It's a standing joke among the president's top aides: who gets to deliver the bad news? Warm and hearty in public, Bush can be cold and snappish in private, and aides sometimes cringe before the displeasure of the president of the United States, or, as he is known in West Wing jargon, POTUS. The bad news on this early morning, Tuesday, Aug. 30, some 24 hours after Hurricane Katrina had ripped through New Orleans, was that the president would have to cut short his five-week vacation by a couple of days and return to Washington. [...]

The president did not growl this time. He had already decided to return to Washington and hold a meeting of his top advisers on the following day, Wednesday. This would give them a day to get back from their vacations and their staffs to work up some ideas about what to do in the aftermath of the storm. President Bush knew the storm and its consequences had been bad; but he didn't quite realize how bad.

The reality, say several aides who did not wish to be quoted because it might displease the president, did not really sink in until Thursday night. Some White House staffers were watching the evening news and thought the president needed to see the horrific reports coming out of New Orleans. Counselor Bartlett made up a DVD of the newscasts so Bush could see them in their entirety as he flew down to the Gulf Coast the next morning on Air Force One.

How this could be—how the president of the United States could have even less "situational awareness," as they say in the military, than the average American about the worst natural disaster in a century—is one of the more perplexing and troubling chapters in a story that, despite moments of heroism and acts of great generosity, ranks as a national disgrace.

I had been mulling over the discrepency between Bush's awareness of the danger posed by Katrina and my own. I spent at least one sleepless night following the storm's progress (and blogging about it), because I had been reminded of the potentially devastating effects of the "nightmare scenario" of an extremely strong storm hitting New Orleans, and another sleepless night trying to determine if the city had indeed "dodged the bullet" as it had seemed it did. I did this, despite the fact that I have no particularly strong relationship to New Orleans (which I've been to once, for a week, while touring with a musical) or the rest of the Gulf Coast, no family or friends in harms way, no property in danger.

Yet at the same time I was losing sleep over what might happen, the President of the United States was apparently unaware of the potential for disaster, unconcerned about the scope of the consequences, and unwilling to cut short his vacation until days after the storm had hit.

Simply amazing.

Dan Froomkin in the Washington Post has a good round up of some of the immediate political consequences of Bush's lack of character. The economic and social consequences we'll be adding up, and coping with, for years to come. [Thanks to Shirley]

(4:00am): Of course, along with the truth come lies and deceit.

I have no specific proof one way or the other, but everything about this story, from the U.K. Daily Mail screams "hoax":

Doctors working in hurricane-ravaged New Orleans killed critically ill patients rather than leaving them to die in agony as they evacuated hospitals, The Mail on Sunday can reveal.

With gangs of rapists and looters rampaging through wards in the flooded city, senior doctors took the harrowing decision to give massive overdoses of morphine to those they believed could not make it out alive.

In an extraordinary interview with The Mail on Sunday, one New Orleans doctor told how she 'prayed for God to have mercy on her soul' after she ignored every tenet of medical ethics and ended the lives of patients she had earlier fought to save.

Her heart-rending account has been corroborated by a hospital orderly and by local government officials. One emergency official, William 'Forest' McQueen, said: "Those who had no chance of making it were given a lot of morphine and lain down in a dark place to die."

I'll be looking to see if anyone follows up to corroborate this story, or debunks it (far more likely, I suspect), but to me it really smells like a complete scam. I think the Mail got taken.

(4:30am): This Times-Picayune story paints a much more palatable, and plausible, picture of what went on in the hospitals of New Orleans:

Despite horrendous conditions, desperate hospital staff struggled to accord dignity to the dead, moving at least a dozen bodies into a chapel and covering each with a blanket or placing them in body bags.

The bodies were not recovered from the hospital until days after the storm passed, officials said.

"Everything was done to protect the remains," Hackney said, adding that security workers remained at the hospital until Thursday or Friday after the storm to keep watch over bodies that were scattered all over the hospital, including the top floors where some had been brought in the hope of rescue by helicopter.

Staff managed to evacuate 270 patients, he added.

[...]

"Nurses stayed up all night, literally, fanning patients with paper or pieces of cardboard just to keep them cool. There were older people lying on the floor on mattresses or right on the floor. Others were manually giving them oxygen for hours at a time," she said, describing the resuscitation bags that were used after electrical ventilators stopped working.

