On day four—Wednesday, August 31—the first signs of real hope emerged as boats arrived to begin the massive transport operation for those remaining. At the same time, discussions began to take place among medical personnel about what should be done with patients whom they deemed unable to be transported by either boat or air. By day five, the situation appeared more desperate. Rescue was under way, but conditions continued to deteriorate. After one of the doctors made the decision to euthanize some of the animals on hand, Dr. Susan Mulderick, a colleague of Dr. Pou, thought that this seemed to be the most merciful way to treat some of the remaining patients as well. Mulderick sought out Pou, and a plan was formed.
Many of Memorial’s remaining patients were already on morphine to ease their pain. In a consultation with Dr. Ewing Cook, another member of the hospital’s staff, Pou was advised by Cook on how to administer a mix of morphine and benzodiazepine. As Fink recounts, “He later said that he believed that Pou understood that he was telling her how to help the patients ‘go to sleep and die.’” This use of morphine, unlike the patients’ current treatment, was not just for comfort. “What Cook was describing to Pou was something else entirely. The drug combination ‘cuts down your respiration so you gradually stop breathing and go out.’”