storm, 24 were LifeCare patients. Either LifeCare didn’t evacuate the patients or the patients were too sick to be evacuated. It was most likely the latter because LifeCare was a long-term acute care facility. They took care of complex medical conditions. Therefore, we can assume that LifeCare made a medical decision – not a moral or ethical decision – to leave those patients even though they may die.

Does Attorney General Charles Foti really care about upholding the rights of citizens, or his own political ambitions? You decide.


Judge Calvin Johnson spoke up months ago to prevent the media circus that Foti seems to be exploiting for his own personal political gain at the expense of Dr. Pou's career and reputation:
"This is not euthanasia, this is homicide," said Foti, who handed his case files over to Orleans Parish District Attorney Eddie Jordan on Thursday. ...

Orleans Parish Judge Calvin Johnson, who held a closed-door hearing six months ago over whether Pou's calls to Tenet were confidential, warned the attorneys then of the legal maelstrom that was building in New Orleans, and that Pou would likely bear the sting of any accusation.

"If this lady is in fact charged with a crime, she is entitled to a fair trial," Johnson said from the bench at Criminal District Court. "And, arguably, that would not entail being tried in the press."

Can Foti be charged with obstruction of justice?

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At 7/21/2006 07:27:00 AM, Anonymous Lenny Zimmermann said...

Garland Robinette may occasionally fly off on a rant, but the thing I like about him the most is that he is not unpersuadable. He seems to be abel to accept criticism of a position and be swayed from where he stood before. I find I really enjoy his show more than most others I've heard on talk radio. (Although Penn Jilette has my vote for best talk radio show, but you have to get that off the net since it doesn't air here.)

At any rate, I can't say I blame him too much for raving on this one. I think it's very thorny. I certainly support euthanasia as a viable choice for a physician and their patient and I also support the powers that be investigating the issue to ensure there was no true fould play involved. In this case I can only hope the DAs have enough evidence to have really followed through on this appropriately ebcause if this is turns out to not be some kind of cut and dried case then I really do think we have sent the absolutely wrong message to the caring folks who do look after our health and the health of our loved ones. So far, though, it's looking like we are sending that message to stay away from here and I just wouldn't be surprised if these charges turn out to be specious at best.

At 7/21/2006 07:35:00 AM, Anonymous Lenny Zimmermann said...

Off topic, but you mentioned recently the topic of poverty. I found a pretty good site with straight graphs and data covering the topic (and others) that seems pretty interesting.

It looks like a collection point of data evaluation moreso then a think tank style redaction for the data. I thought you might might enjoy it, at any rate.

At 7/21/2006 08:28:00 AM, Blogger Schroeder said...

There are times when a outrage is called for. I just think Robinette could tone down the self-righteous pitch in his voice -- it's annoying to listen to, and I do believe there are a lot of people who are swayed by the sound of someone's rant more than what they are ranting.

Having said that, I do respect the fact that Robinette asks worthwhile questions -- that's what I like best about him. He might change his mind, but not until he's completely vilified an opposing viewpoint.

That UNDP Web site is really cool! Thanks for posting the link. I added it to the gutter.

At 7/21/2006 09:02:00 AM, Anonymous ashley said...

Another point Garland made (I talked about it here), is that what medical professional in their right mind will ever volunteer to come her in another disaster?

At 7/21/2006 09:38:00 AM, Blogger judyb said...

You want to hear outrage, tune in to John "Spud" McConnell from 9-11 a.m.! No matter how we express it, we should all be outraged enough to turn the Foti machine off. Garland's right, this area will lose a good number of doctors and nurses if Foti wins this one. I certainly hope he does not, for all our our sake.

At 7/21/2006 10:07:00 AM, Anonymous adrastos said...

Good stuff, Schroeder. I missed Judge J's money quote; glad you added it. Thanks for the quotes and links.

At 7/22/2006 03:38:00 AM, Blogger Schroeder said...

judyb -- maybe Foti will be able to hang his retirement hat on this affair, and good riddance. He's part of the old Louisiana political machine.


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