45 Seconds & the Aftermath

[KTMrad 517]

You gots to live in the moment....and every moment, because you never know.........

> I just got this through one of my connections. It is an incredible first

> hand account of the tornado and immediate aftermath.

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

>

> Source: http://www.mercy.net/joplin/stories-of-mercy/45-seconds

>

> 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 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 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.

>

> 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 oWe 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 .

>

> Nick Gragnani, Executive Director

> St. Louis Area Regional ResponSt. Louis, MO 63102