The TV show on Apple TV + “Five Days at Memorial” based on the book of the same name (which in turn is based on a Pulitzer Prize winning article) is about three quarters through as I finished the book and I write this. Therefore, my criticism and praise of the show should be seen in this context. I’ll try to keep this review free of major spoilers for the TV show, but it is difficult to discuss the issues of this true story without covering some of the events involved.

“Five Days at Memorial” tells the story of what happened to the doctors and patients at Memorial Hospital during Hurricane Katrina in New Orleans when they lost power, were flooded, were abandoned by authorities, and evacuation was difficult to impossible. It is a challenging story that involves issues of disaster preparedness, corporate ownership of hospitals, death, euthanasia, quality of life, triage, race relations, rationing of care, and the potential criminal culpability of doctors for decisions made during emergency situations.

The TV show seems to be told from a particular point of view which in a story like this means taking a particular side. It paints a bleak picture of hospital ownership, which according to the book, are certainly due for criticism; however, the lack of care and forethought shown is disingenuous. It does set a similar tone, but like many “docudramas” it combines characters, invents new ones, and seems to invent situations to fit story arcs and running times. The acrimonious relationship between the staff at Memorial and the staff of the Life Care Hospice hospital, that inhabited the same building, seems to be a fiction made for TV.  It also wholesale moves one situation from a different hospital, Memorial was not the only hospital with major issues during Katrina, to Memorial for dramatic effect.

While I’m painting a picture of the show as being an unreliable narrator that is not to say that it is not entertaining and emotionally engaging. It also shows the importance of disaster preparedness and the dedication of medical professionals. Being in the veterinary profession, the plight of pets and the role they play in the movement of people during emergencies, is of particular interest. While the book does an excellent job of recognizing the issues that looking after pets in an emergency raise, the TV show pays only lip service to this, except for one brutally accurate scene in episode six.

As of episode six, the show is of limited use as a teaching tool about disaster response and medical ethics although it is a show worth watching. It does do an excellent job of showing how rumors start and get out of control but provides no solution for controlling them – unlike the book which forays into comparing how other hospitals, during Katrina, dealt with the same issues as Memorial differently or made the same mistakes.

As a teaching tool for disaster response issues, the book is remarkable. It acts as the crucible for ideas that was never able to be had in public and really needed to be. These are issues that affect us to this day. The book, written in 2013, makes this clear with hindsight as it discusses the withdrawal of ventilators from patients during a potential Influenza pandemic. While Katrina changed many things about disaster response and emergency preparedness, this book shows how much still has to change nine years after its publication and 17 years after Hurricane Katrina.

The book swings wildly between differing points of view on the more contentious issues which buffets the reader much as the characters in the book must have felt. The research is impeccable and paints an impressively detailed picture of both Memorial during Katrina and  that of public opinion, law enforcement, politicians, and the medical community in the aftermath.

It also explores in depth not only moral quandaries faced by doctors and emergency personnel, but also the ethical and legal issues that also arise. It does an extraordinary job of showing how people in decision making positions get trapped by a lack of situational awareness and become prisoners of decisions made with different information at different times.

What Five Days at Memorial shows, both in written form and to a lesser extent its TV cousin, is that heroes can be flawed and that villains can do good. What really needs to be our focus is values. Do emergencies change our values or do our values inform how we respond to emergencies? We need to discuss that, particularly considering COVID 19, and if the TV show helps that happen then it will have done a great service to our society.

However, it will be the book that informs that discussion and that we should use as a foundation. This is what great books do. They focus our minds and give us evidence to think. There are no easy answers in Five days at Memorial and a lot of questions. But what Ms. Fink (more accurately addressed as Dr. Fink since she herself is an M.D.) has done is set us a table for us to dine over and have those discussions. These issues will not go away, and as the book makes clear in the epilogue, we are doomed to make the same mistakes, with the same justifications, or go down potentially dangerous roads, if we do not have frank discussions about how we as a society actually feel about ethical and moral quandaries that often arise in the most trying and difficult of times.