Over the last 24 hours at least 20 comments have been submitted — many broke our Comments Policy and did not get published — for my four-month old article on the Katrina aftermath called When Drowning Is Not Good Enough.

A blog article — unless it’s a review — usually has an active
comments life of 24 hours or so and then the article becomes dead and
grey and comment-less.
There’s no such thing as a coincidence — so when my Drowning
article suddenly become “comments popular” again with most of the
comments coming from IP addresses in the Deep South — one began to get
the inalienable sensation that something was definitely up, especially
when the comments are all directed down a single path with an obvious,
narrow, intent.

That kind of comments flood is usually a Spammer at work but this was
something different.
That effort was coordinated and committed and obviously an attempt to
sway public opinion and I wondered if other blogs dealing with the same
Katrina issue were also “Spammed” by these special interests seeking to
perhaps muddy the record or maybe mollify future ramifications.

I decided to publish several of those comments for the When Drowning Is Not Good Enough
article that met our Comments Policy and that were also unique in
argument but, as is our history here, I will not allow an ongoing,
concerted, outside effort to control the independence of this blog.
This morning I saw a news article from the Associated Press titled 3 Arrested in New Orleans Hospital Deaths that made the sudden rush of comments make sense in context when I read the following:

A doctor and two nurses were arrested overnight in
connection with the deaths of patients at a New Orleans hospital in the
days following Hurricane Katrina, the Louisiana attorney general’s
office said Tuesday.

“We’re not calling this euthanasia. We’re not calling this mercy
killings. This is second-degree murder,” said Kris Wartelle, a
spokeswoman for Attorney General Charles C. Foti.
The three were booked on four counts each after their arrests late
Monday but not yet formally charged, officials said. Wartelle declined
to elaborate on the allegations.

At least 34 patients died there during that period, 10 of them patients
of the hospital’s owner Dallas-based Tenet Healthcare Corp. and 24
patients in a facility run by LifeCare Holdings Inc., a separate
After the bodies were recovered, Orleans Parish coroner Frank Minyard
said they were so decomposed the deaths could only be listed as

He later said samples had been taken from dozens of
patients who died at various hospitals and nursing homes to test for
potentially lethal doses of drugs such as morphine.
Harry Anderson, a spokesman for Dallas-based Tenet Healthcare Corp.,
said the allegations against the medical care workers, if proven true,
were disturbing.

“Euthanasia is repugnant to everything we believe as ethical health
care providers, and it violates every precept of ethical behavior and
the law. It is never permissible under any circumstances,” Anderson

The three arrested late Monday were identified by Wartelle and
sheriff’s officials as Dr. Anna Pou and nurses Cheri Landry and Lori
Budo. Orleans Parish Sheriff’s Chief William Hunter said each was
booked on four counts of “principal to second-degree murder.”

After reading that news story — and I urge you to read the whole story because it informative and fascinating — I realized the how and why of the comments avalanche for my When Drowning Is Not Good Enough

Remember: There’s no such thing as a coincidence.
Recalling the pain and devastation of those Katrina deaths is yet
another vital test of our humanity and a larger reminder there are
still hard questions to be asked in the answers of the living.

UPDATE: July 24, 2007

NEW ORLEANS (Reuters) – All charges against a doctor
accused of murdering four patients in the aftermath of Hurricane
Katrina have been dropped, U.S. prosecutors said on Tuesday.
A grand jury in New Orleans decided not to pursue charges
against Anna Pou, who was arrested along with two nurses from Memorial
Medical Center on second-degree murder charges in June 2006.


  1. I found your blog while searching Dr. Pou on line the day her arrest was announced. I read every article I could find about the arrest, but there were not a lot of relevant details about the charges other than that Dr. Pou and two nurses were being charged with second degree murder. The prosecutor was supposed to make a public statement at 2 pm yesterday.
    The arrest shocked and surprised me. I have worked in health care for twenty years and find it difficult to believe the allegation that Dr. Pou intentionally killed critically ill patients. The allegation that it was done so the medical staff could evacuate is completely ludicrous.

  2. It almost reminds me of the scientology newsgroup, which used to get so bogged down with spam remarks from members of the church that it was nearly impossible to get a reasonable discussion in.
    I wonder how Benjamin Franklin would have reacted had he been told that one day, your objective news articles could get comments attached to them for all to see, some with less than objective ideals!

  3. Here is my first and last name. I also just heard about the arrest yesterday since I just moved to Florida. I have been out of touch with the goings on at LSU where I just finished my general surgery residency. I was the one that posted as JF and do not know how to spam. I stand by what I posted earlier today.
    Jean Fung, MD

  4. Hi Gordon!
    You’re into the center of it! That’s precisely what’s going on here.
    The arrest of Dr. Anna Pou happens Monday night and suddenly on Tuesday we get all these comments shifting blame and shimmying defenses in “medicalese” and legalese and it is a transparent attack.
    Their effort is not only quite obviously coordinated, it also comes across disingenuous and it looks like the troops are rallying around the accused in a strange and uncomfortable manner that, I believe anyway, wounds the non-medical person’s view of Dr. Pou.

