St. John's Regional Medical Center Parking Lot Minutes After The Tornado
45 Seconds: Memoirs of an ER Doctor from May 22, 2011 Emergency Department after
May 22 tornado...
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 4:00 pm 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 5:42 pm 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 EF5 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 losses.
“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 to 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.
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 wimpering 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 EF5 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 Regional 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 despite incredible 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’s 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 |
