One Sunday, in May of 2011, I was scheduled to go to Joplin, Missouri, to help with the go-live of a new electronic charting system at St. John's Regional Medical Center in Joplin. Due to a scheduling mishap, instead of traveling on Sunday, I was told that I would be sent on Monday. But, I never made it to Joplin. That Sunday, May 22, 2011, an EF5 tornado ripped through the town and virtually destroyed the city. St. John's was destroyed, and due to safety concerns after the tornado, we were not allowed to travel to Joplin, even though we desperately wanted to help our sister hospital in the wake of this disaster.
The Joplin Tornado
The tornado that hit Joplin, MO, in 2011 was rated as an EF5. The National Weather Service uses the Enhanced Fujita (EF) scale to rate tornadoes on a scale of 0-5, with EF0 being the weakest and EF5 being the strongest. This scale assigns a rating based on estimated wind speeds and related damage. The Joplin tornado reached a maximum width of over one mile, with wind speeds greater than 200 mph. While it's duration was only 38 minutes, this tornado damaged or destroyed virtually everything in a 6-mile path.
The Joplin tornado caused nearly 3 BILLION dollars in damages. Over 550 business were destroyed, along with over 7500 residential living spaces. Sadly, it claimed the lives of 158 people and injured thousands more. It is ranked as the 7th deadliest tornado on record in US history.
A Hospital Destroyed
The night that the tornado hit, "there were 183 patients at St. John's Regional Medical Center. The hospital took a direct hit from the tornado. Every window in the building was blown out, and the top two floors were ripped from the structure. Doctors and nurses had only minutes to pull patients from their rooms and into hallways before the storm struck, and six people died. Because there were concerns that the structure might collapse, once the tornado passed, the building was evacuated. Later, there would be reports that the entire hospital had been moved four inches off its foundation." (https://obamawhitehouse.archives.gov/joplin)
For a more in-depth and moving discussion of how the tornado affect St. John's, read 45 Seconds: Memoirs of an ER Physician here. Here is a small excerpt from Dr. Kikta's account:
At approximately 5:30 p.m., we received a warning that a tornado had been spotted. I learned that a “Code Gray” was being called. We were to start taking patients to safer spots within the ED and hospital. At 5: 42 p.m. a security guard screamed to everyone, “Take cover! We’re about to get hit by a tornado!”
I ran with a pregnant registered nurse, Shilo Cook - while others scattered to various places - to the only nearby space without windows, a small doctor’s office in the ED. Together, Shilo and I trembled and huddled under a sturdy desk. We heard a loud horrifying sound, like a huge locomotive ripping through the hospital. The whole structure shook and vibrated as we heard glass shattering, light bulbs popping, walls collapsing, people screaming. The ceiling caved in with a crash above us. Water pipes broke showering down on everything. Worried and scared, we suffered in complete darkness. We could feel a tight pressure in our heads as the tornado annihilated the hospital and adjacent medical center. The whole process took about 45 seconds but seemed like an eternity. The hospital had just taken a direct hit from a most powerful category EF-5 tornado.
Then it was over. Just 45 seconds. 45 long, painful seconds. Terrified, we looked at each other and thanked God that we were alive. We didn’t know if it was safe to look for the rest of the staff, patients, and assess our losses. Cautiously, we left our sanctuary.
Rebuilding After the Tornado
"Recovery and response efforts in Joplin were a combination of public and private efforts. e public-sector focused on its own tasks, such as clearing debris so rebuilding could commence and reopening public schools on time for the 2011–12 school year. The private sector—including national charities, the business community, Joplin residents, and thousands of volunteers from outside of the community—made major contributions as well. Non-profits and volunteers were an enormous part of the response-and-recovery efforts in Joplin. By November 2011, more than 92,000 registered volunteers— including 749 different church, charity, business, hospital, and school groups—had contributed more than 528,000 person-hours to the recovery process. Volunteers came from nearly every state in the United States and from as far away as Japan and removed 1.5 million cubic yards of debris, about half of the storm’s total. Individuals, churches, and community organizations supplied thousands of meals to first responders immediately after the tornado and to the volunteers who arrived later during the rebuilding phase." (https://www.independent.org/pdf/tir/tir_18_02_01_smith.pdf)
While it took years for the city to rebuild, Joplin did rebuild! Joplin High School built a new state-of-the-art building, they rebuilt and relocated the public library to a more central location, and in 2017, a new Mercy Hospital Joplin opened its doors to patients.