  5. It’s almost like – if you have nothing valuable to say in your defense, say it loudly. I think I read that in a John Grisham book I once picked up to see if I could read the whole thing in a day.

  6. Hi David,
    I heard a call to a national radio program that fit in with the same vein of thought as expressed in earlier comments to this and the original post.
    The caller said something to the effect that we don’t know what happened, so we need to keep an open mind.
    It struck me as being strange, because there usually aren’t these types of calls to talk radio programs. One takes a side and runs with it either to support or oppose the host.
    You are either for “mercy killing” or euthanasia, or you aren’t. Peter Singer or the Pope is your role model. Calls for moderation in debate forums (or is it fora) are always suspect, because they are “inorganic,” in that they aren’t the average response most people have.
    People in these types of debates don’t usually get caught up in the details of an individual case, but often discuss the issue in the framework of ideas and philosophies and what they may mean for society.

  7. Gordon —
    I think what you say makes a lot of sense. It seems like a defense these days is to not talk specifics. Make the matter a general issue that can be turned into some kind of rallying cry that obfuscates the specificity of what really happened.

  8. Hi Chris —
    I’m not sure what you’re arguing.
    Are you saying the rash of comments postings by first-time commenters on one article over the past day is organic or inorganic?

  9. Hi David,
    I’m saying that the comments here and the call I heard on the radio were not normal “organic” types of comments spurred by debate about a particular topic. People usually express opinions on the broader terms of the debate and not on discrete details, i.e. being “pro or con” about the overall issue.
    Most people — even the most fervent supporter or opponent of any particular social issue — don’t usually get into the deep details any particular case when debating their position. To have a certain doctor’s name mentioned many times in various posts is very “inorganic.”
    I’m using the term “organic” in the way that webmasters use the term.
    From Wikipedia:

    An organic search is a process by which World Wide Web users find web sites having unpaid search engine listings, as opposed to using the pay per click advertisement listings displayed among the search results.

    If it was purely organic, people would have come to your page after finding the post via a search engine.
    Most might have read the post, but only few would have posted a comment.
    Even fewer would have gotten into deep details about a specific non-famous individual.

  10. Right!
    Got it now, Chris!
    Love your argument.
    You are right on target in helping call them out.
    I’ve been actively online nearly all day long on the internet since the early ’90’s and I’m a veteran of online conversations, Flame Wars and other persnickety text interactions.
    You quickly learn how to see trends developing and when things quickly don’t add up to something normal and they begin to smell inorganic you start to look for the underlying self-preserving cause for the barrage.

  11. Another example from the same Grisham book:
    The law firm defending a long-on-death-row client set up a bank of telephones and had a dozen or so people calling into a special polling organization that the state had set up to hear the opinions of people as to whether the client should perhaps be pardoned. They had with them a database of phone numbers of legitimate people that they posed as so it didn’t appear fake. Suddenly the phones at the polling place are ringing nonstop and 99% of the calls are in support of the client.
    Makes you wonder when you get dozens of comments – how many of these are unique people making comments and how many come from one person cloning themself so they can put in their “i totally agree with what xyz said” two pence?

  12. Hi Gordon —
    Thanks for that quote!
    I don’t know how many people here hide behind multiple commenting personas.
    There was definitely a trend here for the Deep South in my Drowning story that was completely unusual and biased one way. That kind of guerrilla attack usually gets started via email messages or phone calls and then they swamp you with their self-righteous support of each other’s messages even though they don’t publicly identify they are in some way privately connected in parallel.
    We had a similar case here awhile back with the gang from Welfaremum.com — but that flood was so obvious and angry it was simple to see how they all scurried over here to put us in our place.

  13. From the previous post, When Drowning Is Not Good Enough, one commentor’s line I just loved was this: “These doctors and nurses stayed for days and days doing everything they could for their patients. They starting administering IV drips to themselves to stay alive.”
    Okaaayy… They couldn’t just open the bottles or bags of solution and drink from them as needed? They had to stick needles into their own arms???

  14. Hi prying1!
    I like your observations! It’s also interesting how these seemingly “innocent” commenters seem to know the inner-workings of what really happened which, in turn, gives them a vested interest in the comments they share.

  15. I read your previous post When Drowning is Not Good Enough along with the comments, this article and the links herein. I am saddened to hear you are being inundated spam.
    For those that do not know how to spam, please check the definition of spam: http://en.wikipedia.org/wiki/Spam_(electronic)
    Under Forum Spam: Spam, aside from unsolicited commercial postings, “consists of repetitous posting of a message (or substantially similar messages).”
    While there seems to be an outpouring of concern from those who stated they know the character of those under the allegations, there must be a better way for those that sympathize / empathize with the medical professionals to get their message across than to litter blog forums with the same information hoping that in doing so to galvanize the favor of its readers.

