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city failed to get a handle on it. Staff had to
     develop their own coping mechanisms. In the first years of the twenty-first century,
     workers knew a moderate storm could fill the streets around Memorial Medical Center
     with enough water that they would have to park their cars a block or so away on “neutral
     ground”—the high berms between lanes. Hospital maintenance men would put on waders
     and pull colleagues to work in a battered metal fishing boat kept suspended from the
     ceiling in the parking garage basement. Equipment, supplies, food, records, and linens
     were again stored in the basement. Many Memorial employees had long ago stopped seeing
     water as a significant threat.

CHAPTER 2
BEFORE THE STORM
SATURDAY, AUGUST 27, 2005
    GINA ISBELL PULLED a white scrub shirt and navy-blue pants over her ample frame. The
     forty-year-old registered nurse had received a worrisome call at home from her boss
     that morning. Hurricane Katrina, revving in the Gulf of Mexico, had strengthened overnight
     and now had a good chance of steering into southeast Louisiana.A hurricane watch covered a wide swath of coastline. Katrina’s strength wasrated Category Three on the Saffir-Simpson Hurricane Wind Scale, projected to grow
     to a fearsome Four or even a catastrophic Five. Meteorologists predicted landfall
     on Monday, with hurricane conditions possible by Sunday night.
    Isbell’s home, her family, and her hospital were in St. Bernard Parish. LifeCare,
     the specialized hospital where Isbell served as nursing director, occupied a single-story
     building there in Chalmette on Virtue Street. The question was whether to move the
     patients somewhere safer, just in case. The risks of transporting very sick patients
     for a false alarm had to be weighed against the risk that floodwaters could rise over
     the rooftop if the forecasts were accurate.
    St. Bernard had been slowly rebuilt after its surrender to spare NewOrleans from the 1927 floods, but a series of subsequent calamities kept residents
     uneasy whenever weather disasters threatened. Many remembered the levee breaks, devastating
     flooding, and pumping-system failure that followed the Category Three Hurricane Betsy
     in 1965. St. Bernard residents had little faith that their officials or their levees
     would protect them.
    It seemed wise to move the patients. Waiting for more certainty in the forecast would
     leave less time for action and make it harder to secure ambulances.
    LifeCare had two other campuses in the area, including a leased space on a high floor
     of Memorial Medical Center that offered heady views of the city. This “hospital within
     a hospital” provided long-term treatment to very sick, often elderly and debilitated
     patients. Many of them were dependent on mechanical ventilators and underwent rehabilitation
     at LifeCare with the goal of breathing on their own and returning home or to nursing
     facilities; LifeCare was not a hospice. It had its own administrators, nurses, pharmacists,
     and supply chain. The staff still called the location “LifeCare Baptist” even though
     Tenet Healthcare Corporation had bought Baptist Hospital and changed its name to Memorial
     ten years earlier. Most of the St. Bernard patients, LifeCare’s leaders decided, would
     be moved there, and the remaining few to another nearby hospital.
    Isbell called up the nurses she’d assigned to the “A” team at the start of hurricane
     season. They would join her at LifeCare Baptist during the storm and the “B” team
     would come to replace them after the storm had passed. The “A”s Isbell chose were
     strong nurses, team players, the ones she would want by her side at a stressful time.
     They had volunteered for the assignment. Working at an unfamiliar hospital would only
     add to the challenge.
    Isbell had a passion for taking care of those whose long lists of medical problems
     put off some other health professionals. It took until nightfall to transfer