What happened inside the hospital during the Joplin, MO tornado

What happened inside the hospital during the Joplin, MO tornado

Dr. Kevin Kikta was one of two emergency physicians on duty at St. John’s Regional Medical Center in Joplin, MO on Sunday, May 22 when an EF-5 tornado struck the hospital.

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 pm ED 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.

What happened inside the hospital during the Joplin, MO tornado

At 5:42 pm, a security guard yelled to everyone, “Take cover! We are about to get hit by a tornado!” While others scattered to various places, I ran with a pregnant RN, Shilo Cook, 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-5 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 20s 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 old 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 RNs 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 news footage 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 RNs, 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 that now resembled flattened recycled aluminum cans the tornado had crumpled  in her iron hands. An EF-5 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 ED 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 that compares 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, RNs, techs, and all of the staff from St. John’s.  I have worked at St John’s for approximately two 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 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.

Kevin J. Kikta is an emergency physician at Mercy/St. John’s Regional Medical Center, Joplin, MO. This post first appeared in The Central Line, the blog of the American College of Emergency Physicians.  Reprinted with permission from the ACEP.

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  • ElleCB

    There just aren’t enough words.

    Thank you for sharing this, and I pray for you and everyone else in Joplin.

    I was working the ED (as a RN) when Hurricane Katrina came ashore. That day and the weeks following were the closest thing I’ve experienced to a war zone.

  • Julie

    Thank you so much for sharing your story. God bless you for staying and continuing to care for the injured despite the dangers you faced. I cannot even imagine what you all went through and are still going through. I guess you just never know what could happen to change your life in an instant. My family and I will continue to keep all of those affected by the tornados in our thoughts and prayers.

  • JadedOne

    Thank you, Doctor..

  • Mindi

    Thank you seems so inadequate for how I feel for everyone who just pitched in to help each other, especially the medical professionals. I’m sure your dedication saved lives that night.

  • gail mcgarrah

    Even though we no longer live there, I and my husband were raised in and around the Joplin area… to hear the details of Dr Kikta’s ordeal and that of those he witnessed is profound and heart breaking….
    Hero’s are made not born, and from this horrific event, we found not only a hero in Dr Kikta, but the countless hero’s he found during his walk of that eventful day.
    Dr Kikta gave honor to all, and he ended his story with a thanks to God and extended a blessing to each.
    I thank you Dr Kikta for the insight and the tears I cried while reading your message…. God Bless to you…

  • mary longe

    Thank you for taking time and energy to tell this harrowing story. It’s a great reminder of living life intentionally and how much we depend on our healthcare providers.

    Thank you for knowing your job so well, you can do it in the dark, in the midst of chaos and great personal risk. The people of Joplin are lucky to have you.

    Mary

  • Terri Dawson

    Thank you for such a humbling story. My heart continues to go out to all who are picking up the pieces from this horrific moment in time.

  • http://www.drjorgedelgado.com Jorge Delgado Pauta

    One of the worst things that can happen to a village, is that the hospital emergency, an experience that may not happen again. There are 45 seconds of anguish, despair to care his own life, moments when he starts spending all his life, who lived through endless seconds colleagues hopital, with its emergency nunidad destroyed and in chaos, and patients everywhere .. .

    A big hug, congratulations and thank God for keeping them alive to take care of the sick and give us the whole world to know the reaction of other civilians, doctors, firefighters and others …

    In this section we have to inspire strong and thank the Almighty, for the forces, is a psychological restablesca the families who lost loved ones in this natural disaster, and know that all universal energies are with you!

  • http://twitter.com/tehk tehk

    Amazing story… paints an extremely vivid image of the catastrophe.

  • Anne Best-Jones

    I am a Registered Nurse of many years experience working with the Eastern Regional Health Authority of the Republic of Trinidd and Tobago in a supervisory position.
    I have never experience such a disaster but praise and thanks to the Almighty for the strength, life and the ability of yourself, nurses, other members of staff and the public who assisted at this time.
    I do not know what you have gone through but congratulations to you and your team for what you have done. Thank God for keeping you alive to take care of the wounded. May the Almighty truly bless you, Dr Kikta, the Nurses and all others who assisted on that fatal day. Keep the mantle flying. Congratulations, God Bless.

    Anne Best-Jones
    RN, LM, CCN.

  • KarenG

    When we think that the price of medical care is too high, that doctors and nurses earn to much remeber the selfless acts they all do and we hear of during times of catastrophic events. I am not a clinician, however, I work in the heatlthcare arena and Dr’s story is the story every day catastrophy or not.

  • DanaW

    Thank you for sharing this.

    As I prepare to learn if my Hodgkins has returned after a 2.5 year reprieve and face the possibility of my own mortality, I think of the 134 people in Joplin who lost their lives in the tornado and am thankful for today.

  • Kathy

    Thank you for the reminders of all the courage and good in the world when all seems lost.

  • http://butterflyjeans582010@gmail.com Deb

    Thank God for the people in the medical field.MY PRAYERS ARE WITH ALL THE FAMILIES AN THOUHGTS GO OUT TO THE FAMILIES THAT LOST LOVED ONES.PRAYER FOR EVERYONE.

    Our gratitude for all the people who helped the community.

  • BobBapaso

    Not only a doctor, but a good writer.