Current Statistics
As of the writing of this post, my hometown of St. Louis, MO, has seen 33 tornadoes touch down in the area since January 2024. It's only July, so there's definitely a chance that we'll see even more before the year is over. Sometimes, they come with a warning and other times, it seems they just drop out of the sky. We’ve also dealt with numerous flash floods due to the rain these storms inevitably bring. And now, we're also dealing with the after-effects of Hurricane Beryl and all of the flooding that this storm brought as it moved inland.
Like surgery, tornadoes can occur at any time during the day. I have spent many a day on call during tornado weather. I have been in the OR when a tornado was sweeping right by my hospital. So the question is, how can we prepare for a tornado, especially when they can hit so suddenly?
How to Prepare
· Disaster Drills: Like fire drills, these are crucial for maintaining order for knowing your roles and responsibilities in a disaster. Questions that must be answered before a disaster include: Where do I report to after the event? Who do I report to? Do I know how to use certain emergency equipment like the medevac bed?
· Know Your Codes: Hospitals have different code systems. Some are color based while others just specifically say what the code is. For weather events at my hospital we will hear “Severe Thunderstorm Warning”, “Tornado Watch,” or “Tornado Warming” are in effect. Some hospitals use a color code system, however. Dangerous weather warnings at many hospitals are known as a “Code Black”. Know your codes and know what your role is when a code is called! Also, know the difference between a “Watch” and a “Warning.” A ‘Watch” means conditions are favorable for severe weather and a “Warning” means the weather is occurring.
· Stay Away From Windows: While this may not a problem for many ORs, if your department has windows, like in a corridor or outpatient area, move patients and yourself to a safe place to avoid broken glass. Also, while it might be human nature to want to look out the window to see if the storms are "really that bad" or to see the tornado, don't do it! A raging tornado or even severe winds can cause windows to burst in an instant. It's not worth the risk.
· Know Where Your Flashlights Are: Each OR should have a flashlight and batteries just in case the power goes out. Where is your flashlight located? Have you ever had to hold a light over the field while the team closed? I have! It's uncomfortable to hold a flashlight for the surgical team, but it's not about me in that moment. It's about quickly getting our patient taken care of so we can move them to a safer place. Flashlight location should be included in your department orientation and in your disaster drills.
· Have An Updated Phone List: This list should include you team and your department, depending on how your OR is set up. It’s important to keep your information up to date in case of any type of emergency.
Are You Prepared?
How often do you actively participate in drills within you department or facility? Not just standing there, getting a check in the bloc, but actively participating, making sure that you're knowledgeable, prepared, and ready for when a disaster occurs? It's so easy to think, "This will never happen to me" or, "They tell us this same stuff every year, who cares?" I think it's safe to say that the events of 2020 and the Covid Pandemic taught all of us that disasters CAN happen. The Joplin Tornado showed us how quickly a devastating disaster can occur, and the extreme, unexpected damage that can occur. More recently, Hurricane Beryl tore through the Caribbean, Mexico, and Texas, leaving damage, destruction, power outages, and loss of life in its wake.
Disasters can happen at any time. It's not a matter of IF, it's a matter of WHEN. So pull out you policies, read through your emergency plans, so that when you find yourself in the middle of a situation, you will be prepared. You'll know what to do, and you can calmly and confidently lead the way to help others in a time of need.
Stay safe and prepared!
Lindsey
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