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Sunday, May 29, 2011

Joplin, Missouri: A Day of Prayer and Remembrance

On May 22, 2011 my family and I found ourselves cautiously watching the dark clouds and the fury of the evening storm. Yet we felt the safety and warmth of our home. Meanwhile, at hour and a half from our home, a town was being hit by a devastating tornado. 

"As day turned into evening in Joplin, a city of 50,000 about 70 miles west of Springfield, the skies brought the deadliest tornado since modern recordkeeping began in 1950. First reported on the ground at 5:41 p.m., the EF5 storm ripped for 20 minutes through business and residential areas, killing at least 139 people." Source

"About 8,000 building units, including apartments, were damaged or destroyed. The Joplin Area Chamber of Commerce estimates that 300 businesses with about 4,000 employees were affected. Insurers’ losses may reach $3 billion, according to an estimate from catastrophe risk-modeler Eqecat Inc." Source

Photo source

Local communities and national organizations have showed an outpouring support for the residents of Joplin. The National Association of Social Workers, Missouri Chapter has joined this effort through their "Missouri Social Work Disaster Relief Fund" and "Volunteer Program."

"Social workers have always been at the forefront of helping others. In our Missouri disasters, several of our social workers have been personally affected and need help themselves. A few have lost their homes, others their jobs, and their businesses (including private practices). Some may have even lost loved ones. Your donation will help them re-establish their lives, so they can continue to help others." NASW-MO

Gov. Jay Nixon has declared Sunday May 29, one week after the devastating tornado that struck Joplin, as an official State Day of Prayer and Remembrance. 

The Governor and local clergy has also organized a memorial service for the victims of the devastating tornado. President Barack Obama will attend the service. "In the most trying times of disaster, grief and loss, Missourians come together to provide support, strength and assistance. During this day of prayer and this memorial service, I invite all Missourians to pause and remember their neighbors and draw upon the resources of their faith in the support of their fellow Missourians." Office of Missouri Governor

The following story by Dr. Kevin Kikta has been published on the St John's/Mercy website. It's a heartfelt story of what he lived in the ER at the St John's Hospital in Joplin on May 22, 2011. The most encouraging story I've read from the Joplin disaster. 

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


Kittie Howard said...

I have goose bumps! Dr. Kikta's moving account of that day's horrific tragedy touched my soul. A heartfelt 'thank you' to Dr. Kikta and the many who worked as a team that fateful day. The images are forever seared . . . .

Laura said...

I'm going to have to come back and finish reading as I have to head out in a few minutes. So devastating...

Mariette VandenMunckhof-Vedder said...

Dearest Doris,

It is hard to read this, whithout choking up... but it does touch the soul and it gives all of us courage. Knowing that we live amidst such great people who pour out love and their ability to tend to those in need, like Dr. Kikta, that is heartwarming.
We cannot undo the devastation... cannot return the lives. But once again, this proves that all together as a nation under God we can give HOPE and we will overcome as we all believe in a better life after this one on earth. Life is precious and it can be very short. Without any warning it abruptly may end. We better be prepared and live our life in the best possible way; service above self is the motto of Rotary and so many outside of Rotary do apply this generously...

Lots of love and thanks for sharing this!


Bob Scotney said...

What a story of devastation. The doctor's experience must have been shattering.In the UK we have no conception of the effects of a tornado let alone one on this scale.

Karin said...

Really a deeply touching post - can't read it without the tears welling up. Thank God for the presence of mind and the skills of Dr. Kikta and all the others he names who were there in this time of greatest need. Simply amazing team work and all the emergency training does pay off!

Deb Shucka said...

What an amazing account of the tornado. Thank you so much for sharing. The entire region and its people are in my prayers.

Ami said...

I've been sending my thoughts that way since it happened. Such a horrible tragedy.. and to me the worst part is the complete inability to do anything at all to stop it. Not preventable.

I'm thankful every day for the medical professionals who are there to help. Who have made it their calling.

