‘A State of Chaos’: The Joplin Tornado

May 22, 2011, Joplin, Mo. The storms had been threatening all day, and the National Weather Service issued a tornado warning at 5:17 p.m. At 5:41, it arrived. With winds clocked at well over 200 mph, it cut a swath through the city from west to east. Traveling more than 13 miles, it ranged up to a mile wide at times. Later it would be determined the tornado contained three separate vortexes. The eye was estimated at 300 yards wide. Initially rated an EF4, it was upgraded after evaluation of radar data and the pattern of destruction to an EF5, the most destructive twister possible.

Within minutes there were 8,000 structures destroyed. This included 400 businesses, two of Joplin’s five fire stations and eight school buildings, as well as an estimated 18,000 vehicles. As it incapacitated St. John’s Regional Medical Center, one of the city’s two hospitals, the storm came within a quarter mile of hitting the other, Freeman West. After going through Joplin, the tornado shifted path to a southeasterly direction. Traffic along Interstate 44 was disrupted as tractor-trailers were overturned and thrown about. This would compromise the later influx of responders.                                        

‘Armageddon’

This can’t happen twice. That was my first thought after hearing a massive tornado had just struck Joplin. Disbelief was the only emotion I felt. Joplin, a relaxed metropolitan city in southwest Missouri where I serve as the EMS medical director, had just become a victim for the second time in recent history. In 2008, a tornado struck just south of the city, killing 11 people, including an entire family of four. A year ago, in May 2011, it happened again. I was driving home from Kansas City when the call came.

“Keep me informed” were the last words I said before hanging up. I then made multiple unsuccessful attempts to call Joplin. Most of the cell service was out. Finally I managed to reach the ER charge nurse at the hospital where I practice. She told me one of the first patients to come through the door had his intestines in his lap. “Do you know how bad the damage is?” I asked. “No,” she replied, “but we’re getting lots of patients coming in the backs of pickup trucks.” I assured her I was driving as fast as I could. The trip from Kansas City to Joplin, about 250 miles, took almost three hours. During the trip home, I tried to think of what I would do.

I work as an attending physician in the emergency department of Freeman West, a community teaching hospital. We see 45,000–50,000 patients annually in our 40-bed ED. On any regular Sunday, those beds would probably be fully occupied. I knew from the sound of the nurse’s voice that this would be anything but a regular Sunday. She was a seasoned ER nurse who’d worked there for at least two decades. The fear in her voice was evident. In nine years working at the hospital, I’d never heard it.

I serve as the EMS medical director for two ambulance services and the Joplin Fire Department. It’s a position of which I am especially proud because of my previous employment as a paramedic with these services. I knew what their people would be going through and felt I should be there with them. To get home, I had to drive south of Joplin to get around the damage. It was already dark as I changed clothes and, with radio in hand, headed to the local Home Depot parking lot, where a triage area was set up.

Local radio coverage was spotty and lacking facts. Nobody had had any time to assess the damage to make any meaningful reports. “Devastation” was a common word heard. While listening to the EMS and fire traffic on the radio, I pulled into the Home Depot lot. The building itself was nothing more than rubble. At that moment I knew I would be living an experience like virtually none other. As one city council member said, we were in “a state of chaos.”