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IN THE DAYS IMMEDIATELY FOLLOWING Hurricane Katrina, Memorial Hospital in New Orleans flooded. The flood marooned patients without the electrical power, medical supplies, or staff needed to sustain life. After nearly a week of hundred-degree heat, inadequate food, rationing of medical supplies, no sleep—and only tenuous whispers of rescue—a few doctors, nurses, and pharmacists injected upwards of twenty patients with lethal doses of morphine or midazolam, or both, with the intention of hastening their deaths.

Whether the deaths of these patients were inevitable, and how near death they were, was and is disputed, though most of the staff who worked that week acknowledged the paltry odds of everyone surviving rescue transportation. Dr. Anna Pou took the brunt of the consequences, though several doctors confessed to participating in the dispersal of medication. She was arrested and charged with one count of second-degree murder and nine counts of conspiracy to commit second-degree murder. The grand jury did not indict her, but she was still embroiled in several wrongful death lawsuits years later.

Pou’s defense team stressed how unimaginable the circumstances were—how impossible it was to make a good decision when all the options were bad. In no world was there enough medication, technology, or manpower to keep everyone alive. For those who were mere hours from death, wasn’t she doing a kindness? Not to mention allowing nurses to care for those who stood a chance.

Those who did not support Pou accused her of acting beyond her scope. A family member of a deceased patient lamented on the evening news, “What gave them the right to play God?”

I don’t know if I support Pou, though I don’t believe I’m in any position to judge her. What I do know, however, is that she is not the first woman to decide between measly alternatives—alternatives that all beget death one way or another. Decisions must be made about who lives and who dies. Not everyone at every moment is compatible with life.

The pity, then, was not that Pou made the decisions she did. The pity was that she was mortal while making them, and that floods have always been mythic sites of divine, not human, judgment. Dilemmas about whom to save during a flood, God taught me, are not for men and women to mull. We were only ever supposed to build an ark.



What strikes me about Noah’s story in Genesis is that it exists at all. I am always surprised that God wanted us to have this memory of him—his quantifying of life’s value and his decision to end it, even if the writer of Genesis insists on God’s regret. I wonder if it would have been less painful if God had simply started from scratch again instead of instructing Noah’s family to be fruitful and multiply the memory.

A professor once told me that I was focusing on the wrong part of the story—that the important part was the rainbow symbolizing God’s promise never to do it again. And perhaps the rainbow is the important part; but the interesting part is that God looked upon the broken hearts of humanity and made a decision about their ability to endure life.

Of course, God does spare one person, one family. God spares Noah, but Noah doesn’t seem especially grateful for this privilege. Noah never offers thanks. He doesn’t pray—although there’s a biblical theme park in Kentucky that likes to put prayers in Noah’s mouth: “Preserve us, O God” is written on a placard inside a fake ark and called scripture.

If Noah ever prayed anything all, I imagine it would have been more desperate than the cordial “Preserve us, O God.” I imagine it would have been more like Rebekah’s cry later in Genesis when, pregnant, she feels a struggle pulse through her womb and begs of God this question: If it is to be this way, why do I live?



When a twenty-week-pregnant woman named Claire asked me to attend her abortion as her doula, I agreed. In our first conversation over the phone I learned she was married; this was her third pregnancy; her husband, Daniel, was having a harder time accepting the reality of the abortion than she was. Doctors said Claire’s pregnancy wasn’t viable—the baby had several genetic abnormalities and would not make it to term. “Lethal fetal condition” was what doctors called it, Claire said. Rather than risk a late-term miscarriage, Claire and Daniel decided to have an elective dilation and evacuation.

I took Claire to the first day of the abortion—the dilation. To begin the dilation, the doctor inserted laminaria into Claire’s cervix. The laminaria, I learned, were kelp, pulled from the water in giant, deep-sea tangles and then dried. Industries divvied them up: sushi wraps, radiation poisoning treatments, gynecological osmotic dilators. They would absorb water from Claire’s body and swell, opening her cervix. She would keep them inside her body overnight.

On the second day, I went to Claire and Daniel’s house to watch their two children while Daniel accompanied Claire for the evacuation. Daniel opened the door to greet me. He looked awful, like a leaf turned over before a storm. Low-pressure systems flip leaves over just before rainfall. The chlorophyll is lighter on the underside of the leaf, intolerant of light. When I was little, my mother taught me to track storms by noticing when the leaves turned. The trees would look ashen, like they might collapse. For a few moments before the water came, the world seemed painfully tender and charged, and I would remember how defenseless it all really was.

“I wish it were otherwise,” he told me, looking soft and green and pale—overturned.



Rhody Mastin is a doctoral student in homiletics at Duke University. She holds a master of divinity from Duke and an MFA in creative nonfiction from Seattle Pacific University.




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