Rita said...

My heart goes out to all those affected by the devastating tornado. This letter was sent to me by my sister and as I read it, tears formed in my eyes. I just cannot imagine all the devastation that the people there have endured. Thanks for sharing all of this with us today and our prayers are still with all who were affected.

Arkansas Patti said...

The media coverage showed the horror of that day but this man's story takes you inside the tragedy and leaves one totally stunned by the enormity of the personal agony these people faced. I will link your post in my blog. This should be read and wallets should be opened. Thank you for posting this.

Frances Garrood said...

Reading this makes me appreciate and feel grateful for the huge benefits of living in a country where a bit of snow or rain constitute a disaster. It also prevents me from taking any of what I have for granted. A moving post, Doris, and I'm thinking of you and your fellow Americans.

Dr. Kathy McCoy said...

Thank you so much for this post. It really gives a much clearer, more devastating view of the disaster in Joplin than any news story could. The courage of the medical teams and of ordinary citizens is inspiring.

Cloudia said...

Our hearts and prayers are with you!

Aloha from Honolulu

Comfort Spiral




Mary Aalgaard said...

Tears kept rolling out of my eyes as I read this. The author says it so well, that the good in people comes out during disasters. I cannot imagine the state of panic they were in, and the difficulties of trying to treat people in the dark without working equipment and medications. Wow. Simply unbelievable. I will share this on fb and mention on my blog.
Thank you for sharing this, Doris. Thanks to the doctor who sat down and wrote it. He DID find words to describe this devastation. I applaud him and all the medical staff. They did this without thought of getting paid or who had insurance. They worked fast and furious and with compassion because that's what medical professionals do.
Thank God.

Mary Aalgaard said...

Tears kept rolling out of my eyes as I read this. The author says it so well, that the good in people comes out during disasters. I cannot imagine the state of panic they were in, and the difficulties of trying to treat people in the dark without working equipment and medications. Wow. Simply unbelievable. I will share this on fb and mention on my blog.
Thank you for sharing this, Doris. Thanks to the doctor who sat down and wrote it. He DID find words to describe this devastation. I applaud him and all the medical staff. They did this without thought of getting paid or who had insurance. They worked fast and furious and with compassion because that's what medical professionals do.
Thank God.

Anita said...

Doris, thank you for sharing this story. I have watched all the news coverage about the Joplin tornado and it breaks my heart to see what the residents have gone through. My own state of Alabama just went through this a month ago. There are so many heros, like this doctor, who put others needs above their own. They all deserve medals.

Cheryl said...

I am glad that Patty shared this with us. The news stories and broadcasts cannot do what this doctor did, bring us right into his life that day. Bless all the medical professionals and EMS workers who are there for everybody at anytime, putting their lives on the line for others.

dr.antony said...

Dear Doris
It is a sad story.My heart goes out to those who suffered.
In the midst of all the pain and sufferings,it is good to see the helping hands.God give them strength.Your Dr.Kikta is an example.Do you know him personally? Convey all the love in the world, from so far away.

Cheryl @ TFD said...

Thank you for sharing this incredibly moving account of the disaster in Joplin by Dr. Kikta. God Bless him and all the professionals who worked tirelessly in such horrible conditions to help those in need. I'm so glad AR Patti provided a link in her post.

Angie said...

What an amazing accout by that doctor ...I felt I was there ...and glad I was not. My heart goes out to everyone who has suffred.

Brig said...

Came via AR Patti. An amazing, horrific story by Dr Kikta.
Blessings all around.

Anonymous said...

