[PPRAANet] Firsy hand tornado report

[DickT-W0RAA]

I belong to several different reflectors/forums (or whatever you wish to 
call them).  One is the Spiderweb Net.  What is attached below is a first 
hand account from an emergency room doctor at St. John's Hospital in Joplin, 
MO.  It's a riveting account of the vastnes and devastation the tornado 
wreaked on Joplin, MO.  I hope you won't mind the bandwidth, but this is 
worth the reading time.

Dick
W0RAA

__________________________________________________

Message: 1
Date: Sun, 12 Jun 2011 08:59:14 -0400
From: "David B. Murray"
To: spiderweb08
Subject: [Spiderweb08] Joplin tornado from a Doctor's perspective

Hi all,

Our daughter Katie works for the Chief of the Sonoita-Elgin Fire District
(referenced at the bitter end), and she sent us the below.  I'm reminded 
once
again that I have no problems.

73 de KD1BL, Brad

-------- Original Message --------

45 Seconds: Memoirs of an ER Doctor from May 22, 2011.

My name is Dr. Kevin Kikta, and I was one of two emergency room doctors who 
were
on duty at St. John?s Regional  Medical Center in Joplin, MO on Sunday May 
22,2011.

You never know that it will be the most important day of your life until the 
day
is over.  The day started like any other day for me: waking up, eating, 
going to
the gym, showering, and going to my 400pm ER shift. As I drove to the 
hospital I
mentally prepared for my shift as I always do, but nothing could ever have
prepared me for what was going to happen on this shift.  Things were normal 
for
the first hour and half.   At approximately 5:30 pm we received a warning 
that a
tornado had been spotted. . Although I work in Joplin and went to medical 
school
in Oklahoma, I live in New Jersey, and I have never seen or been in a 
tornado.
I learned that a  ?code gray? was being called.  We were to start bringing
patients to safer spots within the ED and hospital.

At 5: 42pm a security guard yelled to everyone, "Take cover! We are about to 
get
hit by a tornado!"  I ran with a pregnant RN, Shilo Cook, while others 
scattered
to various places, to the only place that I was familiar with in the 
hospital
without windows, a small doctor?s office in the ED. Together, Shilo and I
tremored and huddled under a desk.  We heard a loud horrifying sound like a
large locomotive ripping through the hospital.  The whole hospital shook and
vibrated as we heard glass shattering, light bulbs popping, walls 
collapsing,
people screaming,  the ceiling caving in above us, and water pipes breaking,
showering water down on everything.  We suffered this in complete darkness,
unaware of anyone else?s status, worried, scared. We could feel a tight 
pressure
in our heads as the tornado annihilated the hospital and the surrounding 
area.
The whole process took about 45 seconds, but seemed like eternity. The 
hospital
had just taken a direct hit from a category EF-4 tornado.

  Then it was over.  Just 45 seconds.   45 long seconds.  We looked at each
other, terrified, and thanked God that we were alive.  We didn?t know, but 
hoped
that it was safe enough to go back out to the ED, find the rest of the staff 
and
patients, and assess our loses.

Like a bomb went off.  That?s the only way that I can describe what we saw
next.  Patients were coming into the ED in droves.  It was absolute, utter
chaos.  They were limping, bleeding, crying, terrified, with debris and 
glass
sticking out of them, just thankful to be alive.  The floor was covered with
about 3 inches of water, there was no power, not even backup generators,
rendering it completely dark and eerie in the ED.  The frightening aroma of
methane gas leaking from the broken gas lines permeated the air; we knew, 
but
did not dare mention aloud, what that meant.  I redoubled my pace.

We had to use flashlights to direct ourselves to the crying and wounded. 
Where
did all the flashlights come from ?  I?ll never know, but immediately, and
thankfully, my years of training in emergency procedures kicked in.  There 
was
no power, but our mental generators, were up and running, and on high test
adrenaline.  We had no cell phone service in the first hour, so we were not 
even
able to call for help and backup in the ED.

