As Hurricane Katrina swirled closer, the elderly nuns who were among the patients at Lafon Nursing Home of the Holy Family packed their medicine and emergency supplies in preparation for evacuation. A sign-out sheet at the nursing home's front desk recorded their departures on the morning of Aug. 27. Sister Paulette signed out at 7:24 a.m., Sister DeSalle at 7:25, Sister Trahan at 7:27, Sisters Jolivete and Miriam at 7:30 and Sister Brinkley at 7:32.
Across the street, 60 more nuns of the Sisters of the Holy Family were also evacuating the convent where they lived, under instructions from their mother superior.
But at Lafon, the nursing home run by the order, more than 100 other elderly patients stayed where they were. Sister Augustine McDaniel, the nursing home's administrator, had weathered other hurricanes in her 68 years and decided that she -- and the patients in her care -- would tough this one out, too.
Faced with moving her fragile patients on jammed roadways, or keeping them at Lafon, a sturdy, low brick building that had survived other hurricanes, McDaniel decided her staff and patients would be better off staying. If things got rough, she would move everyone to the second floor.
Taped under receptionist Gloria Williams's desk were "urgent" instructions to recite in case of a hurricane: "Our Father who art in heaven, through the powerful intercession of Lady of Prompt Succor spare us from the harm during the hurricane season."
No prayer could stop Katrina's rushing waters or ease the fatal heat that followed. When rescue workers finally arrived five days later, bodies were found wrapped in bedsheets in the chapel. Originally told 14 had died, officials eventually recovered 22 corpses.
Three weeks later, Lafon is being investigated by Louisiana's attorney general, along with other nursing homes where people died after a failure to evacuate. The state has charged the owners of one home -- St. Rita's -- with 34 counts of negligent homicide after corpses were found floating in brown storm water. Of about 60 nursing homes affected by Katrina, only 21 evacuated before the storm, according to a list compiled by the Louisiana Nursing Home Association.
McDaniel and the other nuns on the staff have been advised by their attorney not to talk about the ordeal. The story of what happened at this New Orleans nursing home -- pieced together from dozens of interviews with employees and patients, family members of patients, and rescuers -- defies easy characterization.
Those stranded inside watched McDaniel and her staff perform with desperate heroics. When countless rescuers were told of the dire situation inside Lafon and none came to help, employees resorted to looting a Family Dollar for peroxide, alcohol wipes and clothes. A savior finally appeared in a red Ford Explorer towing a boat.
But for children and other family members who had entrusted their parents and elderly relatives to the Sisters of the Holy Family, there is confusion and anger. "I know it's a herculean effort to evacuate people from a nursing home," said Judith Heikes, who finally located her 91-year-old mother in Nashville after she was evacuated. "It would have been traumatic on patients. But they made too conservative of a judgment. And that is putting the best spin on it."
Berita Leonard still has not located her 85-year-old father. "I tried to please my father in every way," says Leonard. "He loved the nuns. But if he is deceased, he did not deserve to die this way."
Sister Augustine McDaniel ran a tight ship. She wasn't shy about lecturing employees who showed signs of sloppiness, asking one delinquent staffer to write an essay about why she wanted to keep her job. A stocky woman with graying hair, McDaniel was a constant figure in the hallways, greeting visiting family members by name. Lafon had a waiting list and a rich history in New Orleans, run by an order of black nuns, Sisters of the Holy Family.
Lafon had 130 patients in 81 rooms on the first floor. Some of the residents could walk to the dining room for meals. In the wing where bedridden patients lived, their photographs were hung on a bulletin board with little stickers that said "You are my sunshine." Upstairs, several nuns who worked at Lafon had small bedrooms and living quarters.
Lafon clearly envisioned the possibility of an evacuation. A state health department form filed in June asked the nursing home, "If an evacuation was called for your parish," where would patients be taken? McDaniel listed two addresses outside New Orleans, in St. Benedict and Franklinton, La.
To ride out the hurricane, McDaniel had a staff of about 22, including five or six nuns. It would be fortuitous that the group included men.
On the weekend of Aug. 27-28, as the hurricane approached, Berita Leonard stopped by to visit her 85-year-old father, Victor Nelson Sr., a retired furniture upholsterer who was staying at Lafon -- Room 239 -- while he recovered from hip surgery. He was 6-foot-1 and wore a wooden cross on a string around his neck. He wore a little black cap that he took off when his daughter came for her daily visits so she could comb his hair.
