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If "Five Days at Memorial" were a novel, critical reaction undoubtedly would be overwhelmingly negative: It is too far-fetched.

Sadly, it isn't fiction. An expanded and updated version of a 2009 magazine article that won author Sheri Fink a Pulitzer Prize, the book describes in remarkable detail Hurricane Katrina's impact on Memorial Medical Center, a New Orleans mainstay, "the place you went to ride out each hurricane."

At the center of the narrative is the decision by certain staff members to euthanize patients who could not be evacuated. Murder, or heroism? Fink's balanced account lets you decide.

Much has already been written about New Orleans at the time: the inadequate preparation by local authorities, followed by the almost criminally inept response by FEMA. The storm hit Monday, Aug. 29, 2005. Early the following morning, city power failed. At the hospital, auxiliary generators kicked in, but with limited power. There was no air conditioning.

About 2 a.m. on Wednesday, Aug. 31, the last of the hospital's generators failed, stopping life-support machines. The stench of urine, overflowing diapers and feces-soiled garments suffused the swampy air, Fink writes.

Chaos in the hospital was overshadowed by chaos on the outside. Gunshots were heard and rumors spread that looters were about to invade the facility and raid the pharmacy.

Usually, disasters are contained. Even in New York on Sept. 11, 2001, emergency personnel and equipment were able to get to the scene. They worked long hours, but they were relieved; they had time to eat, shower and sleep.

Katrina was different, a natural disaster unprecedented in the United States. While a number of Memorial medical staffers left — some to accompany patients, others just to get out of there — many stayed the full five days before being forced to evacuate with a few patients left behind.

One doctor told Fink that he "knew [euthanasia] was technically a crime, but his alternative was to stay in this hostile, unnatural environment until they died on their own. Or leave them to die by themselves, perhaps eaten by animals."

The second half of the book deals with events following the disaster. A doctor and two nurses were arrested and charged with four cases of second-degree murder. A grand jury refused to indict.

With global climate change increasing the likelihood of these large-scale natural disasters, the question becomes: Have we learned anything? And the answer is: yes and no.

Fink visited Memorial before Hurricane Isaac last August and found the hospital's patients safely evacuated — but also found the hospital's electrical switching equipment still located in the basement, the part of the building that is the first to flood.

Meanwhile, the Institute of Medicine, an advisory board of the National Academies, said: "Neither the law nor ethics support the intentional hastening of death, even in a crisis."

Fink, who is a medical doctor and journalist, has written an important book that will make your blood boil no matter which side of the issue you support.

Curt Schleier is a book critic and EMT and a 40-year member of his volunteer ambulance corps.