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Narrative trajectories of disaster response: ethical preparedness from Katrina to COVID-19
  1. Yoshiko Iwai1,2,
  2. Sarah Holdren1,2,
  3. Leah Teresa Rosen1,3,
  4. Nina Y Hu1,4
  1. 1 Narrative Medicine, Columbia University, New York, New York, USA
  2. 2 University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
  3. 3 Weill Cornell Medical College, New York, New York, USA
  4. 4 Department of Emergency Medicine, New York-Presbyterian Hospital, Columbia University Medical Center, New York, New York, USA
  1. Correspondence to Yoshiko Iwai, Narrative Medicine, Columbia University, New York, NY 10027, USA; yoshiko.i{at}


While COVID-19 brings unprecedented challenges to the US healthcare system, understanding narratives of historical disasters illuminates ethical complexities shared with COVID-19. In 2005, Hurricane Katrina revealed a lack of disaster preparation and protocol, not dissimilar to the challenges faced by COVID-19 healthcare workers. A case study of Memorial Hospital during Hurricane Katrina reported by journalist-MD Sheri Fink reveals unique ethical challenges at the forefront of health crises. These challenges include disproportionate suffering in structurally vulnerable populations, as seen in COVID-19 where marginalised groups across the USA experience higher rates of disease and COVID-19-related death. Journalistic accounts of Katrina and COVID-19 offer unique perspectives on the ethical challenges present within medicine and society, and analysis of such stories reveals narrative trajectories anticipated in the aftermath of COVID-19. Through lenses of social suffering and structural violence, these narratives reinforce the need for systemic change, including legal action, ethical preparedness and physician protection to ensure high-quality care during times of crises. Narrative Medicine—as a practice of interrogating stories in medicine and re-centering the patient—offers a means to contextualise individual accounts of suffering during health crises in larger social matrices.

  • medical humanities
  • medical ethics/bioethics
  • narrative medicine
  • philosophy of medicine/health care
  • journalism

Data availability statement

No data are available. This is a narrative analysis of journalistic accounts using narrative medicine. There are no data associated with this manuscript.

This article is made freely available for personal use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

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Data availability statement

No data are available. This is a narrative analysis of journalistic accounts using narrative medicine. There are no data associated with this manuscript.

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  • Contributors All authors are fully responsible for the conception of this manuscript, narrative analysis, and writing of this text. NYH is the guranator of this paper.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement While patients and families were central to the stories we investigated, the nature of our narrative analysis did not involve direct patient or public involvement.

  • Provenance and peer review Not commissioned; externally peer reviewed.