Five Days at Memorial, the grim tale about the disastrous events that took place at a New Orleans hospital after Hurricane Katrina, finished its eight-episode run today on Apple TV. Here, Executive Producer Carlton Cuse (Locke & Key, Lost), who together with John Ridley (12 Years a Slave) adapted the series from the nonfiction book by Sheri Fink, explains what it was like to chronicle the story of healthcare professionals like Dr. Anna Pou (Vera Farmiga) and incident commander Susan Mulderick (Cherry Jones), who faced overwhelming odds to save patients at Memorial Medical Center.

DEADLINE It’s extraordinary how long this has been in the works, obviously starting with Scott Rudin acquiring the rights back in 2013. Why do you think it took so long? 

CARLTON CUSE I believe it’s an incredibly compelling story, but obviously not the easiest story to watch. I think that scared people away and maybe it just took finding the right executives. In this case, Jamie Erlicht and Zack Van Amburg and Matt Cherniss had the temerity to say this is a great story and we’re gonna make this. I give those guys enormous credit for having the kind of courage to make this story, particularly at this moment in time when we’ve just come out of a pandemic where many of the moral and ethical issues were at play. Five Days at Memorial has great resonance.

Did you ever try to reach Dr. Anna Pou?

CUSE No, we didn’t. We made the decision early on that we were going to just use the book as our primary source. The book is incredibly well researched and Sheri Fink spent six years writing it. We talked a lot about the sort of image we were after, like the spinning top at the end of Inception. We wanted to achieve something similar where we told the story from multiple perspectives and gave the audience the chance to draw their own conclusions about what went on. Our perception was that people came away from reading the book with different ideas about what they thought happened. Different people will feel different ways about the moral and ethical issues in question in this story. .

Since Pou ultimately wasn’t charged, did you feel like you had to change anything in the story to avoid being sued?

CUSE We approached this project with a high degree of fidelity to the book. It is an adaptation, a dramatization, it’s not a recitation of facts. So in the process of adapting something, obviously there is kind of a creative application. John and I were trying to tell the story with as much emotional truth as we could find. That’s how we approached it. We weren’t thinking in terms of the legal side. We were thinking in terms of how do we tell this story with authenticity, with heart, and with a sense of conveying the emotional truth.

The amount of real life footage that you used was incredible. Was that a delicate balance, figuring out how much to employ?

CUSE Yes, very much. This story is very metaphoric, but it’s also very insular. So much of the narrative takes place inside this hospital. John and I felt like we needed to really give the audience context. I remember my experience at first reading Sheri’s book, and I thought I knew about Hurricane Katrina. I’d watched the coverage. And then I realized, oh my God, I don’t really know anything at all, not only in terms of how the crisis unfolded, but the specific story of what happened at this hospital and the issues that arose there. John and I both felt the audience needed to be refreshed contextually about what was going on. I give great credit to our amazing editors, JoAnne Yarrow and Colin Rich and also Vikash Patel, who just contributed enormously to figuring that out.

How did you shoot those scenes outside the hospital with all the water? 

CUSE We built a 4 million gallon water tank in Hamilton, Ontario, which is just west of Toronto. It was a city block long, and we built the facade of the hospital, including the emergency ramp, in that water tank. We had the ability to raise and lower the level. The water tank was large enough that we were able to crane large boats into that water tank and drive those boats up and down the street to the hospital. And then around the tank were gigantic blue screens. We had shot an enormous amount of reference photography, and we inserted the background from New Orleans. It was a really laborious and artful combination of practical work with high level, VFX work.

What about the roof that served as the helipad? Where was that and how similar was it to the real thing?

CUSE It was very similar to the real thing. Obviously, we didn’t have access to the actual hospital in New Orleans, which still exists. It’s gone back to being called Baptist Hospital. It’s no longer owned by Tenet. It’s owned by another hospital company. The helipad still exists up on top of the parking garage. We built a helipad in Canada. It was actually an enormously complicated procedure to get Black Hawk helicopters and Coast Guard helicopters into Canada during the pandemic. The Coast Guard really wanted to participate because it wouldn’t be right to tell the story of Katrina without including the Coast Guard’s participation. They were so critical to the efforts to rescue people. They moved heaven and earth to get the permission to come into Canada with a Coast Guard helicopter, and then we filmed the helipad. But again, the helipad was surrounded by green screen. The stairs were a separate VFX element that we built, sort of like a stairway to nowhere. And then through the magic of visual effects, we stitched together the helipad, the stairway, and background footage of New Orleans. I think we achieved a pretty close approximation of what it was like. It was critical for John and I to convey this idea of just how perilous that journey was. Imagine taking patients down seven flights of stairs in the dark with no power across the hospital, through a hole in the machine room, up all the flights of the parking garage, and then up these various rungs of perilous stairs to this rickety helipad on pipes that they weren’t even sure was gonna hold a helicopter? We wanted to convey the terror and heroism that it took or these medical workers to get patients up there.

How did you pull off those claustrophobic interior shots? Did you keep it hot on set?

CUSE We were shooting in Toronto in the summertime in an abandoned wing of a hospital, which ironically was pretty hot. We had air conditioning but during takes the air conditioning had to be turned off, so it would get warm. Early on, John Ridley sent me as a reference this movie King Rat, which is a wonderful example of how to convey people looking very hot and sweaty. Our cast was so committed to telling the story. there was never any pushback about how they’re gonna look sweaty and not glamorous. I mean, everybody was just trying to tell the story with a high degree of authenticity and truthfulness. I cannot say enough good words about our cast.

While telling the story, did you and John have conversations about what you would do in that situation?

CUSE What John and I said to each other many times was how grateful we were that we weren’t in a position of having to make that decision. That was really the bottom line for us, you know? If there’s a message and resonance for this show, as it carries forward into the next crises or whether it’s the pandemic, which has a lot of parallels like who gets on a helicopters, who gets a ventilator, or who gets a vaccine … anytime healthcare workers are put in a position of having to make a decision about who gets care or who gets treatment and who doesn’t, there are just no good choices. I hope that if people learn anything from this show, it’s that we can all be better prepared so our healthcare professionals aren’t in a position of having to make horrible decisions about who gets prioritized over over someone else. That’s an untenable situation.

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