  16. prying1,
    Drinking bags of saline solution is probably not the best way to go in fluids replacement when you are severely dehydrated, as I imagine those people were. You need that fluid with its proper balance of electrolytes in your blood ASAP, hence, the intravenous route.
    As a future physician, I find this case very interesting. I try to imagine myself in a similar situation. In the face with much impending hopelessness, given the circumstances that I knew with the utmost certainty that those patients were not going to get out, I would probably have administered a drug that would sedate them so that they could be spared the horrors of what was happening around them, and, ease the pain and suffering of a most certain death. Would I want the same for my loved ones, or even myself? Absolutely.
    I was not there, nor do I know anyone involved in this case. I think that it is very possible that Dr. Pou’s efforts to sedate those patients was undercommunicated. The staff that made it their business to leave as soon as they could, rather than stay behind for those patients, they are the ones that cast the most shame on my future profession. For those that remained behind after having had a chance to leave, I applaud them.

  17. If one medical professional’s efforts to sedate the patients were undercommunicated, meaning not sufficiently documented, and another medical professional administered another sedative each administered at non-lethal dosages but at a lethal dosage when administered back to back then would that not minimally be a case of negligence?

  18. Today was the first day that I have ever posted in a blog and I now realize why I have not previously. I encountered your website by googling “Anna Pou” today so I am not sure why my timing is in question. Your site was the bottom one listed on the first page. I opened up all the other sites as well but I felt compelled to post a message at yours. No I am not at a bank of phones. I am on my couch in Florida with my laptop.
    I am not sure what to think of the whole situation with Dr. Pou – we did not have any cases of mercy killing/euthanasia at the hospital where I was. We transported several severely ill patients including one who passed away on the way to the airport. The thought of euthanasia never crossed my mind, but every situation is vastly different and I am not sure what theirs was.
    So, Chris consider me one of the fewer.

  19. I found this by Googling Anna Pou. I am not one to usually reply to a “blog.” However, considering the content, I felt obligated.
    I trained under Dr. Anna Pou when she was a teaching professor at the University of Texas Medical Branch in Galveston, TX. I can attest to Dr. Pou’s dedication to her patients, concern for the poor and indigent, and devotion to her profession. She is not only a very skilled Head and Neck Surgeon/Oncologist, but also a person who has a desire to help mankind.
    It does not surprise me that she altruistically volunteered to help during the devastating Katrina catastrophe. It is difficult for me to imagine the events that took place- no electricity, limited resources, flooding, mayhem, looting, and gunshots on the streets with critically ill patients to take care of. It is easy for us bystanders to judge the events that transpired. The facts are that us others fled (FEMA, government officials including the mayor, New Orleans Police, and other medical professionals); Dr. Pou and those brave nurses stayed and were tested like none of us have been before. I don’t know if political or entertainment value are the factors that brought these brave soldiers to trial. Be it what it may, I’m sure Dr. Pou and the nurses will be found to be one of the great heroes of this extremely tragic tale. I would hope we the people would bring the federal, state, and local government to trial for placing us on trial.

  20. I’m not sure about the spamming alegations, but wanted to say that I just read through your February blog conversation for the first time because I googled Anna Pou after reading about her arrest on ccn.com. So, it’s not a coincidence that interest has picked up, but it’s not necessrily sinister either.
    I also wanted to say that I feel strongly that no one should have been administered lethal doses of drugs in the aftermath of Katrina. It leaves no room for an unexpected turn of events–for someone to rise to heroic action, or simply for someone else to come and help.
    I don’t know if in fact Anna Pou killed her patients, but if so, it was wrong. I’m sure people make poor decisions under stress like that, but just because we were not in the situation doesn’t mean we can’t judge the rightness of what happened. In fact, that is a big part of disaster preparedness–decide now while you’re calm what you will and will not do in disaster situations so that you’re better prepared when the time comes and less likely to be impared by your circumstances. For this reason, I think this discussion is important.
    Also, I think it’s valid to point out that Anna Pou stayed while King did not–I was struck by that when I first heard the story so many months ago. If he was so concerned about the patients, why didn’t he stay to defend them? If he really thought other doctors were going to kill them and that was wrong, why did he leave? To protect himself legally? I see this time and time again–people see something they know is wrong, and rather than getting involved and standing up for what’s right, they leave to protect themselves. Very frustrating.
    Finally, Yes, doctors and nursing home owners (and I would even say volunteers off the street if they realized the trouble), should have stayed with these patients, or anyone else who needed help. The person with more power always has more responsibility–maybe that power is nothing more than being more able bodied. I think it’s a false choice to say they were choosing between their own lives and that of their patients. They may have been very scared and extemely uncomfortable but they were not necessarily choosing between their lives and the patients’ lives.

  21. I’m closing down this thread as well because the Spam problem we had yesterday over here is happening again right here today as comments are held for moderation.
    This time they’re indignantly claiming honor in their intentions as well as verifying the incredible “coincidence” they just happened to find us via a Google search!
    They’re making me giggle with their transparent advocacy!

Comments are closed.