Dr. Daniel Nuss is Chair of the Department of Otolaryngology at Louisiana State University. One of the members in his department is Dr. Anna Pou, who was arrested and booked on charges of murder in the deaths of four patients at Memorial Hospital in the days after Hurricane Katrina struck New Orleans. He recently gave us his thoughts on Dr. Pou and what was happening in New Orleans during and after the storm.
How long has Dr. Pou worked for you as Chair of the Department of Otolaryngology?
She joined our group in 2004, but I had known her professionally for at least 10 years before that, as we both were alumni of both LSU and the University of Pittsburgh, although we were not synchronous at either place.
What is her main area of expertise
Head and neck oncology, and microvascular reconstructive surgery of the head and neck. These specialties deal with some of the most challenging and difficult problems in all of medicine. Facial deformities, people who canâ€™t speak, breathe, swallow, hear, etc.
Did you as Chair ask her to stay behind to take care of patients at Memorial Hospital?
No, our group had a standing policy that whomever was on the call schedule when a hurricane evacuation was announced, a so-called â€œCode Greyâ€, would be responsible for staying.
Remember that prior to Katrina, there never had been any episode in which anyone was trapped anywhere, so up to then it had simply been an inconvenience to have to stay.
She was the one on call, and our group had all its’ inpatients at the Memorial Hospital.
What directions did you give her or other members of your department as you realized the storm was about to hit?
The directions were actually clear from medical staff bylaws, in the sense that physicians are required to provide for their patients in times of disaster and must either stay to take care of them, or arrange for another MD to do so.
Dr. Pou, always the most conscientious one, declined to delegate that responsibility to anyone else. True to her usual giving nature, she did release the residents who were assigned to stay on duty with her, allowing them to take themselves and their young families out of harmâ€™s way.
What did you do during the storm? Evacuate or stay in the city?
My mother-in-law was actually an inpatient at Memorial with a serious illness (idiopathic pancreatitis) on the eve of the hurricane, and I packed her up and evacuated her to Houston with my wife, 9-year old daughter, and father-in-law.
Knowing what happened, in retrospect I wish I had arranged for them to get out, and I would have stayed at Memorial.
Why did you decide to set up a legal defense fund for Dr. Pou? How much did you collect and how much was used by Dr. Pou?
In the beginning, it was made clear that the proceedings were not simply going to be â€œmalpracticeâ€ proceedings, but instead would be viewed as â€œcriminalâ€ allegations and therefore, malpractice insurance was of no use to her.
Because of the sensationalistic way in which the case was reported, it was also clear that defending it would be lengthy and expensive.
Knowing Anna Pou to be an extraordinary, dedicated, and highly ethical doctor, I knew there was no truth to the allegations, and every doctor and nurse who knew her and were familiar with her work felt the same.
I decided that as chairman of my university department, in contact with so many alumni and supportive physicians, I should use my position to build support for her. While I was â€œin chargeâ€ of the fund, with donations coming through my office, we quickly received tens of thousands of dollars within 6 or 8 weeks, I would guess.
However, I was admonished by the leadership of the school that it was not appropriate for me to administer this defense fund because of my responsibilities to the University, and at that point Dr. Pouâ€™s brother Michael took over and organized it.
I do not know how much was eventually raised but would not be surprised if it exceeded $100,000.
Did you know or had you worked with the two nurses she was charged with?
I knew them both. They regularly took care of my own head and neck cancer patients and skull base surgery patients. They were superb, dedicated, and highly skilled, seasoned ICU nurses.
After she was arrested and charged what did she do for your department?
She first spent time reorganizing our residentsâ€™ curriculum and didactic education. Much of this was behind the scenes, office work.
Remember, reporters were hounding her and even stalking her, and I did not feel it was in her best interest to work in public places. Also, our whole residency program had just been â€œwashed awayâ€ and there was much to be done.
She was the perfect person to do it. She did it so well that we easily won our accreditation just a few months later.
Have you ever discussed in details the days she spent in the hospital after Katrina hit?
No. She and I both knew she could not talk about them as soon as the allegations were made and lawyers got involved. However, I can honestly say I never felt the need to ask her whether she had done anything inappropriate; I simply knew, based on all our prior interactions, that she would not have lifted a finger to harm anyone.
If you had to describe in one word this whole episode what word would you use?
Kafka-esque. I am mindful of the Kafka novel, â€œthe Trialâ€, in which the protagonist is falsely and aggressively accused of a heinous crime, and the trial takes on an absurd, surreal life of its own.
>What was Dr. Pou’s frame of mind as she went through this ordeal?
It was complex. I donâ€™t pretend to know all the things she felt, but from my point of view it seemed she was extremely hurt that anyone could make such accusations, in view of her entire professional life being spent in devoted selfless giving, and probably frustrated that she had risked her own life to help these people yet was accused of evil deeds.
Nobody mourned the dead more than she did.
Were the people of New Orleans sympathetic to her plight or was public opinion against her?
