A look back: In Joplin tornado's wake, hope rises

Editor's note: In the days following the Joplin tornado in May 2011, CoxHealth Connection editor Randy Berger visited the city to report on CoxHealth’s role in the recovery efforts. While the devastation was overwhelming, it was outweighed by the spirit of hope the CoxHealth team saw in Joplin. Below is Berger's column from the July 2011 issue of CoxHealth Connection, along with images from photographers Russ Weller and Heather Stockford Sade:

Everything you would say when faced with a disaster like the tornado that struck Joplin on May 22 falls short when you’re standing in a debris field that used to be a neighborhood. “Unbelievable.” “Otherworldly.” “There are no words.”

All those expressions are trite, but accurate.

When I arrived in Joplin along with Pre-Hospital’s Pat Brown and Mike Dawson, the city was entering its fourth day of search and rescue. Dawson was planning to check in with CoxHealth ambulance crews that had been providing coverage non-stop in the storm’s wake. Brown, a Joplin native, had volunteered to take us on a tour of the devastation in her hometown. Media Technology’s Russ Weller and Heather Stockford Sadewere gathering video and still images and I, with a notebook and pen, was planning to find words to convey the indescribable.

As we pull into Joplin, parts of Range Line Road near I-44 appear normal, with the exception of rescue vehicles and road signs twisted into abstract sculptures. Turning into a neighborhood on 20th Street, everything changes. West of Range Line, the reference points for what life was like before 5:35 that Sunday afternoon are few: a home with a single wall surrounded by splintered debris, a closet – dress shirts and polos hanging neatly inside – standing alone on a foundation.

As we get closer to the center of the tornado’s path, there are no signs of what had been houses, only unrecognizable debris, all the way to the horizon. On that Thursday morning, only two things remained vertical in the disaster area: tree trunks, minus all limbs and bark, and people – Joplin residents, rescue workers and volunteers taking the first steps toward rebuilding. With so much destroyed, the people from Joplin and the surrounding areas who converged on the disaster zone to help stand out in stark relief.

Over the next few hours, we had the chance to see many people who embody the spirit that will drive Joplin’s recovery. You see it in first responders, law enforcement and National Guard troops working the streets. You see it in the volunteers doing cleanup, barbecuing food and handing out water on street corners.

And you see it in the humbly recounted stories of CoxHealth employees who were on the scene that night and have played an ongoing role in the weeks since. To them, they were just doing their jobs, but their work in the first few days was the leading edge of a tide of recovery efforts and community support that is now even larger than an EF5 tornado.

By now, we all have personal stories about where we were on the evening of May 22. Emergency Department director John Archer had just returned to Springfield from a 2,800-mile motorcycle ride. He had heard a storm was coming, but he didn’t realize how bad things were until he got a call from assistant ED director Crystal White. She had seen that St. John’s in Joplin had been struck by a tornado and was on her way in to work.

White prepared the ED for an onslaught of patients while Archer worked with Dr. John Duff, senior vice president of hospital services, to set up Incident Command. By 7:30 p.m., ED staff had been called and were on standby; many staff members had already come in, anticipating the worst.

“We were doing the best we could to get all of our patients out of the department, either admitted or discharged,” White says. “Everyone was working to get that done. The entire hospital worked unbelievably well that night, from Med-Surg and ICUs to EVS and Central Supply.”

The department also identified nine nurses, six techs and three ED physicians who were dispatched to Joplin with two vehicles full of supplies. Ham radio operators arrived in the command center in the South ED, allowing for some of the earliest contact with first responders in Joplin.

It wasn’t until 2 a.m. that the first patients arrived in the ED and the horror of what had happened became obvious. The department received multiple trauma victims, people who had been trapped under walls and patients who had been impaled by flying debris.

“We deal with trauma every day, but nothing like this,” White says. Many of the ED staff were in tears from the stories they were hearing. Nursing home residents explained how they had been trapped in rubble, a young mother had taken cover at home only to have her two small children ripped out of her arms, a man who had covered his wife with his own body in Walmart to protect her awoke to learn that he had survived, but she had not.

“He was having a lot of trouble understanding that,” White says. “All night, the chaplains and social services helped us tremendously, not only with patients but with our staff as they coped with this tragedy.”

Throughout the evening, Pre-Hospital crews were seeing that tragedy unfold before them in Joplin. Paramedic Jason Blum and his partner, EMT Stacie Mountain, were on one of the first ambulances to arrive. They bypassed the main damage path as they came into Joplin, but signs of destruction were apparent everywhere.

“It looked like a war zone. Shell-shocked people were standing around on the sidewalks, just watching this convoy of ambulances roll in,” Blum says.

After stopping at an EMS staging area, the pair arrived at Memorial Hall. On the way, they passed several pickup trucks loaded with injured patients and the bodies of storm victims.

“The main triage area at Memorial Hall was like walking into a movie,” Mountain says. “Bloodied people were walking around, more people were being carried in. It was overwhelming.”