Leonard told her dad that she was evacuating to Houston. She assumed Lafon would be evacuating -- she'd signed a form authorizing the nursing home to move her father in case of emergency -- but when she ran into McDaniel in the hallway, Leonard said the nun suggested she bring her dad to Houston with her. Leonard thought to herself, "He's 85 years old with a broken hip; where in the world am I going to take him on the highway?" She decided he should stay.
Before leaving that night, Leonard dashed in to check on one of her favorite patients, Sister DeSalle, a nun Leonard knew from her Catholic school days. Leonard was surprised to hear Sister DeSalle say that she and the other sisters who were patients were being evacuated.
The next morning, a Sunday, New Orleans Mayor C. Ray Nagin issued a mandatory evacuation for the city. Judith Heikes called from Illinois and was told that Lafon was hunkering down, with plenty of staff. Karen Cullins called from Baton Rouge and was told the same. A few people drove to Lafon to pick up their elderly relatives.
The staff prepared for the night shift. McDaniel had stocked her "hurricane closet" with medicine, flashlights, batteries, diapers and extra supplies. A generator was at the ready, and an abundance of food and water. Some employees brought their family members with them to Lafon that night. A dietitian, Dora Spencer, brought her two children. Beverly Greenwood, a social worker training to be a nursing home administrator, brought her mother, her stepfather and her 91-year-old grandmother.
Evelyn Leal was also bedding down at Lafon. A seventh-generation New Orleanian, Leal had not wanted to evacuate her home in the Gentilly neighborhood near Dillard University -- she had her little dog, Samson, there -- but her daughter had wrung a compromise from her: Go stay with Dad at the nursing home. Jules Leal was in Room 236A at Lafon, and that is where Evelyn Leal, 85, settled into a chair next to her husband's bed.
It was still dark out the next morning when Leal was awakened by voices. "It's beginning to flood," she heard someone say. Leal put her feet down; she was ankle-deep in water.
A Rush of Water
Outside the wind was growing in force and fury. Greenwood was in the kitchen helping the dietary staff prepare a breakfast of scrambled eggs and grits when someone said, "Oh, my God, water's coming into the kitchen."
Even in the descending desperation of that dawn, the orderliness McDaniel had instilled in her staff was reflected in a logbook at the front desk.
"5 a.m. Called Entergy and spoke w/Ms. Desire. She stated that she will report the power outage and the power should be restored as soon as possible."
"5:07 a.m. Power is restored."
"5:20 a.m. Power outage reported. Spoke with Suzy."
Eleanor Shelmire, a registered nurse, was filling out paperwork when brown water started gurgling up from the drains. Shelmire and her co-workers began moving patients to the large central dining room, the place where McDaniel said they would gather in case of emergency. Greenwood and others tried to hold the glass front doors shut against the wind and water. Pictures were blowing off the walls, and water began seeping into the dining hall where the patients were gathered. The generator failed.
McDaniel directed the staff to move all of the patients to the second floor. With the power out and the elevator not working, stairs were the only option.
"Come on, now, I know you can walk," Shelmire told those who were ambulatory. Gladys Cronin was in her wheelchair as she watched the water "coming in all the cracks in the building and the windows." A pair of staffers would grab either side of a wheelchair and hoist it up the stairs, struggling one step at a time. The water kept coming. Carmelite Cogan -- 91 and in a wheelchair -- was up to her chest in water.
Greenwood used mattresses to float the patients closer to the stairs. The sun was up and they could at least see. Evelyn Leal was beside her husband as he was lifted by his bedsheet and splashed toward the stairs. An Alzheimer's patient, Jules was fussing and disoriented. "Just be quiet, honey. Everything will be okay," Leal told him.
Others were confused or frightened and fought their rescuers. Some patients were so heavy that four staffers -- men and women working side by side -- labored to lift them, pausing to rest halfway up. By now the heat was stifling, and the staff was sweating and panting, racing against the water that sloshed higher.
McDaniel maintained her composure, but Greenwood could see she was upset. "She kept saying, 'I'm so sorry, I'm so sorry,' " Greenwood remembers. After an hour, everyone was upstairs. In a final act of civility, the still-warm breakfast of eggs and grits was served on paper plates.