Generators failed the day after the storm, leaving the building unbearably dark, hot and humid, said Carstens, who had arrived at Baptist with her husband on the eve of Katrina’s landfall.

"I remember it was just so dark … you couldn't see anything and there were looters trying to get in the hospital and there was no security," she said.

To reach helicopters landing on the roof of an adjacent parking garage, staff moved patients through a hole smashed in the side of the building to avoid floodwaters below, Carstens said.

Inside the garage, some patients were placed in the bed of a pickup truck and driven to the top of the garage to wait for helicopters.

Some of the dead later found on the hospital’s upper floors apparently were taken there by staff hoping that they would be rescued from the roof, Hackney said.

This story doesn't contradict the one in the Mail, of course, and there's no logical reason why both couldn't be true, but the T-P story just feels much more believable to me, and not because it paints a fairly heroic portrait of the doctors and nurses.

(Wed 14 Sept 12:30am): The Mail followed up with another story, intriguing for what it did not say:

A BRITISH nurse last night told of the agonising decisions she was forced to make as she 'played God' with patients in her New Orleans hospital, besieged by armed gangs and under fire from snipers.

Sharen Carriere, 46, originally from Holbeach, Lincolnshire, chose to stay at the Memorial Medical Centre in New Orleans when Hurricane Katrina struck, never imagining the horrors that would unfold before her.

Her eyes filling with tears, she said: 'I have been a nurse for 21 years and my job is to care for people. When the hurricane warning came, I volunteered to go in to work. I never thought I would ever be in the position of playing God.

'I literally had to look at patients and make the choice about who would live and who would die. Some patients were so sick that I knew they would not make it. I had to go against everything I believe in and focus on saving those who could be saved. It was the hardest thing I have ever done in my life.' Although she had to make heartbreaking decisions, she said she never witnessed any incidents of euthanasia that other New Orleans medical staff saw.

'People were dying like flies,' she said.

'All I could do was care for the living and try to make the final moments of the dying as dignified and comfortable as possible. [Emphasis added. -- Ed]

Here's how I interpret this story: the Mail, nervous that no other media outlet was running with their story, went looking for confirmation and came across this British nurse who describes harrowing medical triage decisions necessitated by the conditions during the worst of the disaster. The situation she describes are very much like that described in the original story, and so supports it, but she explicitly states that she did not see any euthanasia, so that specific charge, the nub of the Mail's original story, is not verified.

I had a bit of time to think about why the original story doesn't cohere for me. I still don't have a lot of specific reasons, it's still more a matter of instinct, of "smell", but there are these issues:

That doctors from a hospital in New Orleans would do this and then tell the story to a British newspaper is pretty incredible. Why would they tell, when it amounts to confessing to a state felony? Who would think to look closely at the dead patients if they had done it and didn't say anything? Did their intense guilt cause them to pick up the phone and call a newspaper in London?

And how did this "emergency official" or "utility manager" or "government official" (as he's described in the story) in Abita Springs, a town about 30 miles from New Orleans, north of Lake Ponchartrain, find out about what these doctors and nurses did in order to corroborate the story? If he approves of what they did -- "They had to make unbearable decisions" -- why did he tell the relatives of the supposedly euthanized patients what has happened to them? Wouldn't someone who agreed with the decision keep his mouth shut?

Why hasn't any mainstream media outlet run with this story, when they are going with the nursing home deaths and the deaths described by the nurse in the second story?

The story could be true, but it doesn't hang together for me at all. It could have happened, and I can be convinced that it's possible that euthanasia should have happened, but so far I'm not compelled to believe that it did happen.

The claim that doctors and nurses is New Orleans euthanized patients without their consent or that of their next-of-kin is an extraordinary one, and it should require us to have, at the very least sufficient evidence of its occuring before we accept it.

Eliot Gelwan has an entry on this, and there's some discussion connected to it (including a comment by me that repeats part of what I've written here).

Update (9/17): There more on William "Forest" McQueen, the only person named in the story in the Mail, here:

The only disclosed source for this story about euthanasia in Louisiana is an utility manager or emergency official or groundskeeper that may have been hired by the Abita Springs council who works and lives with his brother over a half-hour away from New Orleans where he is presently making phone calls to inform relatives that patients have been murdered with morphine instead of calling his family to let them know he survived.

[More Katrina posts]