I remember a patient in his early 20's gasping for breath, telling me that 
he
was going to die.  After a quick exam, I removed the large shard of glass 
from
his back, made the clinical diagnosis of a pneumothorax (collapsed lung) and
gathered supplies from wherever I could locate them to  insert a 
thoracostomy
tube in him.  He was a trooper; I'll never forget his courage.  He allowed 
me to
do this without any local anesthetic since none could be found. With his 
life
threatening injuries I knew he was running out of time, and it had to be 
done.
Quickly.  Imagine my relief when I heard a big rush of air, and breath 
sounds
again;  fortunately, I was able to get him transported out. I immediately 
moved
on to the next patient, .an asthmatic in status asthmaticus.  We didn?t even
have the option of trying a nebulizer treatment or steroids, but I was able 
to
get him intubated using a flashlight that I held in my mouth.  A small child 
of
approximately 3-4 years of age was crying; he had a large avulsion of skin 
to
his neck and spine.  The gaping wound revealed his cervical spine and upper
thoracic spine bones.  I could actually count his vertebrae with my fingers.
This was a child, his whole life ahead of him, suffering life threatening 
wounds
in front of me, his eyes pleading me to help him..  We could not find any
pediatric C collars in the darkness, and water from the shattered main pipes 
was
once again showering down upon all of us. Fortunately, we were able to get 
him
immobilized with towels, and start an IV with fluids and pain meds before
shipping him out.  We felt paralyzed and helpless ourselves.   I didn't even
know a lot of the RN's I was working with.  They were from departments 
scattered
all over the hospital. It didn?t matter.  We worked as a team, determined to
save lives.  There were no specialists available-- my orthopedist was 
trapped in
the OR.  We were it, and we knew we had to get patients out of the hospital 
as
quickly as possible.  As we were shuffling them out, the fire department 
showed
up and  helped us to evacuate.   Together we worked furiously, motivated by 
the
knowledge and fear that the methane leaks could cause  the hospital could 
blow
up at any  minute.

Things were no better outside of the ED. I saw a man crushed under a large 
SUV,
still alive, begging for help; another one was dead, impaled by a street 
sign
through his chest.   Wounded people were walking, staggering, all over, 
dazed
and shocked.   All around us was chaos, reminding me of scenes in a war 
movie,
or newsreels from bombings in Bagdad.  Except this was right in front of me 
and
it had happened in just 45 seconds .  My own car was blown away.  Gone.
Seemingly evaporated.  We searched within a half mile radius later that 
night,
but never found the car, only the littered, crumpled  remains of former 
cars.
And a John Deere tractor that had blown in from miles away.

Tragedy has a way of revealing human goodness.  As I worked , surrounded  by
devastation and suffering ,  I realized I was not alone.  The people of the
community of Joplin were absolutely incredible.  Within minutes of the 
horrific
event, local residents showed up in pickups and sport utility vehicles, all
offering to help transport the wounded to other facilities, including 
Freeman,
the trauma center literally across the street.  Ironically, it had 
sustained
only minimal damage and was functioning (although I'm sure overwhelmed).  I
carried on, grateful for the help of the community.   At one point I had 
placed
a conscious intubated patient in the back of a pickup truck with someone, a
layman, for transport. The patient was self-ventilating himself, and I gave
instructions to someone with absolutely no medical knowledge on how to bag 
the
patient until they got to Freeman.

Within hours I estimated that over 100 EMS units showed up from various 
towns,
counties  and  four  different states. Considering the circumstances, their
response time was miraculous. . Roads were blocked with downed utility 
lines,
smashed up cars in piles, and they still made it through.

We continued to carry patients out of the hospital on anything that we could
find: sheets, stretchers, broken doors, mattresses, wheelchairs?anything 
that
could be used as a transport mechanism.