Their refuge was a 50-yard-long hallway. The seven nuns who ran the nursing home had bedrooms here with two large lounges, a small laundry and kitchen, a room with a sewing machine and exercise treadmill, and a guest bedroom. Now the lounges and main hallway were a makeshift MASH unit, with a field of wilted bodies laid on the floor or propped in wheelchairs.
The staff gathered sheets and pillows for those on the floor. Many of the patients were soiling themselves, and the staff worked to keep them clean, washing their bodies and disposing of the soiled linens and clothes in large plastic bags.
Shelmire took stock of her supplies; she had medications such as insulin, Tylenol and suppositories. The food in the freezer and refrigerator would keep for a day. Ham sandwiches were made first. The staff poured water into cups with straws and insisted the patients drink. The heat was sapping them.
The first patient to die was a woman who'd been on hospice care before the storm. When her breathing grew more shallow, the nuns prayed over her, then wrapped her body and the staff carried her downstairs to the chapel, a modest room with an altar and 12 pews.
Nightfall brought heat and steam. The staff tore up cardboard boxes to fan the patients. Towels were dampened to cool foreheads. Evelyn Leal's husband was without his medication, and he hollered throughout the endless night, "Evelyn! Evelyn!"
Shelmire and others walked the floor with flashlights, checking on people. "Can I have my pain medication?" one asked. Unable to match their prescriptions, Shelmire could offer only Tylenol. The dietitian's children stayed in a nun's bedroom, but others who were offered rooms refused, including Shelmire, who considered the rooms sacred. Even in this defiled and muddied environment, the nuns still held a special place.
Daybreak Tuesday brought an incredible sight: The water downstairs was receding. By afternoon, the parking lot that had earlier been swamped was drying, and more amazing, the road that ran in front of Lafon -- Chef Menteur Highway -- looked passable. Help would certainly be on the way.
Soon vehicles began to rumble by on Chef Menteur Highway. Greenwood and other employees ran outside to flag them down. A National Guard truck kept rolling. Police and fire vehicles sped by. When a Wildlife and Fisheries vehicle eased over, Greenwood said she begged, "Please help us, we have 103 elderly people in a nursing home." The rescue workers said they were trying to get to submerged neighborhoods where people were stuck on rooftops.
Two other Lafon employees, Pete and his wife, Precious, who both worked in housekeeping, stood in the middle of the street, trying to get anyone to stop. McDaniel and some of the men went across the street to the motherhouse of the Sisters of the Holy Family, and broke in to get more food and supplies.
That night, fires and looting erupted along Chef Menteur Highway, and gunshots popped in the distance. McDaniel and a male employee went out to the parking lot and got one of the cars to start. Still wearing her habit, she and the man rode out for help. They found a New Orleans police officer who promised assistance. A stickler for details, McDaniel wrote down the officer's name and returned to Lafon to wait.
One hour passed, then two, then three. Upstairs at Lafon, Shelmire focused on her patients. She administered suppositories to keep temperatures down. Dirty diapers were changed. Many patients became quiet and stopped eating. Many more were without their glasses and hearing aids, their essentials for making sense of the world. A Spanish-speaking patient had palsy. Evelyn Leal cleaned his face and lifted a water cup to his lips.
At one point, two New Orleans cops did pull into the Lafon parking lot. But they were in search of gasoline. "You could have my gas -- I have gas in my car," Greenwood said. One of the officers called for backup, and when the additional officer arrived, they tried siphoning gas from Greenwood's tank. It was empty. Same with all the other employees' cars in the lot. Someone had stolen all the gas. Before leaving, the officers promised they would radio that Lafon needed help.
On Wednesday morning, Greenwood and some of the others walked to a Family Dollar that had already been looted, and took supplies back to the nursing home. Beneath pictures of saints, they dressed some of the patients in stolen gowns.
Day Three was a day of more promised rescue attempts that never materialized. McDaniel camped out in front of Lafon to stop cars. Two patients who were having trouble breathing were taken out to a van where there was more air and comfortable seats. Even with this macabre and surreal scene, no one stopped.
They finally caught a break. Someone's cell phone chirped to life, offering communication with the outside world. Greenwood made contact with one of her brothers; that call turned out to be Lafon's most important SOS.
Irvin Boudreaux lived outside of Atlanta. In 35 hours, he would manage what no government agency or rescue team could pull off.