Mountain and Blum say that for the size of the disaster, the response was surprisingly well organized. Hundreds of patients had arrived at Memorial Hall, but hundreds of health care workers were also on the scene, ready to help.

By 10 p.m., Pre-Hospital had 15 CoxHealth ambulances in Joplin helping transport patients.

“Our immediate mission was trying to move patients out of Joplin,” says Mike Dawson, EMS operations manager. “This was a massive effort for EMS. On a regular Sunday, 15 ambulances cover four of our regular response areas. To deploy 15 ambulances in 3 or 4 hours is a remarkable thing.”

For the first two days, EMS crews continued to transport patients to relieve first-aid and triage stations as well as Freeman Hospital, which was undamaged but overrun with patients.

By day four, Cox EMS crews were working out of a temporary staging area at Freeman, where they were responding to local emergency calls. As we pulled up to the hospital with Brown and Dawson on Thursday morning, a Freeman nurse came up to our vehicle and thanked the pair for the help CoxHealth EMS was providing – “You guys have been great,” she said. Dawson and Brown say they’d been fortunate to hear that sentiment quite a bit recently.

“The Cox EMS people have been really talked about in this area,” Dawson says. “We’ve had a phenomenal outpouring of bravery and tireless work that our people have put in to make this possible.”

All across Joplin, health care workers were putting in extra work to make sure that those who needed care could still receive it, even as almost a third of the city lay in ruin. After making our stop at Freeman, we went up Range Line to Joplin’s north side, where we found the staff of Oxford HealthCare operating out of the lobby of Destiny Church.

Carl Wilson, a regional director at Oxford HealthCare in Joplin, had been at his home near Webb City on Sunday evening when the tornado struck. After the storm passed, he drove into Joplin to check on the Oxford headquarters, which was near St. John’s Hospital. The facility was destroyed. Oxford’s emergency backup location was at St. Mary’s Catholic Church – seen in the photo above – where all that remains standing is the cross.

As he drove near the scene only an hour after the tornado, Wilson says he was struck both by the devastation and the early signs of human resilience.

“It was pure mayhem on one hand, but then you had people out there doing whatever they could to help another person,” he says.

An Oxford employee was a member at Destiny Church and the pastor offered the building as a temporary office space. By 8 a.m. Monday, Oxford was up and running in the church lobby. Since phone lines were down, staff members worked to comb the neighborhoods, frequently on foot, tracking down clients.

Oxford president Karen Thomas told us that by Wednesday, staff members had made contact with all of their nearly 2,000 clients in the Joplin area.

“Our staff has been dedicated,” Thomas says. “The devastation has been emotionally draining, but they’ve jumped in and they did whatever they needed to do to meet people’s needs.”

On that Thursday morning, you could look east from the now-iconic shell of St. John’s Hospital and see people working to meet the needs of their neighbors in a field of twisted rubble. Looking at the debris, the phrase that comes to mind is “nothing looks like anything.” Without Joplin resident Pat Brown (above) to tell us about what kinds of homes and businesses had existed there just four days earlier, it would have been impossible to imagine.

Brown also shared some important perspective. She lived in Pierce City when an F3 tornado flattened the town in 2003, and she’s seen that town rebound. She reminded us that while the devastation right now is overwhelming, it will be overcome in time.

Even as we were talking on day four, you could already see the first signs of rebirth: Amid the stubble of twisted tree trunks, a crew was raising the first wall of a new building, festooned with an American flag. Near Main Street, someone had scrawled in black spray paint on a newly exposed living-room wall: “Down but NOT out.”

“This is a tragic, tragic thing and everybody here has their own story,” Brown says. On Sunday evening, she had been at work when the storm hit. Working in EMS, she says she’s developed the ability to keep some emotional distance during a crisis.

“We have compassion for our patients, but we have to turn off the emotional side of things a bit,” she says. “We have to be able to separate ourselves to do what’s expected of us.”

That was especially difficult on Sunday night, as Brown came in to do her job as a regional manager for EMS, while hoping her own family was safe in a basement in Joplin.

“This is my hometown; it was emotional when I turned on the TV and saw St. John’s,” she says. “I saw open fields that I knew weren’t open fields before. And I couldn’t get a hold of my family.”

As she scrambled to get ambulance crews together, off-duty staffers started calling, telling her they were on their way in. Her family was fine and out of the storm’s path, but in those first few hours, it was the support of her co-workers that let her do such an important job in a time of crisis.

The worst of times focused everyone on the task at hand. In the weeks since, that kind of focus has persisted on a community-wide scale in Joplin and southwest Missouri. In the months ahead as we help our neighbors rebuild, we should find ourselves inspired and driven by the spirit of teamwork and community that our CoxHealth family showed in those dark first days.

“That night, I thought, ‘I have the best team in the world,’” Brown says. “I had crews who came in and helped – they let me do my job and they helped me do my job. I’m so proud of them; they’re good people.”