  • sharad

    What you did is amazing. We see it on TV but dealing with something like this in real life is a completely different thing. Kudos to people like you, kudos to people in the medical and other noble professions. I live in Tulsa and have been told about these tornadoes that almost never go through cities. I passes through Joplin a couple of days before this tragedy. All this reminds us to just take life as it comes and enjoy every day but at the same time never forget out duties. God Bless!

  • http://jockpost.com paul

    Awesome story Kevin. Very good descriptions of this unfathomable event. I don’t need to experience a tornado of my own — you told me all I need to know.

  • http://www.ibsnspa.com Kevin Teal MD

    Great job under terrible circumstances. God Bless you and keep up the good work.

  • Sandie B RN

    Thank you for sharing the story of human tragedy and heroism. I am so proud of you and the members of the Joplin community for their compassionate response.

  • Chris, RN

    I work at a hospital in Denver and am part of our Emergency Preparedness team. It seems no matter how much we think we have prepared, it’s never enough when things like this actually happen. Thank you for maintaining a courageous and clear head during this horrible event. We pray this never happens to us, but if it does, you have demonstrated wonderful role modeling of how every day competitors worked together to save people in their community! Thank you for sharing this very vivid and moving story. I pray that you and your team are rebuilding your lives and your hospital.

  • Emma, RN

    Thank you for sharing this amazing story. Being a healthcare provider, is not an easy tasks. But it is a calling with dedication and devotion from the bottom of your heart to give care to all people. I salute you Kevin for being so brave on such disastrous incident. God Bless You Doc and More Power!

  • Jan, RN

    As a former military nurse who has seen combat, I can only imagine what you went through. Your professionalism and grace “under fire” shows through every word and action you have demonstrated. You and your team exemplify the highest levels of devotion that can be found. Your patients are lucky to have you, and our profession as health care providers is lucky to have you.

    Thank you for everything that you do on a daily basis. We are keeping you and your colleagues, and the rest of the tornado victims from all the recent storms in our prayers.

  • http://facebook Anne Sprack

    Dedicated to all the those Brave Souls

    The day and come and was almost done
    The darkness came and blackened the sun
    When 45 seconds came and went
    You had to stand by and see what the heaven’s had sent

    The wind funnel had sounded like a mighty roar
    Foundations of your world forever tore
    Windows crashed and glass was gone
    But you all knew you had to move on

    You did whatever you could to save brave souls
    Covering wounds and bandaging holes
    No meds could be found to save the pain
    There was so many wounded it seemed insane

    This epic disaster that was like no other
    People worked as one, to help another
    Love ones lost who did not survive
    Would be remembered by those still alive

    Thank you to all who helped to in that night
    And to remember those that are still in the fight
    To help restore hope in their lives after losing so much
    May God’s hands been there with a gentle touch.

    As a nurse and a medical professional, I am thankful for all those who represented our profession in times of great need. Know that my thoughts are with you and all those affected by this disaster.

  • Molly Ciliberti, RN

    Hugs, love and thank you’s to you and everyone in Joplin’s community who did amazing things in an unimaginable situation.

  • http://www.blessed-quiver.com Michelle

    UNREAL…and almost unbelievable. It’s like something off ER. I was shaking my head, thinking, this can’t be real. It just can’t be.

  • Patti, RN, CEN

    As an emergency services nurse for over 20 years, your strength, caring, and professionalism is amazing. What a blessing you are in this profession.

  • Linda

    Hi from Scotland. When news of this tornado broke I felt I had to say some very special prayers for Missourians – my ancestors emigrated to Maries County in the 1860s and I may still have relatives living in the area so I felt a strong connection with you. My prayers continue

  • Gina

    Your post took me back to the eight years that I lived in Joplin. Newly married, my husband and I were in college at Missouri Southern. He was from the area and worked in the O.R. at St. John’s for a number of years and later at Freeman Hospital, so it was absolutely haunting to see the images of St. John’s and Joplin as I followed the story well into that night and have since then.

    I first heard about the tornado just minutes after it hit via Twitter and immediately began trying to contact friends and family in the area via phone, Facebook and text messages. In the days following the disaster, I became glued to social media, websites, internet radio and TV news.

    My ex-husband left for Joplin the morning after the tornado to check on family and to help with rescue and recovery efforts as so many thousands have done. As an asthmatic, the best choice for me was to give financially and to encourage others to do the same.

    Although I haven’t lived in Joplin for a number of years, I still feel a strong connection to the city where I rented my first apartment, went to college, got my first “real” job and bought my first home; where my two oldest daughters were born; and where I still have friends and family.

    I am so sad about what happened while, at the same time, encouraged by the efforts of so many from within the community as well as from outside. I know it will be a long, difficult road, and that some things will never be the same, but I remain hopeful and believe that Joplin will recover and thrive once again.

    Again, thank you for your post, and God bless the people of Joplin.

  • http://www.PartnersInPediatrics.info Gayle Smith, MD

    Began my day with your post sent on from a friend and colleague. And here’s my prayer not knowing what my day will hold… God grant me a day to use all my gifts and talents in a way that will serve as this fine physician was able to do. It is in selflessness that we see the horrific need addressed with the only thing we often have, our compassion and willingness to try.

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