With his brother and a friend, Boudreaux arrived at the chaotic perimeter of the city Thursday morning, towing a boat and a load of supplies. They were stopped at a checkpoint where only official vehicles could pass. His brother flashed his badge from his job with the sewage and water board. They claimed they were going in to check on sewer lines.
When Boudreaux got to the nursing home, he saw his sister first, and then his mother, sitting on a bucket in the driveway.
He simply could not believe their stories that no one would stop to help. He unhitched his boat and drove off in search of a police officer, a paramedic, anyone, but he saw for himself the futility of the mission. He returned to Lafon, where he took in the gruesome sight. By now, nearly a dozen patients were dead. The heat was stifling, but the smell was worse.
Boudreaux loaded his truck with the children who'd been trapped at Lafon, and his own mother, stepfather and grandmother. He crossed back through a checkpoint and found a state police officer, but the officer refused to take the group. Boudreaux then drove to the Superdome to see if he could use it as a staging area to drop off Lafon patients, but there was too much water to cross, and where it was dry he could see thousands of disoriented wanderers. The old people would never survive this scene. He turned back for Lafon.
The problem was transportation. Boudreaux called his employer, Marathon Oil Corp., and anyone else he could think of. Church buses were being commandeered from other states, but finding a driver who would brave the pandemonium of New Orleans was proving impossible.
By now the emergency operations center in Baton Rouge was aware there was a crisis. Jelynne Burley, a San Antonio woman whose grandmother was at Lafon, called a friend who worked in the Louisiana governor's office. The Nursing Home Association, a trade group that was keeping track of its 53 member nursing homes during the storm, was camped inside the emergency operations command in Baton Rouge. Lafon didn't belong to the organization, but Executive Director Joe Donchess said his employees "told many people many times that we had 50 patients, 70 patients or 100 patients and we needed help immediately. And we were left to figure it out ourselves."
Boudreaux would be their best shot. He found a bus company and a driver for $1,000. Leaving nothing to chance, he found three vans in Lafayette, too. The nursing home group scrambled to find a place to bring the evacuees, but even in the emergency operation center, simple communication was difficult.
When Boudreaux escorted the bus into the parking lot of Lafon, darkness had fallen. Inside the nursing home, flashlights were used as people gathered the patients. Those who were able, walked, such as Evelyn Leal, but her husband and others had to be carried out. Some were laid in the aisle of the bus on pillows. Boudreaux noticed how they "perked right up" in the air-conditioned bus. One patient did not make it; he died before he was loaded. He was the man with palsy, whose face Evelyn Leal had washed every day.
With more than 40 on board, the others would have to wait for the second run. McDaniel, her habit off and wearing a sweat-soaked T-shirt, stayed behind with them.
Ninety minutes later, the bus arrived at Chateau Terrebonne nursing home in the town of Houma, southwest of New Orleans. The staff was waiting. One man had raced to Chateau Terrebonne when he heard that buses were on their way. He saw Greenwood and asked if his father was on this bus or coming on the next.
The man's father was the person who died just before being loaded. "Your father did not survive this ordeal," Greenwood said, and the son grabbed her and held her and cried.
It was after midnight when the charter bus set out for Lafon for the second batch of patients, with Boudreaux in his truck leading the way.
They reached the Mississippi River bridge when the sky boomed with explosions, sonic and bright -- one person who saw it thought it was from a refinery, but that could not be confirmed. Boudreaux said a policeman told him to run for his life. They turned the vehicles around and parked on the shoulder of the road. After a couple of hours, the police opened the roads again.
But the bus driver was too afraid to venture forth. He told Boudreaux he wouldn't make the second run to Lafon.
The sun was coming up. It was Friday. Boudreaux sat on the side of the road. "I was just thinking about them people," he would later say.
He would get a second bus, but it wouldn't arrive until late that afternoon.
On Friday, Dan Martinez and Jim Chesnutt were riding down Chef Menteur Highway when they noticed a dazed man in a hospital orderly's shirt standing under a tree. The two FEMA officials had orders not to stop for anyone without an armed escort, but they pulled over and asked the man if he needed help.
"Don't worry about me," he said, pointing to Lafon behind him. "There's people back there in worse shape."
Lafon wasn't on the list of nursing facilities and hospitals that rescue teams in this part of east New Orleans were searching. Even odder, the parking lot was dry and full of cars. Chesnutt and Martinez decided to take a look.