Nearly everyone I talked to from the very beginning took her side. Although there were some who had doubts, I think most people had a gut-level view that told them it didnâ€™t make any sense to believe that three women who devoted their whole lives to helping people would suddenly â€œsnapâ€ and conspire to kill.
Was the medical community sympathetic?
Even more than the lay public, the overwhelming majority of medical people supported her. I would estimate greater than 98% of doctors and nurses supported her, and most of those were actually very angry at the proceedings.
I received literally thousands of unsolicited emails and notes and even donations from healthcare workers around the world expressing their outrage against the legal proceedings, and their support for Dr. Pou.
Can you describe what New Orleans was like right after the storm?
Hell on earth would come close. Sweltering heat, sauna-style humidity, stench, filthy water everywhere, bodies of people and animals floating by, looting by the denizens of society, gun-wielding crazy people, gunshots from snipers in the night, and most police and rescue squads simply incapacitated.
I had several personal friends who had guns pointed at them, and shots fired, as they tried to evacuate.
Do you think Dr. Pou will go back to clinical care?
Absolutely. It is her life and her calling and her gift to mankind.
How did Dr. Pou cope with this ordeal?
She relied on her deep faith in God, her incredibly close-knit family, and her friends, combined with the knowledge that she had not done anything wrong.
How did Dr. Pouâ€™s family cope with this ordeal?
They were incredible too. The going got tough, and the tough got going.
I was extremely impressed with her mother, her brothers, her sisters, and numerous relatives who all contacted me at different times. Her husband Vince was remarkable in his unwaivering support.
It would have been easy to be bitter, but they remained focused on making people understand Dr. Pou and her legacy of caring. Ultimately I think their efforts solidified the publicâ€™s opinion that she was innocent.
What is her legal status right now? Are there pending charges with the state board of medicine or civil charges?
The Grand Jury ruled, â€œno true billâ€, which means they did not find sufficient evidence to charge her. She was never actually â€œchargedâ€ with a crime; simply accused and booked.
The State Board of Medical Examiners has not intervened. The Louisiana State Medical Society actually came out in her support.
Why do you think she was accused of murder? Was she being made a scapegoat?
I have given this a great deal of thought. …the person whose news interview apparently started the whole inquisition was a guy who had washed out of his own residency, was working at Memorial as a contract physician, and by all accounts was probably an ineffectual physician during the emergency.
My guess is that as the situation at Memorial deteriorated, the really capable, decisive physicians had to step up to the plate like Dr. Pou, Dr. Glenn Casey, Dr. Bill Armington, Dr. Barry Faust, Dr. Richard Deichman, Dr. John Walsh, and others who were the backbone of Memorialâ€™s medical staff and take action.
The less capable ones or those who disagreed with the decisions made probably felt marginalized and disgruntled, and wound up with an axe to grind.
In New Orleans after the storm, there was a universal, overwhelming collective sense of bereavement on a grand scale. This sense of bereavement for some people translated into anger and outrage, and an ambitious attorney general decided he would be the hero and make somebody pay.
Is New Orleans in better shape than before Katrina for a hurricane event?
We hope so. There has been a great deal of massive levee reconstruction and installation of locks and pumping stations, but unfortunately the level of defense needed will take many years and billions of dollars to complete.
At the very least, though, people have now seen how bad it can be, and I would hope more people would get out next time an evacuation is called.
National Geographic magazineâ€™s recent article calls the areaâ€™s future into question because of the enormity of the task.
Do you think the medical care and system will rebound or be permanently altered by the storm. Will Charity Hospital reopen?
It is rebounding, but you have to remember New Orleans is now a much smaller city. I doubt it will ever be as big as before.
But, there are still many people in need and money has been appropriated for a new hospital to replace Charity.
Do you think Dr. Pou can return to being an effective clinician?
Yes I do. If any doctor on earth could overcome this, she can. She is a remarkable person, and as I said, her calling is to care for her patients.
What was her reaction when she heard the news that the Grand Jury failed to indict?
She said this: â€œI fell to my knees and thanked God…”
Were her attorneys confident they could beat the charges?
I talked with her lead attorney many times over the months, and although they were extremely confident that she was innocent, there was always concern over how far the highly politicized process would go.
Remember that an Attorney General is an extremely powerful position in Louisiana.
What does she like to do in her time away from the hospital?
She is extremely family-oriented and is devoted to spending time with her siblings, mother, and husband.
What frame of mind is Dr. Pou in now?
This month she is taking a well-deserved leave of absence to recharge and reflect. The Attorney General has just been resoundingly voted out of office, which is a great affirmation that the public felt he was way off base in his prosecution of this case.
I talked to Dr. Pou a few days ago and she sounded really good. Obviously she still has tremendous challenges ahead because of all the negative publicity and the civil suits pending, but she is one of the strongest people I have ever known, and I believe she will return to her career and continue to help people.
I certainly would trust her with my life.