As I finished up what I could do at St John's, I walked with two RN?s , 
Shilo
Cook and Julie Vandorn,  to a makeshift MASH center that was being set up 
miles
away at Memorial Hall.  We walked where flourishing neighborhoods once 
stood,
  astonished to see only the disastrous remains of flattened homes, body 
parts,
and dead people everywhere.  I saw a small dog just whimpering in circles 
over
his master who was dead,  unaware that his master would not ever play with 
him
again.  At one point we tended to a young woman who just stood crying over 
her
dead mother who was crushed by her own home.  The young woman covered her 
mother
up with a blanket and then asked all of us,  "What should I do?"  We had no
answer for her but silence and tears.

By this time news crews and photographers were starting to swarm around, and 
we
were able to get a ride to Memorial Hall from another RN.  The chaos was
slightly more controlled at Memorial Hall.  I was relieved to see many of my
colleagues, doctors from every specialty, helping out.  It was amazing to be
able to see life again.  It was also amazing to see how fast workers 
mobilized
to set up this MASH unit under the circumstances. Supplies, food, drink,
generators, exam tables, all were there, except pharmaceutical pain meds. I
sutured multiple lacerations, and splinted many fractures, including some 
open
with bone exposed, and then intubated another patient with severe COPD, 
slightly
better controlled conditions this time, but still less than optimal.

But we really needed pain meds.  I managed to go back to the St John?s with
another physician, pharmacist, and a sheriff's officer. Luckily, security 
let us
in to a highly guarded pharmacy to  bring back a garbage bucket sized supply 
of
pain meds.

At about midnight I walked around the parking lot of St. John's with local 
law
enforcement officers looking for anyone who might be alive or trapped in 
crushed
cars.  They spray painted X's on the fortunate vehicles that had been 
searched
without finding anyone inside. The unfortunate vehicles wore X's and
sprayed-on numerals, indicating the  number of  dead inside,  crushed in 
their
cars, cars  which now resembled flattened  recycled aluminum cans the 
tornado
had crumpled  in her iron hands,   an EF4 tornado, one of the worst in 
history,
whipping through this quiet town with demonic strength.   I continued back 
to
Memorial hall into the early morning hours until my ER colleagues told me it 
was
time for me to go home.  I was completely exhausted.  I had seen enough of 
my
first tornado.

How can one describe these indescribable scenes of destruction?   The next 
day I
saw news coverage of this horrible, deadly tornado.  It was excellent 
coverage,
and Mike Bettes from the Weather Channel did a great job, but there is 
nothing
that pictures and video can depict  compared to seeing it in person. That 
video
will play forever in my mind.

I would like to express my sincerest gratitude to everyone involved in 
helping
during this nightmarish disaster.  My fellow doctors, RN?s, techs, and all 
of
the staff from St. John's.  I have worked at St John's for approximately 2
years, and I have always been proud to say that I was a physician at St 
John?s
in Joplin, MO.  The smart, selfless and immediate__response  of the
professionals and the community during this catastrophe proves to me that St
John?s and the surrounding community  are special,.  I am beyond proud

To the members of this  community, the  health care workers from states 
away,
and especially Freeman Medical Center, I commend everyone on unselfishly 
coming
together and giving 110% the way that you all did, even in your own time of
need. St John's Medical Center is gone, but her spirit and goodness lives on 
in
each of you.

EMS, you should be proud of yourselves.  You were all excellent, and did a 
great
job despiteincredible difficulties and against all odds

For all of the injured  who  I treated, although I do not remember your 
names
(nor would I expect you to remember mine) I will never forget your faces. 
I?m
glad that I was able to make a difference and help in the best way that I 
knew
how, and hopefully give some of you a chance at rebuilding your lives again.
For those whom   I was not able to get to or treat, I apologize whole 
heartedly.

Last, but not least, thank you, and God Bless you, Mercy/St John for 
providing
incredible care in good times and  even more so, in times  of the 
unthinkable,
and  for all the training that enabled  us to be a team and treat the people 
and
save lives.

Sincerely,

Kevin J. Kikta, DO
Department of Emergency Medicine
Mercy/St John?s Regional Medical Center, Joplin, MO