McDaniel greeted them at the door, and in urgent efficiency she described the gruesome tableau at Lafon: 12 dead bodies were in the chapel, two more dead were upstairs, and there were 59 others who needed immediate evacuation.
Chesnutt bolted up the stairs and took in the landscape of the elderly, lying on mattresses pads, slumped in wheelchairs, everywhere. Some wearily looked up at him. Most did not.
Martinez radioed for help. Ken Wilson was directing medical operations for the area from a nearby highway overpass when he heard the sobering radio call. An emergency medical physician and medical director for the Orange County, Calif., fire department, Wilson knew they had to get the patients out of there, but he had only three ambulances and he knew that was not enough. There were helicopters in the air, but radio communication with the state authorities was out.
He got an ambulance driver to call his dispatcher in Lafayette, who called someone at the Superdome, who was sitting beside a military liaison with communications to the Air National Guard and Army. Twenty minutes later, the first Black Hawk was fluttering toward Lafon, and soon, an armada filled the sky.
David Shatz, a trauma surgeon with the Miami search and rescue team, looked in the back of the green van parked to the left of the entrance. Two patients were lying on blue foam mattresses in the van. Someone said they had been moved down there because it was cooler than upstairs. Shatz could see one of them was comatose and on the verge of death.
Shatz walked upstairs. Triage, from the French word "to sift," meant making decisions about who was likely to live and die, and Shatz figured there were more to be made. To his surprise, the nuns had largely done the sorting for him. The first patients at the top of the stairs were the fittest. Walking down the hall, he found they seemed progressively weaker. Three or four at the end, he thought to himself, "were clearly on the way out."
At the nursing home parking lot, rescue workers jammed the stalled cars into neutral and pushed them out of the way to make room for the choppers.
A few patients were carried out on hard plastic stretchers, but most grabbed sheets and bedding for a makeshift sling. "Don't drop me," one patient said. Carmelite Cogan, 91, was naked except for a diaper. She later told her daughter that she crossed her arms over her chest for dignity.
One by one, they were brought out to wait for what was now a stream of Black Hawks that took most of the patients to the makeshift hospital at Louis Armstrong International Airport. McDaniel and her staff would not leave until the last patient was taken. One FEMA official told McDaniel she had done a "heroic job."
At the airport, some of the Lafon patients waited for as long as 15 hours before being flown to nursing homes and hospitals around the country. Many waited on stretchers on the dirty floor. Who would ever know their histories. Among them was 100-year-old Rosalie Daste, who suffered from dementia. No one at the airport would know that she had never missed a Southern University football game, that she was famous for her shrimp and okra, and that she made her grandchildren pick up pecans in the hot Louisiana sun because she wanted them to know what life would be like without a college education.
Two days after being airlifted from the New Orleans airport to a hospital in Monroe, La., Rosalie Daste died.
Family members were on their own to locate their loved ones. Many say they made repeated attempts to call McDaniel or her mother superior, Sister Sylvia Thibodeaux, in the days after the evacuation.
The more than 65 nuns evacuated before the storm had fled to a religious retreat center in Alexandria, 190 miles northwest of New Orleans. In an interview, Thibodeaux said she customarily evacuates the nuns in the face of severe hurricanes. She refused to say why Lafon didn't make the same choice.
"They made their own plans," Thibodeaux said. "I assign the sisters, but I do not make the decisions."
Lafon is now an archaeological site of everything that happened there: metal bed frames pushed against walls, the brown watermark, mattresses on the floor, strewn water bottles and stinking carpet.
Flies buzzed on the screen door of the chapel -- with the sign that said "morgue" after 22 bodies were recovered.
But one day last week there was remarkable order, too. The water had stopped short of the desktops, where paperwork remained neatly in place. Pencils still in their holders. Coffee cups half-full. A sweater draped over the back of a chair. The good and careful order of lives interrupted. Patient Alma Koehl still had a stuffed tiger on her bed. Patient Hilda DeMouy's room had a note reminding nurses to take her blood pressure from the right side.
In Sister Benjamin's room, a yellow ribbon from her jubilee party celebrating 50 years of religious life. On a counter in a nurse's room, an open Bible next to a copy of the Times-Picayune with the screaming headline, "Katrina Takes Aim."
Staff writers Jacqueline L. Salmon in Houma, La., and Lisa Rein in Houston and research editor Lucy Shackelford contributed to this report.