Doris, this has to be the best post I've read on your blog or any blog for that matter. It was very moving and it brought things into light that would have been left in the dark if this hadn't been posted. The news crews had great coverage, don't get me wrong, but they seemed to have missed the inside angle that the good Dr. let us see it from.
I found the most encouraging part of the story to be the selflessness of the community and people in general who did all they could to help in any way they could. It was good and reassuring to know that men and women were still capable of doing and acting the way that God had originally intended them to act. They were selfless, humane, compassionate, totally casting their own problems and concerns aside to try to help save another's life. Jesus Christ speaks in the book of Matthew of the greatest two commandments and this is what he said, "Master, which is the great commandment in the law? Jesus said unto him, Thou shalt love the Lord thy God with all thy heart, and with all thy soul, and with all thy mind. This is the first and great commandment. And the second is like unto it, Thou shalt love thy neighbor as thyself. On these two commandments hang all the law and the prophets." (Matt. 23:36-40) The actions of the people of Joplin and those who came to their aid were the actions of a loving and compassionate heart. Nothing less than how God intended for us to act as men and women. To simply love one another whether we be Christian or not. It's just right and it's the moral way to act.
Sorry Doris I wasn't trying to preach on your blog, this story just gave me a reassurance that people can still be who we were intended to be.
Thank you Doris. That was truly amazing and thanks to Dr.Kikta as well. Many prayers are going and have gone out to those in Joplin and will continue to. God bless....

Manzanita said...

I came to your blog from Arkansas Patti's. Thank you for posting that moving, sad account of the tornado. And thank Dr Kikta for his story of the courageous medical community. The nations prayers and support go out to the people of Joplin.

DUTA said...

Since the Chernobil nuclear disaster in 1986, the climate has been getting crazy. Now, with the recent Fukushima nuclear disaster in Japan an even more anomalous climate is to be expected. May God help us and save us everywhere from Nature's fury!

Dianne Heath said...

A very horrific account. I don't know what I would do if a tornado came my way. So much devastation everywhere :(

@ DUTA, you made an interesting point. I wonder sometimes....

Toyin O. said...

This is so sad, I am praying for everyone involved.

MunirGhiasuddin said...

My head started spinning as I read the whole account of the doctor. I saw on the television the details almost like these. They must have been so hard to cope with. May God help them. We realize how petty little complaints in our lives are, when we see such devastation. Thanks for sharing.

Retired Knitter said...

I have linked from this posting to my blog so that this doctors story is read by more. This is our country and our citizens who experienced this terrible tornado. We need to remember that other countries are not the only ones who experience such horror and grief.

and to reflect on the good that humans are capable of during extreme situations.

Hilary Melton-Butcher said...

Hi Doris .. a heart rending account - both yours and Dr Kikta's - and to have a first-hand overview is no mean feat ... but such a worth while report - thanks for printing it out for us.

Those tornadoes have looked quite dreadful .. and certainly my thoughts have been with everyone at this time.

Mother nature is extraordinary .. yet human nature has much to say for itself at times .. when it's put to the test -

Thanks for this excellent post - really tragic to read, but enlightening too .. Hilary

Anonymous said...

Such tragedies test the best and the worst in people. A lot of great, heroic people in Jopplin, Missouri. (I don't think any of us want to be tested this way!)

I'm so glad you're safe, my friend!!
Ann Best, Memoir Author

K. Tree said...

We really are having a rough spring. And it seems like no one is exempt. On a "close to home" note, one of my residents recently moved to Joplin with her family. Happily, she is fine and her family, too. On the down side, their home did not hold up so well. I pray that everyone touched by this weather finds the strength to pull through to the better times that are surely coming.

A Plain Observer said...

these tragedies are devastating and sad. Even sadder is that they happen all the time. Our own Colombia has been hit recently furiously. Do we stop and think about our lives when we see these tragedies unfold? maybe for a while, then we go on and forget that our lives can change in our hot second.

Onlythemanager said...

What a remarkable account of that day. It was horrible enough to see what was shown on tv. I can't imagine the anguish of those who lived it.


I was in the US when you wrote this and have only just arrived home. I hope you're safe and well I saw the events on TV.
Take care.

Snowbrush said...

All that loss, and in little more than a heartbeat too.

David C Brown said...

We must thank God for the people who run towards the danger.